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What can anaesthetists do to help combat the global climate emergency?

The Intergovernmental Panel on Climate Change (IPCC) published its sixth assessment report in 2021 [1]. The report offers a stark and alarming warning that our climate is changing at an unprecedented rate due to human activity. Unless this trend is drastically and rapidly reversed, the climate will continue to deteriorate, which will in turn have a significant impact on the environmental and social determinants of the health of people worldwide [2]. These changes will affect everyone, but the burden will be borne disproportionately by those in lowand middle-income countries [3]. Healthcare professionals have a fundamental responsibility to do no harm [4]. It is unequivocally clear that climate change causes harm to population health [5], and this will only worsen as the crisis deepens [6]. Equally, it is clear that healthcare makes a significant contribution to global environmental impact; estimated to be between 1% and 5% of the global total [7]. Following the 26th UN Climate Change Conference (COP26) in Glasgow in 2021, the UK government has made further commitments to reaching net zero emissions across all four UK health services [8], announcing increased financial investment and a variety of goals and initiatives. As healthcare professionals, we should all be aware of the impact of our practice, and urgently consider ways to reduce this, for the benefit of all. Bill McKribben, the American author and environmentalist, coined the phrase “winning slowly is the same as losing” [9]. We cannot afford to continue making changes at a pace that means climate change will already have caused catastrophic and irreversible damage by the time those changes are in place. The latest IPCC report warns the situation is a “code red for humanity” and highlights how little timewe have to achievewhat is needed. Anaesthesia providers are well placed to make significant contributions to this urgent need to reduce humanity’s impact on the environment. Indeed, anaesthetic gases and volatile agents alone account for 5% of the carbon footprint of acute NHS organisations [10], and there are many other areas where anaesthesia providers can make informed choices affecting the environmental impact of their practice [11]. In a recent issue of Anaesthesia, White et al. presented a global consensus statement on the principles of environmentally sustainable anaesthesia on behalf of the World Federation of Societies of Anaesthesiologists [12]. In this editorial, we examine this consensus statement, particularly in the context of the COP26 conference and the IPCC’s sixth assessment report [1]. The preparation of the global consensus statement was coordinated by a steering committee, formed by anaesthetists who have published in the area of environmentally sustainable anaesthesia. They invited a number of other anaesthesia providers from across the globe to form a working group and to take part in a threestage modified Delphi process. Three important underlying statements were agreed by the working group: patient safety should not be compromised by sustainable practice;