The Lancet Countdown on health and climate change: Australia a world leader in neglecting its responsibilities

Climate is integral to good health and wellbeing, but it can also be a forceful driver of death and disease. Many diseases both here in Australia and globally are climate sensitive — the global magnitude of such diseases was estimated to be 39 503 684 deaths (69.9% of total annual deaths) and 1 530 630 442 disability‐adjusted life years in 2019.1,2 Climate change is the biggest health threat facing humanity.3,4

The Lancet Countdown on health and climate change is a multidisciplinary, international collaboration established to monitor the links between climate change and health globally and to put health at the centre of the response to climate change. It tracks over 40 indicators, reporting its findings annually in The Lancet. The Countdown is to the year 2030, tracking progress as the world moves rapidly towards the near‐term greenhouse gas emissions reduction commitments under the Paris Agreement.

Established in 2017, the Australian MJA–Lancet Countdown — a collaboration of the nation's leading health and climate change experts — conducts extensive assessments of the specific connections between climate change and health, and opportunities (or missed opportunities) of Australia's response. For each of the past five years (2018 to 2022), the collaboration has presented its findings in the Medical Journal of Australia, in unison with the publication of the global Lancet Countdown report. In recognition of Australia's geographic position and the importance of regional relationships, the MJA–Lancet Countdown is actively broadening its scope to Oceania, with, for example, the inclusion of a concise assessment of health and climate change in New Zealand in its 2022 report.5

With Australia as its precedent, the Lancet Countdown has been establishing other regional centres around the world, with centres now in Asia, South America, Europe, and Small Island Developing States, and efforts underway to establish an African centre.6 Regional centres are publishing their own annual assessments of the state of health and climate change in their region, and for the first time this year the regional reports will be published separately from the global report — in the lead‐up to the annual Bonn Conference of the United Nations Framework Convention on Climate Change and just ahead of Earth Day in April 2024 — to allow for more in‐depth analysis and engagement away from the global findings.

In this editorial, being published in the MJA simultaneously with the 2023 global Lancet Countdown report in The Lancet,6 we describe key indicators for which Australia is explicitly mentioned in the report. One of the many adverse impacts of climate change on Australia is highlighted in the 2023 report. With 55% of the region's land area experiencing extreme drought in at least one month per year on average over the past decade — a massive increase from the 14% in the 1950s and the second worst figure globally, not far under the 64% for Africa6 — Australia is clearly on the frontline of the climate change catastrophe. Australia's record 2017–2020 drought, the associated temperature and rainfall extremes, and the devastating Black Summer bushfires of 2019–20207 are stark indicators of things to come.

Australia's particular susceptibilities to climate change are well understood. The 2023 Lancet Countdown report identifies Australia (and New Zealand) as being extremely well served by research on the health impacts of climate change, with about 50 studies per million people exposed to climate change, more than double that of any other region of the world.6

It is therefore an indictment of Australia and its citizens that the 2023 global Lancet Countdown report shows that we lead all other regions of the world in per capita greenhouse gas emissions from our energy sector,6 with, on average, each of us contributing significantly to the changing climate and the death and disease it is causing.8 The report also highlights that this extends to Australia's health care sector, which has the eleventh highest per capita greenhouse gas emissions in the world.6 Additional key messages from the report that are particularly relevant to Australia are listed in the Box.

Australia's first ever national health and climate strategy, when published, will be an important step forward — identifying areas to better prepare the Australian health system for the challenges presented by climate change.9,10 Poised to host the United Nations climate change Conference of the Parties in 2026, our government can take further action between now and then to demonstrate the required leadership on this most important issue, and to better protect Australia and all its peoples. Two actions are clear — Australia must cease fossil fuel subsidies and must increase its greenhouse gas emissions reduction target from the current 43% to at least 50% by 2030 (from 2005 levels).