Representatives of millions of health professionals and thousands of hospitals from around the world call on local, national and global policymakers to act now for healthy people on a healthy planet
SAN FRANCISCO – Sept. 12, 2018 – Today dozens of leading health organizations representing more than five million doctors, nurses and public health professionals, and 17,000 hospitals, in more than 120 countries announced commitments and unveiled a Call to Action on Climate and Health aimed at accelerating stronger advocacy and action in addressing climate change—the greatest health threat of the 21st century. The commitments were made as part of the Global Climate and Health Forum at the University of California, San Francisco, an affiliate event to the Global Climate Action Summit.
The commitments announced at the Forum include efforts by hospitals, doctors, nurses and health professionals to take meaningful action to protect public health from climate change. Among these were more than 176 health care institutions representing 17,000 hospitals and health centers in 26 countries that are committing to reduce their carbon emissions by more than 16 million metric tons a year— the equivalent of shutting down four coal fired power plants.
More than 1,200 of these hospitals in both developed and developing countries are also committing to use only 100 percent renewable electricity to power health. More than 200 nurses in 22 states in the U.S. have committed to the Nurses Climate Challenge, launching a movement committed to educating their peers and forging climate solutions in care settings and in the community. And 24 major health organizations across the United States have joined the We Are Still In (WASI) coalition, adding a health voice to the message that the United States is still committed to the Paris Agreement.
“Every breath matters and we all have an inalienable right to life on a healthy planet. It’s absolutely critical that the health sector’s voice and perspective on climate action is heard loud and clear by the public and at all levels of government.” said Christiana Figueres, former executive secretary, United Nations Framework Convention on Climate Change, and convener of Mission2020.
The Call to Action is endorsed by over 50 organizations from across the globe, including the World Federation of Public Health Associations, the American Academy of Pediatrics, the American Public Health Association, the International Federation of Medical Students Associations, Dignity Health, Kaiser Permanente and the American Lung Association. It outlines 10 priority actions that will significantly protect lives and improve people’s health in the era of climate change:
1. Meet and strengthen the commitments under the Paris Agreement.
2. Transition away from the use of coal, oil and natural gas to clean, safe and renewable energy.
3. Transition to zero-carbon transportation systems with an emphasis on active transportation.
4. Build local, healthy and sustainable food and agricultural systems.
5. Invest in policies that support a just transition for workers and communities adversely impacted by the
move to a low-carbon economy.
6. Ensure that gender equality is central to climate action.
7. Raise the health sector voice in the call for climate action.
8. Incorporate climate solutions into all health care and public health systems.
9. Build resilient communities in the face of climate change.
10. Invest in climate and health.
Climate change threatens to undo decades of health and development gains. Extreme heat and weather events caused thousands of deaths and displaced over 200 million people between 2008 and 2015; air pollution, whose primary driver—fossil fuel combustion—is also the primary driver of climate change, caused over 7 million deaths in 2016; vector-borne diseases are spreading to new communities; the agricultural, food, and water systems we depend on for our survival are under threat; and the frequency and severity of droughts, floods, and fires are increasing.
Climate action in the energy, transportation, land use, agricultural and other sectors would avoid millions of preventable deaths each year. Shifting to renewable energy, sustainable food production and diets, active transportation and green cities will lower climate pollution and reduce the incidence of communicable and non-communicable disease, improve mental health, and bring significant health care cost savings.
“Climate change is the greatest health threat and opportunity of the 21st century and the health sector must lead the way to call on local, national and global policymakers to act now to significantly reduce climate pollution and build climate resilience,” said Dr. Maria Neira, director, Department of Public Health, Environment, and Social Determinants of Health, World Health Organization. “With the right policies and investments today, we have the opportunity to realize our vision of healthy people in healthy places on a healthy planet.”
Today’s announcements were made as part of the Global Climate and Health Forum, focused on building the capacity of the global health response to climate change by strengthening collaboration across all health sector stakeholders, raising the health voice for climate action and mobilizing health sector commitments to climate change solutions. The one-day forum featured prominent speakers from United Nations organizations, climate and health NGOs, health organizations, government and the private sector.
