Energy and cooling efficiency

Demonstration projects in health care facilities.

Cooling is responsible for 7% of global greenhouse gases (GHG) emissions - and the health sector is a large consumer of cooling services. Several critical aspects of health care delivery are contingent on cooling, such as the conservation of cold chains for vaccines, food, or drugs, the maintenance of operational temperatures for medical equipment, and setting comfort temperatures for patients and staff, to name some. 

The Kigali Cooling Efficiency Program (K-CEP) addressed this problem via energy audits focused on cooling in hospitals in Argentina, China, and the Philippines. K-CEP was funded by the ClimateWorks Foundation and implemented by Health Care Without Harm and its partner the Rock Environment and Energy Institute (REEI).

A phased approach

The project was implemented between 2019 and 2021. Stage 1 included the setting of the project, audits, and the facilities’ action plans, while Stage 2 was dedicated to the piloting of energy efficiency projects.



Selected hospitals


  • Dr. J. P. Garrahan Hospital, Buenos Aires.
  • Rosario Outpatient Medical Specialties Center (CEMAR), province of Santa Fe.
  • Hospital Dr. José Giordano of Albardón, province of San Juan.



  • Beijing Ditan Hospital, Beijing.
  • Qinhuangdao Maternity and Children Hospital, province of Hebei.
  • Beijing Huilongguan Hospital, Beijing.
  • Beijing Fuwai Hospital, Beijing.


The Philippines 

  • Amang Rodriguez Memorial Medical Center, Metro Manila.
  • Philippine General Hospital, Manila.
  • St. Paul's Hospital of Iloilo, Panay Island.

* Hospitals in bold were selected to implement the demonstration projects

The audits were conducted in 2019, and the final reports informed on each hospital’s energy use profile, the characteristics of the cooling equipment and refrigerants, opportunities to improve the system's efficiency, and a list of general and specific recommendations for a more efficient and clean operation. 

Based on these results, all the hospitals implemented plans for cooling optimization that included:

  • Creation of energy committees or energy manager positions.
  • Development of training and communication programs.
  • Processes to improve energy consumption measurement and access to information.

At the end of Stage 1, one hospital in each country was selected for a demonstration project.

Demonstration project

The project was based on two pillars: installing renewable energy generation devices, and improving the efficiency of the building. Knowing that solar radiation in the state of San Juan is one of the highest in the world, photovoltaic panels were installed at the facility.

The audit identified that the skylights were the biggest climate-design problem since high-intensity solar radiation leads to increases in temperature, overheating, and glare. The solution was to add reflective films over the skylight’s glasses to minimize the passage of solar radiation to the room, combined with the installation of plant protection using deciduous plants, that have a similar function during summer and spring but allow the passage of sunlight during winter.

The first part of the project was completed by early 2021, and the hospital became the first health care facility in the state of San Juan to use solar energy. After the complete implementation of the renewed skylights system, consultants estimate a 10% reduction in the hospital's energy consumption.

The project focused on improving the cooling efficiency by commissioning a report on the air conditioning system of two of the most relevant buildings of the facility. Consultants conducted a deep and sectorized analysis of the operation of the equipment, to detect modifiable aspects that would improve its efficiency. 

After the exhaustive study of the system, some parameters were modified and these changes had a direct impact on the reduction of energy consumption without affecting its operation or the quality of the health care delivery.

Based on the results of the audit, authorities decided to focus on information and strengthen their measurement system. By purchasing energy consumption monitoring equipment, the hospital will implement a program that provides specific electricity consumption data by type of equipment, sector, and end-use. 

The goal is to obtain detailed information to identify energy-intensive areas, inefficient sectors, determine the performance of cooling equipment and whether they need to be replaced or not. This information can also be used to estimate the economic and environmental benefits of efficient and climate-smart cooling.

Results and next steps

The Final Report presents comprehensive information about the project and the case studies explain details of the pilots implemented at Dr. José Giordano Hospital of Albardón (Argentina), Beijing Huilongguan Hospital (China), and the St. Paul´s Hospital of Iloilo (Philippines). 

A sample Terms of Reference was developed for facilities that want to conduct energy audits, as well as a Checklist to assess the center's work in cooling and energy efficiency.

The results and tools created are coordinated with other Health Care Without Harm initiatives such as the Climate Impact Checkup for health care facilities and the Sustainable Health in Procurement Project (SHiPP).



Note: the Kigali Cooling Efficiency Program (K-CEP) changed its name to the Clean Cooling Collaborative.