Operation Zero

At HCWH Europe, our vision is that every European country develops a national decarbonisation plan for its healthcare sector. To support this, we have established Operation Zero, a groundbreaking project that aims to put the European healthcare sector on the path to net zero carbon emissions, in line with European and international climate commitments.


In 2019, and in partnership with Arup, HCWH published Health Care’s Cover of Health Care's Climate Footprint report Climate Footprint – the most comprehensive global analysis of healthcare’s contribution to climate change to date. Setting out the healthcare climate footprints of 43 different countries from around the globe, this report highlights the scale of the challenge. As a whole, the healthcare sector’s climate footprint is equivalent to 4.4% of global net emissions; if it were a country, it would be the fifth largest emitter in the world. The European Union is the third largest contributor to global healthcare emissions (behind the US and China), accounting for 12% of global healthcare emissions.

With these challenges comes opportunity. There are opportunities for the sector to lead by example, for health professionals to use their trusted voices to educate on the health impacts of climate change and advocate for change, and for the sector to leverage its purchasing power (10% of GDP in Europe) to influence changes within the supply chain.

Health Care’s Climate Footprint described the problem - Operation Zero provides the solution.

Designing net zero roadmaps for healthcare

Through Operation Zero, we have developed and piloted a new methodology that any national or regional health authority can use to measure its healthcare emissions and establish a Paris-compatible decarbonisation roadmap.

Operation Zero is split into two key components:

1. Methodology

Front cover of publication Designing a net zero roadmap for healthcare

Designing a net zero roadmap for healthcare sets out a step-by-step process for establishing a decarbonisation roadmap for healthcare systems that is aligned with the principles of the Paris Agreement, including how to calculate a carbon footprint, model emissions trajectories, and develop the appropriate governance structures to support the process. 

This technical methodology is primarily aimed at analysts working within national or regional health authorities, but also includes guidance for policy officials. It was piloted by three national and regional health authorities, ensuring that it is robust and ultimately drives action among European health systems.

2. Three national healthcare decarbonisation roadmaps

HCWH Europe partnered with three national and regional health authorities to guide the development of and pilot this methodology, supporting participants to generate their own detailed climate footprint analyses and decarbonisation roadmaps. Through these pilots, we gained valuable feedback on the practicalities and limitations of developing national/regional decarbonisation roadmaps that helped to build a more robust methodology. Portugal’s national healthcare decarbonisation roadmap is already available. The remaining roadmaps for the Lazio region of Italy and the Netherlands will be published by their healthcare sectors in the coming months.

Project Partners

Funded by the European Union, the IKEA Foundation, and the Skoll Foundation. Views and opinions expressed are however those of Health Care Without Harm (HCWH) Europe only and do not necessarily reflect those of the European Union, CINEA, the IKEA Foundation, or the Skoll Foundation. The European Union, CINEA, the IKEA Foundation, and the Skoll Foundation cannot be held responsible for them.