Planetary health is at a tipping point, with climate change threatening the well-being of current and future generations owing to extreme weather events, air pollution, food and water insecurity, climate-sensitive infectious diseases, and forced migration1. These disproportionately affect people living in low-income countries, and those of poorer socioeconomic status2, widening inequalities and global injustice. Paradoxically, provision of healthcare generates 4.4 per cent of global net carbon emissions3. The National Health Service (NHS) in England has shown leadership by pledging to become the first net-zero carbon national health service by 20404, calling on all NHS workforce members to help achieve this. . .

. . .In England, medical equipment and medicines account for 30 per cent of the carbon footprint of the health service. The number of single-use items used in an operation can be staggering, for example, over 100 pieces of single-use plastic for a simple tonsillectomy. Single-use surgical instruments, typically used in emergency departments and surgical outpatients, are one of the most carbon-intense products procured in healthcare. . .

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