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Paying tribute to Professor Tony McMichael: one of the world’s public health champions

(This post was updated on 28, 29, and 30 Sept, and 6 Oct)

Tributes are pouring in from around the world for the late Professor Tony McMichael AO, who was internationally recognised for his pioneering work in environmental health, particularly in climate change and health.

Professor Emeritus of Population Health at the ANU, he died early on Friday 26 September at Canberra Hospital, following complications related to influenza and pneumonia. He was 71 (DOB 3 October 1942).

Just a few days before his death, Professor McMichael was emailing colleagues about climate change and health. Colleagues have described him as a giant of public health, an eminent scientist, a generous mentor and a visionary leader.

As this 2009 NHMRC podcast notes, for many years he led the assessment of health risks for the United Nations Intergovernmental Panel on Climate Change, which shared the 2007 Nobel Peace Prize with Al Gore. He said in that NHMRC interview:

“… we’ve started to disrupt the world’s climate system and very many other of the great natural systems that are this planet’s life support system, we are actually beginning to change the conditions of life on earth. And that’s a big deal. That’s what I would regard as the most important aspect of the climate change story. And we’re just now starting to realise that as we begin to see that in addition to all the other impacts that climate change has already begun to have, we can see effects on human wellbeing, human health, in some parts of the world, and we’re expecting that there’ll be many more in the future. It includes infectious diseases as an important part of the story, but it’s only part. There will be a whole range of adverse health effects.”

A 2012 festschrift in Canberra celebrated the breadth of his career and achievements:

“Professor McMichael has made seminal contributions to scientific and human understanding of the health implications of tobacco, the health risks from lead production, uranium mining, rubber production, and ozone depletion as well as climate change.

Many of those present recounted how their careers had been influenced by Professor McMichael’s’ work, particularly his seminal text: “Planetary Overload”, published in 1993, which outlined the threats to health from climate change, ozone depletion, land degradation, loss of biodiversity and the explosion of cities.

Professor McMichael’s work as a public health researcher and epidemiologist has been instrumental in the phasing out of lead in more than 100 countries; key to legal decisions to determine what constituted scientific proof in relation to harm to human health from tobacco; and profoundly influential in highlighting how the health of the natural environment and the health of the biosphere is fundamental to human health.”

***

Tributes

Tributes will continue to be added below and a website has been established in his memory. Towards the bottom of the post are links related to Professor McMichael’s work.

Colin D Butler, Professor of Public Health at the University of Canberra
(This is an extract from a longer article). 

Tony’s leadership role of the student union allowed him to meet many Australians at a formative time who would later become influential. It is reasonable to surmise that this year was a wonderful springboard – but for what? Many NUS leaders have entered politics; instead Tony was to turn to the most political branch of medicine, public health. Being the very first doctoral student of Basil Hetzel at the newly created Department of Social and Preventive Medicine at Monash University (at the time a very young university) must have added to Tony’s sense of self-reliance. Tony was not necessarily bound by the opinions and dogmas of his peers, he could also set his own compass. And he had both the intellect and the courage to do this.

The late 1960s was a time of intense concern about global population growth. McMichael was influenced not only by Paul Ehrlich and Rene Dubos, but a wide cast of ecological leaders and concerns. These led to a series of essays called “Spaceship Earth” in Nation Review, a weekly newspaper. Two decades later, just when the “cornucopian enchantment” was at its peak (ie despite the Rio Summit the time when the concerns about global population and global environmental impact arguably reached their nadir) he published Planetary Overload. Of all his books, this is the most influential and important.

By then McMichael’s reputation as a leading epidemiologist was well-established, and this book may have seemed a gamble. Indeed, before its eager acceptance by Cambridge University Press (facilitated by Professor, later Sir Andy Haines) the same manuscript was dismissed by a reviewer for Oxford University Press.

At that time the integration of Earth System Science and health was scarcely beginning, though the foundation had been laid two decades earlier by Dubos. McMichael has clearly been the most successful and influential thinker to build on that legacy. Today, ecological public health courses are emerging as legitimate and indeed vital.

McMichael died less than a week after perhaps the greatest global climate protest so far in history. US President Obama, assisted by the recent steep fall in price of solar and some other forms of renewable energy appears to genuinely understand the job-creating, economy-saving and civilisation-preserving potential of a rapid transition to clean global energy.

If we are to survive as an advanced, wise and compassionate  species, the work of people like Tony McMichael will increasingly be recognised as fundamental to the shift that we are engaged in.

