Health–Earth (H–EARTH): a new coalition for global health

Wellbeing is threatened by human-induced adverse environmental changes on a planetary scale, in a linked eco-social Earth system. These changes are already adversely affecting ecosystems, energy prices, food prices, and the climate. A “sweet spot” has been passed. From here, without major reform, adverse health consequences appear set to increase, reversing earlier gains. We have called this point of inflection "peak health". Rising inequality and poverty are causes and consequences of our imperiled state.

Altered weather patterns secondary to climate change are worsening heatwaves, droughts and floods, while sea level rise in in many delta is accelerated by human-exacerbated subsidence. Air and water pollution are major problems in many parts of the world; global ecotoxicity is under-appreciated. Food production and distribution systems are under pressure, as in some places are social stability, social cohesion, peace and security, undermining peace of mind and other aspects of wellbeing.

But solutions are emerging, such as cleaner energy, smart cities and a reawakening of sharing, include the Sustainable Development Goals. Recognising, assessing, forewarning, minimising and adapting to the risks brought by these issues is vital if global population health is to be improved and populations to endure.

H–EARTH is an interdisciplinary network building knowledge about global change and health for effective responses by policymakers, practitioners and communities. Linked with networks such as HEAL, Healthy-Polis, and The Lancet-Rockefeller Foundation Commission on Planetary Health, the knowledge synthesised by H–EARTH will be used for degrees and short courses, reports, journal articles and books. H-EARTH aims to help awaken the wider health community and the general population to hasten the sustainability transition, with many positive co-benefits for health, the environment and the economy, including in partnership with government, industry, community and advocacy groups using mainstream and social media. Understanding the adverse health consequences of unchecked adverse global environmental change is also important for many other disciplines, professions, and for all faiths.

Our website is soon to be launched at the University of Canberra at the Centre for Research and Action in Public Health. Memoranda of understanding are yet to be signed, but will likely include with Professors Wael Al-Delaimy, at UCSD Division of Global Health San Diego, CA, USA; Tony Capon, Director United Nations University Institute of Global Health, Trevor Hancock, Professor and Senior Scholar, School of Public Health & Social Policy, University of Victoria, Canada, Jouni Jaakkola Director Centre for Environmental and Respiratory Health Research, University of Oulu, Finland, John Potter Centre for Public Health Research, Massey University, NZ, Andy Morse , associated with the Department of Epidemiology and Population Health, at the University of Liverpool (UK)’s Institute of Infection and Global Health. He is also attached to the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections. The final likely founding member is Prof Sir Harry Burns, at Glasgow, Scotland, UK. He is the professor of global public health and co-director of The Strathclyde Institute of Global Public Health in Glasgow, Scotland. Originally trained as surgeon, he was the Chief Medical Officer for Scotland and is known for his strong advocacy for greater social and health justice.

I will occasionally update this blog.

See http://health-earth.weebly.com/
 

Cognitive dissonance, conflict and climate change

I recently read an article by Christof Rühl, BP's chief economist on energy. All is well in BP's world (forget about "Beyond Petroleum"). There is no mention of peak oil, no mention of the trillion tonne carbon budget, no mention of climate change, except obliquely - there is a mention of carbon emissions, but nothing to suggest urgency. 

Interpretation of data depends very much on one's "causal lens". (For example: what is the cause of a heart attack - is it a blocked artery, is it smoking, or is it the social causes of smoking? Could it be all three? Is it system? I think multiple answers are right, single answers too simple.)

Recently we had a paper on climate change, conflict and health rejected by a political scientist reviewer (curiously assigned by Medicine Conflict and Survival - we did not submit it to a political science journal). That reviewer wrote the "premise [that climate change and conflict are causally related] does not hold". That reviewer had a single answer, we think it is more complex. Some others do too, including in both health and the department of defence. 

Several relevant IPCC chapters use similar data to that in my forthcoming edited book Climate Change and Global Health to reach far more optimistic conclusions than I do (and that Clive Hamilton reaches), but try as I might I cannot fault the following broad reasoning:

1. Without dramatic acceleration of decarbonisation we risk 2 degrees + warming

2. That means more droughts, extreme weather, higher food prices and ongoing sea level rise are all likely; these act as "risk multipliers" that increase the risk of many hazards, including population dislocation and conflict. This may already be happening for conflict, and in some cases famine, eg in Syria, Somalia and before that, Darfur.

3. Hence “business as usual” should be unacceptable, as the cost will far exceed the benefits of continuing with fossil fuels. India may finally be awakening to the benefits of replacing coal with solar.

