Legal Frameworks for Planetary Health in Germany

Where does the existing legal framework already allow for the consideration of ecological sustainability in the healthcare sector? How would it need to change to better enable and promote it? And do current laws perhaps even hinder efforts toward more sustainable practices in healthcare?

These questions guide the cooperation between the Institute for Medical Law at Bucerius Law School in Hamburg, the German Alliance for Climate Change and Health (KLUG), and the Centre for Planetary Health Policy (CPHP). The collaboration focuses on identifying key legal levers, with particular attention to strengthening sustainability in the pharmaceutical and medical device sectors, which account for a substantial share of the healthcare system’s ecological footprint. Another priority is to explore the legal prerequisites for integrating the Planetary Health perspective more strongly into prevention and public health policy.

Project Objectives

The aim of the cooperation between the Institute for Medical Law at Bucerius Law School in Hamburg, the German Alliance for Climate Change and Health (KLUG), and CPHP is to identify important drivers, barriers, and potentials for Planetary Health in medical and health law, and to synthesise recommendations for decision-makers. These findings are disseminated and further developed through expert discussions, events, and publications within the sector and among policymakers.

Methodology

Following an initial analysis of priorities and policy windows relevant to the cooperation, Maren Sowa (Bucerius Law School) and Dorothea Baltruks (CPHP) organised a roundtable with experts on sustainability in the pharmaceutical sector. Insights from these discussions and accompanying background research informed a policy brief, published in early 2023, which attracted considerable attention in professional media and across the sector.

From the outset, the team also examined how the principle of economic efficiency under the German Social Code (SGB V) could be supplemented, accompanied, or expanded by a principle of sustainability. Professor Dr Jens Prütting, Chair of Civil Law VII – Civil, Medical and Health Law at Bucerius Law School, and Dr Max Hügel, Academic Councillor for Public Law at the University of Greifswald, published a legal analysis on this topic.

In parallel, an intensive exchange was initiated with health insurance funds and associations interested in the topic, leading to joint analyses and discussions on potential future amendments to the German Social Codes.

Public health structures in Germany also form an important part of the cooperation. Together, the partners analysed selected state public health service laws in terms of their treatment of sustainability and examined the planning process for the new Federal Institute for Prevention and Health Education (BIPAM).

In addition, in collaboration with researchers from the University of Heidelberg, the partners are developing a policy brief on sustainability in European medical device legislation, scheduled for publication at the end of 2024.