This year, natural disasters exacerbated by climate change and a global pandemic, revealed the growing systemic inequalities in Australia and around the world. With climate change and infectious diseases on the rise, doctors, climate and health experts as well as frontline community leaders are pushing for solutions that both mitigate climate change and reduce inequality.

This is the first article in a two-part series on tackling climate change and inequality.

For many in Australia, 2020 has felt cursed. Just as the cataclysmic bushfires were settling down, some of the same towns devastated by the fires were inundated with floods, hampering recovery efforts and contaminating drinking water. Then as the last bushfire was extinguished— a global pandemic. What’s more is that these floods and fires came on the back of years of drought and water mismanagement, which decimated livestock, fish populations, and dried up major river systems. 

What these crises revealed is that disasters aren't a great equalizer, but a magnifier of existing systemic inequalities. Housing instability, unemployment, domestic violence, mental health and racism, have all been exacerbated by the coronavirus pandemic, with many of these same injustices exacerbated by the bushfire crisis months earlier—All social determinants, that have a significant impact on health and wellbeing. 

The Bureau of Meteorology told The Royal Commission into National Natural Disaster Arrangements that the bushfires "played out" just as predicted. Experts have also warned that climate change, deforestation, and the rise in humans disturbing ancient ecosystems, have been shown to increase the likelihood of infectious diseases and zoonotic pandemics, such as COVID-19. 

With climate change predicted to reach catastrophic levels in the coming decades, and the UN warning we are rapidly running out of time to avoid such devastation, what is the role of doctors and the health sector to address both health inequalities and climate change that, even without pandemics, are creating a perfect storm for the poorest communities in Australian and around the world. 

Aaron Bernstein, the interim director for the C-Change Center for Climate, Health and the Global Environment at Harvard University’s T.H. Chan School of Public Health, told Politico that, the notion that climate and health and environmental policy might not be related is “a ​dangerous delusion.”

calls for a Post-COVID Recovery to address climate change and health equity

Sir Michael Marmot, professor of epidemiology and public health at University College London sees the multiple crises 2020 has thrown at the world as an opportunity to simultaneously address inequality as well as climate change. In fact, he sees them as two sides of the same coin. While he expressed his concern to The Guardian that the climate crisis has been viewed as a “slow-burn” issue that has not elicited the emergency response that’s needed, said that, “coronavirus exposes that we can do things differently...we must not go back to the status quo ante.” 

UN Deputy Secretary-General, Amina Mohammed, also sees this juncture as crucial to address both health inequalities and environmental concerns. “We cannot afford to go back to the world we had before this crisis,” Mohammed said.

 “That would mean leaving unaddressed the vulnerabilities and fragilities that this crisis has brought into plain sight: massive underinvestment in health and social protection; massive global and local inequalities; the onward march towards the destruction of nature and climate catastrophe; the erosion of democratic norms that are core to protecting rights and ensuring social cohesion.”

This concept is not new, over a decade ago, the World Health Organization, in their social determinants of health report stated that, “we need to bring the two agendas of health equity and climate change together.”

In the past few months, places such as Bangladesh, and the Pacific have experienced the trifecta of climate change induced disasters, a pandemic and systemic inequalities. In regards to a recovery plan, Dr Jale Samuwai, the climate finance officer for Oxfam in the Pacific, wrote in an op-ed for Al jazeera that, “governments need to heed the painful lessons of both the impacts of climate change and the pandemic...in re-prioritising national economic strategies during the post-crisis situation, consideration of gender and class-based inequalities, as well as human rights, must become integral components to ensure that the economy will work for all of us, instead of a privileged few.”

Speaking at a recent Vichealth webinar, entitled, ‘Equity during recovery - Addressing social and health inequities as we emerge from lockdown’, Prof. Marmot emphasised that austerity has a damaging impact on society and health equity. Instead, he insisted that the way forward is through rebuilding efforts that address climate change and sustainability. “If we simply do not want to re-establish the status quo, then we have to put the climate change agenda and the health equity agenda together,” Marmot said. 

Sharon Friel, professor of health equity at the Australian National University (ANU), has long argued that although the relationship between climate change and health inequity is complex, understanding that there are common determinants of both problems provides an opportunity to “kill two birds with one stone,”she told The Guardian. 

In the Australia Institute’s event, ‘A Green New Deal,’ which discussed a national covid-recovery plan proposed by the Greens party, the institute’s chief economist, Richard Dennis, also commented that it’s easier to solve a number of problems at the same time, noting that a transition to sustainable energy through green jobs, will boost the economy and lift people out of the unemployment and underemployment crisis that stems back before the pandemic, to the global financial recession of 2008. In response to the government’s recent announcement of cuts to the JobKeeper program, the institute estimates that such a policy would plunge 370,000 Australians into poverty including 80,000 children. 

The Australian Council of Social Services (ACOSS), together with 50 other organisations also argue that, in lieu of the government’s proposed housing renovation scheme, which they say privileges higher income households, an energy efficient low-income housing installation boom will address the climate and unemployment crisis. “Doing so would create tens of thousands of shovel ready jobs, cut energy bills for people on low incomes who will spend back into the economy, and reduce carbon emissions,” ACOSS wrote.

A new report by Ernst and Young (EY) also found that a renewables-led economic recovery will create almost three times as many jobs as a fossil-fuel-led recovery and another recent study by the Australian Energy Market Operator, found that Australia's electricity grid could run with 75% renewables within 5 years, if regulations are updated. 

Yet, leaked documents from the National COVID-19 Coordination Commission (NCCC) recommends the government build a recovery economy based on subsidising the gas industry, expanding gas extraction in Arnhem land, and fracking in the Northern Territory amongst other places. As well as building fossil fuel infrastructure that would operate for decades–steering the Australian government further away from Paris Climate targets, which it is still not on track to meet without bringing in a carbon loophole. This is despite new research from the CSIRO which shows that solar and onshore wind power are now the cheapest low carbon sources of electricity for Australia. 

Dr Graeme McLeay, a retired anaesthetist and a member of Doctors for the Environment Australia and Dr Ingo Weber, an anaesthetist and lecturer at both South Australian medical schools on the health impacts of climate change, slammed the suggestion of a gas-led recovery as “madness” and together with doctors and medical students around the country are supporting an online petition #TurnOffTheGas, which highlights the dangers of gas to the environment and human health.

read part two: Joining the dots -

the role of the medical community in tackling the Climate change and health inequality crises