Computerised Tomography (CT) scan is one of the most common medical imaging performed in healthcare, Each year, 300 million CT scans are performed globally. Of which, around 180M include use of radiocontrast media (RCM). Contrast Enhanced CTs (CECT) create a significant environmental impact, namely: 42,000 tonnes of single use packaging, 900 Tonnes of surgical steel (needles), 90,000 tonnes of plastic tubing and 150,000,000 kWh in energy consumption. These generate on average 9.2 kg of CO2/ scan. In addition, CECTs generates 200,000 tonnes of iodine contamination in water/yr. This is a recognised form of ‘pharmaceutical pollution’. CECTs may also harm patients: needle insertion, toxicity of iodinated RCMs to kidneys (potentially kidney failure) and allergic reactions, which in some cases can be life-threatening. Healthcare systems are responsible for the 4.4% CO2 global emissions (2 Giga tonnes/yr). Of this, ~3 Mega tonnes/yr are generated from CECTs. The EU has declared its NetZero targets of by 2050 through the European Green Deal. We showed feasibility that artificial intelligence (AI, deep learning methods) can extract high level information from non-contrast CT scans and synthesise contrast ‘digitally’. This avoids the need to administer RCM for CECTs. We seek to develop and validate 5 uses cases of CT ’Digital Contrast’ during this Horizon award. By implementing ‘Digital Contrast’ for scans globally, we aim to reduce 30% of the CO2e and iodine RCM waste generated from CECTs by 2033. NetZeroAICT has a grand vision to define a reference framework for scalable development of AI health tools for a future of sustainable health systems. This builds on our prior efforts of AICT consortium, which was established to make CT imaging safer, more efficient, more equitable and more sustainable. NetZeroAICT will accelerate the EU’s trajectory towards NetZero and advance EU’s globally recognized leadership position on Healthcare sustainability.

PALAESTRA is a modular and adaptable platform designed to transform the training landscape for Chemical, Biological, Radiological, Nuclear, and explosive (CBRNe) incident response across Europe. By integrating advanced technologies such as AI-driven scenario generation, digital twin-based training environments, and real-time physiological monitoring, PALAESTRA aims to modernize and enhance the preparation, execution, and evaluation of training exercises. The platform addresses current challenges in CBRNe training, such as the high costs, expertise requirements, and inefficiencies in scenario creation and evaluation. It simplifies these processes through automated tools, enabling institutions to create realistic and data-driven exercises with reduced reliance on specialized knowledge. PALAESTRA also improves safety and engagement by offering immersive simulations that replicate real-world crises without exposing trainees to actual hazards. Designed to strengthen the civil security sector, PALAESTRA emphasises inclusivity, compliance with EU regulations such as GDPR and the AI Act, and ethical AI usage. By reducing instructor workload, enhancing knowledge transfer, and improving access to state-of-the-art training methods, the platform aims to elevate CBRNe preparedness and response capabilities across Europe. This scalable solution provides a cost-effective way for training facilities to adopt advanced methodologies, fostering a more resilient and better-prepared civil security landscape.

Hospital wastewater (HWW) poses a significant environmental and health risk due to the presence of pharmaceuticals, pathogens, and other hazardous substances that are administered in healthcare institutions. Unfortunately, current urban wastewater treatment (WWT) plants are not capable of effectively removing many of the pollutants generated by hospitals. As a result, these contaminants reach and accumulate in natural water bodies, threatening ecosystems and biodiversity, and public health through the contamination of drinking water or food. In addition, public health is also menaced by HWW as it contains important amounts of antibiotic-resistant microorganisms and genes. In fact, Antimicrobial Resistance (AMR) is one of the greatest health threats of our times. While most common medicines are consumed in households, specialized drugs such as cytostatic drugs, some antibiotics, or X-ray contrast agents are mainly distributed in hospitals. Furthermore, HWW is a hotspot for the transmission of antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARG). To reduce the risk associated to these contaminants, it is key to remove them as close to their source as possible, and before they are discharged to the municipal water network. Despite the existence of different technologies that efficiently remove contaminants from HWW, currently, there is no single process that can be used for the comprehensive treatment of HWW regarding the elimination of a mix of pollutants to a high degree. Moreover, technology may be further developed to be more efficient, environmentally sustainable, and cost-effective for hospitals. In this context, the main objective of THERESA PCP is to launch a pre-commercial procurement process (PCP) based on the development of an environmentally sustainable on-site system to decontaminate HWW, being capable of effectively removing, among other contaminants, cytostatic drugs, X-ray contrast agents, antibiotics, ARB and ARG, from HWW.