The Global Climate and Health Forum was hosted by Health Care Without Harm, the University of California San Francisco (UCSF) Global Health Group, the U.S. Climate and Health Alliance and the Global Climate and Health Alliance. The event was sponsored by Dignity Health, Glaser Progress Foundation, Kaiser Permanente, Wellcome Trust, United Nations Development Programme, The Kresge Foundation, The California Endowment, American Public Health Association, Public Health Institute and the American Lung Association. The Forum was organized in collaboration with the World Health Organization.
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The PHA is one of several organisations to endorse a submission to the Foreign Affairs, Defence and Trade Committee on the Trans-Pacific Partnership Agreement (CPTPP) Amendment Bill 2018 calling for an amendment to stop the spread of investor state dispute settlements (ISDS). You can read the full statement here
The PHA is one of a number of organisations who released a joint statement outlining the benefits of updating the Births, Deaths, Marriages, and Relationships Registration Act (BDMRRA) 1995.
Today’s announced changes to the process for amending gender markers on birth certifciates are welcomed by takatāpui, trans and non-binary people.
“This small but significant change will make it fairer for those in our communities, who do not have the resources to use the existing Family Court process,” said Sally Dellow.
Ms Dellow was speaking on behalf of people and organisations who released a joint statement today outlining the benefits of updating the Births, Deaths, Marriages, and Relationships Registration Act (BDMRRA) 1995.
New Zealand’s passports and driver licence processes are recognised as international good practice for trans and non-binary people. Proposals announced today would introduce similar processes for updating gender markers on a New Zealand birth certificate. New Zealand will join a dozen other countries that already follow such a self-declaration approach.
“Most people in our communities can change their New Zealand passport or driver licence, but it does not match their birth certificate. That can cause significant problems when a birth certificate needs to be shown as proof of identity,” said Ms Dellow.
Today’s joint statement is supported by takatāpui, trans and non-binary people and organisations, parents of transgender and gender diverse children; national health, women’s and Rainbow organisations; legal and health academics, and former Human Rights Commissioners. It calls for the 23-year-old BDMRRA to be amended to reflect the current passports policy, by:
- replacing a Family Court application with a statutory declaration process that enables a people to affirm their self-defined gender identity
- removing any other eligibility requirements, such as the need for medical evidence and
- enabling gender markers to be recognised as male, female, or as a third, non-binary gender.
“We are delighted that the Select Committee’s recommendations reflect this approach,” said Ms Dellow. “This makes a huge difference to takatāpui, trans and non-binary people when they get married, have children, sign their parent’s death certificate, or have to show their birth certificate. It has no impact on the equivalent rights for other people.”
Moving to a simple, administrative process will reduce cost for takatāpui, trans and non-binary people, and free up the time of Family Court staff, judges, and of health professionals who have supplied the required medical evidence.
Ms Dellow said, “We hope to continue dialogue with the government on how to provide some form of identity verification document that recognises and protects refugees, asylum seekers, and new migrants who cannot amend documents in their home country and are not permanent residents here.”
“In addition, there is a need for ongoing consultation with our communities in case there are ways the Bill can be improved through its second reading.”
The Select Committee has recommended that any enacted changes are reviewed after five years. “International human rights standards and good practice are evolving fast in this area,” said Ms Dellow. “A two-year review would help New Zealand keep pace with change, so we can continue to demonstrate what it means to fully respect the dignity, equality, and security of all who live here. Our communities expect to be consulted as part of such a review.”
Health risks of “Hothouse Earth” a disaster
A report released this week on the dangers of heading towards “Hothouse Earth” makes it clear that climate change is now a public health emergency.
“Just as we would react to the threat of pandemic, we need to speed up our efforts to tackle emissions and protect health,” says Dr Rhys Jones, Co-convenor of OraTaio: The NZ Climate and Health Council.
The report, published this week in the Proceedings of the National Academy of Sciences of the USA, states, “the Earth System may be approaching a planetary threshold that could lock in a continuing, rapid pathway towards much hotter conditions — Hothouse Earth.”
“We can’t afford to cross these thresholds into a Hothouse Earth,” says Dr Jones. “A Hothouse Earth would pose impossible risks to our health system and the wellbeing of people everywhere.”
“As health professionals, we urge the government to make stronger and more immediate targets to ensure New Zealand’s emissions decrease to net zero by 2040. We must base our decisions on climate science to make sure we do not breach dangerous tipping points. In order for us to safely reach zero emissions by 2040, much of the action is needed in the next crucial five to ten years.”
