AUSTRALIA will have to contend with the health consequences of intensifying climatic extremes as heatwaves, floods, droughts and fires become more frequent, say experts who are calling for urgent action to reduce carbon dioxide (CO2) emissions.

In a Narrative Review in this week’s MJA, Professor Elizabeth Hanna, Honorary Senior Fellow at the Climate Change Institute, Australian National University, and Dr Lachlan McIver, of Médecins sans Frontières, Geneva, said that urgent action was needed to reduce emissions and to realign health services to address shifts in disease burden.

“Current trends suggest a future of increasing heatwaves, even greater rainfall variability, and more fires,” the researchers wrote, noting that current emission rates were likely to lead to a warming of 4°C by 2100.

“Additional heat is likely to generate fewer winter respiratory deaths yet more heat exposure morbidity and mortality. Further exacerbations of Australia’s extreme rainfall variability will intensify water shortages and storm and flood damage, compounded by likely societal interruptions and health challenges.”

Speaking in an MJA InSight podcast, Professor Hanna said that Australia’s status as a wealthy, resource-rich nation provided some protection from the extreme consequences of climate change, but we still faced significant challenges.

“As far as [high income] nations are concerned, we’re an outlier in being highly vulnerable,” Professor Hanna said. “We have the world’s highest natural variability in rainfall, and so further exacerbation of that is going to really stress out our water supplies and our agriculture. We’re also far hotter than most of the other [high income] countries.”

Associate Professor Grant Blashki, a GP and Associate Professor at the Nossal Institute for Global Health, and the Melbourne Sustainable Society Institute at the University of Melbourne, said that the MJA article was a reminder to Australian politicians of the high stakes for future generations’ health.

“Climate change poses a global threat to ongoing gains in public health, and for Australia, as a very dry continent, we are vulnerable to worsening heat waves and other extreme weather events,” said Professor Blashki, who is co-author on an article published on 5 April 2018 discussing the importance of embedding health in the climate change agenda.

“While policy makers debate and negotiate about how quickly to reduce greenhouse gas emissions, the fundamental scientific physical processes that drive climate change continue to raise the average global temperature and put the long term health of Australians at risk.”

Professor Shilu Tong, Adjunct Professor at the Faculty of Health, Queensland University of Technology, said that although climate change had been increasingly recognised as the biggest threat to global health in the 21st century, we were not well prepared for shifts in disease burden, for example, changing mortality patterns and increased likelihood of heat stress.

Professor Tong pointed to recent research he had conducted in this area, including a 2016 finding that increased summer temperature-related deaths were likely in Brisbane, Sydney and Melbourne in the coming decades.

“More action is urgently required to mitigate greenhouse gases emissions and develop public health adaptation plans to tackle the increasing health risks of climate change,” Professor Tong told MJA InSight.

The MJA authors wrote that many vector-borne diseases were climate sensitive, as mosquito densities related to rainfall and temperature, and it was possible that cases could spread to southern regions of Australia. They noted, however, that the picture for climate-sensitive vector-borne diseases remained unclear.

Professor Steven Chown, Professor of Biological Sciences at Monash University, said that the authors were right to be circumspect about the impact of climate change on the spread of vector-borne disease.

“There’s an interaction between what’s being done in the medical research area in reducing the burden of vector-borne diseases – for example, by the World Mosquito Program – and what climate change is doing to improve the situation for indigenous vectors,” Professor Chown told MJA InSight. “So, I think [the MJA authors] are right to be circumspect in the way that that’s actually going to play out.”

He said that attention to biosecurity measures was essential in keeping these risks in check.

“There’s a little mosquito species called Aedes albopictus. It’s a very effective vector of these arthropod-borne viruses [such as] dengue and Zika,” he said.

While A. albopictus was not currently in Australia, it had been detected and eliminated in both the Torres Strait Islands and in Melbourne, Professor Chown said.

