Environment and Climate
The journey to net zero: Calculating carbon emissions using the AKDN Carbon Management Tool.
The 50 kWh solar energy system at the Aga Khan Medical Centre Salamieh in Syria. AKHS
As a healthcare provider, the Aga Khan Health Services (AKHS) has a particular responsibility to invest in approaches that take care of current patients’ needs while safeguarding the wellbeing of future generations. The hospitals and health centres of AKHS therefore promote actions that deliver quality care and are simultaneously good for the environment.
Good stewardship of the environment is one of the cornerstones of AKDN's ethical framework. Each agency has committed to reducing its greenhouse gas (GHG) emissions and achieving net zero by 2030. Read the AKDN Environment and Climate Commitment Statement.
To support this goal, AKHS has developed the AKDN Carbon Management Tool, a comprehensive carbon footprint calculator designed to enable accounting, monitoring, tracking and reporting of organisational GHG emissions. This carbon management tool has been endorsed by the World Health Organization (WHO) and is publicly available on the WHO website.
To reduce our carbon footprint, we must first measure it. But in 2019, existing tools such as those available for calculating the carbon emissions from electricity and transport were far from intuitive. Many used out-of-date carbon conversion factors or lacked data for countries where AKHS works. AKHS has therefore developed a tool that would work in low- and middle-income countries.
The AKDN Carbon Management Tool can be used by other stakeholders within and beyond the health sector, including NGOs, academia and public institutions, to calculate and manage their carbon emissions in order to promote environmental sustainability and low-carbon operations. It is an all-in-one tool to capture all data sets and work with readily available data. It is simple to use without any prior technical knowledge. It does not require data transfer, but instead functions in a way that educates and empowers users, generating costing information and diagnostic dashboards to help identify hotspots and suggest climate actions for users to consider. Since mid-2020, all AKHS facilities have been using this tool to report quarterly data.
- Download the tool from the WHO-ATACH webpage in English or French, along with a manual. Following review and testing, the WHO endorsed the AKDN Carbon Management Tool, recommended its use, and made it freely available on the website of the WHO’s Alliance for Transformative Action on Climate and Health (ATACH). The tool is accompanied by training videos and a user manual, all packaged and available in both English and French.
- Access the training videos from the AKF Learning Hub. These are open to anyone after establishing a (free) account.
- Read a brief description of the tool.
- See how to use the tool: English written instructions / French written instructions.
- For further information or support, write to [email protected].
Using the AKDN Carbon Management Tool to Evaluate AKHS’s Carbon Footprint
All operations have plans in place to reduce their carbon footprint based on:
- improving energy, fuel and water efficiency;
- transitioning to renewable energy;
- reducing consumption and waste;
- greening the supply chain;
- shifting to environmentally friendly inhalers and anaesthetic gases; and
- instilling behaviour change.
We monitor our carbon footprint through quarterly calculations of emissions related to standard factors such as energy consumption and transport, as well as health-specific items such as anaesthetic gas and inhaler use. Importantly, AKHS also estimates emissions related to procurement, which accounts for between 70 and 90 percent of our total footprint. From 2021 to 2025, Scope 1 (direct) and Scope 2 (indirect, from purchased electricity) emissions showed an adjusted reduction of 53 percent across AKHS operations.
The AKHS Sustainability Guidelines for Staff are freely available to all who wish to use them. These guidelines are offered as open access materials to widen engagement of health workers in the sustainability movement. The guidelines support awareness raising for health workers, provide practical tips and stimulate a culture to champion and innovate solutions for sustainability in health care. The guidelines recognise that developing low-carbon and sustainable health care services requires the involvement of all staff, at every level. Co-benefits of actions include saving precious natural resources, lowering the costs of health care, and enhancing institutional reputation and staff motivation.
To receive a copy of these guidelines, please write to [email protected] with a request for "Staff Guidelines".
AKHS's overall approach to climate-smart and environmentally-friendly health care is based on:
- Emphasising health promotion, disease prevention and primary health care. The aim is to avoid people getting sick in the first place, which in turn, prevents the need for travel, diagnostic and medical interventions – all of which have high costs to patients as well as the environment.
