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Climate health experts declare code red for the world, while Australia is stuck on a limb

Croakey is closed for summer holidays and will resume publishing in the week of 10 January 2022. In the meantime, we are re-publishing some of our top articles from 2021.

This article was first published on Thursday, October 21, 2021


Introduction by Croakey: Two important annual reports on the climate crisis and health were released today: the 2021 report of The Lancet Countdown on health and climate change is titled ‘code red for a healthy future’, and the 2021 report of the MJA–Lancet Countdown is called ‘Australia increasingly out on a limb’.

The reports have four new indicators – heat impact on physical and sporting activities, urban green space, diet and health co-benefits, and net value of fossil fuel subsidies and carbon prices. Another three new indicators are also in the Australian report: Indigenous health and climate change, bushfire adaptation, and health and climate change research.

The global report says climate change is beginning to reverse years of progress in tackling the food and water insecurity that still affects the world’s most underserved populations. During any given month in 2020, up to 19 percent of the global land surface was affected by extreme drought; a value that had not exceeded 13 percent between 1950 and 1999.

The report says at the current pace of reducing global greenhouse gas emissions, it would take more than 150 years for the energy system to fully decarbonise, and we are on track for a roughly 2.4°C average global temperature increase by the end of the century.

The use of public funds to subsidise fossil fuels is partly responsible for the slow decarbonisation rate. Of 84 countries reviewed, 65 were still providing an overall subsidy to fossil fuels in 2018 and, in many cases, subsidies were equivalent to substantial proportions of the national health budget and could have been redirected to deliver net benefits to health and wellbeing.

The report also found that the current direction of post-COVID-19 spending is threatening to make this situation worse, with just 18 percent of all the funds committed for economic recovery from the COVID-19 pandemic by the end of 2020 expected to lead to a reduction of greenhouse gas emissions.

“Indeed, the economic recovery from the pandemic is already predicted to lead to an unprecedented five percent increase in greenhouse gas emissions in 2021, which will bring global anthropogenic emissions back to their peak amounts.”

Meanwhile the MJA report – launched at a webinar today – estimates that the cost of heat-related deaths is around $6.8 billion each year in Australia.

The authors call for: a national heat-health strategy; funding and support to ensure Aboriginal and Torres Strait Islander Peoples are at the centre of climate change and health policy-making and implementation; and a target of net-zero healthcare in Australia by 2040, and a national sustainable healthcare unit to work towards this goal.

Below the co-chairs of the MJA-Lancet Countdown, Associate Professor Ying Zhang at The University of Sydney, and Associate Professor Paul Beggs at Macquarie University, write that Australia’s world-lagging climate change responses continue to put health and life at risk.


Ying Zhang and Paul Beggs writes:

The annual MJA-Lancet Countdown report was published today, the fourth such report tracking how climate change is affecting the health of Australians. This is an extension of The Lancet Countdown global effort to track and monitor the health effects of climate change worldwide, ever since this knowledge gap was formally recognised in 2015.

The MJA-Lancet Countdown on health and climate change in Australia is an integral part of the Lancet Countdown global effort to track progress on health and climate change.

We develop and assess indicators across five broad domains: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement.

The Australian Countdown team was established in 2017, and produced its first national report in 2018, and updated it in 2019 and published a special report on bushfires, climate and health in 2020.

The 2021 report released today reports on the full suite of about 40 indicators across each of the five domains:

  • Climate change impacts, exposures and vulnerability
  • Adaptation, planning and resilience for health
  • Mitigation actions and health co-benefits
  • Economics and finance
  • Public and political engagement.

    At today’s launch: co-Chairs Associate Professor Ying Zhang and Associate Professor Paul Beggs

Key messages

Australia is increasingly vulnerable to extreme heat, droughts and bushfires. These extreme weather events not only cause increased demand for health services but also significantly impact on society, resulting in reduced hours of work, disrupted physical and sporting activities, and thousands of people displaced.

We have found that 11.4 percent of Australian deaths are associated with extremely hot or cold non-optimal temperatures, and excess deaths due to heat are increasing over time. It’s estimated that the cost of heat-related deaths is around $6.8 billion each year in Australia.

One of the report’s new indicators examined disproportionate health impacts of climate change on Indigenous Australians. “The elevated levels of cardiovascular and respiratory diseases, unemployment and overcrowded housing, and lack of access to healthcare, increase the vulnerability and decrease the adaptive capacity of Indigenous Australians to climate change health impacts.”

Despite the increasing risks and impacts from climate change, the Federal Government’s responses to climate change are insufficient to protect people’s health.

There remains no national climate change and health adaptation plan for Australia, even though a framework for a national strategy on climate, health and wellbeing for Australia has been proposed.

Compared with international efforts in accelerating the transition to decarbonised societies, Australia continues to lag on implementing adequate emission reduction targets and long-term strategies in mitigation and adaptation.

Australia’s primary energy consumption is dominated by coal, and continues to have a much smaller proportion of electricity from low carbon sources compared with leading countries. The transportation system still heavily relies heavily on fossil fuels.

Australia has demonstrated a world-leading capacity to lead an evidence-based response duringin responding to the COVID-19 pandemic.

However, its climate change adaptation and mitigation strategies are world lagging, which makinge Australians more vulnerable to climate change.

Three recommendations to Australian policymakers

The MJA-Lancet Countdown also produces Policy Briefs for Australian policymakers based on the scientific findings and consultations with experts and stakeholders.

This year’s Policy Brief focuses on three recommendations that will help set Australia’s healthcare system on a more sustainable emissions pathway, and foster national climate change resilience.

Beat the heat: develop a national heat-health strategy to coordinate extreme heat preparation, response, and recovery measures across jurisdictions.

Empower First Peoples: provide funding and support to ensure Aboriginal and Torres Strait Islander Peoples are at the centre of climate change and health policymaking and implementation. Aboriginal and Torres Strait Islander knowledge and practices will be critical to enabling an effective national climate change response.

Sustainable healthcare: establish a target of net-zero healthcare in Australia by 2040, and a national sustainable healthcare unit to work towards this goal. This model is being successfully implemented in England, and has resulted in significant healthcare emissions reductions over the past decade.

The full Policy Brief can be found here on the Lancet Countdown website. 

Want to know more?

This year’s online launch event has been organised by Melbourne-based team members with guest speakers on Thursday 21 October 2021, 1-2pm AEDT. You can find the main web page for the event here.

Partnership to drive more changes:

The 2021 MJA–Lancet Countdown report involves research by 19 experts from seven Australian institutions in collaboration with University College London, supported by The Lancet and The Medical Journal of Australia.

In developing the accompanying Policy Brief, we have engaged with leading Australian medical and health professional organisations.

In addition to the on-going partnership with the Australian Medical Association (AMA), the Australian Medical Students’ Association (AMSA), The Royal Australasian College of Physicians (RACP) and the Climate and Health Alliance (CAHA), this year we have Australian College of Nursing (ACN), Australian Indigenous Doctors’ Association (AIDA) and Public Health Association of Australia (PHAA) joining us as new partners to formally endorse the Policy Brief.

We hope to send stronger and clearer messages to drive more actions on health and climate change.

From today’s launch

Dr Celia McMichael, a co-author, presented findings from The Lancet Countdown.


Professor Lisa Jackson Pulver from the University of Sydney spoke of the importance of all people stepping into responsibilities to care for Country and future generations.


This article is published as part of the #HealthyCOP26 series that Croakey is publishing in partnership with the Climate and Health Alliance (CAHA).