“If our biosecurity systems fail and this species gets in, we could have substantial difficulty, so we have to pay very careful attention to the interaction between how the local environment is changing and how we manage the biosecurity risks to Australia.”

Professor Chown also highlighted the added climate change threat posed in Australia’s urban environment.

“Cities have huge benefits, but they also have an additional burden since they tend to be much warmer than their surrounding environments, varying from about 1° in the tropics to about 3° in temperate areas,” he said.

“Quite a few Australian cities are undertaking plans to mitigate this through tree planting, green building design and so on, but it is something to bear in mind from a human health perspective because most of the Australian population lives in cities.”

Despite the grim picture presented in the MJA article, Professors Tong and Chown said that there was some hope on the horizon.

“The central aim of the Paris Agreement is to keep any global temperature rise this century well below 2°C above pre-industrial levels,” Professor Tong said. “The good news is that 175 of 197 parties have ratified the convention. International efforts to reduce greenhouse gases emissions will undoubtedly facilitate mitigating the more severe effects of climate change on health.”

Professor Chown shared this view but noted that Australia had lagged in its commitment to tackling increasing CO2 emissions.

“Australia has been slow in taking [action on climate change] but I think there is opportunity still to do so. It’s essentially a compound interest problem – we are going to keep compounding our difficulties into the future, if we don’t address them now,” he said.

“And every now and then, we have these amazing rays of hope here, as we saw in South Australia with significant developments in renewables and storage.”

Still, resistance to the science behind anthropogenic climate change has remained in some quarters, including the medical profession.

Professor Blashki said that the climate change issue had become a political football around the world, with varied and sometimes non-scientific perspectives. However, he said, doctors had a “long and proud history” of taking action on public health issues that affected their patients.

“For doctors who are worried about this problem, they can get involved with groups such as Doctors for the Environment, lobby their local members or explore ways to move towards making their practice a GreenClinic,” Professor Blashki said.


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Climate change is real, and is exacerbated by human activity
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  • Agree (13%, 21 Votes)
  • Strongly disagree (10%, 17 Votes)
  • Neutral (7%, 12 Votes)
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7 thoughts on “Health and climate change: call for urgent action

  1. Anonymous says:

    “Control of future global warming therefore depends upon global cooperation and efficacy in reducing carbon emissions” (Elizabeth G Hanna and Lachlan J McIver. Med J Aust || doi: 10.5694/mja17.00640).


  2. Anonymous says:

    First of all collect the evidence and present it in a rational fashion. Its a bit like writing medical papers properly to show that warming is beyond what one expects from chance.
    Perhaps there is a mini ice age coming and burning fossil fuels will save us.
    I had a look at long term graphs of planet earth and it has been much hotter and colder before.

    Meanwhile we shut down our coal power , pay exorbitant power bills and go to sleep at night feeling snug that we are not polluting the world and causing global warming but sell coal to India and China , etc who do it for us.

    Stop being left wing nuts, get real and act on balanced evidence and when you present evidence dont say what you would like the result to be but what it really is.

  3. Geoff Chapman says:

    Now the “global warmists”with their CO2 falsities, are trying to tell us that man can change the environment, but realising he cant(because its so huge,)has resorted to ‘CLIMATE CHANGE”, so that it covers everything, and keeps them in a job.
    How do intelligent scientists (Doctors?) fall for this, when the evidence shows global warming to be a self propagated hoax !

  4. Anonymous says:

    I always find it amusing that MJA Insight runs articles on the latest left-wing agenda pieces on a rotating roster, and tries desperately hard to link them to medicine somehow. Might as well rename it The Guardian – Medical Supplement.

    It also quite interesting to note that the readers who comment often disagree sharply with the opinions given. I strongly believe that this is strictly because of the ‘personality’ that is drawn to an ‘editing’ or ‘academic’ role who write and edit this content.

