Budget 2020 must tackle climate crisis say health organisations

3 May 2020

Leading NZ health professional organisations have written to the Government asking them to prioritise Budget 2020 funding for a just transition to a climate-resilient, sustainable and low-emissions economy.

The letter, led by OraTaiao: NZ Climate & Health Council, was sent to the Minister and Associate Ministers of Finance on Sunday 3 May, and urges the Government to heed health advice that has for many years been warning of the serious health threat posed by the climate crisis.

Signatories to the letter represent more than 70,000 of the health professionals who have been on the frontline of responding to the pandemic. They include all the major health professional organisations representing nurses, clinical and public health doctors, public health workers and a wide range of other health professionals.

“Government spending must do triple duty – by equitably supporting economic wellbeing, addressing climate change, and improving people’s health,” said Dr Alex Macmillan, Co-convenor of OraTaiao: NZ Climate & Health Council.

“An example is investing in transport infrastructure that makes it easy and safe for people to walk, bike and use a wheelchair to get around, which can create jobs, address climate change, increase physical exercise, reduce traffic crashes and lower healthcare costs. Investments in housing, energy and food systems can also create jobs, address climate change, reduce inequalities and bring health savings.”

“Doing these things fairly means they must be grounded in the Articles of Te Tiriti o Waitangi, designed in partnership with local communities, and ensure that benefits accrue to the groups currently most harmed by injustice,” says Dr Macmillan.

“We can’t go back to business-as-usual, because that’s been a disaster for social, economic and environmental wellbeing,” says Dr Macmillan. “Smart investment, on the other hand, can achieve win-win outcomes for people, prosperity and the planet.”

Quotes from signatory organisations

“The RACP sees action on climate change as part of our ongoing campaign to Make Health Equity the Norm for everyone in Aotearoa New Zealand – healthy houses, healthy jobs, and healthy tamariki and whānau,”says Dr Jeff Brown, Aotearoa New Zealand President, Royal Australasian College of Physicians.

“Alison Eddy, Chief Executive of the College of Midwives, recognises the urgent need for the Government to consider the next generation, who midwives welcome into the world every day. There is a fundamental obligation to support intergenerational justice to ensure the environment is safe and protected for our children.”

 ENDS

Media Spokesperson: Dr. Alexandra Macmillan, Mob. 021 322 625

Dr Alex Macmillan (co-convenor@orataiao.org.nz) is a Public Health Physician, Associate Professor of Environment and Health at the University of Otago, and Co-Convenor of OraTaiao: The New Zealand Climate and Health Council.

Government urged to prioritise access to COVID supplies and vaccine ahead of trade rules

“Working in cancer, every day I see the suffering and concern caused by unrestricted pharmaceutical pricing.  Because of IP rules, whānau are being charged a King’s ransom for medicines that will help keep their loved ones alive.  

 
Now there is the chance this will be repeated across the whole of society, as corporations seek to profit from tests and treatments for COVID-19”, warns Dr George Laking, a medical oncologist from Whakatohea speaking on behalf of Doctors for Healthy Trade.

As countries search for a treatment or vaccine for COVID-19, New Zealand needs to ensure access to affordable supplies from offshore, without being held to ransom by pharmaceutical companies or waiting in a long queue behind countries with more influence or deeper pockets.

Two open letters, signed by international and national organisations, have been sent to the Minister of Health and Minister of Trade this week urging them to address concerns that the World Trade Organization’s intellectual property rules could prevent New Zealand’s ability to secure affordable access to medical supplies, especially vaccines and potential medicines to treat COVID-19 that are currently being developed.

One letter was addressed to a small group of countries, including New Zealand, who pledged back in 2003 not to use flexibilities in the WTO agreement on intellectual property that would allow them to import medicines made under compulsory licences in another country, even in a medical emergency.

“It is totally irrational for New Zealand to keep its own hands tied, as it prepares to meet the COVID-19 needs of its population, by voluntarily shutting itself off from patented ingredients, components, and essential medical products and supplies”, says Prudence Stone, CEO of the Public Health Association of New Zealand, who co-signed the letter with Sarah Dalton, the Executive Director of the Association of Salaried Medical Specialists (ASMS).

