Pearls and Irritations

Climate change poses major threats to the health of all people globally. Australia has been slow to recognise this. In an assessment of the health-related content of 58 nations’ plans to reduce their greenhouse gas emissions in line with the Paris Agreement, Australia scored zero.

The United Nations Framework Convention on Climate Change (UNFCCC) requires countries to submit and regularly update their plans to reduce their greenhouse gas emissions in line with achieving the Paris target of keeping global warming under 1.5^oC. These plans are known as Nationally Determined Contributions (NDCs).

The Global Climate and Health Alliance (GCHA) has assessed the health-related content of the NDCs of 58 countries that submitted revised versions to the UNFCCC between October 2021 and September  2022.

Australia, along with six other nations, scored zero out of 18, putting us alongside Bahrain, Belarus, Japan, NZ and Turkey. Only 16 countries scored above 10 in the Healthy Nationally Determined Contributions Report (aka Healthy NDCs), and all were low to middle income nations, with Burundi number one and Cote d’Ivoire number two.

Australia’s zero score reflected a failure to consider health in any form in our latest NDCs, updated by the current government last year. The report reveals just how far Australia has fallen behind other countries in the past 10 years when it comes to action to protect people’s health from climate change.

Comparable countries, like Britain, USA and Canada, show Australia up as missing a striking opportunity to be a global leader in this area.

Despite the low ranking, the failures at the federal government level have been offset to some extent by the dedicated work of individuals (too many to mention) and institutions like the Climate and Health Alliance, and others. This has helped prepare the healthcare system and the health workforce to respond to the challenges posed by climate change, as well as alert the public and guide decision makers to plan to minimise the worst consequences of climate change for the health of all Australians.

The failure of the previous government to acknowledge this massive risk to both population health and the health system on which we rely when health fails has left us in a poor position, and damages our reputation as a first world nation. Australia’s failures on climate change contribute to health risks for people all around the world, not only here.

The categories rated in the assessment in the Healthy NDCs report reflect the avenues for action considered most valuable in any country’s response to the health impacts of climate change.

These include:

• integrated governance, or the extent to which there was coordination between government departments on health and climate change (e.g. has there been consultation with health stakeholders and / or the federal health department on the development of the NDCs?)
• explicit mentions of health impacts in each country’s NDCs (e.g. to what extent do the NDCs reference the spread of vector-borne disease, deaths and injuries from flooding, extreme heat, bushfires?)
• evidence of adaptation and mitigation efforts in the country’s healthcare sector (e.g. is there a national vulnerability assessment, investment in raising awareness and capacity building within health institutions as well as communities?)
• recognising the co-benefits for health that arise from climate action (e.g. avoid ill health and productivity gains – which will also deliver economic benefits)
• economics and finance – the extent to which there is a specific financial allocation to initiatives to protect health from climate change, and maximise health co-benefits of climate action

The Healthy NDCs report also assesses the climate ambition of each nation – and sadly, but not unexpectedly, Australia scored a massive fail here also, with our emissions reduction targets (43 per cent  below 2005 levels by 2030, and net zero by 2050) aligned with global warming of over 4°C, which will unleash catastrophic environmental, social and health  impacts and potentially irreversible global warming.

There are a multitude of ways Australia could boost its rating in this area and establish an effective national response on climate and health. These include:

• For the federal departments developing the NDCs to consult with the health department and health stakeholders to ensure health impacts and health sector actions are reflected
• Establishing cross-sectoral coordination mechanisms to apply a health lens to climate policies in other sectors
• Health Ministers and health departmental officials participating in global climate change talks
• Quantifying the economic value of adverse health impacts of climate change, and health co-benefits from climate action, and investing to respond
• Actively excluding the fossil fuel sector from climate policy decision-making
• Stepping up the level of finance Australia provides to support a Loss and Damage Fund for the world’s most vulnerable people who experience the most severe health impacts and wider impacts of climate change.

A forthcoming report from World Health Organisation (WHO) reviewing Health in the NDCs will reveal over 90 percent  of countries reflect health priorities in their NDCs. Far fewer, just 30 per cent, identify the health co-benefits of mitigation action and even fewer (10 per cent) quantify them.

There is room for improvement in many other nations as well.

As other nations increasingly prioritise health in their climate change response, Australia’s failure to do so will continue to negatively impact both Australia’s population and our global reputation until the government makes it clear that they are ready to lead in ways that are commensurate with the challenge and the opportunity.

There are genuine efforts to begin this process with the development of a National Health and Climate Strategy underway. While the consultation process is limited, and the timeline short, it is heartening to see this commitment from Mark Butler and Catherine King back in 2017 (made as Shadow Climate Change and Shadow Health Ministers respectively) made real.

This in itself offers the opportunity to lift our score, as will the development of a national climate and health adaptation plan (in planning), along with plans to decarbonise healthcare, strengthen health system resilience, and (less well developed, but inferred by the Health in All Policies objective of the draft National Health and Climate Strategy) cross sectoral action to realise health co-benefits from climate action in other sectors.

If explicitly addressed in our next NDCs Australia could substantially lift its score, and enhance the reputation of, and good will towards, Australia from other nations. This is particularly important for our Pacific neighbours and other small island developing nations, not to mention our own Torres Strait Islanders, whose populations are already extremely vulnerable to the health impacts of climate change.

Given that Australia’s bid to host the 31st Conference of the Parties to the UN Framework Convention on climate change (the annual global climate talks) depends on support from Pacific nations, the actions we take as a nation on issues such as health, loss and damage, and climate justice may be critical to a successful outcome.

It is understood Health Minister Mark Butler is currently considering signing Australia up to the Alliance for Transformative Action on Climate and Health (ATACH), a global network launched at COP26 at Glasgow. There are now 60 nations as part of this initiative to work together on climate adaptation and resilience and low carbon and sustainable healthcare, along with financing for this work. Fiji is already a member, as are the UK, US and Germany.

Along with the Global Climate and Health Alliance, the World Health Organisation has been advocating for several years for health considerations to be an integral part of national and international climate policies and processes. As the GCHA report notes, “integrating health into climate policymaking protects populations, maximises economic benefits, and builds public backing for ambitious climate policies. “Failure to include health in NDCs is a missed opportunity for people, the public purse, and political support.” This is finally beginning to be realised by other countries – Australia must follow suit.

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