    This is a phenomenon that is occuring workd-wide in the developed world. For example, the American left-wing papers are leaking readers while blue-collar workers watch Fox News and cote for Trump. Same goes in the medical world. Real doctors gave up reading medical journals uears ago in favour of UpToDate, Therapeutic Guidelines and the occasional Youtube video. I know I will be asked why I am still reading this journal. The answer is that I enjoy it nonethheless!

    Nevertheless, in my meagre experience all my university lecturers were left-wing toffs, and all my high-earning superiors at work were right-wing die hard conservatives. Just saying…

  5. Anonymous says:

    “There’s a little mosquito species called Aedes albopictus. It’s a very effective vector of these arthropod-borne viruses [such as] dengue and Zika,” he said. Even Zika is blamed on climate change 🙂

  6. Prof Andrew Taylor-Robinson, Infectious Diseases Research Coordinator, Central Queensland University says:

    Thank you for this insightful commentary on a thought-provoking article. The increased risk of vector-borne infectious diseases brought about by climate change has been highlighted. Globally, this includes a whole raft of infections such as malaria, dengue, yellow fever, chikungunya and Zika, each of which is transmitted by the bite of an infectious mosquito (the species of which varies depending on which pathogen is being transmitted). These are all major human pathogens, either protozoan or viral, that carry a significant public health threat across a widening footprint within tropical and subtropical regions of the world. Changes in weather patterns, principally relating to increased length and intensity of rainy seasons, have been attributed to be causally linked to burgeoning numbers of mosquito species capable of transmitting infections, and thereby – as a knock-on effect – to a rise in the incidence of clinical disease cases.

    In Australia, in excess of 75 arthropod-borne (arbo) viruses have been identified, some of which are now well established as causative agents of debilitating diseases. As is mentioned in the parent article, these include the now well-known Ross River, Barmah Forest and dengue viruses, but also Murray Valley encephalitis virus, each of which may be detected by both antibody-based recognition and molecular typing. However, for most of the remaining arboviruses that may be associated with pathology in humans, routine tests are not available to diagnose infection. A number of these so-called ‘neglected’ or ‘orphan’ arboviruses that are indigenous to Australia might have been infecting humans at a regular rate for decades. Some of them may be associated with undifferentiated febrile illness – fever, the cause of which is not obvious – for which around half of all cases each year remain undiagnosed.

    This is of particular relevance to Northern Australia, given the Commonwealth Government’s transformative vision for the midterm future of massive infrastructure investment in this region (Our North, Our Future: White Paper on Developing Northern Australia, 2015). An expansion of the industrial and business development of this previously underpopulated region is predicted. This is set to bring into intimate proximity infection-naïve human hosts, native reservoir animals, and vector mosquitoes, thereby creating a perfect storm for increased prevalence of infection with neglected Australian arboviruses. Moreover, the increasing impact, if not necessarily occurrence, of devastating weather system events in the tropical north of the country is likely to lead to elevated numbers of arbovirus-transmitting mosquitoes. Hence, in the wake of damaging tropical cyclones and severe flooding, the robustness and efficiency of health protection systems will be sorely tested.

    As a commensurate response to the potential public health challenge that is thus posed, continuing assiduous attention to vector monitoring and control is required. In this overall context, improved epidemiological surveillance and diagnostic screening, including establishing novel, rapid pan-viral tests to facilitate early diagnosis and appropriate treatment of febrile primary care patients, should be considered a public health priority. Investment in a rigorous identification program would reduce the possibility of significant outbreaks of these indigenous arboviruses at a time when the full impact of climate change on the environment – if not on disease outbreaks per se – is becoming ever more apparent and as population growth accelerates in Northern Australia.

  7. Ulf Steinvorth says:

    Thank you for letting the evidence rolling in, 7 million premature deaths due to air pollution according to the 2014 WHO report, 350 billion $ cost of air pollution according to World Bank Report 2013…

    Telling that the lone voice shouting ‘foul’ and ‘more fossil fuels’ refuses to show their real name in a scientific peer-reviewed journal

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