“New Zealand needs to notify the WTO that it will now import medicines made under compulsory licence elsewhere”

The second letter, signed by nearly 300 international organisations including Médicins sans Frontières Access Campaign, Public Services International and Oxfam International, as well as the New Zealand Council of Trade Unions, Doctors for Healthy Trade, the Public Health Association, the Association of Salaried Medical Specialists and the New Zealand Nurses Organisation, called on WTO Members to stop trying to negotiate new agreements by the Internet, in which developing countries could not effectively take part:

“The first and only priority for trade negotiators at this time should be to remove all obstacles, including intellectual property rules, in existing agreements that hinder timely and affordable access to medical supplies, such as lifesaving medicines, devices, diagnostics and vaccines, and the ability of governments to take whatever steps are necessary to address this crisis. …

We call on WTO Members to ensure that all countries have the flexibilities to set aside trade rules that constrain their ability to resolve the pandemic crisis, without fear of repercussions, and to cease other negotiations and activities that divert their energy and resources from that goal.”

The signatories called for a fundamental rethink of the kind of trade rules that encourage such monopolies and put people’s lives at risk in every country of the world.

Contact:

Dr George Laking 0221248262

Prudence Stone 0272898987

Jane Kelsey 021765055 (for WTO information)

Public Health Association defends government’s approach to COVID-19

                                                      

The Public Health Association supports the public health leadership demonstrated by New Zealand’s government in its pandemic response to COVID-19. Many more people would have died without this rapid evidence-based operation.

CEO Dr Prudence Stone says many PHA members expressed their disappointment to her this week that a few members of the academic community were publicly questioning New Zealand’s response to COVID-19.

“The aim for our government is to ensure that New Zealand does not see the kinds of scenes we see playing out every day on our TV screens: the chaos, confusion and utter despair in European cities and now the United States” Dr Stone said.

“When we don’t see these same results here, we shouldn’t jump to a conclusion that COVID-19 in Aotearoa is, as Simon Thornley says, ‘not the disaster we feared’. It would have been without the government action. We averted it through preventative policy. That’s public health in action.”

Members of the Public Health Association are mindful, however, that New Zealand’s Health & Disability System, as well as its Welfare System, were under review as New Zealand went into lockdown. The Health & Disability System Review panel looked at evidence showing health outcomes were inequitable in New Zealand by race, mental health, sexuality and disability. The Welfare Expert Advisory Group saw evidence that New Zealanders seeking income support were not being treated with dignity by our welfare system.

“In a pandemic, this inequity of health outcomes and poor service to New Zealanders needing income support will only be amplified,” Dr Stone said, “unless we take action on addressing these inequalities with the same public health approach by our leaders.”

Dr Stone said the Public Health experts among the PHA’s membership acknowledged that elimination of the COVID-19 virus may not be possible globally, unless and until a vaccine is discovered and distributed everywhere. Elimination within New Zealand should however be  possible before any global end-point, provided that the present level of public health action is maintained and combined with effective longterm border protections.

“On both fronts, national and global, the public health approach is necessary to not only prevent the disease spreading, but eliminate it one day altogether,” said Dr Stone. “New Zealand must ensure it can import a vaccine, if and when one is developed, with an equitable distribution programme to implement its supply here in Aotearoa. If there are roadblocks to either, government should clear them now. That’s more public health action to come that is clearly necessary.”

The Public Health Association’s Asian Caucus Chair Dr Lifeng Zhou hopes the public remains assured of the measures being taken by government and follows the appropriate code of the Alert Level government makes official throughout this pandemic. New Zealand’s approach is being heralded internationally as a best case scenario and example of the Public Health framework being applied by decision makers.

“We all need to draw on our common humanity and be explicit about our values. Recognising this will help us make good decisions in difficult situations so that, for example, the need to impose restrictive measures and to protect ourselves does not conflict with fairness, respect, and neighbourliness” Dr Lifeng Zhou said.

Contacts for Media:

Dr Prudence Stone, CEO 027 2898987

Dr Lifeng Zhou, Asian Caucus Chair Lifeng.Zhou@waitematadhb@govt.nz

 

Francis Kewene is a Māori Caucus representative on PHA's Executive Council.

