In responding to the “code red” planetary health crisis documented this week by the Intergovernmental Panel on Climate Change, we are so far from where we need to be. Collectively as humanity and specifically as Australians.
How can the health sector contribute to transforming Australia’s killer political dynamics?
We float a few provocative suggestions below, and welcome responses and other suggestions from our readers and wider networks.
1. Pharmacy-led
When was the last time you had a script filled or bought something in a pharmacy, and were given information to improve your climate health literacy?
Imagine a day when every pharmacy in Australia had posters and information clearly explaining the urgent need for climate action, including analysis of local politicians’ history on climate action, and news about local mitigation and adaptation activities.
These are not such far out ideas considering the history of how the pharmacy industry exerts influence, and the potential not just for harnessing their political power for climate action but also for wider learnings.
As Associate Professor Lesley Russell wrote at The Conversation in 2019, politicians are very responsive to community pharmacies because of the Pharmacy Guild’s lobbying clout, the reach of pharmacies into every community, and the substantial political donations they make.
She said:
Community pharmacies have a unique ability to garner public support for their causes from loyal customers. This can be a potent deterrent for any politician proposing changes the Pharmacy Guild views as adverse.
We saw this during the 2013 election campaign when customers were petitioned to save their local pharmacies, supposedly under threat after a move by the Rudd Government to reduce the price of prescription medicines.”
A recent article in the Canadian Pharmacy Journal noted that pharmacists are uniquely positioned and skilled as trusted healthcare professionals and clinical leaders to take a leadership role in climate action.
As well as reducing the carbon footprint of medication use, the article suggested pharmacists engage in advocacy: “The urgency of climate change warrants immediate action from leadership, individuals and organisations.”
As a professional group, pharmacists have not been high profile in climate health leadership; a poll of more than 200 Australian pharmacists who read AJP reported last year that while 76 percent believed climate change is happening, just 48 percent of poll respondents agreed that pharmacists will have a crucial role to play as climate change.
About one in ten respondents do not think climate change is relevant to pharmacy or pharmacists at all.
Nonetheless, pharmacists, individually and collectively, are a hugely untapped resource for climate health action. And the wider health sector can also learn from how they wield political power.
Doctors, nurses, midwives, physios, optometrists and other allied health professionals – make improving the public’s climate health literacy part of your day job. Speak with your patients about the environmental and political determinants of their health. Explain to your patients and wider community that how they vote has direct repercussions for their own health as well as for their children’s survival.
Incorporate consideration of the carbon emissions of various interventions into shared decision making. Back at the pharmacy, scripts arrive with a clear accounting for the medication’s carbon footprint.
Redefine the boundaries of professional practice. How can it be professional to keep to business as usual while this is exactly what is destroying the planet and your children’s futures?
2. Invest in mass communications campaigns
The health sector is relatively privileged. Many of those working in the sector are likely to have some spare cash.
As a sector, come together to self-organise a climate health levy on companies, organisations, policy makers and health professionals. Try to raise enough dollars to out-do the fossil fuel sector in buying political influence.
The funds raised could support mass communications campaigns to help grow climate health literacy and wider understanding of the need for urgent change – in politics, systems and communities.
In these campaigns, demonstrate what the Federal Government failed to do with its COVID communications: make them engaging, humorous, meaningful. Don’t speak down to communities but work with them in creating messaging that resonates and supports meaningful change.
Ensure the campaigns are informed by evidence and deep engagement with diverse communities.
3. Learn from the pandemic
The pandemic has reminded the world that dealing with global health threats requires holistic efforts to address the wider determinants of health and health equity.
We’ve learnt throughout the pandemic that institutional racism, insecure work, inequity, poverty and poor health literacy – of communities and systems – are life-threatening. The climate crisis has striking parallels.
The health sector has to do so much more than decarbonise. Health leaders must speak up for climate justice and climate equity. This means privileging the knowledge and voices of those most likely to be harmed by climate change.
It means addressing the wider determinants of health inequities as part of climate responses – racism, structural inequalities – and having these inform, not be an afterthought, in our actions.
The pandemic has shown the importance of local knowledge and networks; for example, the wider health sector has so much to learn from the pandemic responses of Aboriginal Community Controlled Health Organisations (ACCHOs).
As many Aboriginal and Torres Strait Islander health leaders have said, so many times, privilege Indigenous knowledges and experience over millennia in caring for Country.
4. Support those already working in the space
Don’t reinvent the wheel. Support those already established and working in the space – the Climate and Health Alliance, Seed Mob, Doctors for the Environment and plenty more. Support ACCHOs and the wider primary healthcare sector.
Many of these groups are also leading on efforts to decarbonise health services, through tackling medical waste and high-carbon services.
Donate your time as well as your dollars. Donate a week every month, or take a year off your regular job. Invest your time and money where it really counts. We acknowledge that many people in the health sector are already doing this; but so many more could step up. Employers too. Imagine a time when you could access paid leave for climate action.
5. Foreground climate equity in all health reform
It’s been said forever, but now really is the time to make it happen: comprehensive primary healthcare and prevention must be at the forefront of health reform and investment.
We need community-based models of healthcare that are driven by community needs rather than fee-for-service and profit motivations. And we need payment structures that reward care encompassing both patient and planet. Incentivise carbon-neutral episodes of care and sustainable choices in management under the MBS. As a priority, subsidise pharmaceuticals on the PBS that place a premium on minimising their carbon footprint. The time for action is now.
6. Zero tolerance
We are not being partisan when we say: get political. Call out the lies. As Adam Morton wrote in The Guardian this week: “…the bullshit has to end.”
Of course journalists need to do a much better job of calling out the BS. But so do health leaders. Be loud and clear in calling out the lies, whether they come from politicians, the media, industry or other vested interests. When you hear misinformation, be an advocate for the facts.
Based on the latest science, and taking into account Australia’s national circumstances, the Climate Council has concluded that Australia should reduce its emissions by 75 percent below 2005 levels by 2030, and achieve net zero emissions by 2035.
Even if there was political will and widespread community support to work towards these targets, the challenge would be momentous. As it is, the most pressing challenge is to generate the political will and community support.
And there the health sector has a clear brief.
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