Abstract
Biomedicine is undeniably powerful in addressing acute health crises and life-threatening conditions. However, it often relies on high-tech interventions, synthetic pharmaceuticals, and resource-intensive hospital systems that carry a significant environmental cost. For instance, health care facilities in the U.S. alone contribute to about 10% of the nation’s total greenhouse gas emissions. 1 If the U.S. health care sector itself were a country, it would be the world’s 13th largest emitter of greenhouse gases, ahead of the entire U.K. The production, transportation, and disposal of pharmaceuticals and medical supplies generate considerable waste, including harmful by-products that pollute waterways and ecosystems. 2
Moreover, single-use plastics and non-recyclable materials dominate hospital supplies, from syringes and IV bags to packaging and personal protective equipment. The surge in medical waste, particularly during the COVID-19 pandemic, has exacerbated this problem. In a world where reducing waste and conserving resources is becoming increasingly urgent, health care must find ways to mitigate its environmental impact without compromising patient care. 3
Traditional, Complementary and Integrative Medicine: Naturally Aligned with Sustainability
Traditional, complementary and integrative medicine (TCIM) offers a range of therapies that inherently promote sustainability. These practices focus on natural, low-tech, and low-impact methods that not only enhance personal well-being but also minimize environmental harm. By emphasizing prevention, balance, and the use of natural resources, TCIM is well-positioned to lead the charge toward a more eco-conscious health care system.
Herbal medicine and sustainable agriculture
Herbal medicine embodies sustainability through its reliance on plant-based remedies. Unlike synthetic pharmaceuticals, which are often derived from petrochemicals and produced through energy-intensive processes, herbal medicines are typically grown, harvested, and processed with minimal environmental impact. 4 –6 Furthermore, regenerative agricultural practices used in the cultivation of medicinal plants can enhance biodiversity, improve soil health, and reduce carbon emissions. 4 –6
Sustainable farming practices, such as the use of organic farming methods and agroforestry, are increasingly aligning with the TICM sector. The cultivation of herbs using eco-friendly practices not only ensures the availability of high-quality medicinal plants but also supports broader environmental goals. 6 By advocating for regenerative agriculture and the responsible harvesting of medicinal plants, herbal medicine can set an example for sustainable sourcing in health care.
Non-pharmacological therapies and minimal resource use
Non-pharmacological therapies, such as osteopathy, chiropractic, but also procedures dependent on medical devices, such as acupuncture, cupping or Gua Sha, have a comparably low environmental footprint. The main instruments such as acupuncture needles or cupping heads are simple, reusable, or recyclable (if properly sterilized) and require minimal production resources compared with the production advanced medical equipment or pharmaceuticals. 7 Furthermore, the treatments do not rely on high energy inputs, hazardous chemicals, or disposable materials.
This low-tech and low-resource approach is in sharp contrast to the energy-intensive procedures of many biomedical treatments. For example, many conventional therapies require sophisticated machinery, sterilized disposable products, and pharmaceuticals with complex supply chains. The minimalist approach of non-pharmacological TCIM procedures could reduce the carbon footprint of health care and make them a model for environmentally conscious treatment options.
Mind-Body practices: Empowering sustainable wellness
Yoga, meditation, and other mind-body practices could contribute to sustainability in health care by shifting the focus from high-cost, high-impact medical interventions to self-care, and preventive health. The widespread adoption of these practices in daily life could contribute to long-term sustainability by reducing dependence on pharmaceuticals and costly medical interventions. 8 Furthermore, the growing popularity of virtual yoga and meditation classes has significantly reduced the need for transportation and physical infrastructure, contributing to a smaller carbon footprint while promoting global access to holistic health. 9
Potential Threats of TCIM to the Ecosystem
While TCIM can offer significant environmental benefits, it is not without its risks to the ecosystem and can also contribute to ecological harm. One of the most significant threats arises from the use of endangered animal species and overharvesting of medicinal plants in the preparation of remedies.
Use of endangered animals in "herbal" medicine
Traditional remedies in some medical systems, particularly in Asia, sometimes involve the use of animal parts from endangered species such as tigers, rhinoceroses, and pangolins. These animals are often hunted illegally and their body parts are used in traditional treatments, which not only threatens biodiversity but also fuels illegal wildlife trade. 10 The demand for these animal-based remedies has driven some species to the brink of extinction.
In response, efforts have been made to regulate these practices and substitute animal products with plant-based or synthetic alternatives. 11 However, more work is needed to ensure that practitioners and consumers are educated about the environmental consequences of using animal products in “herbal” remedies.
Overharvesting of wild medicinal plants
Another significant concern is the overharvesting of wild medicinal plants, which can lead to habitat destruction and the depletion of plant species. Many herbal medicines rely on wild-sourced ingredients that are not cultivated sustainably, posing a threat to biodiversity. 10 Plants like echinacea, ginseng, goldenseal, and wild yam are at risk due to overharvesting, as demand for these ingredients outpaces their natural regeneration rates. 12
Addressing these issues requires robust regulation of medicinal plant harvesting, greater investment in sustainable agriculture, and education for both practitioners and consumers on the importance of using sustainably sourced ingredients.
Future Directions: A Greener Future for Health care?
As TCIM continues to grow in popularity, it is essential to address both the opportunities and potential pitfalls associated with its integration into a sustainable health care system.
A major pitfall is the lack of stringent regulation and standardization across the TCIM industry. While the sector offers many sustainable solutions, the absence of globally enforced standards for sourcing medicinal plants and animal products could exacerbate environmental issues rather than alleviate them. 10 –12
The field however has a unique opportunity to lead the way in sustainable health care by promoting and enforcing ethical sourcing practices. This includes supporting farmers who practice regenerative agriculture, reducing reliance on endangered animal species, and ensuring the long-term viability of medicinal plants. Educating consumers about the sustainability of their health care choices is critical. As public awareness of environmental issues grows, patients are more likely to choose certain therapies if they are informed about the environmental benefits of these practices. Practitioners have the opportunity to lead this conversation, promoting both personal and planetary health.
As society continues to confront the urgent challenges of climate change and environmental degradation, health care must evolve to meet these demands. TCIM, with its emphasis on natural, low-impact therapies, offers a valuable model for how health care can become more sustainable. To fully realize its potential as a sustainable health care solution, we must prioritize ethical sourcing, regulate harmful practices, and invest in scientific research that validates the efficacy of these therapies.
The shift toward a more sustainable health care system is not only necessary for the planet but also for the long-term health of future generations. By integrating the principles of sustainability into health care, we can create a system that is as healthy for the environment as it is for the people it serves.