As a former Māori health promoter, a Health Protection Officer, and now a Hauora Māori Professional Practice fellow in the Department of Preventive and Social Medicine at the University of Otago, I felt a responsibility and obligation to volunteer to help with contact tracing for coronavirus.
 
Over a week ago I received an email inviting me to a training session at our local Public Health Unit. The tension as I arrived in the building was palpable. I arrived in a large board room already filled with familiar and unfamiliar faces. Everyone was sitting side by side, less than a metre from each other, which under the circumstances surprised me, and on one wall there was a screen filled with people in a number of different sites on Zoom.
 
The person leading the session launched straight into how we would conduct the contact tracing, the survey we needed to run through, and the resources we would need to support this work. I could feel the tension rising in my body. I could feel my brain spin as I felt a silent scream build: “Where is the whakawhanaungatanga? Where is the humanity of introductions? This is not my normal. This is not my normal!”
 
Then I could no longer hold the scream when I was told we would need to apologise before we asked the ethnicity question in the survey as “this question often makes people uncomfortable”. I was shocked. Enough apologising.
 
“Enough!” I raised my voice in a room of people who did not know me and whom I did not know.
“And by the way, if we are going to be working together, if we are to support one another, let’s connect first. We should have had a moment at the start of this sessions to introduce ourselves to one another.”
 
Silence. The training recommenced.
 
Each and everyone of us is doing our bit during these challenging times. Everyone is doing their best, but we know that doing our best must not be to the exclusion of Māori and our Māori normal. Our normal has changed, but we can still stay connected, we can still support, and find strength through our whakapapa.
 
My name is Francis Kewene, I am a small piece of paua in the eye socket of my tupuna carved on the wall of our wharenui. I am a mama, a sister, a cousin, and aunt. I am a worker, I am part of a team, I am part of a community trying to do what we can.
 
We as members of the Public Health Association choose to be here because we believe in the power of the collective. I reach out to you all, and ask members, particularly the Māori members of the PHA to raise our collective voice. Share what is happening in your communities with one another through this pānui. Through our email links we can support each other with our skills, expertise and aroha.

Francis.kewene@otago.ac.nz

Te Rōpū Whakakaupapa Urutā National Māori Pandemic Group

Media release from the Equality Network 31 March 2020

Equity of coronavirus outcomes is worth watching out for

 

We can be justifiably proud of our Government’s approach to the COVID-19 virus crisis. It has acted quickly to recognise the WHO's recommendations. The national 'lock-down’ will do much to stop the spread of the virus, and government's support for people and businesses is to be commended. This will hopefully put us in a better position to face the future and recover from the damage that the virus is doing, and will certainly continue to do. Further, most are following government instructions and people are working together in their communities to make the best of their situations by forming neighbourhood support groups.

However, some cracks are opening and even though the Government is responding with changes to the support packages, many would describe the crisis as a three way issue.

First is the virus and the damage it is doing to people. Then there is no doubt that there will be long term damage to the economy. But thirdly, many people concerned about social justice are now describing the crisis as an inequality crisis and the Government must recognise this.

Those most affected are those on basic incomes or benefits. Many cannot store food and must visit supermarkets every few days. At present they find that shelves are empty of many basic needs, owing to an excess of panic-buying by selfish hoarders. Many cannot afford to top up their cellphones, do not have IT devices for their children to access educational programmes, have no internet access, and do not have strong neighbourhood support groups.

Many of those with mental health problems feel powerless, especially if they live alone. There are still many uncertainties about what will happen, as well as the anxieties of subsisting on a very low benefit or income. And the stress levels for many young people are very high.

And what about the homeless? Those sleeping rough, couch-surfing and living in overcrowded accommodation will further struggle to self-isolate and survive.

COVID-19 is having disproportionate impacts on those most vulnerable. Those at the lower end are suffering, whereas those who are well-off have the resources to cope much better. So it is an inequality crisis and the Government must do something about it. In the Global Financial Crisis the poor suffered most and took much longer than the wealthy to get over the impact. 

