Introduction by Croakey: Imagine the outcry if an influential and critically important global tobacco control conference was hosted by the tobacco industry, and attended by swarms of tobacco industry lobbyists?
Yet that is exactly what we see with the fossil fuel lobby and the global climate negotiations known as COP, or the Conference of the Parties to the United Nations Framework Convention on Climate Change. And it’s happening again at the COP29, now underway in Baku, Azerbaijan.
As carbon dioxide emissions from fossil fuels continue to increase, the World Health Organization recently released a new report, Health is the argument for climate change, which calls for an urgent transition away from fossil fuels as “an act of collective self-preservation”.
The alternative, as climate health experts write below, is a breakdown in healthcare systems within a matter of decades. Below their article are links to reports from COP29, including calls for early warning systems for extreme heat events, and comments from a First Nations delegation.
Aletha Ward, Mark Holmes, Tracey Tulleners and Tracy Levett-Jones write:
The healthcare sector stands at a crossroads. The choices we make today – how we vote, which leaders we empower, and what policies we prioritise – will determine whether our future health systems collapse under the strain of climate breakdown or emerge prepared for the challenges ahead.
This isn’t just about technological advances or the ability of communities to adapt – it’s about political will. As the world gathers for COP 29, it is clear that climate inaction is a political issue. This is about power and who wields it, and the consequences will reverberate across our hospitals, primary healthcare centres, and communities.
The World Health Organization (WHO) has declared that climate change is the greatest threat to global health in the 21st century, a reminder that our actions now have life-or-death consequences for future generations.
Climate breakdown
In this future, the world failed to take meaningful political action during the critical decades leading up to 2050. Fossil fuel interests continued to dictate policy, prioritising short-term profits over long-term health. As a result, healthcare systems have crumbled under the weight of an uninhabitable climate.
Hospitals overwhelmed: Urban hospitals are no longer places of refuge but centres of chaos. In cities like Sydney and Melbourne, emergency rooms are overflowing as heatwaves reach 45°C – now a regular occurrence. Healthcare workers, trained to heal, are forced into triage mode, deciding who will receive life-saving care as power grids falter and cooling systems fail. This didn’t happen overnight – it was the result of years of political complacency. Governments had decades to invest in climate-ready infrastructure, but they chose not to, favouring fossil fuel interests over the future of public health.
Primary healthcare in remote communities: In First Nations communities like the Torres Strait, rising sea levels and unpredictable weather patterns have devastated healthcare services. Chronic underfunding of Aboriginal Community Controlled Health Organisations (ACCHOs) left them without the resources to prepare for climate impacts. Remote health services, left to fend for themselves, are overwhelmed by cases of heat exhaustion, mosquito-borne diseases, and food insecurity. These are not just climate impacts – they are the consequences of political decisions that have long ignored the calls for climate justice from First Nations peoples.
Social and emotional wellbeing crisis: Mental health services are stretched to breaking point. With mass displacement, loss of cultural lands, and continuous climate-induced trauma, mental health workers are overwhelmed. First Nations communities face profound grief as the lands that hold their ancestral stories are submerged. Politicians ignored early warnings from healthcare professionals and scientists, opting instead for policies that valued economic growth over human wellbeing.
Aged care collapse: The aged care sector, neglected in political discussions, has been decimated by climate breakdown. Older Australians, already vulnerable, are now exposed to extreme heat, fires, and floods. The failure to invest in climate-resilient infrastructure has made aged care facilities unsafe, leading to frequent evacuations and preventable deaths. Political leaders could have acted, but their inaction has led to the collapse of care for our most vulnerable citizens.
Path to hope: healthcare transformed
In an alternative future, voters and policymakers in the 2020s made bold decisions to prioritise climate justice and public health. Fossil fuel interests were held to account, and healthcare was reimagined as a cornerstone of climate action.
