HEAL Network to tackle impacts of environmental change

IN November 2021, we celebrated the inaugural Healthy Environments and Lives – HEAL 2021 – Conference. This coincided with the federal government’s announcement of the $10 million National Health and Medical Research Council Special Initiative in Human Health and Environmental Change that will fund the HEAL Network over the next 5 years to provide national and international leadership in environmental change and health research.

This investment in the HEAL Network could not have been more timely. There is increasing scientific evidence indicating that we are facing a global health crisis due to rapid environmental change. This has been described by the United Nations Environment Programme (UNEP) as a triple planetary crisis of climate change, biodiversity loss, and pollution, with major health and economic impacts, that could exceed those of the COVID-19 pandemic.

There is also increasing recognition that tackling this crisis is a great opportunity for improving human health, mainly through improved air quality, water security, active mobility and healthier nutrition. However, this evidence has not resulted so far in sufficient global or national action to tackle climate change and environmental degradation.

The HEAL Network, a broad coalition of 100 investigators and more than 30 organisations from across Australia, aims to bridge this gap between knowledge and action by bringing together Aboriginal and Torres Strait Islander wisdom, sustainable development, epidemiology, and data science and communication to address environmental change and its impacts on health across all Australian states and territories. The vision of HEAL is to catalyse research, knowledge exchange and translation into policy and practice that will bring measurable improvements to our health, the Australian health system, and the environment.

Environmental health research as a catalyst for action

A great source of inspiration and knowledge for the HEAL Network is the Aboriginal and Torres Strait Islander more than 60 000-year long track record of caring for Country and successfully adapting to environmental change.

To date, Aboriginal and Torres Strait Islander people have not been sufficiently included in national conversations about environmental change. As highlighted in the recent discussion paper on Climate change and Aboriginal and Torres Strait Islander health by the Lowitja Institute, climate change presents an opportunity for redress and empowerment of Aboriginal and Torres Strait Islander communities to lead climate action planning based on their intimate traditional and historical knowledges of Country. However, there are gaps in research and data, and most reporting on climate change currently does not include Aboriginal and Torres Strait Islander or local knowledge in the assessment, translation, and reporting of findings. Furthermore, many sustainable solutions are known, such as clean energy and climate resilient housing, but access to these solutions is not equitably available across Australian communities.

To redress this fundamental injustice, we have consulted with Aboriginal and Torres Strait Islander organisations, public health and environmental authorities, health sector organisations, and data providers to integrate this complex social, environmental, economic and institutional “ecosystem” into a cohesive, multidisciplinary research network. As such, HEAL aims to be a model for integrated research and translation into practice based on key enablers, including strong engagement and co-design with federal and state governments, public health and health care sectors, charities, communities, business and industry. This will involve respectfully bringing together Aboriginal and Torres Strait Islander knowledges and culture with Western knowledges, and a dynamic, transparent and inclusive governance structure that will nurture future research leaders.

The Australian health system’s resilience, preparedness and responsiveness to environmental change and extreme weather events need to be strengthened by addressing the upstream environmental, social and cultural determinants of health and reducing inequalities. This involves mitigating and adapting to climate change; managing the risk of bushfires, floods and air, soil and water pollution; improving housing, energy, water and food security; and developing a sustainable economy to heal the planet.

The United Nations Sustainable Development Goals call for action by all countries to promote prosperity while protecting the planet. They recognise that ending poverty must go hand in hand with strategies that build economic growth and address a range of social needs including education, gender equality, health and wellbeing, social protection, and job opportunities, while tackling climate change and environmental degradation.

There have been numerous success stories for public health and the environment, including meaningful action to protect the stratospheric ozone layer, phase out leaded petrol, and ban tobacco smoking in public places. However, environmental change represents a bigger challenge – and opportunity – for public health as it cannot be solely addressed with technological innovation or new legislation. It requires a broader paradigm shift that will affect – and improve – many aspects of our lives and communities.

Importantly, HEAL focuses on solution-driven research that will provide robust scientific evidence to underpin structural policy and practice changes. This evidence will be based on a holistic assessment of social and economic costs and benefits, and distributional effects of policies to support long term solutions. HEAL will build on a rich ecosystem of projects, networks and initiatives within and beyond the health sector, including the Healthy, Regenerative and Just Framework for a national strategy on climate, health and wellbeing for Australia proposed by the Climate and Health Alliance.

A key component of the HEAL Network is the development of Communities of Practice (local knowledge exchange forums), including researchers, practitioners, Indigenous and other community organisations, charities, businesses, and decision makers in all Australian jurisdictions. Based on initial gap analyses and stakeholder consultations, we have established ten interdisciplinary research themes that will cover most of our research and capacity building activities. These themes are:

• Indigenous knowledge systems;
• data and decision support systems;
• science communication;
• health system resilience and sustainability;
• bushfires, air pollution, and extreme events;
• food, soil and water security;
• biosecurity and emerging infectious diseases;
• urban health and built environment;
• rural and remote health; and,
• at-risk populations and life course solutions.

The health sector as a catalyst for action

In the global climate change negotiations and policy arena, human and environmental health considerations are becoming more prominent. Health was chosen as a science priority area for the 2021 United Nations Climate Change Conference in Glasgow (COP26), which brought a stronger health focus to the summit. Interestingly, Alok Sharma, President of COP26, used health terms to stress the need for rapid climate action.

“We have kept 1.5°C alive. But, its pulse is weak and it will only survive if we keep our promises and translate commitments into rapid action”, he said in his closing statement.

The key health priorities for COP26, building climate resilient and low carbon health systems, are particularly relevant to the Australian health system, which is vulnerable to climate change and extreme events such as bushfires, heatwaves and floods. Globally, the health care sector makes a significant contribution to greenhouse gas emissions, waste generation, and water usage. If it were a nation, the global health system would be the fifth largest emitter of greenhouse gases on the planet. As part of the COP26 Health Programme, a group of 50 countries have committed to develop climate-resilient and low carbon health systems in response to growing evidence of the impact of climate change on human health.

In Australia, where the health sector contributes around 7% to the national greenhouse gas emissions, it is imperative to make similar commitments. The Australian Medical Association and Doctors for the Environment Australia have called on the Australian health care sector to reduce its carbon emissions to net zero by 2040, with an interim emission reduction target of 80% by 2030.

Furthermore, health professionals have an important role to play by raising public awareness of the damaging effect of climate change, advising patients and the public on how to improve their health by minimising exposure to pollution and reducing their environmental footprint, and supporting action within the health care sector and more widely to reduce greenhouse gas emissions and waste.

Conclusion

HEAL promises a transformative change in environmental health research and practice by sustainably and respectfully bringing together Indigenous knowledges, Western science and data, local and regional priorities, health care practice, communication and policy making to address the health effects of climate change and environmental degradation. Most importantly, HEAL will nurture equitable and reciprocal relationships between communities, scientists and policymakers, and grow the next generation of environmental health researchers in Australia through a comprehensive training program.

The inaugural HEAL conference was an open call for research collaboration and action, as well as a demonstration of sustainability in its own right. Organised as a nearly zero-carbon hybrid event, it enabled online participation from across Australia and internationally, as well as face-to-face interaction in four jurisdictions, actively involving researchers, communities, practitioners and policymakers. The conference content will be available on the HEAL 2021 website.

Professor Sotiris Vardoulakis is the Director of the NHMRC Healthy Environments and Lives (HEAL) National Research Network, and Professor of Global Environmental Health at the Australian National University.

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.