Planetary health leadership to drive climate action across pharmaceutical supply chains: insights from qualitative research and a call to action
Booth, A. Wieringa, S. Shaw, S.
Booth, A.
Wieringa, S.
Shaw, S.
Publication Date
2025
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© 2025 Author(s) (or their employer(s)). No commercial re-use.
Peer-Reviewed
Yes
Open Access status
openAccess
Accepted for publication
2025-06-19
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Abstract
Introduction: Pharmaceutical manufacture, delivery, and use produces an estimated 10-55% of national health care greenhouse gas emissions. Addressing pharmaceutical supply chain
emissions is essential to mitigating health care’s climate impact. Our research aimed to explore the constraints to pharmaceutical supply chain climate action, and how planetary health
leadership can overcome these challenges.
Methods: We conducted 21 narrative interviews with representatives from pharmaceutical companies, and industry and health system stakeholders. Interviews explored perspectives on
climate action across pharmaceutical supply chains. Analysis was informed by argumentative discourse analysis enabling identification of key storylines.
Results: Climate action across pharmaceutical supply chains is sporadic and insufficient to achieve health system climate goals. Critical constraints to climate action include: (a) structural
constraints, particularly complex, fragmented, global supply chains as well as restrictive net zero infrastructure in some countries where supply chains operate, and (b) conceptual constraints, the ‘patient-profit-planet dilemma’, where climate action is perceived to conflict with patient wellbeing and financial considerations. Planetary health leadership can help overcome these constraints in three key ways. Firstly, planetary health leadership can help reconceptualise health care delivery, and the role of pharmaceuticals, to align patient and planetary wellbeing whilst meeting financial pressures. Secondly, planetary health leadership can mobilise collective climate action across pharmaceutical supply chains, reframing climate change as a shared problem, and challenging issues of transparency, competition, and blame. Thirdly, planetary health leadership can challenge wider systems that constrain climate action, leveraging the economic and political power of pharmaceutical supply chains to drive global decarbonisation efforts.
Conclusion: Planetary health leadership must confront considerable constraints to embed planetary health considerations across pharmaceutical supply chains. Leaders in this space
must be willing to go against the status quo, challenge entrenched norms and structures, to enable wider spread and support for sustainable health care delivery
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Accepted manuscript
Citation
Booth A, Breen L, Wieringa S et al (2025) Planetary health leadership to drive climate action across pharmaceutical supply chains: insights from qualitative research and a call to action. BMJ Leader. Accepted for publication.
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Article