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Environmental Health Australia conference: Someone call a doctor, the planet has a fever!

I begin by acknowledging the traditional owners of this land, the Peramangk people.

I also acknowledge Minister for Health, the Hon John Hill; Mayor of the District Council of Mount Barker, Ann Ferguson; Professor Mark Daniel; other distinguished guests and speakers; and, members of the Environmental Health Profession.

Thank you for the opportunity to be part of the 2009 Annual Environmental Health Australia Conference, with the theme “Putting Environmental Health through the Mill - Local actions with Global impacts,” which is a theme that I believe is an important one for all of us, no matter our profession.

Whether you are a health professional, a politician, or a parent, the impact of climate change on health is becoming increasingly more evident.

Indeed, while we must remember that the Aboriginal communities of Australia themselves were forced to adapt to the remarkable changes in Australia’s climate over tens of thousands of years, the rapid climate changes that we now face will be a far more formidable challenge, especially for communities with a host of existing health and social challenges.

According to the World Health Organisation, climate-related natural disasters already account for more than 60,000 deaths globally per year, the majority of which occur in the developing world.

It is clear from the statistic I just mentioned that health is one of the most severely affected sectors to the adversity of climate change, with the largest global killers, such as malaria and malnutrition, highly sensitive to climatic conditions.

We are already seeing the impact that local and global climate change is having on health in a multitude of ways, and while governments will increasingly turn to environmental health experts for advice about adaptation options to reduce, but not eliminate, forecast impacts, we must do everything we can to protect those at greatest risk.
A recent a paper prepared by the Climate Institute, that looks at ways in which we can minimise the human health impacts of climate change in Australia by 2020 and beyond, highlights that children, the elderly, rural, regional and remote communities, and coastal communities are all at greatest risk from the health impacts of climate change.

So what are these health impacts of climate change:

Increasingly, research has proven that climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations.

The World Health Organisation and the Intergovernmental Panel on Climate Change discuss three kinds of health impacts directly caused from changes in climatic conditions.

1) Direct impacts – increases in mortality from heat stress, floods, cyclones, and bushfires;
2) Consequences of changes to ecosystems and biological process including an increase in transmission of vector borne diseases  – particularly mosquito borne infections such as Ross River Fever, and flood and water borne diseases; and

3) Consequences that occur when populations are disrupted or displaced, including mental health impacts, or food, water, and health service shortages.

We hear a bit about water security here in SA, this is not just a key political issue in the lead up to the next state election, but a very real issue that our state faces due to a drying climate.

Direct impacts:
As all of us here today know, there is overwhelming scientific evidence suggesting that humans are affecting the global climate, which has a knock on effect of creating wide ranging implications for human health. Variability and change in global climate conditions are intrinsically linked to death and disease through natural disasters, such as heatwaves, floods and droughts.

Current statistics show that around 1,100 people aged over 65 are estimated to die each year in Australia due to excessive temperatures.
A recent analysis conducted by the Australian Conservation Foundation, outlined the projected effect of very hot temperatures and climate change deaths on Australians over 65 living in Australian capital cities by the year 2100 (twenty one hundred).

This study showed that without an effective climate change policy action solidly in place, it is estimated that we could see between 8,000 and 15,000 heat related deaths each year by the year 2100.  

The deadly nature that heatwaves have on the human population was shown to the extreme in 2003, when more than 52,000 people lost their lives across Europe. 14,802 deaths alone were recorded in France, with those with restricted mobility, and the elderly making up most of the unfortunate victims of the August heat wave. 

And while these events in the summer of 2003 were indeed tragic, it is unfortunately an occurrence that we can expect to see more of, with heatwaves set to increase in frequency and intensity, particularly if governments continue to fail on reducing global greenhouse gas emissions.

In an article in The Australian last week, it was revealed that the week-long heatwave in January that was felt across South Australia, Victoria, Tasmania, and parts of NSW, claimed more than 400 lives, 374 of which were in Victoria alone.  I should note that these figures are not inclusive of the recent bushfires victims of Black Saturday.

According to Victoria’s chief medical officer, the report conducted into the heatwave found “there was a 62 per cent increase in deaths from January 26 to February 1 as temperatures soared to more than 15 degrees above average.”

Back home, here in South Australia, the Health Department reported up to 80 sudden deaths in the 12-day period from Australia Day, as temperatures climbed into the mid-40s.

This dramatic rise in heat related deaths is an alarming indication of what is to come if we continue to fail to act on climate change policy. 
What we need is a strong commitment by our Federal Climate Change Minister, and indeed the Prime Minister, to the substantial reduction in greenhouse emissions, not the measly 5% by 2020 that is currently offered by the Federal Government.

Research conducted by the Climate Institute has suggested that the risk of heat related deaths is likely to be greater in the southern cities of Australia, as opposed to the warmer northern cities, which is largely due to people not being used to fluctuating temperatures and not adapting to their environment accordingly.

