Open letter from health professionals on the plastics treaty

Over 18 million health professionals, represented by 63 health organizations across 88 countries, and more than 1,000 individual signatories, urge plastics treaty negotiators to protect both the planet and patients in an open letter.

April, 2024

Distinguished Delegates and Chair of the International Negotiation Committee for a Plastics Treaty,

As health professionals who have taken an oath to the ethical principle to first do no harm, we are committed to health and well-being for all. Plastic poses an ongoing crisis for human and planetary health, which will inevitably worsen with the planned dramatic increase in plastics production, unless global action is taken. 

We urge delegates to commit to a just and equitable Treaty that respects human rights, limits the production of plastics, eliminates unnecessary plastics products including single use plastic, prioritizes detoxification, and ensures transparency of plastic products and materials. Actions throughout the full life cycle of plastics is necessary to eliminate the harmful effects from production, use, recycling, and disposal of plastics and to protect human and planetary health. 

We call on delegates to develop an ambitious and just Treaty to end plastic pollution, including in the health sector. The health sector requires special consideration in the Plastics Treaty, not an exemption. A blanket exemption is inconsistent with the health mission of the sector, and would inhibit innovation and momentum for plastics reduction, reuse, and redesign. It is contrary to growing global efforts for a sustainable health sector.

Plastics have become ubiquitous in healthcare, with a dramatic shift towards single-use items in recent decades (e.g. tubing, examination gloves, catheters, intravenous infusion devices, transfusion sets, diagnostic equipment, gowns, etc). However, many non-essential uses of plastics in the health sector can be eliminated, including non-medical applications (e.g. maintenance, food, interiors, office). Essential uses of plastics can often be detoxified and designed for reuse. 

Therefore, we appeal to governments to consider a program of work on plastic products in the health sector, to be further developed, in alignment with other international initiatives on health and chemicals, wastes, greening the supply chain and climate.

There are health impacts at each stage of the plastics life cycle. Plastics used in health care require thousands of hazardous additives (including carcinogens, neurotoxicants, endocrine disruptors) that can leach from products and waste, and persist in the environment, threatening patients, communities, workers (including waste workers), and ecosystems. Exposure to hazardous chemicals from plastic is a particular concern for vulnerable patients including fetuses, newborns, and young children. This toxicity and chronic exposure represents a significant burden of care for the health system around the world. In addition, the lack of full product ingredient information impedes efforts to reuse, recycle, and to move to safer alternatives. Transparency and traceability of hazardous chemicals in healthcare products and articles is therefore essential to speed up the redesign and detoxification of plastic products.

Plastics, and their chemical additives are primarily made from petrochemical feedstocks. Reducing our dangerous dependence on fossil fuel-based plastics will help limit global warming and the further degradation of the planet’s ecosystems. Failing to do so will lead to dire health consequences, and the loss of key natural resources and ecosystem services critical to both human and non-human species health, undermining One Health and planetary health.

Communities, health workers and health systems already face the alarming impacts of plastics production and pollution. The worst impacts of plastics’ production and disposal are not equally distributed, but instead are concentrated in the most vulnerable and under-resourced communities. The treaty should uphold the universal right to a clean, healthy, and sustainable environment, and address the human rights impacts of each stage of plastic production and waste management. 

We welcome the resolution WHA76.17 and the report by the Director-General of the World Health Organization (WHO), which recognize the health sector’s “critical role and unique expertise to contribute to the sound management of chemicals and waste and protecting from their harmful impacts on health and well-being”. From reusable textiles and medical devices, to the elimination of unnecessary single use products, health care providers are transforming the sector and have a critical role to play in reducing the public health threat by addressing plastic use and seeking safer alternatives.  

We cannot rely on false solutions like chemical recycling that extends unsustainable plastic use and reliance on fossil fuels, which do not generate real health improvements. Only a significant reduction in plastic production and use can do that. 

As doctors, nurses, researchers, health care professionals, and associations, we have a moral and professional obligation to prevent harmful exposures to hazardous chemicals from plastics in the health sector. We commit to continuing action to protect human health, and urge your commitment to a Treaty that strongly supports health, human rights and justice. A Treaty that protects the planet is also a Treaty that protects our patients. 

Sincerely,

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Please refer to supporting information and resources for evidence on each of the arguments.

