Abstract
Public procurement of food is seen as a critical tool for a paradigm shift and for facilitating the development of specific policy objectives to build sustainable food environments. Furthermore, the harnessing of the purchasing power of hospitals, prioritizing local and sustainable food, offers the potential to transform food production systems into more resilient production models and bring them in line with current European sustainability strategies. This paper analyses the current situation of sustainable food procurement strategies in Osakidetza, the Basque Health System, and identifies the challenges and action plans needed to develop a sustainable food strategy. Sustainable food procurement is still incipient in Osakidetza. This roadmap proposal is a basic but necessary contribution as a starting point. Likewise, we find contributions from agroecology that are interesting for the construction of sustainable food environments in health systems.