Greening public health: embedding environmental sustainability in research and practice

The triple planetary crisis (climate change, pollution, and biodiversity loss) is reshaping health conditions worldwide, yet public health itself contributes to the problem through carbon-intensive and polluting activities. What distinguishes public health is that its environmental footprint arises both from activities shared with other scientific disciplines (e.g., laboratory work, computing, and academic travel) and from activities specific to the field, including surveillance systems, mass screening programs, vaccination campaigns, and community-based interventions. In this perspective, we argue that environmental sustainability should be considered a core dimension of research quality and ethical integrity in public health, consistent with the fundamental principle of "do no harm." Embedding sustainability requires both systemic transformation and individual engagement. This includes integrating environmental criteria into funding, governance, and evaluation frameworks, as well as adopting frugal, low-carbon, low-pollution practices in everyday work. Importantly, public health holds a distinctive lever compared with other disciplines. Its preventive mission has the potential to reduce the emissions-intensive burden associated with downstream curative care. In this sense, investing in prevention is also an investment in decarbonization and lower pollution. While acknowledging the complexity of measuring environmental impacts and the primacy of health benefits, we contend that a more sustainable, climate-resilient, and environmentally responsible public health is not a compromise; it is a more coherent, effective, and credible approach.