Making it Greener While Keeping it Cold: Sustainable Energy Services for a Humanitarian Medical Cold Chain

The primary contributor to global warming is the rising amount of emissions produced by human activities, which are fuelling a climate crisis that has increased the number of armed conflicts and had devastating impacts on societies, biodiversity, food and water security, and human health. These together have led to an increasing demand for humanitarian assistance, prompting the establishment of more humanitarian medical cold chains (HMCCs).
HMCCs, however, are inherently risk-averse and energy-intensive. They rely predominantly on fossil fuel-based energy services to ensure supply chain resilience (SCR) so that they are kept cold continuously. Yet, using fossil fuel-based energy services is one of the main causes of climate change, creating a dilemma at the heart of HMCC operations. One solution is to use more sustainable energy services; however, these are often considered insufficiently resilient, secure, feasible, or cost-effective alternatives for HMCCs.
As global supply chains transition towards more sustainable energy service structures to address the climate crisis, the humanitarian sector is also beginning to reimagine its operational structures for more environmentally sustainable approaches. This transition also calls for a rethink of HMCCs. It requires not only the integration of renewable energy sources (RES) but also transformations in supply chain strategies, effective collaboration among HMCC stakeholders, and new theoretical approaches that support both the supply chain resilience and supply chain sustainability (SCS) of HMCCs.
Through panarchy theory – a theory of change – this thesis explores the balance between sustainable and resilient energy services in HMCCs’ sustainable energy trajectory to address the climate crisis while ensuring operational resilience. By mapping the conditions that justify energy service choices in HMCCs and exploring their influence on the adoption of sustainable energy services, this thesis provides humanitarian organisations with an analytical framework to understand their position within the broader socio-ecological systems across space and time, and how and where they can initiate the change towards sustainable energy services in HMCCs.
The thesis argues that, even within marginal yet critical systems such as HMCCs, sustainability and resilience do not exist as trade-offs. Instead, convergence approaches allow both to be pursued and managed simultaneously, fostering adaptive, resilient and climate-responsible HMCCs.
This thesis encourages the humanitarian sector to consider critically how the adaptability of HMCCs, which are critical and fast-paced, influences the feasibility and adoption of sustainable energy services. It provides a foundation for the systematic implementation of sustainable energy goals within humanitarian organisations, acknowledging that while sustainable energy services may not always be the most immediately feasible option, adopting a holistic energy system perspective is crucial. Change is imperative, and time is running out to address the dual challenge of making HMCCs greener while keeping them cold.