While the Federal Government is currently failing badly on greenhouse gas emission mitigation, the ACF have predicted that through implementing a policy of rapid and dramatic reductions in greenhouse gas emissions, we could halve the number of current and future heat-related deaths.

The correlation of dry conditions with heatwaves is also expected to increase the menace of bushfires in the coming years.  The recent bushfires that ravished more than 12 Victorian communities, claiming 173 lives, and injuring more than 500, is a cruel and devastating depiction that we as Australians are all too familiar with. 

And while the biggest health impact to date has been depression relating to a 50 year drought, the devastation of recent bushfires could arguably become the leading cause of depression throughout Australia in years to come.

Considering the recent fires in Victoria are largely thought to have been exacerbated by the drying climate, the prediction that the number of extreme fire days in Australia is likely to increase dramatically, this is the opportune time for the Federal Government to take the lead in combating climate change to reduce, the increasing health concerns associated with varying climatic conditions that are set to plague future generations.

Transmission of vector borne diseases

Aside from the predicted increase in extreme fire conditions, we are also expected to see an increase of extreme weather events such as storms and heavy rain, which could lead to indirect health outbreaks of illnesses such as Ross River virus, malaria, Murray Valley encephalitis and dengue fever, these being the most relevant to Australia.

Such mosquito borne diseases are strongly influenced by stark variations in climatic conditions, which is cause for concern for areas of Australia not previously considered to be at high risk of mosquito-borne infections.
 
According to a paper commissioned by the Commonwealth Department of Health and Ageing in 2002 entitled “Human health and climate change in Oceania – a risk assessment”, the potential spread of dengue fever due to global warming caused by high greenhouse emissions could reach down to Maryborough and Gympie in the east and the Carnarvon in the west.

While studies have shown that increases in climatic temperatures have increased instances of malaria infection, health risks of dengue fever for Australians are also considered deeply concerning.  While fast acting treatments to reduce the spread of malaria have generally been considered effective, treatments to reduce the longer period of dengue infection are not that readily available in Australia.     

Between December 2008 and March this year, there were several dengue fever outbreaks in North Queensland, covering the area from Port Douglas to Townsville, with an estimated 900 people affected.
In a recent publication entitled “The Sting of Climate Change” The Lowy Institute delivered a grave warning that the way in which climate change is travelling, it will inevitably “intensify already significant malaria and dengue problems” in our region. 
 
And, while we can expect to see an increase in heat-related illnesses and mosquito-transmitted diseases, we are also set to see increased trauma and demand for aid from neighbouring countries in the Asia-Pacific region affected by climate change.

Displaced people:

As a key player in the global community, Australia has the opportunity to help address the health impacts directly and indirectly that result from climate change in our neighbouring countries. 

Numerous scientific reports have shown that climate change will displace people around the world by making their immediate environment unhabitable.
The Australian Conservation Foundation rightly points out, that many of our neighbouring nations – not only in the Pacific but in many parts of Asia – are more susceptible than Australia to the adverse affects of climate change.  Specifically, the low lying island nations in the Pacific, which are already experiencing the affect of sea level rise.  

The Stern Report commissioned by the British Government concluded that between 150 million and 200 million people could be displaced by climate change by 2050.

Although our Pacific Island neighbours have made virtually no contribution to the greenhouse pollution now causing climate change, they will be among the first victims.

The government of Tuvalu and Kiribati have approached the Australian and New Zealand governments on several occasions to request a plan for the migration of their populations as their homelands become unhabitable.

While New Zealand has implemented a ‘Pacific Access Category’ under which 75 people from Tuvalu and Kiribati may migrate to New Zealand every year, Australia is yet to implement a similar policy, which could assist our smaller neighbours seriously affected by climate change.

While some have argued that Tuvalu’s present problems are being caused by overpopulation and poor environmental management, the future outlook for the Pacific islands is indeed bleak. 

A statement by The Intergovernmental Panel on Climate Change in its Third Assessment Report in 2001, highlights the problems that face the small island states with the increasing threat of climate change:

The small island states account for less than 1% of global GHG emissions but are among the most vulnerable of all areas to the potential adverse effects of climate change and sea-level rise. 

Although the severity of the threat will vary regionally, sea-level rise is expected to have disproportionately great effects on the economic and social development of many small island states.

Developing country populations, particularly in remote islands, arid and high mountain zones, and in densely populated coastal areas, are considered to be the most vulnerable groups who are at imminent risk from the health impacts of climate change.  As a key player in the global environment, Australia needs to play a leading role in assisting those countries hardest hit by the effects of climate change in terms of water and food security, sea level rise and extreme weather events. 

At the recent CSIRO's Greenhouse conference in Perth, Climate Change Minister Penny Wong announced that Australia would commit $20 million to help nations in the Pacific and East Timor better understand how climate change would affect them.

