dhb open letter

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Open letter: Healthcare workers call on the New Zealand Government to address District Health Board (DHB) greenhouse gas emissions.


Addressed to:

Minister for Climate Change Issues and Minister of Health

Parliament Buildings

Wellington 6160, New Zealand


DHB greenhouse gas measurement, reduction and reporting

Healthcare in New Zealand (NZ) has a dirty secret – we are contributing to climate change, one of the biggest health threats of the 21st century. However, by reducing emissions, the health sector can help lead the transition to a low carbon society as well as promoting and protecting health.

The NZ Public Health and Disability Act 2000 Section 22, Objective (j) requires that DHBs ‘exhibit a sense of environmental responsibility by having regard to the environmental implications of its operations'. NZ has committed under the Paris Climate Agreement to reduce greenhouse gas emissions by 30% below 2005 levels by 2030. The health sector will need to contribute to this target.

Some DHBs (e.g. Counties Manukau DHB, Auckland DHB) have already taken steps to measure and reduce their greenhouse gas emissions by participating in the CEMARSTM (certified emission measurement and reduction scheme) program administered by Enviro-Mark Solutions, a wholly-owned subsidiary of Landcare Research. This program is internationally recognised, ISO accredited, and administered by a crown entity.

There are many compelling reasons for DHBs to reduce greenhouse gas emissions including cost savings, population health and health equity gains, healthcare quality improvement and reducing the health impacts of climate change.



  1. The Ministry of Health to set greenhouse gas emissions reduction targets for DHBs in line with commitments under the Paris Agreement.
  2. The Ministry of Health to mandate all DHBs to measure, manage, and reduce their greenhouse gas emissions in accordance with the ISO 14064 standard.
  3. DHBs to report progress towards greenhouse gas emissions reduction to the Ministry of Health annually.


We recommend that the Ministry of Health negotiate a collective contract with Enviro-Mark Solutions on behalf of DHBs, and provide funding on an equitable basis to DHB's (eg by top-slicing) to meet costs of CEMARSTM participation.




Dr David Galler, Intensive Care Specialist

On behalf of the Sustainable Health Sector National Network New Zealand (SHSNN).


Dr Rhys Jones and Dr Alex Macmillan, Public Health Medicine Specialists

On behalf of OraTaiao: The NZ Climate and Health Council.


Key references

NHS Sustainable Development Unit. Save Money by Saving Carbon: Decision Making in the NHS Using Marginal Abatement Cost Curves. NHS SDU, Cambridge, 2010. http://www.sduhealth.org.uk/documents/publications/1279123659_ljvk_save_money_by_saving_carbon.pdf
World bank. Climate-Smart Healthcare: low carbon and resilience strategies for the health sector. World Bank, Washington, 2017. http://documents.worldbank.org/curated/en/322251495434571418/pdf/113572-WP-PUBLIC-FINAL-WBG-Climate-smart-Healthcare-002.pdf
World Health Organization. Health in the Green Economy: Co-benefits to health of climate change mitigation – healthcare facilities. http://www.who.int/hia/hgebrief_health.pdf?ua=1
Watts N, Adger WN, Agnolucci P, et al. Health and climate change: policy responses to protect public health. The Lancet, 2015; DOI:10.1016/S0140-6736(15)60854-6. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60854-6/abstract
Bennett H, Jones R, Keating G et al. Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action. NZMJ, 2014.  http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no-1406/6366


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