n an era of increasing environmental challenges and healthcare demands, partnerships have emerged as a critical tool for delivering environmentally sustainable and socially equitable healthcare.

But there is a difference between the more general concept of “sustainable partnerships,” meaning those that can endure, and environmental sustainability partnerships. The latter are driven by the need to develop solutions to address environmental challenges such as those posed by the links between the climate crisis, resource limits, and the impacts on planetary and human health. While environmental challenges may be specific and urgent, the problems posed, and answers to them, are often fraught with particular complexities such as longer time horizons and technological, societal, and regulatory constraints.

This article will define sustainability partnerships, explore their multifaceted benefits within the healthcare sector, outline the key elements that underpin successful collaborations, showcase the Sustainable Markets Initiative and other prominent examples, and describe their vital role in shaping a future in which healthcare prioritizes both human and planetary health.

Sustainability partnerships can be defined as long-term collaborative relationships between two or more entities, united by a common goal of achieving environmental sustainability objectives. Sustainability partnerships are essential for addressing the complex, interconnected challenges facing the healthcare sector today; they allow for the integration of diverse experiences and perspectives; they optimize effort by reducing duplication and optimizing outcomes; and they facilitate knowledge sharing and innovation. Furthermore, cross-sectoral knowledge exchange allows healthcare systems to benefit from insights and strategies successfully implemented in other industries.

Addressing the climate crisis and broader sustainability issues within healthcare necessitates a system-level approach: the problems are deeply embedded within the system itself and so must their solutions be. Therefore, sustainability partnerships are not merely beneficial but fundamentally required to enact meaningful change.

Approaching sustainability in a pre-competitive manner, where organizations share resources and ideas, increases efficiency and accelerates progress, particularly in developing solutions and metrics. These benefits, among many others, help to mitigate the seemingly unpredictable and uncontrollable complexity of the health system. In the face of the urgency of the threat that climate change poses to human and planetary health, sharing knowledge and resources becomes not just advantageous but imperative.

Sustainability partnerships manifest in various forms. Cross-sector partnership is demonstrated by the work Kaiser Permanente has done with technology companies like Willdan and Trane Technologies to address energy usage in many of their medical centers, resulting in millions of dollars in energy savings and contributing to Kaiser Permanente’s overall ambition to reduce their CO2e emissions.

GSK’s partnership with the University of Nottingham to develop greener chemical processes relevant to the pharmaceutical industry is an example of industry-academic partnerships, and has, among other successes, led to the creation of a research center, the GSK Carbon Neutral Laboratory for Sustainable Chemistry at the University of Nottingham.

Regardless of the type, the underlying tenet is that there must be core commonality uniting the members of the partnership in their collaboration.

The Sustainable Healthcare Coalition, founded in 2011, is one organization that exemplifies the importance of sustainable partnerships. The coalition drives action on net zero healthcare by bridging public and private sectors to build partnerships among a range of stakeholders that unlock sustainable solutions. The coalition’s members bring extensive experience, resources, and an appetite for sustainable change to their collective ambition of accelerating and amplifying action towards net zero healthcare.

The coalition has demonstrably impacted the clinical trials landscape by launching a ground-breaking methodology, guidance, and carbon calculator in response to a recent call from CEOs of companies involved in the Sustainable Markets Initiative to the clinical trials community to measure and reduce clinical trial emissions. Through a sustainability partnership approach, the coalition has promoted adoption of the tool and facilitated its increasingly widespread uptake. Academic partners have now produced footprints of 12 clinical trials and industry partners have footprinted three clinical trials, addressing a paucity in the literature of clinical trial emissions data.

The coalition is a member of His Majesty King Charles III’s Sustainable Markets Initiative (SMI), founded by the then Prince of Wales in 2020. SMI’s ambition is to accelerate the transition to a sustainable future and aims to facilitate action between world leaders and CEOs, positioning sustainability at the “heart of global value creation” while uniting the private sector and driving economic growth with a default sustainable focus across markets, industries, and supply chains.

The SMI Health Systems Task Force (HSTF) comprises 14 global health CEOs, including the pharmaceutical and consumer health industries, and leaders from the private sector, nongovernmental organizations (NGOs), National Health Services, and academia, vital for ensuring that all perspectives contribute towards the solving of healthcare challenges. In the five years since the Task Force was launched, there have been a number of successes, including a collaboration between the pharmaceutical industry and their supply chain partners which has collectively procured renewable power in China to support decarbonization of healthcare value chains with the potential to save 250,000 tons of emissions per year.

Organizations and initiatives like the Sustainable Healthcare Coalition and SMI operate with the goal of driving systemic change by creating new “rules of the game” that incentivize sustainable practices. This involves establishing new standards and/or metrics that are inherently good for business but also foster a different kind of competition focused on sustainability performance. These metrics, such as the clinical trial carbon calculator, serve as vital system tools, providing a mechanism to drive and measure progress towards sustainability goals.

The UK Health Alliance on Climate Change (UKHACC) serves as another compelling example of a successful sustainability partnership within the healthcare sector. This coalition of health organizations and other stakeholders in the United Kingdom advocates for action on climate change to protect and promote public health and functions as a strategic alliance to bring together diverse expertise and resources to achieve shared sustainability goals and amplify their impact.