- Using technology to help patients receive information and care close to home. We use – and plan to invest further in – digital health solutions, telephone consultations and telemedicine to support remote diagnosis and consultations. This limits travel needs and also allows for quicker detection and resolution of health problems – all of which are also good for the environment as well as patients. Find out about the AKDN Digital Health Resource Centre.
A teleconsultation at Aga Khan Health Services, Afghanistan (AKHS, A).
AKHS
To overcome barriers to specialised care in remote regions, AKHS, Afghanistan has leveraged eHealth, offering services like teleconsultations, telepathology, teleradiology, and eLearning to bring essential health care closer to underserved communities.
Read more related case studies.
4.1 Eco Design
Eco-design of Aga Khan Provincial Hospital, Bamyan, Afghanistan.
Kiana Hayeri
The Aga Khan Provincial Hospital in Bamyan is designed using special low-impact, rammed earth architecture to be culturally sensitive to the surrounding area, and also climate-friendly, durable and seismic-resistant.
All new facilities are designed to meet the best of possible environmental standards. We are actively retrofitting older facilities, with an emphasis on reducing carbon emissions, air pollution, energy and water consumption. We are also considering preparation and adaptation for more severe weather extremes.
Our architects and engineers have a long-standing tradition of working together to build facilities that fend off the worst of the weather and make full use of natural light and ventilation. These features reduce energy needs for heating, cooling and lighting. New facilities aim to satisfy the requirements for Excellence in Design for Greater Efficiencies or “EDGE” certification.
Major equipment must be energy efficient, and we continually seek better energy solutions for fixtures and fittings, and energy and water consumption. Given our net-zero targets, AKHS hospitals now use LED and sensor-responsive lighting, water efficient taps and toilets, and Energy Star-rated equipment and appliances.
For newer projects, wherever space permits, engineers install rainwater harvesting mechanisms to make the most of rainfall. Treated water is also routinely used for flushing toilets and irrigating grounds. Some facilities have reverse osmosis plants to produce the highest quality drinking water on site – preventing the need to transport potable water, which comes at a high cost to the environment. Plans are in place to install these features at all locations gradually. Wherever possible, and generally for larger projects, heat from generators and other equipment is being considered for heating water and supplementing heating too.
4.2 Insulation of Buildings
Aga Khan Basic Health Centre Chatorkhand, Pakistan, with improved insulation and rooftop solar panel.
AKHS
We are investing in improved building insulation, particularly in countries with extreme seasonal climates such as harsh winters and hot summers. These measures aim to enhance energy efficiency by reducing the demand for heating and cooling, thereby lowering energy costs and associated emissions. Enhanced insulation also helps maintain comfortable, stable indoor conditions for patients and staff, supporting quality care. Ultimately, these efforts contribute to consistent, climate-resilient health care delivery throughout the year, regardless of external conditions.
Read more related case studies.
4.3 Renewable Energy
As part of our commitment to net zero targets, we are investing in renewable energy and improved insulation to reduce our environmental footprint and enhance energy efficiency across our facilities. Renewable energy projects, including solar power and retrofitting initiatives, were implemented at:
- an old facility at the Aga Khan Comprehensive Health Centre in Singal, Northern Pakistan;
- Basic Health Centres in Gilgit-Baltistan, Pakistan;
- the Aga Khan Outreach Health Centre in Kuze, Mombasa;
- Aga Khan Medical Centres in Kisii, Kimilili and Bungoma in Kenya;
- the expanded Aga Khan Hospital Kisumu;
- the Aga Khan Medical Centre Mwanza in Tanzania; and
- the Aga Khan Medical Centre Salamieh in Syria.
Aga Khan Health Services, Afghanistan, has solarised over 120 of its facilities. Other current installations include a 1.35 megawatt-peak solar system at Aga Khan Hospital Dar es Salaam, Tanzania, a 620 kilowatt-peak solar power system at Aga Khan Hospital Mombasa, and more Basic Health Centres in Pakistan. The solarisation project is ongoing, with many more facilities across AKHS planned for inclusion.
For these projects, estimates for solar covering energy needs range from 30 to 90 percent, with cost recovery projections between three and a half to eight years. In the future, we expect even better results as prices of solar installation continue to reduce and technology improves. We have an ongoing work agenda to increase the use of renewable energy and gain energy efficiencies in larger hospitals and field operations. In areas with less sunlight, such as Northern Pakistan, we are exploring geothermal energy prototypes too.
