Healthcare accounts for 5-7% of global carbon emissions, which equate to approximately all or the emissions from either Japan or Russia. A large part of those carbon emissions come from the manufacturing of medical devices and pharmaceuticals (‘Procurement’). This provides tremendous opportunities for us to drive how the medical technology industry designs and produces these goods in order to reduce carbon emissions. We must take responsibility for the entire life-cycle of what we consume in the delivery of healthcare – This responsibility is termed ‘Product Stewardship’. However, there is a general lack of Governance in sustainable healthcare delivery. Healthcare workers, hospital administrators and government themselves lack awareness of our shared responsibilities in this area. As clinicians the lowest carbon footprint clinical test is the omission of unnecessary tests. In many ways low-middle income countries lead the way here as they have never embraced the super-cycle of high turnover disposable waste. As institutions like the Canadian Medical Association, the UK NHS and the Lancet Countdown commit to NetZero healthcare by 2050 we must demand the same from our medical device and pharmaceutical partners. Our first premise has always been “First do no harm”. For more head to: codachange.org/podcasts