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Will the McKeon Review get the message about the need to prioritise research into health and climate change?

The McKeon Review of Health and Medical Research is due to report by the end of this year, with recommendations for a 10-year strategic health and medical research plan for the nation.

The review’s consultation paper has already come in for a bucket of criticism at Croakey, especially for its glaring lack of attention to what has been described as the “biggest threat to global public health of the 21st century”.

In the article below, public health advocates warn that research into climate change and health must be a priority, given that we have entered “a period of unprecedented and rapid global environmental change”.

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An urgent need to prioritise research into health and climate change

Dr Elizabeth Haworth, Dr Brad Farrant and Fiona Armstrong write:

The recent consultation paper from the McKeon strategic review of national health and medical research has been criticised by health professional groups and researchers for overlooking what many consider to be the major threat to health: climate change.

The Climate and Health Alliance, a coalition of health professional groups, health service providers, and health consumers, has expressed serious concerns that the recent review not only failed to prioritise climate change and health, but to mention it at all.

This raises questions about the willingness of the review committee to acknowledge the broader social and environmental determinants of health. It also highlights the shortcomings of the current paradigm of health in considering upstream global drivers of ill health and health risks.

Professor Tony McMichael, one of the world’s leading researchers in climate and health, said the consultation paper from the National Strategic Review of Health and Medical Research in Australia contained a disappointing “but predictable set of recommendations.” It provides a “sobering reminder” of the need to expand “concern, research effort, resources and policy to abate the big and unprecedented systemic threats to population health and survival from human induced climate change and other extraordinary global environmental changes”.

The international medical journal The Lancet identified climate change as ‘the biggest threat to global public health of the 21st century’ in 2009. In September this year, a report commissioned by 20 governments on the human and economic costs of climate change showed that climate change is a direct cause of 400,000 deaths each year, along with 4.5 million deaths annually attributable to urban air pollution and other environmental hazards in carbon-intensive economies. These losses cost the world $1.2 trillion in 2010 alone.

Australians already face serious risks to health from climate change, as documented in the 2011 Australian Government Climate Commission report: The Critical Decade: Climate Change and Health. More heatwaves; increasing frequency and severity of extreme weather events; more infectious diseases; more vector borne diseases; more disease and premature deaths due to air pollutants all adversely impact health. The report also warned of inadequate health service preparation in an already stressed healthcare system.

While the review, chaired by Simon McKeon, has identified the need for funding ongoing public health research, nowhere does the report acknowledge the need for research on health impacts of climate change or the carbon intensive economy.

Climate change threatens natural and built systems that protect and preserve health, ranging from direct infrastructure damage to disruption of social and organisational structures required for community resilience. Weaknesses of existing health and public health systems need to be identified so that they can be strengthened by informed policy.

People’s health around the world is already at serious risk from climate change with less than one degree of global mean temperature rise. Our current emissions path, which shows no sign of abating, is predicted to deliver a four degrees global average temperature rise over the next few decades.

The observed rate of climate change is occurring much faster than predictions, so even this may be exceeded. What is known of human’s physiological ability to adapt to these rapid changes in temperature, which also have implications for food and water security, mass global migration, and social and ecological disruption?

Such a rapid change is unrecorded in human history, and no one can be sure humans will be able to adapt. Given this dramatic gamble, it seems unthinkable that a 21st century society, especially one that considers itself a “clever country”, could undertake a review of its national health and medical priorities and fail to even consider the most profound risk to health. And yet this is what we are seeing.

The Climate and Health Alliance (CAHA) recommends that research on the health impacts of climate change and the health benefits of climate action should be part of a collaborative global health improvement program, aiming to reduce the adverse impacts of climate change and improve adaptive resilience.

This is in line with the roadmap for applied research in The Lancet in 2009, the Australian National Adaptation Research Plan – Human Health of the National Climate Change Research Facility and major public health bodies worldwide.

However, spending on health and medical research with any relationship to climate change by the National Health and Medical Research Council over the last decade was just 0.23% of the total spend. This is completely disproportionate to the risks posed to health.

How can governments find $5 trillion to bail out the financial sector and yet be unable to find funding for critical health priorities like addressing climate change?

Assumptions that rely on a business-as-usual world are ignoring the weight of evidence that we are living in a period of unprecedented and rapid global environmental change.

Australia, as a wealthy and developed country with a large land mass, highly variable climate, existing problems with water supply and drought and a recent history of health problems following catastrophic weather events has both a responsibility and opportunity to act as a leader in the field of climate-health research.

Protection and improvement of the health of the public requires a clear-eyed evaluation of the most serious threats to health supported by a comprehensive interdisciplinary research program. This includes healthcare itself becoming a low carbon industry.

These challenges to health require looking beyond narrow ‘medical’ approaches to health, and giving consideration to broader ‘upstream’ factors. As Professor Tony McMichael points out, lessons from history such as the collapse of the Mayan civilisation, highlight the risks of ignoring warning signs of environmental pressures.

We should not imagine ourselves immune to these risks and must heed the warnings, and invest in the research to help us respond and manage them.

The next phase of the McKeon strategic review is an opportunity to reconsider our national health and medical research priorities, and enable integrated health research to address the ‘biggest threat to global public health of the 21st century’.

Brad Farrant is a post doctoral researcher at the Telethon Institute for Child Health Research. He is interested in how ecological factors like biodiversity loss, population growth, peak water and climate change will interact to affect children’s development now and in the future.

• Elizabeth Haworth is an epidemiologist and public health researcher and consultant based in Tasmania formerly Senior Clinical Lecturer in Public Health at the University of Oxford.

• Fiona Armstrong is a health and climate policy and communications professional and Convenor of the Climate and Health Alliance.

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Further reading recommended by Croakey

• The Guardian has a useful portal for climate change news and resources

• This report from The Atlantic, 5 Charts About Climate Change That Should Have You Very, Very Worried, links to recent reports from the World Bank and the US National Research Council warning of the need for urgent action, and includes some sobering infographics, as well as a link to this sobering clip from Grist’s David Roberts. 

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