The Aga Khan Medical Centre in Salamieh, Syria, has transitioned from diesel generators to solar power. Initially reliant on 60 KVA and 200 KVA generators, the centre installed a 50 kWp solar panel system in 2022, which now powers most clinical operations, including VRF systems and mammograms, while generators are retained for occasional backup. The system yields significant financial savings and avoids approximately 72 tonnes of CO2e annually.
Read more related case studies.
4.4 Refrigerants
New air conditioning models at AKHS, Mombasa.
AKHS
Electric vehicle at AKHS Dar es Salaam, Tanzania. Sixty percent of the AKHS Tanzania fleet is electric.
AKHS
A large part of the agenda focuses on reducing greenhouse gas emissions through innovations in resource use, waste management, and the procurement of environmentally-friendly items. This includes improvements in energy efficiency, low-emissions transport (shifting to electric vehicles (EVs) and motorbikes or hybrids), water conservation (including recycling, rainwater harvesting and conservative use), and air pollution reduction. It also involves minimising waste through more prudent use of materials and better waste management practices. In addition, a carbon lens is applied to guide purchasing decisions for pharmaceuticals (including anaesthetics and inhalers), medical devices, food, air conditioners (with specific refrigerants and energy efficiency requirements) and other products. Efforts are underway to work with suppliers to identify and address hotspot emissions, while also fostering a culture of environmental sustainability among staff and other stakeholders.
The theatre team at AKHS, Tanzania has significantly reduced emissions from anaesthetic gases by adopting greener alternatives.
AKHS
5.1 Anaesthetics
Many anaesthetics are known to contribute significantly to healthcare’s carbon footprint. As well as being powerful greenhouse gases, some anaesthetic gases are also ozone-depleting substances and as such, also have consequences for skin cancer. Consequently, efforts are underway to reduce emissions from these products.
As part of our net zero plans, we started identifying the types and volumes of gases we were using and making better substitutions wherever possible. As a result, most AKHS health facilities have either stopped or significantly reduced the use of the most potent greenhouse gas ozone-depleting agents, including desflurane and nitrous oxide. We prioritise the use of oxygen/medical air, sevoflurane, intravenous anaesthesia, and regional or local anaesthesia instead of general anaesthesia where clinically appropriate.
We are actively working to reduce the impact of anaesthetic gases by increasing the use of low-flow anaesthesia to minimise gas volumes and, where possible, capturing and reusing these gases.
Read more related case studies.
We are examining ways to use these gases prudently and experimenting with novel techniques which reduce consumption without compromising safety. Often, making such changes also reduces costs.
A group of AKHS anaesthetists are working on implementing changes and sharing lessons learnt across the network. We are also seeking opportunities to share information on the carbon footprint and ozone depletion qualities of anaesthetic gases with anaesthetists in private and public sectors to influence best practice more broadly.
5.2 Inhalers
It is well known that air pollution is a problem in many low and middle-income countries where AKHS works, but what is not known is the fact that some treatments for respiratory illness can contribute to climate change.
In particular, pressurised Metered Dose Inhalers (pMDI) use gases to deliver medications which are potent greenhouse gases. The propellant gases used in pMDI are up to 3,350 times more potent than carbon dioxide as greenhouse gases. A single pMDI, if fully used, can release as much greenhouse gas emissions as a small car driven for 180 miles; a single patient may use more than 12 inhalers a year.
Fortunately, there are alternatives. Some propellant inhalers are better than others for delivering the same type of drug; either they use less propellant or a less damaging propellant. In most cases, dry powder-based inhalers can be just as clinically effective and have a small fraction of the environmental impact. For these reasons, dry powder inhalers are predominantly (90 percent) prescribed in Sweden.
We are committed to reducing our own contributions to air pollution and the carbon impacts of respiratory care including:
- reducing the contribution of all our operations to air pollution (eg through smart choices of fuels used and incineration practices in health facilities);
- reviewing how inhalers are prescribed, dispensed, and used (often inhalers are not fully or properly used, reducing their health benefits and creating unnecessary waste);
- favouring lower-carbon or propellant-free inhaler alternatives where clinically appropriate; and
- disposing of inhalers in an environmentally safe way.
