Global meetings like the G20 Leaders Summit are not generally reported through a health lens, although the decisions undertaken at the conference can have profound ramifications for health, at a local and global level.

For example, yesterday’s landmark agreement  between the US and China ,which included the announcement of further emission reduction goals, lends some hope to meaningful discussion regarding climate change and health at the summit.  The health impacts of climate change,  social and economic inequality and the TPP are just some of the concerns Croakey contributors would like to see discussed at the G20.

Below, Croakey contributors share their hopes for the summit.
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Stephen Leeder, Emeritus Professor of Public Health and Community Medicine, University of Sydney and Editor-in-Chief, Medical Journal of Australia

Q: What are some of the critical health issues facing the Summit?

Jeff Sachs will be there with Ban Ki-moon (UN Secretary General), so there will be disruption if sustainability gets no coverage. Climate change is now listed. The macroeconomic interplay of health and development should come up, and Ebola is a great excuse!

Q: What are some headlines you’d like to see arising out of the meeting?

“G20 seeks harmony between sustainability and growth”

“G20 says “take climate change seriously” to Abbott”

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Alison Verhoeven, CEO of the AHHA

Q: What are the most important health implications of the meeting?

Andrew McAuliffe from AHHA will be taking part in a panel on Social Determinants of Health at the H20 side meeting, which is being organised by Mukesh Haikerwal and the World Medical Association in Melbourne on the 14 November. He and Linc Thurecht will subsequently present on 5 December to the International Hospital Federation, a summary of this presentation is below.

The health of an individual is shaped by the circumstances of their life. More than just age and biological risk factors, one’s health is impacted by a range of societal factors experienced through their life course. Australia is generally considered to be one of the healthiest countries in the world.

Yet these aggregate statistics mask an underlying distribution of the health status of the population. There are many large groups within Australia who in general do not experience as healthy a life as the majority of Australians including: Aboriginal and Torres Strait Islander peoples; those with a disability; many who live in rural and remote areas; socioeconomically disadvantaged people; and humanitarian and refugee immigrants.

There are a variety of likely complex factors that contribute to these outcomes. However, the pressures this produces across the health system are manifest with the opportunity costs associated with health inequalities in Australia being significant.

In particular, the impact of health inequalities on hospitals has been estimated at around 5 per cent of total expenditure. Compounding this is the structural ageing of the Australian population that will produce growing pressures on the primary and acute healthcare systems over coming decades.

In this talk, the disadvantage experienced by segments of the Australian population and the pressures this produces within the health system will be outlined.

The competitive tensions between different levels of government in the provision of health services will also be discussed, along with significant recent developments in the Australian political landscape as it relates to the provision of healthcare services and international issues raised at the H20 International Health Summit.

Q: What are some headlines you’d like to see arising out of the meeting?

The Ebola crisis must be high on the agenda for G20 participants as an immediate issue requiring strategic cooperation.

The health impacts of climate change, the role of social determinants in health, and the health and wellbeing of refugees are also issues which require international collaboration and leadership from G20 nations.

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Psychiatrist Peter Parry

Q: What are the most important health implications of the meeting?

The TPP negotiations need to be discussed. They represent the fight between big money corporations and the public good – e.g. In Australia, for example this may impact on PBS and affordable medications.

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Dr Claire Hooker, Senior Lecturer, Centre for Values, Ethics and the Law in Medicine, University of Sydney

Q: What are the most important health implications of the meeting?

I would love to see some attention to the social determinants of health arising from the G20 meeting (although I don’t expect this).

Specifically, these issues seem crucial:

1. Given that we are anticipating more and more serious epidemic / pandemic events as a result of climate change, increased contact to wildlife reservoirs and movements of pathogens, for example as mosquito populations shift, what level of health infrastructure does a country need to maintain in order to mount an effective control response?

What scientific networks do countries need to invest in in order to ensure sufficient resources and trained personnel to swiftly produce diagnoses, treatments and vaccines?

2. We have overwhelming evidence that widening socioeconomic disparity produces poorer and more costly health outcomes at every level of income – including the most wealthy. How will governments produce policy that address the root causes, i.e., social-structural causes, of ill health? what is necessary for healthy communities?