“The measures we take to reduce New Zealand's contribution to global warming can directly benefit the health of all New Zealanders. Well-designed climate action can bring about reductions in cardiovascular and respiratory disease, cancers, obesity, food insecurity and child poverty, as well as easing the financial pressures on the health sector.”
“The health risks of a Hothouse Earth mean that we must treat climate change as a public health emergency,” says Dr Jones.
Media Spokesperson: Dr Rhys Jones, 021 411 743
Dr Rhys Jones (Ngāti Kahungunu) (email@example.com) is a Public Health Physician and Senior Lecturer at the University of Auckland, and Co-convenor of OraTaiao: The New Zealand Climate and Health Council.
OraTaiao: The New Zealand Climate and Health Council is an organisation of health professionals concerned with climate change as a serious public health threat. The Council also promotes the positive health gains that can be achieved through action to address climate change. See: www.orataiao.org.nz
About Climate Change and Health Information is available in the following paper from the 2014 NZ Medical Journal:
‘Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action’. http://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2014/vol-127-no-1406/6366
Health threats from climate changes include: worsening illness and injury from heat and other extreme weather, changing patterns of infection including food poisoning, loss of seafood and farming livelihoods, food price rises and mass migration from the Pacific. Those on low incomes, Māori, Pacific people, children and older people will be hit first and hardest, but nobody will be immune to the widespread health and social threats of unchecked climate change. Direct and indirect climate change impacts are already being seen here from warming oceans and sea level rise.
Health opportunities from reducing greenhouse gas emissions, easing pressure on health budgets include: rapidly phasing out coal; switching from car trips to more walking, cycling and public transport; healthier diets lower in red meat and dairy; and energy efficient, warm homes will all cut emissions while also reducing the diseases that kill New Zealanders most and put our children in hospital – cancer, heart disease, lung diseases and car crash injuries.
Māori sexual and reproductive health promotion organisation Te Whāriki Takapou is highly critical of the decision by ACC to spend $18.4m on the ‘Mates and Dates’ programme rather than invest in culturally appropriate teacher-led sexuality education in schools.
Sexual violence, like so many forms of violence experienced by Māori, will not be reduced by programmes like Mates and Dates. The programme is unconnected to the realities of Māori and fails to draw on the wealth of historical and contemporary Māori knowledges and practices associated with healthy relationships.
What is required is an evidence-based national plan for culturally appropriate comprehensive sexuality education that includes consent and sexual violence. There are programmes underway in some schools where teachers are already addressing consent and sexual violence as part of comprehensive sexuality education. However, the road block to rolling out a national plan and programmes across all schools, including Māori-medium schools, is the lack of specific policy, funding and the political ‘will’ to lead the charge.
Political will may change given increasing international attention. This month the United Nations Convention for the Elimination of All Forms of Discrimination Against Women, an international treaty ratified by New Zealand in 1985, released its report on the government’s progress to eliminate discrimination against women. The report noted the high level of gender-based violence in New Zealand, especially domestic and sexual violence and very low levels of reporting of violence within Māori communities where only 20% of family violence and 9% of sexual violence is reported.
The report also highlighted the lack of culturally appropriate approaches and distrust in public authorities that prevent Māori and other ethnic minority women from seeking protection from domestic and sexual violence.
Dedicated Ministry of Education and the Ministry of Health funding for sexuality education programmes, resources and professional development for teachers is a national disgrace.
Māori organisations like Te Whāriki Takapou spend around $100,000 per annum, almost half their contract, to research and produce evidence-based eight session programmes for teachers to freely download and deliver to students attending Māori-medium schools. These programmes use Māori knowledge and practices to support teachers to teach sexuality education and sexual violence prevention in culturally appropriate ways. The decision by government to spend $18.4m on the Mates and Dates programme and not redirect these funds to teacher-led comprehensive sexuality education is not justicable.
Te Whāriki Takapou supports the position that consent and sexual violence prevention is best taught by well-resourced and supported classroom teachers as part of culturally appropriate sexuality education.
Māori students benefit from sexual violence prevention programmes that are part of a well-resourced national cross-sectoral plan developed with Māori. Where Māori-medium schools are concerned, these programmes should be underpinned by Māori knowledges and practices.
Mates and Dates does not meet these criteria and despite funds of $18.4m, will not prevent sexual violence experienced by Māori students.