Professor Anthony Capon, Director, International Institute for Global Health, United Nations University (UNU-IIGH), UKM Medical Centre, Kuala Lumpur
While we have lost one of the world’s public health gurus, there is no doubt that Tony’s legacy will continue to inspire public health generations to come.

Professor Martin McKee CBE, European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine
Tony was totally inspirational. Although I don’t work on climate change – sadly I do more to increase it – we did write some papers on what might be termed futurology together, the challenge of depletion of resources. However, we also had many absolutely fascinating discussions at their house in Primrose Hill when they were in London (although Tony did make sure of this by adding place cards with topics for conversation sometimes!). Although we only met up infrequently in recent years I shall greatly miss him, and global public health has lost a true hero.

Fiona Armstrong, Climate and Health Alliance
He was a generous mentor and wise counsel. He was a quiet champion of CAHA’s work, an inspiration and guide. As Maria Neira from WHO said at his festschrift: “Tony is the guru on climate and health”. What will we do without him? Thank goodness for the many PhDs he supervised, and colleagues he mentored, because he leaves behind a living legacy of champions for environmental protection and climate action. But such a contribution to human knowledge in the field – it will be a long time, if ever, that it could be matched.

Tim Lang, Professor of Food Policy, Centre for Food Policy, School of Arts & Social Sciences, City University London, London
What a truly great person and a giant thinker about public health. How very, very sad but what a legacy of work and inspiration. He’s been a key figure in the renaissance of ecological public health thinking and analysis; indeed, I would say, the key figure.

Colin L Soskolne,Professor Emeritus, University of Alberta, Edmonton 
We are all, I am sure, grief-stricken at the loss of such a GIANT of a colleague whose legacy will endure through each of the topics that he so deeply reflected on and made so accessible….the world has lost a major force for good!

Professor Corey Bradshaw, University of Adelaide, wrote at his blog:
…he was one of the foremost thinkers and visionaries in the relationship between environment and human health…A powerhouse in the general and multidisciplinary approach to the drivers of declining human health, Tony researched everything from classic human epidemiology to the sociological aspects of declining human health in the face of climate disruption…. He was the sort of man to inspire people to think outside of the box. I am deeply saddened by his passing, even though I only knew him superficially. He was a visionary, and his absence will impoverish the field of human wellbeing research and management for many years.

Professor Elizabeth Waters, University of Melbourne
Tony McMichael’s contribution to high quality evidence and standing up for climate and health, and the social determinants of health, was incredible and extraordinary; as well as being kind, gentle, clever, strategic, and a determined public health leader. Tony’s legacy will be to keep bringing the evidence on determinants of health and scrutiny of industry influence on evidence into public debate. Sincere thoughts to his family, friends and colleagues.

Stephen Leeder, 
Emeritus Professor of Public Health and Community Medicine, University of Sydney, and Editor-in-Chief, Medical Journal of Australia
I visited Tony in Canberra Hospital a week ago. We chatted about letters received at the MJA following publication of his (and colleagues) open letter to the PM seeking inclusion of climate change on the upcoming G20 agenda. One letter suggested that we were scurrilous fascists and another Russian socialist lackies.  He found this entertaining.

We also discussed his vulnerability, how one or more chronic health problems diminish reserves in all body systems. He was disappointed that the flu had caused a deterioration in his tenuous renal function.

We chatted about the fact that we had first appeared together on Peter Ross’ evening ABC program Nightcap in 1971 or 2, discussing suicide rates and the work that Basil Hetzel and others had done to reduce the availability of barbiturates and how female suicide rate had fallen.

He has an active writer on environmental matters and edited a newsletter I think at Monash called Spaceship Earth – the lines were clearly drawn for his outstanding career in ienvironmental epidemiology and public health. His festschrift detailed all of these contributions and his strong commitment to the artistic world through music and of course the joyful experience of many in being his friend and the love and loyalty of his family.

We exchanged a few other whimsical and gentle thoughts.  I left him deeply worried.  I went back the next day and the ward sister told me Judith had taken him in a wheel chair for walk. She told me where to go to look for him but I could not find him.  A splendid bouquet from the Public Health Association of Australia stood alone in his empty room.

Dr Rodolfo Saracci, Honorary Director of Research in Epidemiology at the Italian National Research Council at Pisa.
I am losing a long time friend, and we are all losing one of the most thoughtful and humanistic scientists of our time (that he was an original and technically most sound epidemiologist is in a sense secondary).

