The Future Healthy Countdown 2030: holding Australia to account for the health and wellbeing of future generations

It is time to reimagine wellbeing and place the future of our children and young people at the centre of public action

As we approach World Children’s Day and the 2022 United Nations Climate Change Conference (COP27), we are once again reminded of how lack of leadership and coordinated action is threatening the future of humankind and, particularly, that of our children, young people and generations to come.1 Although climate change had already affected how younger generations and their parents imagine a healthy future, the onset of the global coronavirus disease 2019 (COVID‐19) pandemic has only served to heighten their concerns.2 Research from around the world indicates that children and young people have been disproportionately burdened by the changes and challenges of the past 3 years. The sudden disruptions and high uncertainty at critical points of their development, along with the mental health and financial impacts on their parents, have placed a heavy toll on their wellbeing.3 However, even before the pandemic, there were growing concerns that, for the first time, the current generation of children would be less healthy than their parents.4

In the early days of the COVID‐19 pandemic, some hopeful voices heralded that such a collective threat could be our “great leveller”.5 The pandemic shock would be so profound that societies and governments would take action to address inequalities. We saw this possibility in the rapid development of a COVID‐19 vaccine within 12 months and in the implementation of social protection measures such as the JobKeeper Payment.6 However, as we moved past the initial crisis, what has followed is far from that vision. In Australia, despite the “no‐one is safe until we all are” narrative, deep inequalities have persisted.

More than ever, we need sustained cross‐sectoral leadership to reimagine wellbeing in our nation, and to build a shared language that can drive us towards more equitable systems, having intergenerational considerations at the centre. As part of our contribution, VicHealth, with a group of the nations’ leading scientists and institutions and in collaboration with young people, will launch in 2023 a national monitoring and accountability mechanism for children’s and young people’s health and wellbeing: the Future Healthy Countdown 2030. We will systematically analyse, track and annually report on progress made in Australia towards a nation where no young person is denied a healthy future and opportunities to thrive.

We intend to publish the Future Healthy Countdown 2030 annually in The Medical Journal of Australia close to World Children’s Day. The Countdown will address priority areas for the wellbeing of Australia’s children and young people today, and it will emphasise the aspects outlined below.

Ensure young people’s voices drive intergenerational accountability

Today, a lack of institutionalised agency and intergenerational accountability leaves the voices and priorities of young people unheard and under‐represented in policy decisions. In designing the Future Healthy Countdown, we want them to also play a part.7 Young people will help us understand what they value for their wellbeing, unequal conditions that characterise their contexts, and their priorities.

Highlight the non‐health determinants of health and wellbeing

At the core of the Countdown is the recognition that social (eg, racism), economic (eg, income) and environmental (eg, air pollution) factors have a central role in shaping the health and wellbeing of children and young people. These broader factors also help us to better understand health inequities, and they need to be taken into consideration for any metrics that speak to an inclusive and just vision of health and wellbeing for all.

Aggregate, not duplicate

The Countdown will build on existing and important work already available on national and global platforms. The Australian Government has committed to leaving no‐one behind through the 2030 Agenda for Sustainable Development,8 the National Children’s Mental Health and Wellbeing Strategy,9 and Australia’s Youth Policy Framework.10 As we emerge from this latest phase of the COVID‐19 pandemic, we do not need additional targets. What we need is coordination of government efforts and action. The Future Healthy Countdown 2030 will be a vital platform to build support for joint action towards a healthy future, setting a mechanism to hold governments at all levels and leaders across sectors accountable.