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Marilyn Wise, Associate Professor, UNSW Centre for Primary Health Care & Equity

Q: What are the most important health implications of the meeting?

One of the most important health implications of this meeting is linked to the balance between labour and capital.

Inequality (social and economic) is bad for the health of populations, and that inequality is increasing, and the share of income going to labour, compared with the share going to capital, has been falling steadily everywhere.

There was a wonderful special report in The Economist of October 4th-10th 2014, about the issue of the maldistribution of wealth between labour and capital in what is called, a third wave of the industrial revolution.

Besides the frightening figures on the redistribution of wealth away from labour across the world, the other interesting part of he Economist’s report is the suggestion that it’s ok for people to work but not to earn a living wage that is sufficient to support people and families. And the acceptance that we will need to learn to “tolerate a ‘growing underclass’ while continuing to search for a technological solution to underemployment.”

I realise that this isn’t a direct health-related story but if we’re serious about the future health of our nation, then this is one of the largest issues on the current global political, economic, and social table.

The need to focus attention on redistribution of wealth (and the associated resources such as education, health care, housing, etc) and to ensure that all people have been accorded social dignity and respect seems to me to be vital for the future.

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Dr Tim Senior, GP and Wonky Health columnist

Q: What are the most important health implications of the meeting?

For the G20, the two big issues must be climate change and inequality. They are both massive drivers of ill-health.

Climate change particularly is not an issue on its own, but one that frames all the others – all human action occurs in (not on or separate from) our environment, and instability in the climate has massive, if unpredictable, effects for every other area of human endeavour.

In this context, wanting to talk about growth, in the absence of discussing climate (or inequality) is just pie in the sky. It sounds about 30 years out of date to me.

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Dr Ginny Barbour, Medicine & Biology Editorial Director, PLOS

Q: What are the most important health implications of the meeting?

I find it very surprising that there is minimal focus on health on the G20 agenda. Linked to that is also the lack of explicit discussion on inequality, other than in very general terms. We know that health and inequality are linked and in turn drive economic health and therefore these seem two surprising and disappointing omissions.

Also completely lacking on the public agenda at least is any discussion of refugees, and health and other issues associated with that. This would be a high priority for me, given the huge waves of refugees we are currently seeing globally.

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Dr Christine Walker, Chronic Illness Alliance

Q: What are the most important health implications of the meeting?

The main problem with the health implications of the G20 is that health is absent – either in terms of its funding implications or the impact of all the other discussions on health.

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Additionally, the Climate and Health Alliance has issued the following statement regarding the G20 conference:

Dear Friends and Colleagues,

As you know, the G20 Leaders Summit is on this weekend in Brisbane and world leaders are gathering to talk about issues ranging from development, employment, taxation, infrastructure, investment and trade.

But not climate change.

Meanwhile the coal industry is at the G20, working to secure greater subsidies and less regulation of their deadly product. Coal causes hundreds of thousands of premature deaths each year , largely from exposure to air pollution from coal fired power plants in developing nations.

Leading climate and energy scientists from around the world say any further expansion of coal is incompatible with avoiding dangerous climate change. Coal must be quickly substituted for zero emission technologies, and the majority of fossil fuel reserves must stay in the ground.

However the Prime Minister Tony Abbott declared “coal is good for humanity ” and “coal is essential for the prosperity of the world ”.
The Qld Premier Campbell Newman recently claimed  those opposing Australia’s coal exports are “condemning people in China, but particularly in India, who live in poverty, condemning them to that poverty .”

He went on to say: “To take 1.3 billion people in India out of poverty is going to require significant energy, and coal particularly is what they’re after.”

India doesn’t want our coal

This might come as something of a surprise to the people of India, wrote Indian energy policy analyst Shankar Sharma in an open letter to the Qld Premier last week:

“This statement, if reported correctly, indicates to me that you did not have the benefit of effective briefing by your officers.”

“Not only is it “highly irrational to assume that everyone in 1.3 billion is poor ,” writes Mr Sharma, but “it is surprising that it seems that you have not been briefed on the social and environmental aspects of burning large quantities of coal in a densely populated and resource constrained country like India.”

The Indian Energy Minister Piyush Goyal has just told the World Economic Forum they will be investing US$100bn in renewable energy in the next five years .

