Over 100 people (and counting) have committed to the Coda Earth Action Agenda

1 in 5

Almost 1 in 5 deaths globally are a result of fossil fuel air pollution

5th Largest

If healthcare were a country, we would be the 5th largest carbon emitter in the world

The Coda Action pathway:

We must act to protect our patients, our healthcare systems, and our planet

Healthcare is a significant carbon emitter and we have a responsibility to Primum non nocere – first do no harm.

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Healthcare providers are among the most trusted members of our communities. With that trust, comes the responsibility to protect the health of our patients and the stability of the natural systems upon which both health and healthcare systems depend. Ironically, the delivery of healthcare is enormously carbon intensive. If healthcare were a country, it would be the fifth largest carbon emitter in the world.

One of the tenets of medical ethics is the principle of Nonmaleficinece (Cause no harm).

This plan sets out meaningful, achievable and sustainable actions to reduce the Carbon Emissions generated in the delivery of healthcare.

We are focusing action on the areas of highest impact

The actions follow a ladder of engagement, building from individual (micro) to team (meso) and finally, to national (macro) actions.

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In order to identify the high-impact areas for action, a diverse group (gender balanced from six continents) of healthcare workers and scientists with competencies in communication, economics, policy, planetary health research and system change was assembled (Led by Dr Courtney Howard). The expert group developed a framework for action using a ladder of engagement:

Micro Actions – Designed to be taken by individuals.

Meso Actions – Groups acting together within local health systems

Macro Actions – Healthcare at a national level

The action pathway follows three steps:


Each action is plotted along a clearly stepped-out pathway, and is summarised in a standardised template. The template simplifies each action into its constituent parts which are underpinned with supporting references. The initial steps in the pathway are:

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Commit – A small but vital step in driving social change

Examine – Individual Carbon calculations to educate ourselves

ACT – Targeted actions designed to institute change within three domains:


Shifting Clinical Practice: Making changes in how we deliver care

Shifting Teams: Organising Net Zero teams within scopes of practice

Shifting Energy: Move healthcare away from utilising any fossil fuel energy

Three clinical practice documents are to be released at the beginning of June including for Anaesthetic Gases, Respiratory Inhalers and Reducing unnecessary pathology test ordering. Other clinical practice action templates are following shortly, for both pre-hospital and nursing care.

We need your help to crowdsource the best solutions

Global practice of healthcare varies enormously, so share your experiences, comments and solutions to improve the plan.

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Importantly, the individual action templates have been authored by small groups of experts. It is acknowledged that these templates do not represent the enormous diversity of global medical practice which is determined by many factors including geography, accessibility, economics, supporting infrastructure and professional culture. The templates for action serve only as a starting guide.


As an integral part of the plan, we seek to crowdsource diverse global experiences, commentaries and solutions. The opportunity to constructively contribute to the plan is provided through the portal and the curated contributions will be published on the website. In this way, the plan is designed by experts but the final construction is community built.

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