Mitigating climate-related health risks in Lebanon: implementation of national standards for climate-ready hospitals.

Abstract

Background: Climate change increasingly disrupts healthcare systems worldwide by simultaneously increasing service demand and undermining infrastructure reliability. Hospitals face escalating risks from extreme weather, energy insecurity, and water scarcity, while contributing nearly 5% of global greenhouse gas emissions. These challenges are particularly acute in the Middle East and North Africa (MENA) region, where fragile health systems and resource constraints heighten vulnerability. Lebanon's health sector exemplifies this intersection of climate risk and systemic fragility. This study aimed to develop nationally tailored standards for climate-resilient and environmentally sustainable healthcare facilities in Lebanon, translating international climate-health frameworks into actionable, context-specific guidance aligned with national legal and operational realities.

Methods: A multiphase methodology was applied, including a scoping review of international standards and guidance (WHO, ISO 14001, ISO 9001, ISO 26000), structured consultations with key national and international stakeholders, and synthesis of draft standards into thematic areas. Clauses were aligned with existing Lebanese environmental and health legislation to ensure compliance and to prioritize urgent mandatory actions over longer-term strategic actions.

Results: The resulting standards comprise 10 thematic areas covering governance, environmental management, climate emergency preparedness, community engagement, sustainable procurement, and performance monitoring. Legal screening enabled phased implementation, distinguishing urgent compliance-driven actions from longer-term strategic enhancements. Implementation assessment demonstrated that the standards could guide gap identification, cost estimation, and prioritization of climate-resilience investments at facility level.

Conclusion: Climate-resilient healthcare standards for Lebanon provide a practical framework for strengthening service continuity during climate shocks while reducing the sector's carbon footprint. Institutionalization and MoPH-led enforcement will be essential for long-term uptake.