Te Whāriki Takapou – Alison Green, Chief Executive (MOB: 02102784821)
However, another event resulting in greater loss of life and far-reaching consequences has been barely noted outside academia – that is, the 1918 influenza pandemic.
Unfairly labelled at the time as the ‘Spanish’ flu, it is estimated to have killed at least 50 million people globally, including between 8 and 9,000 New Zealanders (around 1% of the total population), disproportionately Māori (estimated 5%).
Samoans have especial reason to remember the 1918 flu, following so soon after New Zealand’s seizure of Samoa from the Germans in 1915. In November 1918 the NZ Administrator permitted flu-infected passengers to disembark from a NZ ship. Within weeks, 90% of the Samoan population was infected; subsequently 30% of adult men, 22% of adult women and 10% of children died.
Sickness and death were not evenly distributed across the population. Because influenza is spread so easily via droplets from coughing and sneezing, it is particularly virulent where people live or work in close contact – in 1918 this included the armed forces and areas where men worked closely together such as mining. Unsurprisingly, Māori and others living communally or in over-crowded urban conditions with poor access to medical help were disproportionately affected.
Most influenza deaths occur from secondary infection from opportunistic pneumonia bacteria, and most can be avoided by vaccination. In NZ, the pneumococcal vaccine for babies is free, and there is a National Immunisation Register for everyone born since 2005. But old-fashioned hygiene – covering coughs and sneezes and hand-washing – are still the most reliable way to avoid infection.
In a world where globalisation and anti-microbial resistance expose us to new strains of familiar and unfamiliar diseases, the possibility of a pandemic as virulent as 1918 is a threat we all need to take seriously. Just as in 1918, every new threat to our health hits those already most disadvantaged.
New Zealand’s most thorough chronicler of the 1918 flu epidemic is Geoffrey Rice, Emeritus Professor of History at the University of Canterbury, whose book Black November, first published in 1988 and updated in 2012, was motivated by his father’s childhood memory of the appalling sights he witnessed in the small timber and railway town of Taumarunui. A nine-year-old at the time, he recalled lighting fires in the morning in houses where the adults were ill, and finding a woman asleep in bed beside the body of her husband, blackened in death.
Professor Rice wrote this in a memory of the 1918 flu epidemic for the Stuff news website in November last year: “It has often been said that New Zealand’s losses in that war ‘forged the nation’ out of a collective sense of shared grief and loss. Yet it can also be argued that the experience of the 1918 flu, when neighbours risked their lives to help neighbours, and communities rallied to care for the sick, helped confirm the more admirable qualities of the Kiwi character: bravery, compassion, fairness, resourcefulness, good humour and optimism in the face of adversity”.
This week saw a major milestone achieved for global Indigenous health through the launch of the World Federation of Public Health Associations (WFPHA) Indigenous Working Group. The Indigenous Working Group was formed during the World Congress on Public Health last year in Melbourne, and will be Co-Chaired by Carmen Parter, PHAA Vice President (Aboriginal and Torres Strait Islander) and Adrian Te Patu (Ati Haunui a Paparangi: Ngati Ruanui: Ngati Rangi: Nga Rauru: Rangitane ki Wairarapa: Ngati Apa; PHA Executive Council Vice President) who is a WFPHA Governing Council Member. The group will also include Co-Vice Chairs Summer May Finlay (Aboriginal and Torres Strait Islander SIG Co-Convenor) and Emma Rawson (Ngāti Ranginui, Ngai Te Rangi and Raukawa; PHA Executive Councillor). The picture of Adrian, Carmen, Emma and Summer was taken this week outside the United Nations building in Geneva.
The Indigenous Working Group aims to be a catalyst for reducing the significant health disparities and inequities experienced by Indigenous people globally. It is underpinned by the UN Declaration on the Rights of Indigenous Peoples which clearly states the importance of self-determination for the world's Indigenous people.
The PHA was proud to co-host the launch of the Indigenous Working Group with WFPHA and the Public Health Association of Australia, and congratulates the Group's members on this major achievement. We look forward to seeing the group's progress and working closely with them for improved health outcomes for Māori and Pasifika people and Indigenous people worldwide.
View the recorded video from the live streaming of the group's launch.
Keep in touch with the group: Follow the Indigenous Working Group on Twitter at @IndigenousWFPHA and on Facebook
Public health specialist Dr Ashley Bloomfield has been appointed to the Ministry of Health as the new Director-General of Health for a 5 year term.
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