The Government must among other things:

• Significantly increase benefits. Implementing the recommendations of the Welfare Expert Advisory Group would be a great start
• Increase the incomes of the low paid by increasing the Working For Families Tax credits, making them available to all and not just to those in the workforce
  
  
• Ensure that there are enough well stocked food outlets so that all can get food when they need to and ensure that panic buying does not result in empty shelves
• Ensure that the homeless are well looked after. This will significantly slow the spread of the virus, and benefit us all
• Encourage the establishment of neighbourhood support groups.

With this further support from Government we can get through this together and significantly reduce inequality of outcomes for COVID-19.

Dr. Prudence Stone for the Equality Network: 0272898987 

           
More Equal Societies Are Better For All

The Equality Network is a network of 36 New Zealand organisations such as the PHA, all of whom promote social justice. It operates under the principle that more equal societies are better for all. For more information visit: www.equalitynetwork.org.nz

 

Dr Lifeng Zhou, Chair of the PHA's Asian Caucus calls for everyone to work together, all countries/territories, ethnic groups, faiths and cultures, in the containment of the Pandemic COVID-19:
 
Dr Tedros Adhanom Ghebreyesus, the Director-General of World Health Organization (WHO) declared (11 March 2020) that the outbreak of COVID-19 in the world is a ‘pandemic’. A pandemic is defined as the uncontrolled worldwide spread of a new disease.

COVID-19, caused by the novel coronavirus, officially named as SARS-Cov2, is a new illness that can affect lungs, airways and other organs. According to WHO as of 18 March 2020, there were 191,127 confirmed cases reported globally with 7807 deaths. China and the Republic of Korea had significantly declining epidemics, but the spread of SARS-Cov2 in other parts of the world is significant.

WHO calls for all countries and territories to take urgent and vigilant action to work together, to do the right things with calm, to protect all citizens of the world.

However, since the emergence of COVID-19 we have seen instances of public stigmatisation, the rise of racism and use of stereotypes against some population groups. This is harmful and unethical, as stigma can, according to WHO, 1) drive people to hide the illness to avoid discrimination, 2) prevent people from seeking health care immediately and 3) discourage them from adopting healthy behaviours.

While we’re very happy to see the Ministry of Health show its understanding of and respect for the Chinese culture when 157 people from Wuhan were held in quarantine for two weeks, we are also dismayed to hear how Chinese people have experienced stigma and discrimination associated with public fear of the novel coronavirus in New Zealand.

The recent Public Health Expert blog of “Getting Through Together: Ethical Values for a Pandemic” written by Ruth Cunningham, Charlotte Paul and Andrew Moore, provides balanced ethical considerations when responding to a pandemic like COVID-19. We all need to draw on our common humanity and be explicit about our values. As they put it: “Recognising this will help us make good decisions in difficult situations so that, for example, the need to impose restrictive measures and to protect ourselves does not conflict with fairness, respect, and neighbourliness.”

The PHA together with its Asian Caucus call each of us to be intentional and thoughtful when communicating on social media and other platforms, showing supportive behaviours as we fight against our common health threat: the novel coronavirus.   
 
Be Safe by following public health advice;
Be Smart by being informed from accurate sources;
Be Kind and support one another to fight COVID-19

We wish you all the best in this difficult time of lockdown due to the COVID-19 pandemic. We will try to continue to work and function from home as normally as we can.

Our Zoom facility is on hand for all branches, caucuses and SIGs to deploy for remote face to face meetings online. Please contact Fiona (fiona@pha.org.nz) or Alyssa (pha@pha.org.nz) for support to plan your zoom meetings.

Coronavirus (COVID-19) - what is it?

Coronaviruses are a large and diverse family of viruses which includes the common cold and severe acute respiratory syndrome (SARS).

In January 2020, officials identified a new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, formerly known as 2019-nCoV). The disease caused by this new virus has been named COVID-19 (CO for the coronavirus family, VI for virus, D for disease and 19 for the year the virus emerged).

New Zealand has 589 confirmed and probable cases of COVID-19. and one death. The Ministry of Health (MoH) says 'With continued vigilance the chance of widespread community outbreak is expected to remain low'.

See MoH's latest media release for a summary of the current status.

