Dear Editor,
Global warming and its associated weather phenomena pose a major threat to individuals and communities alike. Healthcare is itself a contributor, accounting for around 6% of global greenhouse gas (GHG) emissions generated by facilities, medical services, medications, patient travel and staff commute. Calls to action on climate change 1 and decarbonizing the health system 2 reflect an increasingly aware medical community. In the United Kingdom, the National Health Service (NHS) has set the goal to achieve ‘net zero’ by 2040 (GHG scopes 1 and 2), which was implemented into legislation in 2022. 3 Briefly summarized, establishing sustainable medicine encompasses demand‐sided policies (e.g. promotion of primary prevention and public information) and supply‐sided policies (e.g. improvement of waste management/recycling, reduction of overdiagnosis/overtreatment). 4 Non‐governmental organizations (NGO) leading these efforts include Health Care Without Harm (https://noharm.org/) and the Global Health and Climate Alliance (https://climateandhealthalliance.org/).
Although these NGOs do not provide dermatology‐specific toolkits, an online cross‐sectional study of 158 dermatologists found that 94.3% were concerned with climate change. 5 We aimed to identify dermatological activity related to climate change and sustainable healthcare. To do so, 215 dermatological associations were identified via the International League of Dermatological Societies (ILDS) website. Of these, 201 (93%) were contacted by email in May 2024 and three questions were posed: (1) Does your association or membership acknowledge climate change? (2) Does your association incorporate measures regarding climate change or environmental sustainability in its governance? (3) Is there member activity in the field of climate change or environmental sustainability? Twenty‐two responses were received (response rate 10.9%) with 86.4% of respondents stating that their organizations explicitly acknowledge climate change, whereas the remainder did not have an official climate stance. Only eight responding associations have implemented measures into their governance. Table 1 summarizes selected responses anonymously. We identified six working groups on climate change or sustainability in dermatological professional organizations. Member activities include scientific projects (original research and review articles and symposia in national conferences), provision of educational materials and advocacy. However, our results imply a significant gap between individual and organizational efforts. The very low response rate in this survey is concerning and might reflect a lack of priority in dermatological professional bodies. Policymaking plays a major role in sustainability, and medical associations are leading the way within their respective fields. 6 As governance will be key to sustainable healthcare, we now urge dermatological societies to officially acknowledge climate change and its impact on dermatological disease and implement concrete measures towards climate adaptation, mitigation and environmentally sustainable dermatological practice. 7 Here, we provide an action plan encompassing strategies considering advocacy, governance, research and education illustrated in Figure 1 to serve as a blueprint. Founding and supporting national sustainability committees or working groups is a pivotal step to provide country‐specific guidance. Building a global dermatological sustainability network to orchestrate transnational activities could then follow. Dermatological societies have the capacity to influence national policymakers and spur action within the healthcare system. As a direct measure, we propose opting for lean patient pathways and reduction of patient and staff travel where feasible. This encompasses fostering teledermatology solutions. As data are sparse on GHG footprints of established therapeutic interventions, prioritizing research funding towards generating these data may in turn lead to incorporation of environmental impact into clinical decision‐making. We further propose incorporation of implications of climate change and benefits of resource saving in care delivery into curricula of dermatology trainees and nurses. Additionally, attendee travel accounts for the largest share of GHG emissions associated with medical conferences; therefore, continued virtual or hybrid formats are desirable from a sustainability perspective, expanding accessibility and attendance. To conclude, the climate crisis demands substantial action within the medical community including our specialty of dermatology. 8 We aim to champion climate‐related governance and country‐specific resources from dermatological societies.
TABLE 1.
Selected responses from dermatological associations in May 2024.
| Do your association or their members acknowledge climate change? | Did your association incorporate measures regarding climate change or environmental sustainability in its governance? |
|---|---|
| If yes, could you briefly list some details? | |
| ‘Only on the individual/personal level, not as an organization’ | ‘No’ |
| ‘I want to be honest and say that it is not something our organization has discussed formally’ | Not applicable |
| ‘We as an association do recognize climate change’ |
‘I am not sure about the question regarding the governance. But if you clearly talk about the policy then there are no such measures applied in the form of any laws despite the government recognizing the climate change problem Many of our colleagues including myself working with neglected tropical diseases have been working on providing proper and concrete evidence relating to the climate change and surge of dermatological conditions but as mentioned earlier no concrete work has been done in dermatology’ |
| ‘I am afraid that while individual members of the […] acknowledge climate change, the Society has not issued a statement on climate change, does not refer to climate change on its website, has not adopted any specific measures regarding climate change or environmental sustainability in its governance, and has no specific member activity in relation to climate change’ | |
| ‘Yes, the members of our society acknowledge climate change’ |
‘During our conference arrangements we do not give congress bags or other physical promotion materials for the participants We do not hand out printed materials as much as we used to; rather, we use the types of e‐communication thereby reducing the environmental damage’ |
| ‘We as an association do not focus on those issues and questions you highlighted in your e‐mail. We cannot answer whether our members themselves or in small local associations are engaged or not’ | |
| ‘The […] has developed a participatory strategic paper to identify fields of action and (proactive) measures that can be taken to ensure quality, efficiency, the impact of care, and professional relevance in view of the expected developments over the next 10–15 years in the healthcare system, in medicine and in dermatology and dermatological sub‐disciplines’ | |
| ‘Our association and its members currently do not have an official stance on acknowledging climate change’ | ‘We have not incorporated any measures regarding climate change or environmental sustainability in our governance. There are no active member initiatives related to climate change or environmental sustainability within our association’ |
| ‘Not formally but its consequences are already our concern, concerning exposome changes driving atopic dermatitis’ | ‘Not so far but all our annual meetings are in a hybrid format but primarily to increase outreach in low income countries. The meetings are also responsible but not frugal, because maintaining social links is also important’ |
FIGURE 1.
Action plan for dermatological societies towards climate change.
FUNDING INFORMATION
None.
CONFLICT OF INTEREST STATEMENT
Dennis Niebel received travel reimbursements, honoraria or research funding from: Abbvie, Almirall, AstraZeneca, Boehringer Ingelheim, Bristol Myer Squibb, Eli Lilly, GlaxoSmithKline, Incyte, Janssen‐Cilag, Kyowa Kirin, LEO Pharma, L'Oreal, MSD, Novartis, Pfizer, Regeneron, Sanofi and UCB Pharma. Simon Tso received travel reimbursements, honoraria or research funding from Almirall, Beiersdorf, Eucerin, La Foundation La Roche‐Posay, L'Oréal, Menarini and UCB Pharma. Eva Parker received travel reimbursements and honoraria from L'Oréal. Misha Rosenbach and Eva Parker are the co‐chairs of the American Academy of Dermatology's Expert Resource Group on climate change and environmental issues. Hok Bing Thio and David de Berker are co‐chairs of the Climate Working Group of the European Academy of Dermatology and Venereology. Susanne Saha and Dennis Niebel are co‐chairs of the Arbeitsgemeinschaft für Nachhaltigkeit in der Dermatologie e.V. All authors are writing as individuals and not on behalf of their respective professional bodies. The remaining authors have no conflicts of interest to declare.
ETHICAL APPROVAL
This study did not require formal approval of the IRB.
ETHICS STATEMENT
Not applicable.
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the corresponding author upon reasonable request.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.