Reinventing Health Supply Chains for Climate Resilience and Emission Reduction

The report warns that global health care supply chains, responsible for more than 80% of the sector’s emissions are deeply vulnerable to climate disruptions and urgently require redesign for resilience and decarbonization. It outlines six strategies to transform product design, manufacturing, logistics, procurement, regulation, and financing to build a low-carbon, climate-resilient health system.

The Asian Development Bank, working alongside Health Care Without Harm, Unitaid, and the OECD, opens its 2025 paper with an urgent warning: the health care supply chain, the vast ecosystem that produces and delivers medicines, devices, and diagnostics, is both a major contributor to the sector’s carbon footprint and one of its deepest points of fragility. While global health policies often focus on hospitals and clinical services, these research institutions argue that the real climate and resilience crisis lies upstream. More than 80% of all health sector emissions come from supply chains, and their sprawling, globalized nature makes them increasingly vulnerable to climate shocks. From Puerto Rico to India and China, storms and floods have already forced factory shutdowns, revealing how dependent the world is on a few climate-exposed manufacturing hubs.

When Globalization Collides with Climate Change

The report details how decades of hyper-globalization have created intricate production routes designed for efficiency but dangerously exposed to disruption. Active pharmaceutical ingredients may be synthesized in one region, processed in another, packaged elsewhere, and shipped across continents before reaching a patient’s hands. A single clonazepam pill consumed in Canada may travel over 63,000 kilometers during its journey, evidence of both astonishing interdependence and staggering carbon impact. Climate change intensifies every weak point: extreme heat compromises cold chains, floods sever transportation routes, and storms disrupt electricity-dependent warehouses. The authors caution that without reform, supply chains will become more expensive, more unpredictable, and more inequitable, particularly for low- and middle-income countries already facing fragile access to medicines.

Innovation at the Heart of a New Supply Chain

To counter these risks, the report urges a transformation of how health products are designed and produced. Climate-smart product innovation should prioritize durability, recyclability, low-carbon materials, and resistance to extreme temperatures. Research partnerships spanning governments, manufacturers, academia, and communities are essential to developing thermostable vaccines, greener pharmaceuticals, and low-waste diagnostics. Market-shaping tools like advance purchase commitments can incentivize manufacturers to invest early in greener technologies. One example highlighted is Bangladesh’s move to build domestic, renewable-energy-powered vaccine and diagnostics manufacturing, demonstrating how emerging economies can leapfrog to resilient, climate-adapted production models.

Reinventing Logistics and Procurement for a Hotter World

Logistics, one of the major contributors to global health supply emissions, also demands rethinking. The report calls for decentralizing storage hubs, deploying disaster-resilient cold chains, optimizing transport routes, and reducing dependence on high-emission air freight. Zambia’s solar-powered medical warehouse shows how renewable energy can stabilize cold chain operations even when national grids fail. Procurement, meanwhile, is described as the health sector’s most powerful lever for change. Governments and multilateral agencies, responsible for billions of dollars in annual purchases, can reshape markets by demanding transparent emissions data, favoring reusable products, sourcing regionally, and embedding sustainability criteria into supplier contracts. Improving procurement literacy is equally important: health workers, supply officers, and purchasing teams must understand the climate implications of the products they choose.

Financing the Transition to Climate-Safe Health Care

The paper concludes that none of these solutions will scale without strategic investment. Development banks, governments, and private investors must deploy financing to support local manufacturing, renewable-powered infrastructure, green R&D, and climate-risk insurance mechanisms that help early adopters shoulder initial costs. Regulation must also evolve, requiring life-cycle assessments for health products, harmonizing sustainability standards, and enabling “green fast-track” approvals for low-carbon innovations. To illustrate the power of coordinated change, the authors point to the global phase-out of mercury thermometers and sphygmomanometers, now replaced by safer digital devices due to collective regulation, procurement pressure, and industry innovation. This transformation, they argue, proves that health supply chains can be rebuilt for resilience and sustainability when global actors move in unison.

The ADB’s analysis delivers a clear message: the future of climate-resilient health care hinges not only on hospitals or medical workers but on the invisible arteries that move products around the world. As climate threats accelerate, rethinking supply chains is no longer an option, it is a prerequisite for protecting health systems and the communities they serve.