Health voices on climate change: are governments listening?

A RECENT consultation on climate change and health policy with health care stakeholders across Australia has revealed that health professionals and health organisations have much to contribute when it comes to public policy development.

A cornerstone of public policy development is engagement with experts in the field and affected stakeholders to ensure that the inputs have integrity, accuracy and relevance. The current and emerging health threats from climate change present a challenge to all countries, as new climate norms are unheralded. Continued protection of human health requires the contribution of health stakeholders to ensure effective and evidence-based responses.

The world is witnessing shifts in health risk profiles, amplification of existing health threats, and a series of threats related to global warming that are new to local communities. A novel approach to tackle both climate and health policy together is needed to accommodate the unique complexities arising from the relationship between human health and our warming climate.

While there have been some efforts towards citizen engagement in Australia (Community Cabinets; the 2020 Summit), concerted and deliberate efforts to enlist the expertise and wisdom of the wider community have been limited.

Low income nations appear to do this better: an article from the Australian Parliamentary Library documents mentions the “examples of sophisticated endeavours to engage citizens in policymaking and the design and delivery of services, including in co-production,” in nations such as Albania, Brazil, Columbia and the Philippines.

This is a pity, since citizen engagement should feature strongly if we are to have an effective democracy, and there is good evidence that sound decisions are made using collective wisdom.

As the world becomes ever more complicated and even the most cohesive democratic societies seem fractured, it is increasingly vital that those developing solutions for complex problems engage with the “wisdom of the crowd”.

This is particularly so when it comes to policy on climate change and health, both complex policy areas alone, and even more so when it comes to considering their interaction.

Prompted by deepening concerns about risks to health from increasing climate disruption and a corresponding failure of governments to respond, individuals and groups from the national health and medical community have stepped forward to collaborate with parliamentarians and policymakers to fill the gap.

Over several months during 2016, a consultation regarding the need for a strategic national response to the risks posed to the health and wellbeing of people from global warming and climate change, led by the Climate and Health Alliance, has engaged with hundreds of people across the health sector. Clinicians from medicine, nursing, midwifery, public health, health promotion, social work, psychology, rural and remote health, dietetics and paediatrics, along with academics, lecturers, CEOs, presidents, professors, hospital managers and departmental leaders, policy and communications officers, GPs, pharmacists and researchers have all contributed.

A series of consultation processes provided the opportunity for both expert and concerned stakeholders to share their views, voice their concerns, and offer their ideas about what is required in a national public policy response on climate change and health, including how to protect vulnerable communities from climate change. Prevention strategies to avoid future health harm and promote health and wellbeing, included the need to limit further warming, and supporting transition to a low carbon economy, especially within the health sector.

The consultation process involved face-to-face and online engagement, and included public forums and roundtable meetings, and featured three key elements:

• a survey accompanying the discussion paper proposing a national strategy on climate, health and wellbeing for Australia (released June 2016);
• an online discussion forum held for 9 days, using the com platform (in August 2016); and
• a health leaders roundtable and meeting with parliamentarians in Canberra (in October 2016).

Each of these efforts provided opportunities for engagement by different groups of stakeholders, with the benefit of allowing for a wide cross section of views and expertise from people both professionally distant and geographically disbursed.

What is striking from the results, however, is a dramatic convergence of views when it comes to what is required.

The findings from the survey reveal a high level of climate literacy among the respondents, amid serious concerns about the inability of the health workforce’s and the health sector’s current capacity to respond effectively to the worsening health impacts of climate change. There was a strong consensus about the need for the federal government to provide leadership, and a growing frustration at the failure of the Commonwealth to develop effective policies to tackle global warming, and to acknowledge and respond to health risks in climate policy. An overwhelming majority of respondents (98%) agree on the need for a national strategy on climate, health and wellbeing.

There was strong consensus among health groups that without a national strategy on climate change and health, Australia will fail to meet its obligations regarding the citizens’ “right to health” under the global climate covenant, the Paris Agreement.

Another strong theme with wide agreement was the importance and value of including the health voice in policy development to protect health against climate change threats and to help garner community support and action to reduce emissions.

Health leaders at the roundtable highlighted the power of the health voice, as experts on factors that contribute towards, or serve as barriers to, good health, and as respected and trusted professionals could help shift community opinion in favour of climate action. These attributes provide both the opportunity and moral imperative to deeply engage the health community in national policy decisions on climate change.

“Engaging a larger and more powerful group of health professionals at all levels is essential to creating the social licence for politicians and policymakers to lead a federal government commitment to a climate and health strategy.” (Climate change and health lecturer, Online Discussion Forum)

This quote, from an academic who lectures in advocacy for policy and on climate change and health, articulates precisely the strategy of engagement that has underpinned the consultation process around a national strategy on climate, health and wellbeing.

The pathways for action identified by the consultation include:

• the development of a framework for a national strategy on climate, health and wellbeing for Australia;
• the need for education and capacity building among health professionals to ensure they can communicate to their patients the immediate and long term personal health threats from climate change, and recommend health protective actions;
• the need for whole of government approach to ensure collaborative action, supported by research, and informed by health stakeholder participation and engagement;
• the importance of improving climate literacy in the general population, parliamentarians and policymakers;
• the need for ongoing community advocacy and campaigning to create the social licence for parliamentarians to address climate change;
• the importance of investing in an environmentally sustainable, low or zero carbon health care sector that has the triple benefit of financial efficiency, social responsibility and climate resilience; and
• the need for Australia to build (re-establish) a world leading climate and health research capacity to identify the country’s specific vulnerabilities, support surveillance, monitoring and assessment of health risks, and track the cobenefits of climate change mitigation policy and strategies.

So where to from here? Over 30 leading health groups are supporting the Our Climate Our Health campaign, which has seen a leap in engagement on the problem. These groups are united in their support for the development and implementation of a national strategy on climate, health and wellbeing for Australia. They are working in collaboration with politicians and policymakers to achieve this goal.

Early findings from another research project on barriers to including health cobenefits in the development of Australian climate change mitigation policies identified a lack of champions from both within and outside of government to advocate for their inclusion.

Those champions exist. Australia’s health sector has stepped forward. The question is whether governments are listening.

The efforts of health groups to engage with parliamentarians and policymakers appear to be bearing fruit. The three major political parties (the Liberal–National Coalition, the Australian Labor Party and the Greens) met with health groups to forge a discussion in 2016, and in June 2017, a representative of the three parties will cohost a parliamentary launch of the Framework for a National Strategy on Climate, Health and Well-being for Australia.

Will the inclusion of health in the frame of climate policy help change the narrative away from the simplistic notion of climate change as an environmental and energy problem, towards the profoundly human and social issue it truly is?

We hope so. The health and medical communities in Australia, along with international colleagues, are clearly ready and willing to offer their expertise and insights to help governments confront, and then respond to, the health impacts of climate change. Our health, and that of future generations, is at stake. The time to deal with health threats from climate change is now.

Fiona Armstrong is the founder and executive director of the Climate and Health Alliance, and the architect of the Our Climate Our Health campaign for a national strategy on climate, health and wellbeing for Australia.

Dr Liz Hanna is an honorary senior fellow at the Climate Change Institute and the Australian National University, and is president of the Climate and Health Alliance.

Dr Rebecca Patrick is a lecturer in Deakin University’s School of Health and Social Development, and she is affiliated with the Climate Action Network Australia.

The authors also acknowledge the assistance of Hilary Murchison, a final semester Bachelor of Public Health and Health Promotion student at Deakin University and current intern at the Climate and Health Alliance.

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