Australia’s National Health and Climate Strategy: the next steps

Australia’s National Health and Climate Strategy’s vision is to be commended, but detail of how the Strategy’s objectives will be implemented is still unclear.

In December 2023, the Australian Government’s Assistant Minister for Health and Aged Care, the Hon Ged Kearney MP, launched Australia’s first National Health and Climate Strategy at the COP28 United Nations Climate Change Conference.

This National Strategy is an important step towards protecting Australians from the significant health threats of climate change, while delivering sustainable, high quality health care. Many health groups, including the Australian Medical Association, Doctors for the Environment Australia, the majority of Australia’s medical colleges and the Climate and Health Alliance have long advocated for its development in conjunction with the establishment of a National Health, Sustainability and Climate Unit.

The Strategy’s vision for “healthy, climate-resilient communities, and a sustainable … high-quality [and] net zero health system” is to be commended and its successful implementation would provide the urgently needed framework, coordination and actions for the health sector to deliver on its objectives and protect the health of both people and the planet.

The Strategy’s four objectives are to:

• build a climate-resilient health system and enhance its capacity to protect health and wellbeing from the impacts of climate change;
• build a sustainable, high quality, net zero health system;
• collaborate internationally to build sustainable, climate-resilient health systems and communities;
• support healthy, climate-resilient and sustainable communities through whole-of-government action which recognises the relationship between health and climate outcomes.

Highlighting the strengths of the Strategy

Firstly, its development has been informed by extensive consultation with the health community, including First Nations, primary care and aged care stakeholders.  

A preliminary paper for consultation received over 270 written submissions and was accompanied by 16 face-to-face and virtual workshops. The evolution between the preliminary consultation paper and the final strategy suggests this was more than a “fig-leaf” consultation.

Further, the strong emphasis on First Nations communities’ knowledge and experience in climate and health decision making is consistent with the National Agreement on Closing the Gap.

Secondly, the Strategy’s objectives are comprehensive in covering emissions reduction and climate resilience, aiming to address both in relation to the health system’s direct responsibilities and more broadly through multisector actions and international collaborations. The 49 Actions that sit under the objectives are excellent first steps, with many based on learnings from health systems further ahead in their climate action, such as England’s National Health Service.

Thirdly, the Strategy’s emphasis on prevention, care closer to home and the reduction of low value, harmful care and variations of care is to be applauded.

With careful application, such priorities can improve population and patient health outcomes and create financial savings while reducing emissions. This approach also aligns with other initiatives to improve safety and quality of care while addressing health care’s environmental impact, such as the Choosing Wisely initiative and the Australian Commission on Safety and Quality in Healthcare’s recently released draft Environmental Sustainability and Climate Resilience Healthcare Module.

Areas of concern

Detail of how the Strategy’s objectives and actions will be implemented is yet to be elucidated, although the development of a health system decarbonisation roadmap and an emission reduction trajectory are included as actions.

Of particular interest is why actions covered in the Strategy, which have been underway for several years in leading health systems internationally, have not yet been implemented in most Australian health systems. This suggests that exploration of barriers and enablers to action is required. Although the Strategy does include a chapter on enablers, including workforce, research, communication, collaboration and governance, these crucial elements for implementation are underdeveloped and exclude one critical enabler of action: financing.

Appropriate funding is fundamental for implementation, coordination and evaluation of progress, even with many of the actions expected to generate savings over various time scales (particularly compared with the “do nothing” option).

Yet the Strategy is currently silent on funding, apart from recognising that actions that require funding will require further consideration, with an update on delivery of actions to be expected by 2026. A strategy without funding will fail to realise its vision and objectives; commitment to appropriately fund the strategy must occur in the 2024–25 Budget.

Lastly, although the Strategy recognises that all parts of the health system must be involved for an effective response to climate change, the degree of involvement, ownership and accountability of state and territory governments and the private health sector is not clear. 

Nevertheless, the Strategy sets out a comprehensive set of foundational actions to respond to Australia’s climate and health challenges.

Attention now needs to turn to financing and rapid implementation of the Strategy to enable the urgent transformational changes required to effectively respond to the health impacts of climate change while minimising Australia’s health sector’s significant contribution to the problem.

Angie Bone FAFPHM is a public health physician and Associate Professor of Practice in Planetary Health at Monash Sustainable Development Institute in Melbourne. She is a member of Doctors for the Environment Australia and the Public Health Association of Australia.

Eugenie Kayak is an Anaesthetist, Enterprise Professor of Sustainable Healthcare at the Melbourne Medical School, University of Melbourne, Co-convenor of Sustainable Healthcare for Doctors for the Environment Australia and was part of the CMO’s Advisory Group for the development of the National Health and Climate Strategy.

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

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