Egypt: Advancing climate and health through digital resilience, leadership, and governance

Implementation process

EHA’s employs a five-stage approach to sustainable healthcare:

Stage 1: Governance on climate and health

• Built institutional capacity by hiring a multidisciplinary team.
• Conducted specialized training programs.
• Developed a strategy for the Sustainability and Green Transformation Unit.
• Established committees in all hospitals to localize and implement the strategy.

 

Stage 2: Climate-resilient and sustainable operations

• Conducted carbon footprint, vulnerability & adaptation (V&A), energy audits, and environmental assessments.
• Assessments inform localized adaptation planning, support national scale-up, and help access climate finance.

 

Stage 3: Digitalization and innovation

• National Digital Health Model: integration of payer, provider, and infrastructure (data governance, HIS, cybersecurity).
• Paperless Transformation: end-to-end digital workflows for appointments, records, prescriptions, billing, labs, and supplies.
• Implementation scale: rolled out in 6 governorates, covering 262 primary care units, 36 hospitals, 87 RIS/PACS, 23 dialysis units, 29 operating theatres.
• Data-driven decision-making: analytics dashboards at department, facility, and enterprise levels.
• Digital health innovations: telemedicine, virtual hospitals, expanded accessibility in remote areas.

 

Stage 4: Adaptation and mitigation projects

• Renewable energy: solar stations in hospitals/PHCs.
• Energy efficiency: optimized air conditioning, chillers, lighting (LED), and daily audit teams.
• Water management: purification units, recycled irrigation, water-saving faucets.
• Greening: 6,000 trees planted, drought-resistant landscaping.
• Sustainable waste: autoclaving/shredding instead of incineration.
• Eco-Mobility: bicycle lanes, parks, EV charging stations.
• Digital health for mitigation: telemedicine to cut travel emissions.
• Toxic Material Phase-out: elimination of mercury devices; hospitals certified mercury-free.

 

Stage 5: Partnerships and community engagement

• Staff training: ongoing sessions on climate, sustainability, and green practices.
• Public awareness: education sessions, booklets, hospital-based videos.
• Circular practices: program for expired medication collection and safe disposal/repurposing.

 

Lessons learned

The first wave of carbon footprint assessments across EHA facilities highlighted both achievements and gaps, offering key lessons to strengthen future efforts:

• Strengthen data collection systems: Establish a centralized framework to capture all emission sources, covering Scope 1 (direct), Scope 2 (indirect from energy), and Scope 3 (supply chain and external activities).
• Engage suppliers and partners: Work with suppliers and contractors to obtain reliable data on their emissions, sustainability practices, and net-zero commitments—critical for Scope 3 accounting and greener procurement.
• Improve internal energy monitoring: Install departmental sub-meters to enable detailed tracking of electricity use and support targeted energy efficiency measures in high-consumption areas (e.g., radiology, operating theatres).
• Track non-medical supplies: Develop systems to monitor the environmental footprint of overlooked items such as cleaning products, IT equipment, and office materials, which can add significantly to emissions.
• Standardize tools and methods: Adopt uniform methodologies, emission factors, and reporting templates across all facilities to ensure consistency, comparability, and credibility of assessments.
• Invest in capacity and awareness: Provide continuous training for facility managers and technical teams on environmental data management and carbon accounting to build sustainable, in-house expertise.

 

Challenges

Despite significant progress, Egypt’s healthcare sector still faces major barriers to scaling and sustaining climate-health action:

Coordination and integration

• Weak collaboration between health and climate sectors.
• Limited integration of climate risks into national/subnational health policies and planning.
• Lack of institutionalized contingency plans for uninterrupted services during climate shocks (heatwaves, floods, sandstorms).

 

Monitoring and tracking

• Insufficient surveillance of climate-sensitive diseases (vector-borne, waterborne, respiratory).
• Underreporting of health impacts from extreme weather events.
• Early warning systems not yet embedded in public health frameworks.

 

Infrastructure and investment

• Limited investment in climate-resilient health infrastructure, especially in vulnerable areas.
• Many facilities require retrofitting to withstand climate stressors.
• Renewable energy deployment is still small-scale.

 

Capacity building

• Healthcare professionals lack training on managing climate-related health risks.
• Insufficient research, forecasting, and data capacity for evidence-based decision-making.

 

Prioritization and strategic focus

• Climate-health adaptation remains underprioritized in national climate policy.
• Balance needed between mitigation (emissions reduction) and adaptation (resilience-building).

 

Supply chain and procurement

• Lack of sustainable, resilient medical supply chains.
• Green procurement policies not fully adopted in public health institutions.

 

Data gaps and reporting limitations

• Emissions reporting: fragmented, inconsistent, no standardized methodologies.
• Medical waste: limited data on generation, treatment, disposal.
• Transport emissions: patient/staff mobility impacts often overlooked.
• Building efficiency: incomplete data on energy use/emissions in facilities.

 

Pilot carbon footprint assessment gaps (WHO 2022 Mission, Sharm El-Sheikh Hospital)

• Missing data on electricity transmission/distribution losses.
• No supplier-specific/net-zero data for Scope 3 (Tier 3).
• No department-level energy consumption breakdown.
• No data on FMCGs and non-medical supplies (detergents, IT, hospitality).These gaps risk underestimating Scope 2 & Scope 3 emissions, reducing credibility of reporting.

 

Recommendations

Climate-resilient healthcare facility design

• Retrofit and design facilities to withstand extreme heat, flooding, sea-level rise, and power disruptions.
• Promote modular, flexible infrastructure for rapid response to climate emergencies and outbreaks.
• Integrate resilient water and energy systems (e.g., rainwater harvesting, solar power, passive cooling).

 

Prioritizing adaptation in developing countries

• While mitigation is important, adaptation must take priority in resource-constrained LMICs.
• Strengthen early warning and emergency preparedness.
• Build institutional and community resilience to climate-related health threats.
• Enhance local risk assessment capacity and context-specific adaptation strategies.

 

Sustainable waste management

• Scale up recycling of autoclaved medical waste (non-biohazardous) into safe disposal or reuse streams.
• Establish national guidelines for non-incineration waste treatment technologies (e.g., shredding, autoclaving).

 

Green and sustainable procurement

• Develop and enforce sustainable procurement policies for low-carbon medications, devices, and supplies.
• Require suppliers to disclose chemical content and environmental impact of products.
• Prioritize vendors with green certifications, EMS standards, or net-zero commitments.

 

Institutionalizing telehealth and digital health solutions

• Accelerate regulatory adoption of telehealth, including integration into reimbursement frameworks.
• Expand digital health to reduce travel, physical infrastructure reliance, and emissions.
• Invest in equitable access: digital infrastructure, provider training, and community digital literacy.

 

 

 

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