Can One Health help reduce the environmental impacts of the healthcare system in Switzerland? Insights from an interdisciplinary focus group

Healthcare systems contribute to about 5% of the emissions of the greenhouse gases globally when taken together. With 6.7% of its national emissions of greenhouse gases, the Swiss healthcare system is among the biggest contributors worldwide when taken per capita. Although isolated initiatives to reduce environmental impacts have emerged these last years, there is a strong need for better understanding the barriers and the possibilities for a heuristic framework like One Health to facilitate transformation, in particular in the Swiss context. The main objective is to explore to what extent One Health can facilitate transformation of the Swiss healthcare system and a secondary objective is to examine the role of bioethics in reducing healthcare's environmental impact. A focus group was conducted with nine experts from different disciplines (medicine, environment, veterinary medicine, public health) at the premises of the Swiss Medical Association in Bern on January 27th, 2025. The discussion lasted 180 min and was audio-recorded. Verbatim was transcribed and analyzed using thematic analysis following COREQ guidelines. Three additional individual interviews were conducted with participants who were not able to attend the focus group. Six key themes emerged: the need to reorganize healthcare delivery, the specificity of the Swiss governance system, the need to adopt solutions that are “good enough”, One Health as a heuristic framework for systemic change, the required expansion of the borders of bioethics to include environmental and animal welfare considerations and the possible tensions between different dimensions within the One Health framework. Integrating environmental perspectives through a One Health approach is a possible solution to reduce the environmental impacts of the Swiss healthcare system. The study identifies both barriers (complexity of the Swiss healthcare system, siloed departments) and opportunities (professional willingness to collaborate, the development of post-Covid initiatives) for implementing sustainable healthcare transformation in Switzerland.