Seeing through green: critical thinking for sustainable pharmacy practice

By Tarek Hussein, MBA, BScPhm, RPh, C.Mgr., LSSGB, DTM

While the health care sector is essential to global well-being, unfortunately, it has a significant environmental footprint. To put this into perspective, the aviation industry contributes two to three per cent of global greenhouse gas emissions. In contrast, the health care sector contributes approximately 4.4 per cent of these global net greenhouse gas (GHG) emissions, and in some high-income countries, this figure can rise to 10 per cent. Within this footprint, the supply chain accounts for about 71 per cent, highlighting the critical need for sustainable practices within the industry. Pharmaceuticals alone contribute to 25 per cent of health care GHG emissions, with metered dose inhalers and anesthetic gases accounting for 5 per cent of this share alone and the remaining 20 per cent stemming from other chemicals and medications. 

Consumers — including your patients — are becoming increasingly environmentally conscious; consequently, environmental claims are increasingly used in advertising products and services. However, as the demand for greener products rises, so does the prevalence of misleading environmental claims, known as greenwashing.

Greenwashing undermines genuine sustainability efforts by making false or misleading claims about the environmental benefits of products or services. For pharmacy professionals, it is essential to contribute to environmental sustainability and critically evaluate and implement authentic green practices that lead to real reductions in emissions and waste. 

Examples can include using misleading packaging, such as using specific colors to imply eco-friendliness, using particular terms such as "100 per cent natural" or "ethically sourced," or a lack of transparency about a product or service's environmental claims.

In general, there are three types of environmental claims that you should be aware of.

• Type 1 involves third-party certified eco-labels, which offer high credibility and assurance.
• Type 2 involves a company's self-declared environmental claims.
• Type 3 is an environmental declaration based on life-cycle assessment (LCA) and provides detailed information about a product's entire life cycle. 

Increasingly, countries around the world are introducing safeguards to combat greenwashing. In Canada, Bill C-59 was granted royal assent in June 2024. It introduced amendments to the Competition Act to prohibit false or misleading representations of a product's benefits towards the environment that are not based on adequate and proper testing.

Understanding and managing GHG emissions is critical for any organization, including pharmacies, in the fight against climate change. Emissions are categorized into three scopes to help organizations better identify and mitigate their carbon footprint.

Scope 1 Emissions: These are direct GHG emissions from sources owned or controlled by an organization. This includes emissions from company-owned vehicles, on-site fuel combustion, and industrial processes. For pharmacies, this could mean emissions from the pharmacy's heating systems or fleet vehicles used for deliveries. Direct control over these sources makes Scope 1 emissions the easiest to manage and reduce by improving energy efficiency and adopting cleaner technologies.

Scope 2 Emissions: Indirect GHG emissions from purchased electricity, steam, heating, and cooling. Even though these emissions occur at the facility where the energy is produced, they are counted in the organization's carbon footprint because of its energy use. Pharmacies can address Scope 2 emissions by investing in renewable energy sources, enhancing energy efficiency, and purchasing green energy.

Scope 3 Emissions: All other indirect emissions occurring in an organization's value chain. For pharmacies, this includes emissions from the production and transportation of purchased goods, waste disposal, business travel, employee commuting, and the use and disposal of sold products. Scope 3 emissions often represent the most significant portion of a pharmacy's carbon footprint, making them the most challenging to address. Effective strategies include engaging with suppliers to reduce emissions, optimizing logistics, promoting the proper disposal of medications, and encouraging sustainable practices among employees and customers.

By identifying and taking action across all three scopes, pharmacies can significantly reduce their environmental impact and contribute to global sustainability efforts. Understanding these scopes is essential for developing effective climate action strategies and achieving meaningful reductions in GHG emissions.
 

Generally, strategies for pharmacies to confront climate change fall into two categories: mitigation and adaptation.

Mitigation aims to reduce emissions within pharmacies and, by extension, the health care system. When a pharmacy looks to reduce its emissions, there are four main areas: operations, sustainable procurement, infrastructure, and medication optimization.

In operations, pharmacy professionals could, for example, adopt paperless technology as part of the pharmacy's workflow. This might mean implementing processes such as e-prescribing platforms or providing virtual care where suitable to reduce patient and staff transportation emissions. 

For sustainable procurement, many are familiar with the use, reuse, repurpose, renew, and recycle principles, which most pharmacy professionals probably practice in some form daily. This may involve monitoring one's own inventories to minimize overstocking, purposefully purchasing alternative medication bottles to reduce plastic waste, or eliminating single-use and unneeded plastic products in the pharmacy. 

The concept of improving infrastructure is not restricted to the pharmacy business. Think about using energy-efficient LED lights, power-saving functions on computers, energy-efficient refrigerators, freezers, motion sensors on light switches for infrequently used rooms such as restrooms or assessment rooms, low-flow faucets, etc.

Pharmacy teams can adapt to mitigate emissions by implementing medication optimization, de-prescribing practices, improving medication adherence, and disposing of unused drugs and devices in an environmentally conscious manner. 

Adaptation aims to prevent or minimize the impact of climate change on health care and create climate-resilient pharmacies or practice sites. There are three areas: disaster planning, direct health impacts, and supply chains.
We are in an era of hurricanes, tornados, wildfires, and, more recently, a nationwide heat wave. These disasters could potentially result in significant impacts on the availability of medications for patients, and the lack of this availability could affect patient health. A disaster recovery plan is critical to ensure prompt accessibility to medications and patients' information.
 

As you start implementing your environmental strategies in your pharmacy, consider keeping a few tips in mind. I call them the pharmacist's three E's.

The first is to Explore: Get out of your comfort zone. Get out of the dispensary. Get out from behind the counter and go search for local community resources. Connect with other like-minded businesses and organizations and find what inspires you.

The second is to Evaluate: Small steps make big differences. Find where you are at. What have you already done? What assistance do you need? Listen to the experiences of others. Find your baseline and seek the necessary information and resources to grow.

The last is to Engage: Engage your team by acting as a role model. Share your experiences and motivate others in your community to follow you.

Tarek Hussein is the Adaptation Co-Lead at the Canadian Association of Pharmacy for the Environment, CAPhE, an organization devoted to the pharmacy profession’s impact and response to planetary health and climate change through research, education, partnerships, and communication within the realm of climate mitigation, adaptation, operations, and supply chain management. For more information, please visit CAPhE.CA.