Q&A: is pharma ready to address the health effects of climate change?

As climate change makes its presence felt, is pharma ready to play a leading role in addressing the global health threats that global warming presents? With the anticipated growth of vector-borne diseases, respiratory disease, bacterial diarrhoea and malnutrition, how can pharma R&D and the supply chain be reformed to help tackle the threat? Abi Millar finds out. 

Abi Millar: How great a threat is climate change to human health, and why?

Rich Quelch: Climate change is perhaps the most complex issue facing modern society, affecting every aspect of human life, including health.

There will be beneficial health impacts from milder winters, which could help to reduce the wintertime peak in deaths. Hotter summers could also help to limit disease-transmitting mosquito populations, for example. However, scientists agree that most impacts will be adverse, with some declaring a public health emergency. According to the World Health Organization, climate change is expected to cause approximately 250 000 additional deaths per year between 2030 and 2050.

The transmission of vector and water-borne diseases like malaria, dengue fever and cholera will increase with small changes in temperature and precipitation. Increasing air pollutants will result in more respiratory illnesses and early deaths. And more frequent extreme weather events will endanger populations, put food supply at risk and place huge pressures on healthcare systems.

Even for those living in less affected areas, this uncertainty is likely to have an adverse effect on millions of people’s mental wellbeing. So much so, the term ‘eco-anxiety’ has been coined by doctors to describe a new psychological disorder in which people worry (to an extreme) about the climate crisis.

To what extent are these health risks being explored? Why do you think this subject has attracted comparatively little attention? 

While the health risks are increasingly being explored, these are poorly understood compared to the effect on economic activities, infrastructure and ecosystems. In fact, less than 4% of spending on climate change adaption is channelled into health, according to a Lancet report.

This is because many health implications are secondary to an initial event or change in the environment. Today, most of the focus is on slowing or even reversing climate change, so its secondary effects are being somewhat overlooked.

Another reason why investment is lagging is that climate action requires a lot of right-now sacrifice for a down-the-line payoff. There are many competing factors with climate change, all of which need to be addressed quickly.

However, the tide seems to be turning and WHO recently set out its global strategy to reduce environmental risks to health. Part of the current challenge is closing knowledge gaps on certain risks to health, including climate change. New evidence needs to be communicated better through new platforms. 

What kind of role will the pharma industry play in mitigating the health impacts of climate change? And how should the industry be preparing itself?

Whether it be a fast-developing public health emergency, or a slow but steady increase in respiratory diseases, the pharma industry needs to have the agility to respond quickly and support the effective functioning of healthcare systems.

The pharma and biotech industries are no stranger to the chaos caused by extreme weather on their research and manufacturing capabilities. In 2017, Pfizer’s manufacturing facilities in Puerto Rico were wiped out during a devastating hurricane season, resulting in a loss of an estimated $195m in inventory. So, pharma must prepare itself in order to support others.

Investment in sites’ resilience is key. This means patching vulnerabilities that could close plants, e.g. via flood barricades, emergency power generators, and keeping critical digital infrastructure on higher floors.

Governments may start to enact policies to force big pharma companies to diversify the locations of their production facilities, particularly for products that are lifesaving and have no substitutes. Companies may also be required to carry heavy inventory to protect against supply chain disruption. And it is vital to keep global supply chains moving in the aftermath of a large-scale climate event. 

To facilitate the new pharmaceutical landscape, a fresh and agile approach is needed, one that leans towards an all-in-one solution that isn’t restricted to one manufacturing location or field of expertise. 

How much attention is being paid to creating sustainable supply chains? What are the main challenges here, what needs to change, and what kind of progress have we seen to date?

Pharma, as one of the largest global industries, is both part of the problem and the solution when it comes to minimising the adverse effects of climate change. However, many trailblazers in the industry are changing the status quo and creating a more sustainable pharma supply chain.

There are multiple ways pharma can reduce its carbon footprint. Any new pharma plants should incorporate green spaces and energy-saving technologies. This might mean installing rainwater harvesting systems, solar panels, inverter-driven machinery and reactive lighting, as well as robotics that increase production yields and accuracy with reduced input. 

Pharmaceutical waste continues to be a huge problem, so more research is taking place around bio-based PET. It’s made from ethylene derived from sugarcane, which has a negative carbon footprint, using CO₂ and releasing oxygen when cultivated.

Researchers are now testing pioneering technology that converts PET waste back into virgin grade material to be used again. Cutting-edge manufacturing methods like 3D visualisation and printing are also helping to reduce waste by eliminating the need for multiple prototype designs.

Is now the time to act? What is the business case for investing in sustainability measures now, rather than waiting?

When we think about the future of the pharmaceutical industry – and the future of Planet Earth – we’re actually not talking about the future at all, but the here and now. The effects of the climate crisis are already being seen and felt by everyone.

Investing in climate resiliency and reducing the impact of the pharma industry on the environment will be costly to the sector and the commercial benefits of doing so will not be realised for some time. But the most successful pharma companies of tomorrow will be those who invest in and build agile and efficient supply chains – both virtual and physical – today.

What are some of the key questions the industry needs to start asking itself in relation to climate change?

We are only as healthy as the environment we live in. Pharma has social and environmental responsibilities to fulfill, as does every other industry. Patient safety has always been and will always be the number one priority for the pharmaceutical industry, but that is going to become much more complex in the coming decades.

It’s important to remember that the people who will suffer the most from climate impacts are low income, very young, very old, and people with chronic conditions. If action isn’t taken, we’re at risk of widening health inequalities, which we’ve worked so hard to close over the past half-century through healthcare delivery and medical advances.

It’s not an overstatement to say that a level of opacity still exists in big pharma. It isn’t uncommon for large multinational companies to group their environmental data across their product divisions – pharmaceutical, medical equipment and agricultural. This can make it difficult to see the collective impact of the pharmaceutical supply chain on the environment. 

This needs to change as a matter of urgency if pharma is to succeed in minimising the health implications of climate change and supporting global efforts to reverse it.