Greening the pharmaceutical sector: rhetoric or reality?

Climate change is the greatest global health threat of the twenty-first century, and paradoxically, health systems themselves contribute significantly to climate change, accounting for approximately 5% of global greenhouse gas emissions. Pharmaceuticals are one of the largest contributors to these emissions. Achieving net zero in healthcare requires systemic change across the pharmaceutical sector, demanding action from pharmaceutical companies, regulators, policymakers, health providers, and patients.

Recognising this urgent issue, Green Templeton student Dr Amy Booth (DPhil Translational Health Sciences) and Governing Body Fellow Professor Sara Shaw convened a high-level panel, supported by the college’s Annual Fund, to explore how to make the pharmaceutical sector more environmentally sustainable. The panel featured Green Templeton Associate Fellow Dr Chris Winchester (CEO, Oxford PharmaGenesis), Professor Liz Breen (University of Bradford), Dr Samantha Holmes (Sustainable Healthcare Coalition), and Mark Wilson (Health Care Without Harm).

Amy Booth reports and reflects on the panel discussion

The panel discussion formed part of Oxford’s MSc in Translational Health Sciences’ Sustainable Health Care module and short course, now in its second year. This intensive programme brings together global students to explore how environmental crises intersect with healthcare, and how health systems can evolve to reduce their environmental impact. The panel attracted a diverse and very engaged audience, including Oxford students, health professionals, pharmacists, industry representatives, and even the President of the Royal Pharmaceutical Society.

Panellists highlighted several environmental impacts of pharmaceuticals including (a) pharmaceutical pollution from improper drug disposal that harms ecosystems and drives antimicrobial resistance; (b) greenhouse gas emissions of pharmaceuticals, highlighting clinical trials that have significant carbon footprints; and (c) packaging waste, including from paper patient leaflets. A key discussion point was around some of the notable actions occurring across the pharmaceutical sector to reduce these impacts, specifically at the health provider and patient level, and by pharmaceutical companies.

Health provider and patient sustainability action

The environmental impact of pharmaceuticals is largely driven by demand for medicines, both from health providers and patients, but awareness about pharmaceuticals’ full environmental impact remains limited. Panellists questioned how much people know about where their medicines come from, what happens to them after use, and the environmental costs across their lifecycle, from production to disposal. Solutions to reducing pharmaceutical environmental impacts at the point of care were shared as examples of emerging practice, including prescribing low-carbon medicines, piloting medicine reuse schemes, replacing paper with e-leaflets, and promoting non-pharmaceutical alternatives like social prescribing.

Industry-level sustainability action

Panellists noted that the pharmaceutical industry has begun to implement actions to reduce its environmental impact. Most major companies have set net zero targets and are working to shift to renewable energy, use greener logistics, embed eco-design into drug development and manufacturing, and engage suppliers to reduce Scope 3 emissions (indirect emissions across the supply chain). However, the challenges are substantial. Over 80% of industry emissions are in supply chains, which often span tens of thousands of suppliers across diverse regulatory and infrastructure environments. Audience members questioned whether current industry actions are sufficient, while acknowledging the complexities involved in driving change at scale.

The panel offered a range of actionable insights to spread and scale sustainability across the pharmaceutical sector, from immediate, pragmatic changes to more transformative, long-term shifts in how we think about healthcare:

1. Take action without waiting for perfection: The most immediate takeaway was to start now. We do not need perfect data or solutions to begin reducing environmental impacts. Small, evidence-based interventions can make a real difference, especially when scaled. As one panellist put it, “Sometimes a small step is better than no step at all.”
2. Promote transparency and accountability: Greater transparency is essential, not just around the environmental impacts of pharmaceuticals, but also the actions already being taken. Public visibility and open reporting can help hold the industry accountable while highlighting and building on existing progress.
3. Drive innovation through collaboration: The pharmaceutical industry has vast scientific and technical expertise. Leveraging this for sustainability, through open collaboration across sectors and disciplines, can accelerate the development of greener solutions in research, manufacturing, packaging, and beyond. Initiatives like the Sustainable Healthcare Coalition, which helps companies map and address carbon hotspots, show the value of collaborative, data-driven action.
4. Embed sustainability into research, education and practice: Sustainability needs to be woven into the fabric of healthcare education and practice. From training pharmacists and prescribers to launching public awareness campaigns and implementing local collection schemes for unused medicines, environmental sustainability must become a norm across the system.
5. Realign financial incentives: Profit remains a powerful driver. The challenge – and opportunity – is to align financial incentives with sustainability. This includes integrating sustainability into procurement criteria, encouraging low-carbon prescribing, and empowering investors and shareholders to push for stronger environmental action.
6. Rethink health and care delivery: The most transformative recommendation was to reimagine healthcare itself. Moving beyond a model that centres on pharmaceutical treatment, panellists called for a shift toward prevention, health promotion, and addressing social determinants of health. This involves embracing non-pharmaceutical interventions, such as social prescribing, and prioritising systems that support long-term wellbeing over reactive, treatment-focused care.

Final reflections

Greening the pharmaceutical sector is no easy task. But action is underway, and momentum is growing. The challenge now is to scale and spread these efforts, with pragmatism, collaboration, and persistence. The political and economic landscape is shifting, and progress can feel slow. But we must stay the course. Pharmaceutical companies, health providers, and patients are beginning to make sustainable choices, and these must be encouraged and expanded. At the same time, we must think bigger, transforming not just how medicines are made, but how we conceptualise health itself. Prevention, education, social support, and non-pharmaceutical interventions must play a greater role in our systems of care.

This is not just a challenge for industry, or policy, or academia. It is one for all of us.