Health sector leadership is central to the fight against the climate crisis

The health impacts of climate change demand Australia rapidly end its reliance on fossil fuels

“We have a choice. Collective action or collective suicide. It is in our hands.”
  UN Secretary‐General António Guterres, July 20221

Catastrophic floods in Pakistan and Australia. Record-breaking heatwaves in Asia, Europe, the Middle East and North Africa that have fuelled devastating wildfires. Drought in East Africa that has placed millions of people at risk of starvation. The scale of natural disasters in 2022 emphasises with destructive force that we are now living with the consequences of the climate crisis. This year, the Intergovernmental Panel on Climate Change warned that to avoid the worst effects of climate change and keep warming under 1.5°C, “immediate and deep” reductions in global greenhouse gas emissions are urgently needed.2 Even then, limiting warming to 1.5°C might not be enough to avoid a number of irreversible climate tipping points, and a rise of 2°C could be disastrous.3 In November, world leaders, civil society and business representatives meet in Egypt for the 27th UN Climate Change Conference of the Parties (COP27) in what is widely regarded as a critical moment to accelerate action towards the goals of the United Nations Framework Convention on Climate Change and the Paris Agreement.

Today we publish the fifth annual report of the MJA–Lancet Countdown on health and climate change.4 Twenty experts in public health, epidemiology, mental health and climate science from 13 institutions have come together to track progress on climate and health in Australia across 26 indicators covering five domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co‐benefits; economics and finance; and public and political engagement. They detail how Australians are already experiencing direct and indirect health impacts of climate change through shifting risks of infectious diseases, heat and heatwaves, floods, bushfires and smoke, and droughts. These health consequences are not equitably distributed across our society — people living in remote areas, those with pre‐existing health conditions, socio‐economically disadvantaged people, and Indigenous Australians are particularly vulnerable to current and future consequences of a changing climate. Yet despite the compelling evidence of these impacts, the report finds that Australia is underprepared to deal with future climate and health crises and that the country’s transition to renewable energy remains “unacceptably slow”.

Nonetheless, there are reasons for hope. After a lost decade of climate inaction, Australia is experiencing a window of opportunity for rapid and systemic action on climate and health. The May 2022 federal election represented a seismic shift in politics: although the Labor Party won over the Liberal–National Coalition, a record number of seats were taken from both major parties by Greens and independent candidates who campaigned on the basis of strong climate change policies.5 An emissions reduction target of 43% and net zero emissions by 2050 was subsequently enshrined into legislation by the Australian Parliament in September.

These commitments are an important start, but they fall short of what is needed.6 The task now is to turn the electoral appetite for change into greater action by individuals, businesses, organisations and governments. Achieving meaningful progress will require, at least in part, breaking the hold that the fossil fuel industry has had on the policy process in this country for too many years — what political historian Judith Brett has described as state capture through the narrative that the industry’s interests are deeply embedded with the national interest in terms of energy security and prosperity.7 Ending the social licence for Australia to be reliant on fossil fuels requires a reframing of this discussion that puts health at the centre.

Why health? Beyond the clear health impacts of the climate crisis, health is a powerful vehicle for change. Health consistently ranks highly among the public’s concerns and priorities, doctors and scientists are some of the most trusted professionals in Australia, and the values we attach to health — be it around wellbeing, empathy, fairness, community or protection — are compelling ways to connect and motivate.8 The health sector, moreover, is responsible for around 7% of Australia’s carbon footprint.9 Health care workers can articulate the links between climate and health through discussions with peers, patients, their wider communities, and local and national policymakers. Health facilities must lead by example through decarbonising the delivery of health care and preparing the health system to cope with the consequences of climate change.10,11 Universities need to equip the next generation of health practitioners to address the risks and impacts of climate change.12 Professional health and medical associations have opportunities to advance action against climate change through their roles in member education and engagement, and advocacy.13

The latest MJA–Lancet Countdown report should act as a wake‐up call for Australia to abandon its reliance on fossil fuels and redouble efforts towards building resilience to the harmful health effects of the climate crisis. The leadership of the health sector is fundamental to this endeavour and for achieving a more healthy, sustainable and just world.