Care for a cleaner world – Why aiming for carbon neutral care matters, and what it means for asthma and COPD

COPD | 11/3/2023
Care for a cleaner world – Why aiming for carbon neutral care matters, and what it means for asthma and COPD
Approximately 260 million people are affected by asthma worldwide, and at least 300 million by chronic obstructive pulmonary disease (COPD)1, 2 with the numbers projected to increase in the future. Inhaled therapy is the most common form of treatment due to its effectiveness and tolerance. However, there is an increasing need to minimize the carbon emissions in society and also across healthcare services, including national health organisations, device producers and the pharmaceutical industry. The detrimental impact of health care on environment and climate can be mitigated through minimising greenhouse gas (GHG) emissions and offsetting – creating carbon neutral care options also for asthma and COPD3.

Climate change, loss of biodiversity and overconsumption are different sides to the same sustainability crisis that threatens the harmony of the planets ecosystems. Primarily attributed to an excess of carbon and other greenhouse gas emissions, this imbalance creates a greenhouse effect, which is rapidly heating up the Earth’s atmosphere and altering ecosystems with unprecedented outcomes. In fact, many studies link planetary health to human health, showing that climate change and biodiversity loss are health threats. Health effects often impact vulnerable groups disproportionately. 
To mitigate climate change, reducing human-induced global greenhouse gas emissions is essential. In fact, the United Nations has described the quest to become carbon neutral as the world’s most urgent mission4. This is a mission that the pharmaceutical industry too must consider, while providing care to promote human health. It is for this reason that many pharmaceutical companies have announced plans to reach net zero climate emissions carbon neutrality in the coming decades. 

What is carbon neutrality exactly?

What does carbon neutrality mean and how is it achieved? In short, carbon neutrality means reducing the carbon footprint of any activity to net zero through a combination of in-house efficiency measures, switching to renewable energy, and encouraging external emission reductions in the value chain5.  
For a single pharmaceutical product to become carbon neutral, for instance, the company must first minimise the direct and indirect greenhouse gas emissions across all the activities within the product’s lifecycle. Secondly, the remaining emissions, which cannot be eliminated, need to be offset by projects that remove the same amount of greenhouse gases that are emitted into the atmosphere5 

Similarly, for a company to reach carbon neutrality, it needs to first calculate its own climate emissions, then reduce them where possible, and offset the rest. There are also different levels to carbon neutrality: beyond a company’s own operations, major emissions are usually produced in its supply chain and through its products. Usually, a company’s journey toward carbon neutrality may thus start from its own operations or selected products and then span out to include the more of the supply chain, products and employees’ emissions5  

Reducing the climate impacts of asthma and COPD treatment

Inhalers are the mainstay treatment for asthma and COPD. Through its design, medicine is targeted to the airways where they work effectively with minimum side-effects. With asthma and COPD affecting hundreds of millions of people across the globe, and the prevalence of respiratory diseases projected to increase globally, reducing the emissions of inhalers can have a significant effect on diminishing climate impacts. In fact, there has been a consistent effort in the pharmaceutical industry to reduce the climate effects of inhaled therapy, already starting in the 1980s. One milestone was the decision to ban ozone-depleting chlorofluorocarbon propellants (CFCs) in inhaled products by the Montreal Protocol in 19873 

However, the most used inhalers, pressurised metered dose inhalers (pMDIs), still use potent greenhouse gases called hydrofluoroalkane (HFA), which contain hydrofluorocarbons (HFCs), to push the medicine out of the inhaler. HFA-134a, which is used in most pMDIs has 1300-fold global warming potential compared to carbon dioxide6. Currently the pharmaceutical industry is searching for environmentally better solutions to pressurize pMDI devices. 

The introduction of propellant-free inhaler models in the 1990s was another leap forward for climate-friendly care. Dry powder inhalers (DPIs) deliver powdered medication where the active ingredient is expressed without the need for a propellant. Because propellants contain HFCs, potent greenhouse gases, preferring DPIs can diminish climate impacts significantly. Carbon footprint of pMDIs is approximately 13-fold higher when compared to DPIs and can be even much higher depending on the comparison pairs6  

Carbon neutral care is the future

In addition to providing care options that are by design more climate-friendly, pharmaceutical companies are now also taking other actions to reach full carbon neutrality in asthma and COPD care. Many companies have assessed the carbon footprint of asthma and COPD products and published them in medical journals. These are used as the basis for creating a journey toward net zero carbon emissions, together with a verified partner specialized in carbon neutrality programmes.   

In practice the journey means minimizing the carbon footprint of the asthma or COPD product – an inhaler, for instance – across its entire lifespan from sourcing of the raw materials to manufacturing, distribution and end-of-life disposal. Methods to reduce emissions may include, for instance, using renewable energy in production facilities, and reducing scrapping by cooperating with suppliers to choose the best, most sustainable materials. Focus can also be put in environmental packaging materials and transportation methods.  

After the company has minimised emissions wherever possible, the remaining emissions can be offset through projects that reduce greenhouse gas emissions elsewhere. These projects can include, for instance, reforestation and forest protection programmes, as forests act as natural carbon sinks removing CO2 from the atmosphere through photosynthesis. After it has been verified by a third party that the product’s remaining carbon footprint is offset through carbon reduction schemes, the product can be said to be carbon neutral.   

Carbon neutral care requires a consistent effort by the pharma industry, as well as subcontractors, regulators and healthcare professionals. To build a path towards a greener future all stakeholders need to collaborate closely to ensure effective and safe health care, while making the necessary changes to secure a healthy environment and clean air for all of us to breath for generations to come. 



      1. Asthma international | Key facts. Revised May 2023. Asthma ( (Accessed October 2023) 
      1. Adeloye et al. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med 2022;10: 447–458. 
      1. United Nations Environment Programme. Medical and Chemicals Technical Options Committee 2018 Assessment Report. 
      1. Wilkinson A et al. The environmental impact of inhalers for asthma: A green challenge and a golden opportunity. Br J Clin Pharmacol 2022;88:3016-22.  


      You might be interested in these:

      Best for the planet and the patient – What to know about the environmental impacts of asthma and COPD care

      Best for the planet and the patient – What to know about the environmental impacts of asthma and COPD care

      How sustainable is your inhaler? Respiratory specialist, Professor Christer Janson’s ground-breaking study on the environmental impacts of asthma and COPD treatments, has revealed some surprising results.

      Orion Corporation is a globally operating Finnish pharmaceutical company. We develop, manufacture and market human and veterinary pharmaceuticals and active pharmaceutical ingredients. The dry powder inhaler developed at Orion is in the core of our respiratory therapy area.