Healthcare systems (HSs) provide essential services to populations yet require a large amount of energy to perform duties and tasks. Specifically, 4.4% of global net carbon emissions can be attributed precisely to the activities of HSs. Therefore, it seems unlikely that the targets of zero carbon dioxide (CO₂) emissions by 2050, set by the Paris Agreement, will be met without rethinking the role and impact of HSs towards climate change. Here we summarize the available literature on CO₂ emissions depending on direct and indirect Hss activities. We show that the number of studies addressing this topic is still very limited and that most of the emissions derive from the supply chain HSs rely on to perform their tasks. Furthermore, we highlight how this topic is addressed unevenly among countries. Indeed, we found that less economically developed countries are less represented in the literature on this topic and that, even in economically developed countries, most of the studies come from English-speaking countries. In the discussion, we stress that health workers and policymakers should pay more attention to this issue in order to tackle climate change and related health issues, following the example of few virtuous countries. Finally, some potential impact mitigation strategies are discussed.

医疗保健系统 (HS) 为人们提供基本服务，但需要大量能源来履行职责和任务。具体而言，全球净碳排放量的 4.4% 可准确归因于 HS 的活动。因此，如果不重新考虑HS对气候变化的作用和影响，《巴黎协定》设定的到2050年二氧化碳（CO ₂ ）零排放的目标似乎不太可能实现。在此，我们总结了有关取决于直接和间接 HSS 活动的CO ₂排放的现有文献。我们表明，涉及该主题的研究数量仍然非常有限，并且大部分排放来自 HS 所依赖的供应链来执行其任务。此外，我们强调各国对这一主题的处理方式不平衡。事实上，我们发现经济欠发达国家在这一主题的文献中代表性较少，而且即使在经济发达国家，大多数研究也来自英语国家。在讨论中，我们强调卫生工作者和政策制定者应效仿少数有德国家的榜样，更加关注这一问题，以应对气候变化和相关健康问题。最后，讨论了一些潜在的影响缓解策略。