We have started examining the inhalers we were purchasing as part of our net zero plans, and begun an education programme to alert physicians and pharmacists to the relative impacts of different inhalers.
Kitchen green waste is composted at the Aga Khan Hospital, Kisumu (Kenya): the generated manure is used to plant trees within the facility.
AKHS
5.3 Waste Management
Waste management begins with conservative usage and segregating waste. Where possible, we use options such as sterilisation / chemically treating or burying waste in preference to incineration. Additionally, kitchen waste is either used for animal feed or composting, while paper, metallic material, used cooking oil and containers are recycled with certified companies.
When we embarked on the journey to reduce our negative impact on the environment, we reviewed waste management practices to examine room for improvement. Many facilities adopted tactics to reduce the waste burden on landfills or incineration by optimising minimisation at the source, composting, reusing, and partnering with recyclers.
Hospitals and health facilities use incinerators to burn hazardous waste. We ensure that we conduct incineration in the most energy-efficient and environmentally friendly way. This starts with training. Without training and support, operators tend to burn more waste than they should.
For waste that has to be burned, we ensure that each incineration cycle uses the full capacity of the incinerator, limiting wasted space. This practice maximises the use of energy and greatly reduces the amount that is burnt.
We offer freed-up incinerator space to other health facilities and provide training for other hospitals. Gilgit Medical Centre in Northern Pakistan offers incineration services to private health operations as well as the regional government hospital. In the process of these collaborations, better waste management by all partners has been the result. We have calculated that the environmental benefits far outweigh the cost of transporting waste to this central facility. We hope to continue to expand best practices in waste management and incineration within our countries of operation.
As technology improves, we replace old incinerator units with those that are better designed in terms of energy use and air pollution. Our latest installation at Dar es Salaam is one of the very highest of fuel-efficient, minimised pollution designs rated for medical, municipal and animal waste incineration.
Promoting recycling at the Aga Khan Hospital Mombasa, Kenya.
AKHS
5.4 Progress Indicators
When monitoring carbon emissions, organisations often face challenges in accurately reflecting operational changes within their reporting. For example, expanding services by adding new hospitals will naturally increase total emissions, while closing facilities will reduce them. However, these fluctuations do not necessarily indicate meaningful progress in emission reduction efforts.
To address this, we have developed a set of intensity-based indicators that account for operational activity. These indicators provide a more accurate way to track emission performance over time and can be used alongside absolute emissions to better reflect real progress in reducing environmental impact.
Generally, two levels of indicators are required to monitor carbon emissions and take into account operational activity:
- Facility-level indicators
These indicators are used to assess emission sources and evaluate the results of targeted interventions at facility level. - Normalised intensity-based indicators
These indicators account for differences between operations and changes over time. They help to adjust emissions for real operational activity, so that changes like expansion or closure of hospitals do not distort performance results.
Please contact us if you would like further information on how AKHS measures progress.
Read more related case studies.
As we progress with measurement and actions to reduce carbon emissions across our own operations, we also learn from and share our experience with others within and beyond the health sector. We strategically collaborate to disseminate our expertise and tools, including to local governments, academia, partners, and WHO. This collaboration involves conducting online sessions and actively participating in various fora, such as the UNFCCC Conference of the Parties (COP) and the Alliance for Transformative Action on Climate Change and Health (ATACH).
Through direct engagements and in partnership with WHO, representatives from Ministries of Health and Environment from over 60 countries worldwide have received orientation training on using the AKDN carbon management tool and on how to plan actions to align with the UNFCCC COP26 Health Programme commitments to develop climate-resilient, sustainable, and low-carbon health systems.
In 2025 we were nominated to lead the NGO constituency within ATACH, supporting the implementation of its 2024-2028 strategic plan.
We engage with communities and health systems to support adaptations to, and withstand the consequences of, extreme weather events. As we implement actions, we will continue to use our voice as health advocates to increase attention to the climate agenda and influence policies and practice at local and global levels.
