HN Summary
• Pharmacists play a key role in reducing healthcare’s environmental impact, including emissions from medications and waste.
• Through deprescribing, sustainable practices, and medication stewardship, they improve both patient outcomes and system sustainability.
• Leadership and national collaboration are helping integrate planetary health into everyday clinical practice across Canada.
Climate change is increasingly recognized as one of the most significant health challenges facing Canadians. Extreme heat events, declining air quality, and disruptions to health services are already affecting patient outcomes across the country. At the same time, Canada’s health care system contributes substantially to greenhouse gas (GHG) emissions—accounting for approximately 4.6 per cent of national emissions, a level comparable to the aviation sector. Within this context, pharmacists working in planetary health are emerging as essential leaders in aligning high quality patient care with environmental sustainability.
Why pharmacy matters for planetary health
Pharmaceuticals and pharmacy operations play a disproportionate role in the environmental footprint of health care. Canadian and international analyses show that approximately one quarter of health system emissions are linked to pharmaceuticals, including medication manufacturing, procurement, use, and disposal. Medications also contribute to environmental pollution, with pharmaceutical residues detected in water sources across Canada and globally, potentially affecting ecosystems and antimicrobial resistance patterns.
Pharmacists are uniquely positioned to address these challenges. Through medication optimization, deprescribing, sustainable procurement, and waste reduction, pharmacists can achieve environmental benefits while maintaining—or improving—patient outcomes. These actions align closely with national efforts to build climate resilient, low carbon health systems, including commitments by Health Canada under Canada’s 2023–2027 Departmental Sustainable Development Strategy.
Evidence-based impact in canadian health care
Planetary health pharmacy initiatives are intricately linked to quality improvement and patient safety. Research demonstrates that inappropriate or excess medication use increases both clinical risk and environmental harm, while deprescribing where appropriate improves patient outcomes and reduces system costs and waste. Sustainable inhaler practices, optimization of antimicrobial use, and responsible management of anesthetic and high impact medications have all been identified as areas where pharmacist led interventions can significantly reduce emissions without compromising care.
At the system level, Canadian studies emphasize that leadership and governance are crucial to realizing these gains. Reports from CASCADES indicate that integrating sustainability into existing pharmacy quality and safety frameworks is one of the most effective strategies for achieving measurable reductions in environmental impact.
Leadership in practice: Kirsten Tangedal, BSP, ACPR, MHSc, CHE
A leading figure in advancing planetary health pharmacy in Canada is Kirsten Tangedal, Manager of Pharmacy Practice at the Saskatchewan Health Authority (SHA) and Chair of CSHP’s Planetary Health Community of Practice. In her health system leadership role, Kirsten supports large scale implementation of practice standards, quality initiatives, and strategic priorities across pharmacy services in Saskatchewan, embedding sustainability as a core component of practice rather than a parallel initiative.
A leader in planetary health, Kirsten advances sustainable pharmacy practice through education, collaboration, and system level leadership. As Chair of CSHP’s Planetary Health Community of Practice, she connects with pharmacy professionals nationwide to share evidence based tools and practical solutions. Plus, she has contributed to the development and dissemination of pharmacy specific sustainability resources that enable measurable change at the point of care.
“Being a part of the Planetary Health Community of Practice is important to me as not only am I interested in the impact of planetary health on healthcare, this also connects me with individuals with similar interests and allows me to stay in touch with a quickly evolving area of evidence,” says Kirsten. “Lots of work is happening regarding sustainability nationally and worldwide, and it’s important that we connect to build on what is currently occurring and share knowledge.”
Building a sustainable future for health care
As Canada works toward net zero and climate-resilient health systems, pharmacists will continue to be central to success. Their expertise in medication stewardship, systems design, and interprofessional collaboration uniquely positions them to deliver “triple win” outcomes: better health, lower costs, and reduced environmental impact. National calls to action on planetary health—from academic institutions to health sector coalitions—underscore the urgency of integrating sustainability into everyday clinical practice.
By supporting planetary health pharmacy roles and leaders such as Kirsten Tangedal, health care organizations can ensure that environmental responsibility becomes an integral part of safe, effective, and patient centred care. In doing so, pharmacy professionals are helping protect not only today’s patients, but the health of future generations.