Health associations

  • Alliance of Nurses for Healthy Environments, 

  • Armenian Women for Health and Healthy Environment (AWHHE), 

  • Asociación Colombiana de Patología,

  • Asociación Colombiana de Salud Pública,

  • Asociación de Bacteriólogos Javerianos

  • Asociación Latinoamericana de Cirugía Endoscópica,

  • Asociación Mexicana de Cirugía Endoscópica,

  • Asociación Mexicana de Cirugía General,

  • Association Française de Pédiatrie Ambulatoire (AFPA)

  • Associação pela Saúde Emocional de Crianças_ASEC, 

  • Association of Anaesthetists, 

  • California Nurses for Environmental Health and Justice, 

  • Canadian Association of Nurses for the Environment,

  • Canadian Association of Physicians for the Environment (CAPE), 

  • Canadian Federation of Medical Students Health and Environment Adaptive Response Task Force,

  • Center for Public Health and Environmental Development (CEPHED), Nepal,

  • Center for Sustainable Hospitals, Denmark

  • Centro Estatal de Vigilancia Epidemiológica y Control de Enfermedades (CEVECE) México,

  • Climate Code Blue,

  • Climate and Health Alliance,

  • Climate Psychiatry Alliance,

  • Colectivo Cero Desabasto, 

  • Colegio Nacional de Bacteriología, Colombia

  • Collaborative for Health and Environment (CHE)

  • Congregations of St Joseph, an NGO at the United Nations

  • Diaverum, Spain,

  • Doctors for the Environment Australia, 

  • Empowered At Dusk Women's Association Uganda

  • Endocrine Society, 

  • Environmental Health Project, 

  • European Confederation of Primary Care Paediatricians

  • Global Climate and Health Alliance

  • Global South Coalition for Dignified Menstruation, Nepal 

  • groundWork, Friends of the Earth South Africa,

  • Health Care Without Harm

  • Health Environment and Climate Action Foundation (HECAF360)

  • Instituto de Salud Socioambiental FCM UNR Argentina

  • Instituto Nacional de Salud Pública de México

  • International Federation of Medical Students Associations

  • International Society of Doctors for Environment, ISDE

  • Italian Cultural Association of Pediatricians

  • Lanakaná, Brazil 

  • Medical Society Consortium on Climate and Health,

  • Medical Students for a Sustainable Future,

  • Médicas y Médicos Por La Nación, México,

  • Michigan Clinicians for Climate Action, 

  • National Association of Hispanic Nurses – Denver Chapter, 

  • National Association of Pediatric Nurse Practitioners, USA

  • National League for Nursing, USA

  • Philippine Academy of Family Physicians - Special Interest Group on Planetary Health

  • Philippine Medical Association, 

  • Philippine Society of Nephrology

  • Philippine Society of Public Health Physicians

  • Physicians for Social Responsibility, San Francisco Bay

  • Physicians for Social Responsibility, Maine

  • Physicians for Social Responsibility Oregon

  • Physicians for Social Responsibility, Pennsylvania

  • Physicians for Social Responsibility, Texas

  • Physicians for Social Responsibility, Washington

  • Planetary Health, Kenya

  • Planetary Health Eastern Africa Hub

  • Projeto Hospitais Saudáveis, 

  • Radiologists for a Sustainable Future, 

  • Santa Clara County Medical Association, USA

  • Society of Latinx Nurses (SOLN)

  • Sociedad Española de Farmacia Hospitalaria 

  • SPDM Associação Paulista para o Desenvolvimento da Medicina, Brazil

  • Swiss Medical Association,

  • The Centre for Sustainable Healthcare

  • The Environmental Health Leadership Foundation

  • The Finnish Association of Lifestyle Medicine

  • The Maryland Psychiatric Society

  • Tzu Chi Medical Foundation, 

  • UK Faculty of Public Health,

  • UK Health Alliance on Climate Change

  • University College London Hospitals NHS Foundation Trust

  • Veterinary Sustainability Alliance, 

  • World Federations of Public Health Associations

  • World Medical Association

Health care facilities and systems

  • Cejam-hospital geral de Itapevi, Brazil

  • Clínica San Rafael, 

  • Clínica santa María de Guadalupe, 

  • Dime clínica Neurocardiovascular

  • E.S.E. Hospital Departamental Universitario Santa Sofía de Caldas, 

  • ESE Hospital San Rafael de Pacho

  • Fundacion Hospital Municipal Leonidas Lucero FUNDHALL, Argentina

  • Fundación Hospital San Pedro (Horacio Andrés Mora Bucheli) 

