Policy responses to climate crisis and health in Australia: a need for urgency

The extraction and burning of oil, coal and gas is overheating our planet. The result is a changing climate that is becoming more extreme and less predictable. According to the Bureau of Meteorology (https://media.bom.gov.au/releases/1250/preliminary‐summary‐of‐australias‐climate‐in‐2024), for instance, 2024 was Australia's second hottest year on record. With intensifying climate events like extreme heat, drought, flooding and bushfires, as well as associated threats to biodiversity and food and water security, come myriad adverse impacts on health. Two articles in this issue of the MJA speak to the health implications of the climate crisis and the policy responses required to rise to this challenge.

Until recently, local transmission of Japanese encephalitis virus (JEV) in Australia was limited to the Torres Strait and Cape York. A widespread outbreak in 2022–23 in New South Wales, Queensland, Victoria and South Australia heralded that the country might be entering a new era in the epidemiology of this mosquito‐borne virus. Indeed, at the end of last year, Victoria reported its first case of JEV since the last outbreak (https://www.theguardian.com/australia‐news/2024/dec/31/japanese‐encephalitis‐case‐found‐in‐victoria‐prompts‐high‐risk‐warning). Dowsett and colleagues (https://doi.org/10.5694/mja2.52550) explain how a changing climate could be contributing to the emergence and spread of JEV in Australia through increases in rainfall, temperature and levels of evaporation and humidity, which in turn affect the interactions between JEV vectors, hosts and the environment.

After reviewing Australia's JEV surveillance efforts to‐date, Dowsett and colleagues conclude that “there is a pressing need to shift from a reactive ‘surveillance and response’ approach to a more proactive, comprehensive ‘predict and prevent’ strategy, particularly in regional areas of Australia where populations are at greater risk”. Key recommendations for action include developing comprehensive surveillance systems that target multiple diseases with overlapping ecology and transmission (such as JEV, West Nile virus, and Murray Valley encephalitis virus), utilising multidisciplinary One Health approaches, and the creation of a central data repository to assist in the rapid detection and containment of outbreaks, potentially led by the nascent Australian Centre for Disease Control (www.cdc.gov.au). These efforts should be complemented by enhancing research capacity for the diversity of vector‐borne diseases that affect Australia and our region.

Recognising that our population is already experiencing the impacts of climate change on health and wellbeing, in December 2023, Australia launched its first National Health and Climate Strategy (https://www.health.gov.au/our‐work/national‐health‐and‐climate‐strategy). Writing in the MJA, Beherns and their colleagues (https://doi.org/10.5694/mja2.52552) from the Australian Department of Health and Aged Care outline the core aims and elements of this landmark strategy, reflect on its first year, and discuss anticipated implementation challenges. The authors explain that “at the heart of the Strategy is an ambitious agenda to transform Australia's health system into one that is sustainable and climate resilient while improving care quality and health outcomes”. Since its launch, work has begun on 31 of the 49 actions within the Strategy, with 12 of those 31 actions completed or in the final stages of completion by the end of 2024. Planning has also commenced for a further 14 actions.

One particularly important element of the Strategy is the ongoing development of a Health National Adaptation Plan (HNAP). These national plans are an initiative under the United Nations Framework Convention on Climate Change, and are intended to provide a national framework for countries to anticipate and manage climate‐related health risks. According to the latest global report from the Lancet Countdown on health and climate change (https://www.thelancet.com/journals/lancet/article/PIIS0140‐6736(24)01822‐1/abstract), as of December 2023, 43 of 82 (52%) countries that had committed to building climate‐resilient health systems through the COP26 Health Programme reported having developed an HNAP, up from just 6% the year before. Australia's commitment to developing its own national plan thus represents a significant step towards building climate resilience within our health system and bringing the country in line with global best practice on climate and health action.

Overall, the success of Australia's National Health and Climate Strategy must be assessed in the long term and will undoubtedly face setbacks and resistance. It must also be judged in light of actions taking place in other areas of government, not least of which include the ongoing new approvals of fossil fuel projects and enormous financial subsidies to major producers and users of fossil fuels — actions that are incompatible with efforts to avoid the worst effects of climate change. Nonetheless, early progress on implementation of the Strategy is encouraging, especially given the arguably catastrophic national inaction on climate change and health that characterised the years preceding its announcement. Owing to its importance for Australia, planetary health is a core focus of the Journal and we encourage our authors to continue to submit research and analysis in this area.