Hospitals of the future: Hospitals are no longer reactive – they are models of climate adaptation. Designed to withstand extreme weather, they run on renewable energy, with green spaces integrated to cool the air and support mental wellbeing. These healthcare systems are the product of political movements that prioritised people’s health over fossil fuel profits. With advanced climate monitoring systems, healthcare professionals can prepare and respond to crises well before they occur.
First Nations leading the way: In rural and remote communities, ACCHOs have become global models for climate adaptation, blending traditional knowledge with modern science. This transformation did not happen by chance – it was the result of political leadership that empowered and listened to First Nations communities. Indigenous-led health services now lead climate innovation, designing food sovereignty projects, climate-adapted housing, and mental health programs that help communities thrive despite ongoing climate challenges.
Thriving social and emotional wellbeing: Mental health services are now integral to climate adaptation. Governments responded to early warnings from mental health advocates, recognising that climate breakdown isn’t just about physical infrastructure—it’s about people’s social and emotional wellbeing. Programs are in place to help communities process climate grief, and First Nations frameworks guide this transformation. This progress shows what can happen when political leaders act with foresight and compassion, placing wellbeing at the core of climate strategies.
Aged care redefined: In this future, aged care services are prioritised in climate-resilient policy. Older Australians live in homes designed to withstand extreme weather, powered by renewable energy and staffed by healthcare professionals trained in both aged care and climate adaptation. This transformation only happened because voters demanded that politicians prioritise care over cuts, ensuring aged care systems could protect vulnerable populations in a climate-challenged world.
Action matters now
The healthcare future we face is not inevitable – it will be shaped by the political decisions we make today.
As COP 29 convenes, it is clear that our political leaders hold the power to steer us toward a future of preparedness and sustainability or let us continue down a path of climate breakdown and collapse.
Our votes matter, and the leaders we elect must commit to decarbonisation, renewable energy infrastructure, and policies that prioritise public health and climate justice.
It is no longer acceptable to support political parties that sideline healthcare in their climate agendas – health professionals and the public alike must demand that climate-ready healthcare is at the forefront of every party’s platform.
For too long, the fossil fuel lobby has dominated political decision-making, but now healthcare professionals and communities must hold their leaders accountable for the decades of inaction that have harmed our planet and health.
Politicians who refuse to confront the climate crisis should be voted out, while those who champion climate action should be supported at all levels of government.
Healthcare systems will not evolve on their own. It will take political courage and voter demand to ensure hospitals, aged care facilities, and mental health services are fully equipped to meet the challenges of a changing climate. Policies promoting climate adaptation, from renewable energy investment to community-led initiatives, must become central to both our national and international agendas.
By 2050, healthcare systems will either be overwhelmed by the consequences of climate breakdown or thriving as models of sustainability and resilience. This is not just a matter of science or innovation – it is a political choice.
The power to shape this future lies with us, and with the politicians we choose to support.
As the world looks to COP 29, the time for half measures is over. We must demand climate justice, and that begins with how we vote today.
If we choose wisely, 2050 can be a year where healthcare systems lead the charge in building a fair, sustainable, and healthy future for all.
Author details
Dr Aletha Ward is Senior Research Lead – First Nations at the University of Southern Queensland. She is active in climate and health research and advocacy, including as:
Co-Founder and Ambassador – Climate Action Nurses
Chair Climate and Health Faculty – Australian College of Nursing
Non-Executive Director – Climate and Health Alliance
Leadership team – Planetary Health Collaborative for Nurses and Midwives
Climate and Health Representative – Australian Primary Health Care Nurses Association.
Mark Holmes, RN., RM., BN, MMid, MAv (Human Factors) is Deputy Chair of the Australian College of Nursing Climate and Health Faculty.
Dr Tracey Tulleners is Lecturer in Nursing, Department of Nursing & Midwifery, University of Southern Queensland
Distinguished Professor Tracy Levett-Jones is Professor of Nursing Education in the School of Nursing & Midwifery at The University of Technology Sydney.
• Also follow #GreenHealthForum24 for news from the Greening the Healthcare Sector forum, an online event taking place this month.
Reports from COP29
See Croakey’s archive of articles on fossil fuels and health