  • Fundación Santa Fe de Bogotá, 

  • Hospital D'María, Veracruz, 

  • Hospital Estadual Americo Brasiliense, 

  • Hospital Estadual Serrana - FAEPA HCFMRP-USP, 

  • Hospital General Salvatierra, 

  • Hospital Monseñor Sanabria, Caja Costarricense de Seguro Social

  • Hospital Municipal Otumba Bicentenario, Mexico

  • Hospital Municipal Temoaya, 

  • Hospital Zonal Cutral Co Plaza Huincul, 

  • Ministerio de Salud de Perú

  • Subred Integrada de Servicios de Salud Norte E.S.E., 

  • Unimed Vitória, Vitória. Espírito Santo. 

Other supporting organizations

  • AbibiNsroma Foundation

  • Achievers Ghana

  • Action for Liberty and Economic Development 

  • Africa Rise Foundation 

  • Angels of Hope, South Africa

  • A Plastic Planet and Plastic Health Council

  • ACT Promoção da Saúde, 

  • Asociación Ecológica Santo Tomás, A.C., 

  • Association For Promotion Sustainable Development, India

  • Bertha Centre for Social Innovation and Entrepreneurship, University of Cape Town, 

  • Canadian Child Care Federation (CCCF),

  • Canadian Community of Practice in Ecosystem Approaches to Health (CoPEH-Canada)

  • Canadian Environmental Law Association

  • Canadian Partnership for Children's Health and Environment, 

  • Center for International Environmental Law (CIEL)

  • Centro de Estudos e Pesquisas (CEJAM)

  • CES Technology SAS, Colombia

  • Child & Social Development Foundation, Siri Lanka 

  • Children and Young People Living for Peace (CYPLP) Nigeria

  • Colectiva Malditos Plásticos México

  • Collaborative Coalition Against Community Challenges (CCACCH)

  • Community Action Against Plastic Waste (CAPws), 

  • Community Health Empowerment Organisation Limited Uganda (CHEEO),

  • Earth Island Institute Asia-Pacific

  • ECOCITY, 

  • Environmental Investigation Agency (EIA)

  • Fossil Free 

  • Fundación El Árbol, 

  • Fundación FAMICINE, Festiverd, Venezuela

  • Fund SAF-TESO , Uganda

  • GAIA Africa (Global Alliance for Incinerator Alternatives Africa)

  • Gallifrey Foundation, Switzerland

  • Girlkind Kenya 

  • Global Alliance for Incinerator Alternatives (GAIA)

  • Grambangla Unnayan Committee, Bangladesh

  • Health and Environment Justice Support (HEJSupport)

  • Human Environmental Association for Development, 

  • Humanitarian Enhancement Aid for Resilient Transformation-HEART, Bangladesh

  • Instituto Movive, Brasil

  • International Youth Council-Yemen (IYCY)

  • Investors for Social Change Innovation (ISCI), Cameroon

  • IRO Organization for Community Development, Iraq

  • La Red de Acción en Plaguicidas y sus Alternativas para América Latina (RAP-AL) Uruguay

  • Local Sustainable Communities Organisation (LOSCO), Uganda

  • Minderoo Foundation

  • Nawat organization, Syria

  • Network Advancement Program for Poverty and Disaster Risk Reduction (NAPPDRR), Nigeria

  • Occupational Health, Safety and Environment Foundation (OSHE foundation), 

  • Oceana, Brazil

  • One Million Trees 4 Kilifi, Kenya 

  • Projeto Saude e Alegria, 

  • Reacción Climática, Bolivia

  • RSK Group Ltd, 

  • Red de Acción por los Derechos Ambientales (RADA), 

  • ReThink Plastic

  • Sisters of St Joseph of Carondelet 

  • SSF - Sustentabilidad Sin Fronteras, 

  • Stichting Huize Aarde, 

  • Street Youth Connection Sierra Leone (SYC-SL)

  • Sustainable Community Development Hub, 

  • Thesambas Community Based Foundation 

  • Trash Hero World

  • Tree Adoption Uganda 

  • Voice for Disabled People Association (VDPA), 

  • WALHI/Friends of the Earth Indonesia,

  • WECF International,

  • Women's Healthy Environments Network, 

  • Women Unlimited Eswatini

  • WoodSafe Sustainable Solutions

  • Youth and Women For Opportunities Uganda

  • Youth Organization for Hope and Care Zanzibar 

  • Zero Waste Society, Ukraine