Ethical Considerations of Climate Justice and International Air Travel in Short-Term Electives in Global Health

Abstract

In July 2022, the American Society of Tropical Medicine and Hygiene Green Task Force advocated to acknowledge the health impacts of climate change, particularly on those in low- and middle-income countries, and called on global health organizations to act. Simultaneously, academic medical centers are resuming Short-Term Electives in Global Health (STEGH) as travel restrictions imposed during the COVID-19 pandemic ease in most countries. International flights by trainees from academic medical centers in high-income countries (HIC) on these electives encapsulate the climate injustice of who generates carbon emissions and who bears the impacts of climate change. Using “decolonization” and “decarbonization” as guiding principles, we suggest several strategies that global medical education programs in HIC could implement. First, restructure rotations to halt STEGH with minimal benefit to host institutions, optimize trainee activities while abroad, and lengthen rotation duration. Second, programs can calculate the carbon impact of their STEGH and implement concrete measures to cut emissions. Finally, we urge academic medical centers to promote climate-resilient healthcare infrastructure in host countries and advocate for climate solutions on the global stage.

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“…The reasons for this are likely many, but we suspect that many United States and European students have recognized that they can pursue their professional interests in equity by working domestically, especially considering the important and active struggles that arose from the murder of George Floyd, the repeal of reproductive rights in the United States, and the rise of far-right extremism that increasingly pushes anti-immigrant rhetoric and policy, etc. Many others are concerned about the environmental impact of international flight to participate in only a short-term experience ( 42 ). There is also an ongoing conversation on how to best embed anti-racism and anti-colonialism praxis in global health ( 43 ).…”