And while on the surface, this commitment is a step in the right direction, the fact that Australia has only committed to an emissions reduction target of just a 5 per cent by 2020, and refused to accept climate change refugees from small Pacific nations such as Tuvulu, again highlights that this announcement has failed to adequately address the real issue at hand.

It is estimated that based on current breakdowns, the money will be distributed between the Department of Climate Change, AusAid, the Global Environment Fund and the World Bank, which means that only a small percentage of the $20 million will go to the Pacific islands to deal with actual adaptation strategies.

The existence of some of these small islands is at stake, and as part of the global community that has contributed to global warming, Australia has an obligation to lead by example and provide support to our poorer neighbours to cope with the devastating impact of climate change on their communities.

So what should we be doing to mitigate the impacts of climate change?

First, and foremost, Australia must take adaptive measures to reduce the future health risks of climate change at the personal and community level.

We know that minimal research has been conducted in Australia estimating the cost of the current climate sensitive diseases or of health-specific strategies to combat the increased risk.

The Australian Conservation Foundation report “Climate Change Health Impacts in Australia” specifically states that:
“The health costs of a particular disease will be direct through personal and public expenditure on treatment, prevention, and control and indirect, through productive income foregone, losses to tourism, etc. Together these represent the costs the health system incurs in responding to outbreaks or disasters, as well as of avoiding them.” 

We need to see governments commit to planning for climate change as part of any future discussion in health services, which must include a discussion on preparation for potentially large numbers of displaced people in our region, as the effect of climate change continue to worsen.

Having said that however, I must make the point that while there is much more that can and should be done by the Federal Government, there has been some positive thinking and some money directed towards Australian climate change adaptation initiatives.

The National Climate Change Adaptation Framework, endorsed by the Council of Australian Governments (COAG) in 2007, outlined strategies for building capacity to adapt to climate change and reducing vulnerability in key sectors and regions.  The framework itself specifically refers to potential adaptation strategies to minimise the impact on human health, which highlights that the Government does seem to have now appropriately recognised that adaptation initiatives is an important and emerging area of environmental health, with long-term career opportunities aplenty!

There has also been some thinking about climate change in health here in South Australia.

In 2007, the State Government issued a strategy paper entitled “Tackling Climate Change: South Australia’s Greenhouse Strategy 2007-2020” which outlines the state’s response and strategies to tackle climate change.

Yet despite announcing their commitment to tackling climate change, with priority areas such as reviewing the vulnerability of critical state infrastructure; and addressing the adaptation needs of those communities where early adaptation is needed, it is disappointing that there has been no specific initiatives addressing the health aspects of climate change that have been included in the last two state budgets.

Perhaps the Minister could give us an indication on whether we can expect to see funds directed towards the health impacts of climate change included in this year’s State Budget?

So where do we go from here?

Raising awareness of the health risks of climate change is essential, and doctors and health professionals alike have the opportunity to demonstrate our dedication to mitigating the health impacts of climate change.

As the Climate Institute aptly conclude in their Climate Change Health Check report “the magnitude and urgency of the problem of climate change requires that all who understand the threats to health and who are in a position of influence must act to shape and strengthen the community’s attempts to reduce greenhouse gas emissions.”

The speed and amount of global warming can still be reduced if the level of global emissions is cut rapidly. Future carbon dioxide concentrations would then ‘stabilise’ at a lower level. If this were to happen, the dangerous impact on ecosystems, and human and non-human species, could be lessened.
We need to see the Rudd Government show leadership and commit to cutting emissions by at least 40% by 2020, not the measly 5% as announced in December last year.

Other countries have already rejected the rationale for such relatively weak targets.

Decisive and immediate action to alleviate greenhouse gas emissions is essential, and the Government must commit to greater emission reduction targets that will go in some way to reduce the extent and severity of the impacts of climate change.

The Greens’ position is that we should aim to reduce emissions by at least 40% by 2020 and to achieve net zero emissions as soon as possible thereafter. Numerous independent studies suggest that cuts of this magnitude are achievable and affordable.

The Greens have long championed for a full energy efficiency upgrade for all of Australia's homes, and the Local Green Jobs package that we negotiated as part of the Stimulus package, is a clear demonstration of the remarkable economic potential in that exciting transformation.

Many countries around the world, even the new Obama administration, see the solutions to climate change being entirely consistent with the solutions to the global financial crisis.

We need to rapidly and boldly invest in new sustainable energy and transport infrastructure. Though this transformation will not be easy, it is not the economic doomsday scenario some will have you believe, and it will actually create jobs.

As I said at the beginning, regardless of whether you are a health professional, a politician, or a parent, the health impacts of climate change are real, and becoming increasingly more evident.

The human health impacts of climate change in Australia will partly depend on how our community addresses the challenges before us.

The only thing now holding us back is the political influence of those with a vested interest in maintaining the status quo.

Footnotes not included in this transcript. References for information sources available upon request.

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