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Belt and road initiative (BRI) contains the transport, construction, and energy-related projects to push the wheel of economic development of BRI's participant at the cost of ecological consequences. These sectors are highly energy-intensive and upsurge the CO 2 emission. Energy efficiency and renewable energy are considered two essential solutions to control CO 2 emissions. Energy efficiency is proficient in yielding energy and demand savings that can relocate the electricity generation from primary energy resources, that is why, nowadays, energy efficiency is considered as an energy resource worldwide. Fiscal policy is a vital policy tool regarding energy policies related to production, growth, distribution, and energy consumption. Therefore, this study investigates the relationship between energy efficiency and CO 2 emission in light of the fiscal policy index for BRI countries. The results infer that energy efficiency and fiscal policy deteriorate the CO 2 emission. On the other side, FDI and GDP will lead to an increase in CO 2 emission. This study provides useful insights for policymakers on how to take preventive and remedial measures to reduce CO 2 emissions in different sectors and demonstrated that technology in the energy sector could help to mitigate climate change through energy efficiency. Furthermore, future research can be carried out on how digitalization, energy efficiency monitoring processes, and management process can help to mitigate.

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The previous studies focused on environmental issues, identifying their root causes, urging prompt action to reduce environmental degradation. In this context, the current article extends the literature by incorporating the ecological impacts on the health sector and the role of sustainable development. The present study adds to the body of knowledge by examining the relationship between CO 2 emissions, sustainable development, energy efficiency, energy intensity, and health expenditures for SAARC countries from 2000 to 2020. Fully modified OLS (FMOLS) and dynamic OLS (DOLS) are used and diagnostic tests to check the association between the variables. The empirical analysis validated the long-run impact of the examined factors on health expenditures. The results show that energy efficiency and sustainable development have a statistically significant negative effect on health expenditures, vice-versa for CO 2 emission. Energy efficiency, energy intensity, and CO 2 emissions have been shown to have a one-way causative relationship with health expenditures, but sustainable development and economic growth have a two-way causation relationship. The better health status of the SAARC economies necessitates the establishment of long-term development strategies, environmental sustainability, and an examination of the energy sector. This work's conceptual and empirical advances have significant policy ramifications for this part of the globe and its efforts to improve sustainability.

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