Ethical Considerations of Climate Justice and International Air Travel in Short-Term Electives in Global Health.

Abstract

In July 2022, the American Society of Tropical Medicine and Hygiene Green Task Force advocated to acknowledge the health impacts of climate change, particularly on those in low- and middle-income countries, and called on global health organizations to act. Simultaneously, academic medical centers are resuming Short-Term Electives in Global Health (STEGH) as travel restrictions imposed during the COVID-19 pandemic ease in most countries. International flights by trainees from academic medical centers in high-income countries (HIC) on these electives encapsulate the climate injustice of who generates carbon emissions and who bears the impacts of climate change. Using "decolonization" and "decarbonization" as guiding principles, we suggest several strategies that global medical education programs in HIC could implement. First, restructure rotations to halt STEGH with minimal benefit to host institutions, optimize trainee activities while abroad, and lengthen rotation duration. Second, programs can calculate the carbon impact of their STEGH and implement concrete measures to cut emissions. Finally, we urge academic medical centers to promote climate-resilient healthcare infrastructure in host countries and advocate for climate solutions on the global stage.