New Zealand is currently at Alert Level 4 – Eliminate

'These alert levels specify the public health and social measures to be taken. Nationwide, New Zealand is currently at Level 4 – Eliminate. This means that it is likely that the disease is not contained. See more information about Alert levels.

Find out how to look after your mental health and wellbeing when you have to stay at home.

Health and care workers - expressions of interest for COVID-19 response

We are seeking expressions of interest from health and care professionals who are able and willing to work for a limited amount of time as part of the national strategic approach to managing COVID-19. Find out more'

For COVID-19 health advice and information, contact the Healthline team (for free) on 0800 358 5453 or +64 9 358 5453 for international SIMS.

See the MoH website for detailed information on the virus. The MoH has developed a useful 'what you need to know' sheet. MoH also has a Facebook page to keep you up to date on the situation. 

How to minimise the risk of getting sick
Stay at home unless you are an essential worker. Stay up to date with the Government's announcements and advice and follow the Ministry of Health's COVID-19 webpage to keep up with the latest developments.

Strictly observe good hand and respiratory hygiene. This means:

• covering coughs and sneezes with disposable tissues or coughing/sneezing into your elbow
• disposing of used tissues appropriately in a bin
• washing hands for at least 20 seconds with soap and water and drying them thoroughly, or using hand sanitiser:
  
• • before eating or handling food
  • after using the toilet
  • after coughing, sneezing, blowing your nose or wiping children’s noses
  • after touching public surfaces
• keeping 2 metres away from people who are unwell
• limiting alcohol and drug use (as this may affect your ability to adequately follow the advice above).

The measures above are especially important for people who have existing health conditions, such as those with diabetes, renal failure, chronic lung disease or compromised immune systems.

Book your flu vaccination asap
Another very important thing you can do is to get vaccinated against influenza as soon as you can.

More than 800,000 influenza vaccines have been distributed to vaccination providers.

This ensures vaccines are available to vaccinate priority groups, such as those over 65 years old, pregnant women, children with a history of respiratory illness and frontline workers.

It's worth noting that influenza immunisation doesn’t normally start until April, and the flu season doesn’t normally start until late May.

Be patient while our health system works through any backlogs. There will be more stock available in the first half of April. 

Flutracking 

Flutracking is an online survey which asks if you have had a fever or cough in the last week and which can help us track COVID-19. 

Registering online will help our surveillance efforts by providing early detection of community spread of the flu and also of COVID-19 symptoms.

People are encouraged to register online at the Flutracking website.

This is a practical thing everyone can do to help monitor flu and COVID-19 symptoms throughout NZ.

Not only is getting vaccinated against the flu the best way to avoid the flu but it will also leave the health system free to cope with those who do contract COVID-19 and not clog up the system with flu victims.

Useful Links
World Health Organization (WHO) COVID-19 website
WHO COVID-19 Q&A
MoH website
MoH social media:
Facebook page: @minhealthnz
Twitter channel @minhealthnz 
NZ Government COVID-19 website
Johns Hopkins University's CSSE has a one-page dashboard that allows visitors to track every single confirmed case in the world, as well as deaths and recovery figures, in near real-time.

University of Otago Public Health Expert blog:
Avoidable hospitalisations: Helping our health system get through COVID-19
Getting Through Together: Ethical Values for a Pandemic
NZ Should Prepare for a Potentially Severe Global Coronavirus Pandemic
What does the novel coronavirus epidemic mean for New Zealand?

Other stories on COVID-19
How to talk to a loved one who's breaking isolation rules
New Zealanders in coronavirus self-isolation urged to register
Closing NZ's border against extreme pandemics stacks up, study finds

Please take care of yourselves and those around you.

Arohanui from your national office team (now all based at our homes).

We recently made a submission to the Justice Select Committee on the Inquiry into 2019 Local Elections and Liquor Licensing Trust Elections. 

We recently made a submission to the Justice Committee on the Sexual Violence Legislation Bill. We will be appearing in person before the Committee to give an oral submission next week in support of our written submission.

We recently wrote a submission jointly with the NZ College of Public Health Medicine, and an endorsement of Ora Taiao's submission, on the Climate Change Response (Emissions Trading Reform) Amendment Bill.