Background Health-care services are necessary for sustaining and improving human wellbeing, yet they have an environmental footprint that contributes to environment-related threats to human health. Previous studies have quantified the carbon emissions resulting from health care at a global level. We aimed to provide a global assessment of the wide-ranging environmental impacts of this sector.Methods In this multiregional input-output analysis, we evaluated the contribution of health-care sectors in driving environmental damage that in turn puts human health at risk. Using a global supply-chain database containing detailed information on health-care sectors, we quantified the direct and indirect supply-chain environmental damage driven by the demand for health care. We focused on seven environmental stressors with known adverse feedback cycles: greenhouse gas emissions, particulate matter, air pollutants (nitrogen oxides and sulphur dioxide), malaria risk, reactive nitrogen in water, and scarce water use.Findings Health care causes global environmental impacts that, depending on which indicator is considered, range between 1% and 5% of total global impacts, and are more than 5% for some national impacts.Interpretation Enhancing health-care expenditure to mitigate negative health effects of environmental damage is often promoted by health-care practitioners. However, global supply chains that feed into the enhanced activity of health-care sectors in turn initiate adverse feedback cycles by increasing the environmental impact of health care, thus counteracting the mission of health care.
On 3 April 2020, the Director-General of the WHO stated: "[COVID-19] is much more than a health crisis. We are all aware of the profound social and economic consequences of the pandemic (WHO, 2020)". Such consequences are the result of countermeasures such as lockdowns, and worldwide reductions in production and consumption, amplified by cascading impacts through international supply chains. Using a global multi-regional macroeconomic model, we capture direct and indirect spill-over effects in terms of social and economic losses, as well as environmental effects of the pandemic. Based on information as of May 2020, we show that global consumption losses amount to 3.8$tr, triggering significant job (147 million full-time equivalent) and income (2.1$tr) losses. Global atmospheric emissions are reduced by 2.5Gt of greenhouse gases, 0.6Mt of PM 2.5 , and 5.1Mt of SO 2 and NO x. While Asia, Europe and the USA have been the most directly impacted regions, and transport and tourism the immediately hit sectors, the indirect effects transmitted along international supply chains are being felt across the entire world economy. These ripple effects highlight the intrinsic link between socioeconomic and environmental dimensions, and emphasise the challenge of addressing unsustainable global patterns. How humanity reacts to this crisis will define the post-pandemic world.
Detailed and comprehensive accounts of waste generation and treatment form the quantitative basis of designing and assessing policy instruments for a circular economy (CE). We present a harmonized multiregional solid waste account, covering 48 world regions, 11 types of solid waste, and 12 waste treatment processes for the year 2007. The account is part of the physical layer of EXIOBASE v2, a multiregional supply and use table. EXIOBASE v2 was used to build a waste-input-output model of the world economy to quantify the solid waste footprint of national consumption. The global amount of recorded solid waste generated in 2007 was approximately 3.2 Gt (gigatonnes 1 ), of which 1 Gt was recycled or reused, 0.7 Gt was incinerated, gasified, composted, or used as aggregates, and 1.5 Gt was landfilled. Patterns of waste generation differ across countries, but a significant potential for closing material cycles exists in both high-and low-income countries. The European Union (EU), for example, needs to increase recycling by approximately 100 megatonnes per year (Mt/yr) and reduce landfilling by approximately 35 Mt/yr by 2030 to meet the targets set by the Action Plan for the Circular Economy. Solid waste footprints are strongly coupled with affluence, with income elasticities of around 1.3 for recycled waste, 2.2 for recovery waste, and 1.5 for landfilled waste, respectively. The EXIOBASE v2 solid waste account is based on statistics of recorded waste flows and therefore likely to underestimate actual waste flows. Keywords:circular economy consumption-based accounting industrial ecology multiregional input-output municipal solid waste waste input-output Supporting information is linked to this article on the JIE website Conflict of interest statement: The authors have no conflict to declare.
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