The coal industry plan to expand, regardless of the damage they cause

Coal industry leaders know their days are numbered. That’s why they have engaged Burson-Marsteller, the PR company which handled the PR for the 1984 Union Carbide gas leak  in Bhopal, India and formerly made a living spruiking the benefits of tobacco.

Now they’ve helped Peabody Energy and others set up the Advanced Energy for Life campaign, aimed at influencing world leaders  to help them “fight energy poverty ” and suggesting that without access to coal, the developed world will forever be consigned to poverty. In an extraordinary display of hubris, they even claim “coal is key to human health and welfare, along with a clean environment .”

As they make plain in this video, their goal is to secure policy commitments from world leaders at the G20 that support the expansion of coal.

We can’t let this happen!

As health and medical professionals, we can’t just stand back and allow the coal industry to wreck the planet and cause the deaths of thousands of people in this callous and calculated pursuit of profit.

The industry is on the attack – just last week, when CAHA President and Australian National University climate and health researcher Dr Liz Hanna responded to the sobering findings of the latest IPCC report by pointing to the dangers of Australian coal exports, Minerals Council CEO Brendan Pearson responded by suggesting Dr Hanna was “unable to distinguish between ideological prejudice and scholarship  ”!

What can you do?

Write a letter to the editor or an opinion piece for publication in one of the major newspapers or online publications expressing your concerns about the unfettered expansion of coal in Australia and the risks it poses to people’s health and the climate.

Contact details:

Courier Mail use this online form
Brisbane Times use this online form
The Australian [email protected]
Sydney Morning Herald [email protected]
The Age use this online form
The Adelaide Advertiser use this online form
The Canberra Times [email protected]
The West Australian [email protected]
The Hobart Mercury use this online form
Northern Territory News use this online form
Croakey (health blog at Crikey) [email protected]
Climate Spectator [email protected]
Renew Economy [email protected]
The New Daily [email protected]

Hit the airwaves

ABC Radio Brisbane 1300 222 612
4BC 13 13 32
ABC Radio National 1300 225 576

Get cracking on social media

·        Twitter – tweet the Premier @theqldpremier and let him know your thoughts on the matter (use these hash tags: #climate #coal #climate2014 #renewables #G20)
·        Facebook – share these info graphics herehere and here  and some of the links below
Need more information?

Here are some links to recent reports:
·        Lagging Behind: Australia and the Global Response to Climate Change  (The Climate Council)
·        The fossil fuel bailout: G20 subsidies for oil, gas and coal exploration  (Overseas Development Institute / Oil Change International)
·        Fossil fuel exploration subsidies: Australia (Overseas Development Institute / Oil Change International)
·        Mining the age of entitlement   (The Australia Institute)
·        The mouse that roars: Coal in the Queensland economy   (The Australia Institute)
·        Unburnable carbon  (Carbon Tracker)

Here are some useful newspaper articles:

·        Take it from us: India needs renewables, not more Australian coal  (The Guardian)
·        Solar, not coal, best option for world’s poor – IEA (RenewEconomy)
·        Renewables as green as you would expect (Scientific American)
·        ‘Coal exports a killer for thousands’, says ANU academic Elizabeth Hanna  (The Australian)
·        Tony’s Abbott’s ‘coal is good’ line is familiar, and troubling  (The Guardian)
·        Not so cheap: Australia needs to acknowledge the real cost of coal  (The Conversation)
·        Australia, India’s dirty energy friend (SBS News)

Here are some recent health / medical journal articles:

·        A critical decade for energy transitions   (Australian New Zealand Journal of Public Health)
·        Climate change: health risks mount while Nero fiddles  (Medical Journal of Australia)
·        Open letter to the Hon Tony Abbott MP urging the Prime Minister to include human-induced climate change and its serious health consequences on the agenda at the G20 (Medical Journal of Australia)

Here are some resources on coal and health:

·        Joint statement on Health Effects of Coal  (CAHA and Climate Council)
·        The unpaid health bill  (Health and Environment Alliance)
·        Health and Energy Policy: Briefing Paper  (CAHA)
·        The Human Cost of Power  (CAHA and PHAA)
·        How coal burns Australia (DEA)

More useful resources can also be found on http://endcoal.org/
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* For previous Croakey reading on health and the G20 meeting click here.

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