Achieving net zero

How our health operations are slashing carbon emissions while saving thousands

AKDN / Lucas Cuervo Moura

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The 400-KW solar plant of the Bamyan Provincial Hospital in Afghanistan provides for the majority of the …

AKDN / Sameer Dossa

Inspiring via nature in the early years

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Children receive immunisations in northern Pakistan under the Hayat project which uses a mobile application that helps track health services delivered by field workers. Hayat is a mobile health application and web portal developed by Aga Khan University. 


Health Service Delivery

AKHS's overall approach to climate-smart and environmentally-friendly health care is based on:

  • Emphasising health promotion, disease prevention and primary health care. The aim is to avoid people getting sick in the first place, which in turn, prevents the need for travel, diagnostic and medical interventions – all of which have high costs to patients as well as the environment.

  • Using technology to help patients receive information and care close to home. AKHS uses and plans to invest further in digital health solutions, telephone consultations and telemedicine to support remote diagnosis and consultations. This, in turn, limits travel needs but also allows for quicker detection and resolution of health problems – all of which are also good for the environment as well as patients. Find out about the AKDN Digital Health Resource Centre.

  • Using evidence-based approaches driven by population health needs. The philosophy of this approach is to minimise unnecessary consultations, interventions and treatment.

The hospital in Bamyan’s special low-impact, rammed earth architecture is designed to be not only culturally sensitive to the surrounding area, but also climate-friendly, durable and seismic-resistant.



All new facilities are designed to meet the best of possible environmental standards. AKHS is also actively retrofitting older facilities, with an emphasis on reducing carbon emissions, air pollution, energy and water consumption. AKHS is also considering preparation and adaptation for more severe weather extremes as a result of changes in climate.

Our architects and engineers have a longstanding tradition of working together to build facilities that both fend off the worst of the weather and make full use of natural light and ventilation. In turn, all such features reduce energy needs for heating, cooling and lighting. New facilities aim to satisfy the requirements for Excellence in Design for Greater Efficiencies or “EDGE” certification.

Energy efficiency is a criterion for all major equipment. Better energy solutions for fixtures and fittings, and energy and water consumption are also continually being sought. Typically, AKHS hospitals use LED and sensor-responsive lighting, water efficient taps, toilets and Energy Star-rated equipment and appliances.

For newer projects, wherever space permits, engineers install rainwater harvesting mechanisms to make the most of rainfall. Treated water is also routinely used for flushing toilets and irrigating grounds. Some facilities have reverse osmosis plants to produce the highest quality drinking water on site – preventing the need to transport potable water, which comes at a high cost to the environment. Plans are in place to install these features at all locations gradually. Wherever possible, and generally for larger projects, heat from generators and other equipment is being considered for heating water and supplementing heating, too.

The Aga Khan Medical Centre Gilgit, Pakistan.

AKDN / Christopher Wilton-Steer

Since the Bamyan experience, every AKHS installation has explored and aimed for the maximum possible use of solar energy. More recent projects include retrofitting an old facility at the Aga Khan Comprehensive Health Centre in Singal, Northern Pakistan and at the Aga Khan Outreach Health Centre in Kuze, Mombasa. The design of the proposed expansion at the Aga Khan Medical Centre Gilgit, Pakistan and the Aga Khan Hospital Kisumu, Kenya also include solar energy. Current plans also include a 40KW solar system for the Aga Khan Medical Centre, Mwanza, Tanzania and a similar system for the Aga Khan Medical Centre Salamieh, Syria. For these projects, estimates for solar covering energy needs range from 40 to 90 percent, with cost recovery projections between five to eight years. In the future, AKHS expects even better results as prices of solar installations continue to reduce and technology improves. In areas with less sunlight, such as Northern Pakistan, AKHS is exploring geothermal energy prototypes as well.

AKHS has won two awards for our solar projects, including from the Prince Sadruddin Aga Khan Fund for the Environment and the Access 2 Energy (A2E) award for the Health Centre in Singal in Northern Pakistan and the Medical Centre in Mwanza in Tanzania, respectively.

In 2019, AKHS started identifying the types and volumes of anaesthetic gases it was using during surgeries. It stopped using the most potent greenhouse gas, Desflurane, and made better substitutions wherever it was possible. 

AKDN / Kamran Beyg


Many anaesthetics are known to contribute significantly to health care’s carbon footprint. As well as being powerful greenhouse gases, some anaesthetic gases are also ozone-depleting substances and as such, also have consequences for skin cancer. Consequently, we are looking at ways to reduce emissions from these products.

In 2019, we started identifying the types and volumes of gases we were using and making better substitutions wherever possible. As a result, AKHS health facilities have stopped using the most potent greenhouse gas, desflurane. However, isoflurane, halothane, sevoflurane, and nitrous oxide which are also problematic from the perspective of global warming, and in some cases ozone depletion, are still being used.

AKHS staff are actively working on reducing the impacts of these gases by:

  • wherever possible, changing from high-carbon or ozone-depleting gases to lower carbon and more ozone friendly alternatives;

  • exploring the reduction of nitrous oxide and replacement in surgery with oxygen or medical air;

  • increasing the use of low-flow anaesthesia to reduce the volumes used of all gases;

  • using alternatives to fluorinated gases, such as intravenous anaesthesia; and

  • wherever possible, capturing and reusing anaesthetic gases.

In all instances, AKHS is examining ways to use these gases prudently and experimenting with novel techniques which reduce consumption – but without compromising safety. In many cases (but not all), making such changes also reduces costs.

A group of AKHS anaesthetists are working on implementing changes and sharing lessons learnt across the network. AKHS is also seeking opportunities to share information on the carbon footprint and ozone depletion qualities of anaesthetic gases with anaesthetists in private and public sectors to influence best practice more broadly.

The relative impacts of anaesthetic gases are shown in the table below. The Ozone Depleting Potential (ODP) of each gas is compared with the most common ozone depleting substance, CFC-11; whereas the Global Warming Potential (GWP) is shown relative to the most common greenhouse gas, carbon dioxide.