UKHACC has been instrumental in pushing for policy changes that directly address the health impacts of climate change. For instance, their advocacy efforts contributed to the UK government’s commitment to phasing out coal-fired power plants, a move projected to significantly reduce respiratory illnesses linked to air pollution. Furthermore, UKHACC actively engages in public awareness campaigns, educating healthcare professionals and the public about the direct links between climate change and health outcomes, such as the increased incidence of heatstroke during extreme weather events or the spread of vector-borne diseases.

For another example, the Pharma Pollution Hub is a cross-sectoral consortium working to reduce the environmental impact of medicines used in UK healthcare. Recognizing that no single entity can solve this multifaceted problem alone, the Pharma Pollution Hub brings together a diverse array of stakeholders, including pharmaceutical companies, academic researchers, wastewater treatment facilities, and regulatory agencies. Their work demonstrates that different parts of a complex problem necessitate different partners, reflecting the crucial need for multistakeholder engagement to effectively address systemic issues like pharmaceutical pollution.

The hub has pioneered research into innovative wastewater treatment technologies capable of removing persistent pharmaceutical compounds from effluent. Through collaborative pilot projects, they have demonstrated the feasibility of implementing these technologies at scale, paving the way for cleaner and healthier aquatic ecosystems. Furthermore, the Pharma Pollution Hub promotes responsible medication disposal practices among healthcare providers and the public, reducing the amount of pharmaceuticals entering the environment in the first place. By fostering collaboration across diverse sectors, the Pharma Pollution Hub is not only mitigating the environmental impact of pharmaceutical waste but also demonstrating a replicable model for tackling other complex environmental challenges within the healthcare system.

More Effective, Efficient, and Environmentally Responsible

Several key benefits of sustainability partnerships contribute to more effective, efficient, environmentally responsible healthcare systems:

• Resource optimization and efficiency: A core focus on resource efficiency ensures that partnerships create value for all participants by reducing duplication and waste. The Sustainable Healthcare Coalition brought together sustainability experts from member companies like Johnson & Johnson, GSK, AstraZeneca, and Becton Dickinson to produce an open-access standard for performing life cycle assessments of pharmaceuticals and medical devices. Published in 2012, this eliminated the duplication of effort that would have been required for other companies to create their own individual guidance.
• Innovation through collaboration: Collaboration can provide breakthrough solutions by fostering new ideas and approaches to complex sustainability challenges. For example, the coalition brought stakeholders together in a Low Carbon Clinical Trials group who worked collaboratively to create the clinical trial carbon calculator, utilizing expertise within both clinical trial logistics and carbon accounting. The tool itself was an innovative and ground-breaking development in its ability to model and measure such a complex system.
• Enhanced trust and transparency: Open communication and transparency are vital for building trust among partners, leading to stronger and more resilient collaborations. This is core to the way the Sustainable Healthcare Coalition works as a trusted, neutral third party. For example, in the project to create a care pathways framework, it created a “safe harbor” for discussion, convening direct competitors from the life sciences sector and health systems themselves to develop a single, open, transparent methodology and guidance. By fostering joint action in a pre-competitive space, the coalition created a level playing field and a credible, trustworthy resource.
• Alignment of objectives: A shared commitment or vision ensures that objectives are aligned and that all parties prioritize sustainability for the long term, fostering a unified sense of purpose. The SMI HSTF companies’ joint commitment on supply chain decarbonization exemplifies the importance of a unified purpose, bringing together CEOs of global healthcare giants to make a public collective commitment to drive decarbonization across their supply chains. Their open letter to suppliers created a unified demand signal to the market and derisked this move for the sponsor companies.

Despite their considerable potential, establishing and sustaining successful sustainability partnerships presents several challenges:

• Navigating conflicting interests: Successfully navigating potential conflicts of interest requires open dialogue and a commitment to ensuring that everyone’s needs are met, while maintaining a common purpose.
• Complexity of diverse needs: The partnership must possess the flexibility to accommodate the diverse needs of all participants, ensuring that success for one translates into success for all, which can be difficult to achieve in practice.
• Requirement for specialized expertise and resources: Fostering these relationships requires imagination, technical skills, relationship-building expertise, and dedicated resources, which may not always be readily available.
• Need for continuous nurturing and adaptation: It is also critical to acknowledge the evolving nature of effective partnerships; they require continuous nurturing and adaptation, demanding ongoing commitment and effort from all parties.

Next Steps: Partnerships and Policies

Sustainability partnerships represent a fundamental mechanism for transforming healthcare into a truly sustainable sector. To fully realize this potential, healthcare organizations must proactively seek out partnerships with a broader range of stakeholders, while policymakers must create supportive regulatory frameworks that incentivize collaborative innovation. While challenges such as aligning diverse stakeholder interests remain, the future of healthcare depends on embracing the collaborative spirit and shared commitment that define successful sustainability partnerships. Only through these concerted efforts can we ensure a healthcare ecosystem that prioritizes both human and planetary health.

To learn more about sustainable healthcare initiatives in Europe, read the first and second articles in this series co-authored by the Sustainable Healthcare Coalition and DIA, or this contribution co-authored by the Partnership Brokers Association and DIA, or plan to attend DIA Europe 2026 in Rotterdam.