Professor Andrew Wilson, Menzies Centre for Health Policy, University of Sydney
My memory of Tony will be of his extraordinary ability to bring together different strands of science to make the case for public health action, a great public health physician and epidemiologist.

John Mendoza, mental health advocate
Tony McMichael has been the gentle giant of the public health movement in Australia for 3 decades. When he spoke or wrote it was precise, purposeful and powerful. 

I was fortunate to have a first hand experience to work with Tony in Adelaide in the late 1980s. He played a key role in getting legislation through the SA parliament to ban all forms of tobacco advertising and sponsorship. Only the second jurisdiction in the world, after Victoria, to do so.

Tony not only guided the small working group of which Lyn Roberts, Cathy Charnock and I were members but he was our key link to the Premier, John Bannon, who remained cautious on this legislation. See Tony played tennis with the Premier and when things got ‘tight’ he made sure that it was a good match and the Premier won.

Getting this legislation up, is just one small example of the dozens of real world changing contributions of this great Australian.  My sympathies to his family at this time.

Wael Al-Delaimy, Professor of Global Health and Epidemiology, University of California, San Diego
Tony was an epidemiologist in his own league. He was able to combine the scientific integrity, ethics, and demeanor of a nobleman with the humbleness of an overachieving scientist, mentor and a great leader. I had the pleasure to meet him on several occasions throughout my career, first during my PhD years, then when I was at the International Agency for Research on Cancer (IARC) where he lead a group of us to write the Fruits and Vegetables Monograph, but most of my interaction was when he was President of ISEE (International Society of Environmental Epidemiology) between 2008 and 2010 and I was chairing the Ethics and Philosophy Committee. There were some challenging decisions he had to take on behalf of the society that were the right thing to do but clearly negatively impacted him in terms of personal relationships but he did not disappoint by choosing the right thing. His demeanor in running meetings was unique and I learned so much from him.

It is a real loss for all of us to see him leave this world, but all of us will someday, but our reconciliation is that he left behind him such a legacy and touched everyone he met.

Sharon Friel, Director and Professor of Health Equity, Director, Menzies Centre for Health Policy, Regulatory Institutions Network, ANU
I will miss Professor Tony McMichael for many things. His visionary thought; his huge intellect; the way he combined passion and evidence in pursuit of health equity and environmental health; his mentoring of me to be bold in vision and action; and his wicked sense of humour and terrible attempts at a Scottish accent. It was a privilege to have known him.

Billie Giles-Corti, McCaughey VicHealth Centre for Community Wellbeing, Academic Centre for Health Equity, The University of Melbourne
Like everyone, I was so saddened to hear that Professor Tony McMichael had passed away on Friday – this is incredibly sudden and sad. Tony was a leading international thinker focussed on the impact of climate change on health and I have spent sometime this morning reading some of his ideas, and listening to some of his talks.  http://m.youtube.com/watch?v=BNMBABY4dHc

I first met Tony in the late 80s when I worked at the National Heart Foundation national office coordinating its workplace health program. Tony chaired the Heart Foundation’s tripartite Committee that brought together health, business and unions with the focus on creating health promoting workplaces.  He was a formidable chair and a bit intimidating for someone new to the game, but I learnt a lot from him. It was my first experience of the complexities of intersectoral action, in action. Not easy but critical.

Tony at the time was an occupational epidemiologist who went on to become the person we know today:  an international intellectual focussed on the health impact of climate change. He has been a wonderful supporter of my own work on the built form and health over the years and provided sage advice from time to time, particularly about lifting our focus from chronic disease impacts, to include climate change impacts.

Listening to his talks this morning, has left me more committed to the need for the public health community to push for compact walkable more sustainable cities. While density is ‘contested’ space in academic circles, to me it is completely irresponsible – socially, environmentally and economically – that we continue to build suburban low density development on the urban fringe.

A focus on sustainable healthy, liveable and cities is critical for both social and environmentally sustainability – reading the Sunday age article on Cranbourne focussing on the social impact of urban planning reminds me again that we ignore these issues at our peril http://www.theage.com.au/national/-10lrj6.html.  As a public health community we need to ensure that our research is connected to policy and a constituency of advocates who can help create the tipping point necessary to ensure we produce better outcomes that create healthy and sustainable cities.  None of us can do this alone.

So if anything good can from the passing of a valued colleague who has contributed so much in his 71 years, is to redouble our commitment to keep going and to do better. If not now, when?  Vale Tony we are much the poorer for your loss.

Simon Chapman, Professor, Sydney School of Public Health, University of Sydney