6.1 Awards Received by AKHS
We have received several awards for our net zero work and the innovative AKDN Carbon Management Tool for monitoring carbon emissions, earning recognition at local, national, and international levels. These include:
- Green Hospitals – Silver Award, International Hospital Federation (IHF), for AKHS, Pakistan (2022);
- the Energy Globe National Award, Kenya, for AKHS, Kenya (2022);
- the Environment Institute of Kenya – Nyanza Region, for the Aga Khan Hospital, Kisumu, Kenya (2022);
- Access to Energy (A2E), for the Medical Centre in Mwanza, Tanzania (2021); and
- the Prince Sadruddin Aga Khan Fund for the Environment, for projects at the Health Centre in Singal, Northern Pakistan.
6.2 Publications
The following publications highlight key contributions by AKHS and our partners in advancing sustainable healthcare practices, including the broader impact of the AKDN Carbon Management Tool in supporting low-carbon strategies across the health sector.
- Decarbonising healthcare in LMICs: potential pathways to net zero emissions
BMJ 2021; 375. - The AKDN’s approach to supply chain carbon foot printing
Cleaner Logistics and Supply Chain, 2023. - Cleaning up plastics in healthcare waste: the transformative potential of leadership
BMJ Innovations 2023. - Evaluating progress and accountability for achieving COP26 Health Programme
Lancet Planetary Health 2024. - Establishing carbon management systems to reduce emissions in healthcare
SSRN 2024. - Implementation of a novel greenhouse gas emissions monitoring system in 219 health-care facilities across 7 countries
SSRN 2026. - Measurement framework for accelerating the transition to sustainable health care
The Lancet Planetary Health, 2026.
Digital health and low-carbon technologies
Afghanistan – Digital health PDF
Aga Khan Health Service, Afghanistan (AKHS, A) links its main hospitals in Afghanistan with outlying health centres in 10 districts, some of them up to 21 hours' drive from a hub hospital. The system supports teleradiology, live teleconsultation, telepathology and eLearning. Between January 2020 and October 2024, it served around 18,000 patients, sparing them an estimated 11.3 million kilometres of travel and $397,000 in transport costs. AKHS, A estimates this avoided 1,600 tonnes of CO2e from public transport use. Around 5,800 staff have been trained through eLearning. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Afghanistan – Digital imaging PDF
At Bamyan and Faizabad Provincial Hospitals, Aga Khan Health Service, Afghanistan is moving X-ray reporting from printed plastic film to digital images that doctors can view directly from a shared server. Since committing to strengthen existing efforts in digital X-ray reporting in 2022, annual film printing reduced by mid-2025 by 99 percent at Bamyan and by 67 percent at Faizabad. The two hospitals now save around $45,000 and 820 kg of plastic a year. The change paid for itself in under a year. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Energy-efficient cooling
Pakistan – Environmentally friendly air conditioners (AC) PDF
Aga Khan Health Service, Pakistan (AKHS, P) is replacing older air conditioners that use R22 and R410A refrigerants, both with high global warming potential, with more efficient units that use R32. Rewriting their procurement criteria to favour energy savings and lower environmental impact has helped raise the number of local vendors offering R32. In 2023, AKHS, P replaced three-quarters of its R22 units thereby reducing emissions by approximately 61percent per kilogram of refrigerant, and a fifth of its R410A units thereby reducing emissions by approximately 40 percent per kilogram of refrigerant. Bills are expected to be up to 30 percent lower than for the old ones due to lower power consumption. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Low-carbon clinical practices
Tanzania: Reducing carbon emissions from anaesthetic gases PDF
Aga Khan Health Service, Tanzania has cut emissions from anaesthetic gases across the six operating theatres at its hospitals in Dar es Salaam and Mwanza. From early 2023, anaesthetists phased out nitrous oxide as a carrier gas, using oxygen and medical air instead, and replaced isoflurane with sevoflurane. Anaesthetists also use regional or local anaesthesia instead of general anaesthesia where clinically appropriate. Emissions from anaesthetic gases fell by 44 percent in 2023 compared with 2022, while surgical cases fell by only three percent. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Renewable energy
Since 2022, Aga Khan Health Service, Afghanistan (AKHS, A) has fit solar power to 123 of its 235 facilities in Bamyan, Badakhshan and Kabul provinces in Afghanistan, including offices, sub-health centres and hospitals. This was achieved with the generous support of UNDP. These facilities previously used an estimated 302,000 litres of diesel a year. Solar now meets around 48 percent of these facilities' energy needs. The installations total 774.9 kW and all have batteries, with 1,663.2 kWh of storage between them to keep services running. AKHS, A estimates the change to save $276,000 in running costs and avoid 815 tonnes of CO2e each year. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Afghanistan – Solar refrigerators PDF
Since 2022, Aga Khan Health Service, Afghanistan (AKHS, A) has installed solar direct-drive vaccine refrigerators at each of the 309 immunisation centres it runs in Badakhshan, Bamyan, Takhar, Baghlan and Kabul provinces in Afghanistan. They replaced fridges that ran on liquefied petroleum gas (LPG), which was expensive and in erratic supply. Immunisation programmes can now reach areas lacking electricity. Each fridge runs on two solar panels, uses R600a, a refrigerant with low global warming potential, and has remote monitoring of storage conditions in real time. AKHS, A estimates the change to save about $54,000 on LPG and avoid around 131 tonnes of CO2e annually. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Afghanistan – Solarisation Bamyan Provincial Hospital PDF
Aga Khan Health Service, Afghanistan (AKHS, A) has run Bamyan Provincial Hospital in Afghanistan since 2004, when it had 35 beds, 15 of them in a tent powered by a diesel generator. In 2013 AKHS, A built a new 141-bed, earthquake-resistant hospital with the generous support from Aga Khan Foundation Canada and the governments of Canada and France. In 2016 it added a 400 kW solar plant, now backed by 720 batteries holding 2,160 kWh. Solar supplies about half the hospital's electricity consumption, saving approximately $270,000 and 130,000 litres of diesel a year, and avoiding about 350 tonnes of CO2e. The plant paid for itself within seven years. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Afghanistan – Transition from generators to hydropower PDF
In 2022, Faizabad Provincial Hospital, a 180-bed hospital run by Aga Khan Health Service, Afghanistan, has transitioned from running on four diesel generators to a 1,000 kVA transformer and transmission poles. These connect the hospital to the city's grid, which is fed by hydropower from the Shurabak dam. Diesel use fell by 96 percent, from around 360,000 litres in 2021 to 14,000 litres in 2023. Operating costs fell by approximately 44 percent, saving $147,560 a year and avoiding 928 tonnes of CO2e. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Kenya-Kisumu – Hospital and health centres solarisation PDF
Between April and June 2023, solar systems were installed at Aga Khan Hospital Kisumu (230 kWp), at Kisii Medical Centre (39.2kWp), Bungoma Outreach Health Centre (29.4 kWp) and Kimilili Outreach Health Centre (14.2 kWp). By the end of March 2025, the four systems had generated around 746,000 kWh, saving approximately $147,000 and avoiding about 80 tonnes of CO2e. Diesel use by backup generators fell by an average of 10 percent in 2024 compared with 2023. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Kenya/Mombasa – Hospital solarisation PDF
Aga Khan Hospital Mombasa has fitted a 620 kWp solar photovoltaic system to cut the cost and carbon of running clinical services such as theatres, labour rooms, imaging, Accident and Emergency and air conditioning. Power switches between solar and the existing grid without interruption. Between its completion in November 2025 and the end of June 2026 it generated 491 MWh, a third of the hospital’s electricity, saving approximately $94,000. Aga Khan Hospital Mombasa expects annual savings of around $141,000 and 61 tonnes of CO2e avoided, with payback in about three years. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Pakistan – Solar power and insulation PDF
Aga Khan Health Service, Pakistan (AKHS, P) runs Basic Health Centres across remote parts of Gilgit-Baltistan and Chitral region, where winter temperatures fall below freezing and grid power is unreliable. The centres at Chatorkhand and Gulmit had run on unreliable grid supply, a diesel generator and firewood, with poor insulation making winter hard on women giving birth there. AKHS, P has fitted both with a 10 kW solar system, 10 kWh of battery storage and improved insulation. At Gulmit, grid use fell by an estimated 49 percent between 2022 and 2025, the diesel generator is gone and firewood use is down 61 percent. Energy costs have fallen by 34 percent and carbon emissions by 46 percent, about 1 tonne of CO2e. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Aga Khan Health Service, Syria (AKHS, S) has transformed the Aga Khan Medical Centre in Salamieh from diesel generators to solar power. Since 2022, the 102 panels with a total capacity of 50 kWp provide enough electricity for heating, cooling, mammography and X-ray on most days. Generators stay on standby for cloudy winter days and busy clinics. AKHS, S expects the system to pay for itself within five years and avoid around 72 tonnes of CO2e a year. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Tanzania – Solar power PDF
Aga Khan Health Service, Tanzania (AKHS, T) has fitted solar systems to three facilities: Aga Khan Hospital, Dar es Salaam (1,353 kWp), Mwanza Hospital (137 kWp) and the Dodoma outreach centre (50 kWp). The Aga Khan Hospital, Dar es Salaam had run on grid electricity and generators, from diagnostics to refrigeration, which accounted for more than 70 percent of its Scope 1 and 2 emissions. Work began in September 2024 and finished in May 2025. Between the last quarter of 2024 and the end of June 2026, the three systems generated 2,563 MWh, saving around $154,000 and avoiding about 937 tonnes of CO2e over those 21 months. AKHS, T expects payback in about 8.6 years. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Sustainable transport
Tanzania – Electric vehicles PDF
Aga Khan Hospital, Dar es Salaam, run by Aga Khan Health Service, Tanzania (AKHS, T), has been using electric vehicles to reduce diesel usage since 2024. With its current fleet of five electric vehicles, AKHS, T projects annual savings of approximately $22,000 in fuel cost and avoidance of around 36 tonnes of CO2e. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Syria – Greening the transport fleet PDF
In December 2023, Aga Khan Health Service, Syria bought its first hybrid vehicle, a Toyota RAV4 used at the Aga Khan Medical Centre in Salamieh, as a first step towards cutting its fleet's fuel use. Compared with the petrol car it replaced, the hybrid is expected to use around 57 percent less fuel, saving about $6,583 and 9.3 tonnes of carbon emissions a year. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Tree planting and greening initiatives
Kenya/Mombasa – Restoration of mangrove forests PDF
Between 2019 and 2022, Aga Khan Hospital Mombasa has restored around 3.9 hectares of mangrove forest along Tudor Creek, planting almost 12,000 seedlings of three native species. The hospital started the work in response to the Kenyan government's 2018 call for a national tree-planting drive, and chose sites with scientists using satellite imagery and aerial photography. Partners include the Aga Khan Foundation, Kenya Forest Service, Mombasa County Government, Diamond Trust Bank, and local schools and community groups. Mangroves supply coastal communities with fish and honey, protect shorelines from erosion, storms and flooding, and can store up to five times more carbon than forests on land, partly in their root systems.
Waste management
Kenya/Kisumu – Composting kitchen waste PDF
Since 2019, Aga Khan Hospital Kisumu in Kenya has cut its kitchen waste by adjusting menus and portion sizes, and swapping fizzy drinks for fruit juice made in-house. The hospital kitchen has also diverted kitchen organic waste from landfill by composting green waste and using suitable food leftovers as animal feed. The compost generates manure, which is used in the hospital's gardens and for tree planting. These steps remove an estimated 3.2 tonnes of waste a year and avoid around 2.9 tonnes of CO2e. The hospital no longer needs to buy manure, and pays less to have waste taken away. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.
Tanzania – Minimising kitchen waste PDF
Aga Khan Hospital, Dar es Salaam, which serves around 2,000 meals a day to patients and staff, cut its kitchen waste by nearly 65 percent between January 2023 and January 2024, from around 6,200 kg to 2,200 kg. Kitchen staff trained in more economical peeling and trimming, suppliers began delivering meat and fish ready-prepared, and kitchen staff matched portions to what patients wanted. Suppliers also take back leftovers and trimmings for animal feed. The reduction avoided an estimated 4.06 tonnes of CO2e from landfill. Switching to large water bottles and reusable glass jugs cut the hospital's use of 350 ml single-use plastic bottles by 97 percent, from almost 111,400 a year to 3,000. Carbon emissions were calculated using the WHO-endorsed AKDN carbon management tool.