4. Hence, (peaceful) civil disobedience to oppose climate change is called for, in fact, it’s imperative.

While exceeding the trillion tonne carbon budget does not guarantee 2 degrees of average warming (hence “dangerous” climate change is not inevitable) we might get four or even more degrees of warming with only slightly more fossil fuel combustion. Also, if we were to exceed the carbon budget without provoking obviously dangerous climate change then the fossil fuel lobby and their denialist allies will just encourage even more planetary gambling.

Apart from Clive Hamilton and James Hansen there are not too many senior academics saying this really clearly; it’s rather surreal; sometimes it seems I am trying to pinch myself to make sure I’m not dreaming. The apparently surreal nature is probably part of cognitive dissonance, a kind of self-protection. It would be very comforting if I could really believe people like climate denialist Andrew Bolt is correct when it comes to climate change; I suspect that collectively many of us would prefer to not think the implications right through. (Recently however, Frank Ackerman has attacked fellow economist Richard Tol for being too optimistic, and for selectively analysing the literature.)

An analogy is the false calm ("The Gathering Storm") before WWII. Winston Churchill could see war coming, but most of his peers carried on desperately hoping peace would endure. Of course, the war did come. So too, global chaos later this century and beyond seems to be very likely if we stick with “business as usual”. Churchill couldn’t stop the war, and maybe we can’t stop dangerous climate change, but we have to try. And I certainly can’t do much on my own, hence I appreciate your ideas and potential opportunities. But renewable energy use is expanding at a fantastic rate, we must promote that as well as energy efficiency. We must stay hopeful and keep advocating for change.

Is Australia's NHMRC grant assessment process corrupted?

In 2013-2014 I led an unsuccessful "Centre of Research Excellence" grant application to Australia's National Health and Medical Research Council (NH&MRC). We proposed to train 15 early career researchers (10 PhDs, 5 post docs). It was my third attempt, but the first time I had led such an application. We were unsuccessful. Nothing surprising there; these grants are notoriously difficult.

However, this grant application (and the previous two) was relevant to climate change, heatwaves and how ecological changes might change infectious diseases epidemiology. Several projects integrated various aspects of these problems. We also had an extensive "research translation" component, involving many community and professional groups. We had advice and support from the Chief Medical Officer of Australia, the Chief Veterinary Officer of Australia and we had the Department of Defence as an Associate Investigator, including for a study to assess the impact of extreme heat on their workforce. It was the best of the three (group) grant applications I have been closely involved with and many people commented on how much they liked it.

But not the assessors. One, especially, ridiculed it, showing his (or her) own bias and lack of diligence. Reviews are an opaque, anonymous process. People whose names we don't know can and in this case did make factually wrong and even insulting comments about us (our names and CVs are of course shown to them), and there is nothing we can realistically do. We did complain, having little faith in a fair hearing, but the NHMRC response to our appeal was perfunctory, showing the same bias and a dismissiveness bordering on contempt.
 

Someone I know who had worked for a while with the NHMRC commented that while they are not “corrupt” (as I had suggested) that they “bend over backwards to not get the Minister (of Health) offside”. Our current Minister of Health, Peter Dutton, is a former drug squad policeman. I have watched him a bit on the ABC. He seems to have a very simplistic understanding of health, such as that it primarily arises from hospitals, health care workers and technologies such as new drugs and maybe surgical techniques, rather than underlying health determinants, such as the expectation of a fair go in the Lucky Country. He could learn from Sir Harry Burns, the former chief medical officer of Scotland who states "we need compassion, not judgments about poor people'.

We all recognize science under the Soviet Union was corrupted; McCarthyism in the US influenced many things (not sure if this included science), George Bush junior's regime did, too. I think for a while, under the Bush/Cheney regime, investigations into whether ground water quality was affected by fracking were legally prohibited.

It would be very naive to think that Australian science is entirely free of such taint, though much of it probably operates via self-censorship, nods rather than spoken or written directions.

The standard advice about applying for scientific grants in Australia is that assessments are random and good applicants should persist. But in the case of climate change and health I do not believe this is the case. And I believe it is in the national interest to state this. Eventually, those with power in the NHMRC system will realise the harm their outmoded beliefs are doing.

Of course, you, the average reader, have no idea if I am exaggerating or simply whinging. Some will assume I have no grounds for complaint. I am, however, the sole editor of the book Climate Change and Global Health. I am one of the three Australian contributors to the health chapter of the most recent IPCC report. I am a recipient of an Australian Research Council Future Fellowship (in 2010). I have given over 70 invited talks at conferences and as special lectures overseas. I am approaching retirement. I do not expect to ever get an NHMRC grant. I do not see how publishing this can do me any good at all, personally, though probably no one of any influence will notice this blog.

But I sincerely feel my perception of bias has validity; it fits with other evidence of disdain for the risk of climate change by the Australian government, and I need to get this off my chest. Keeping quiet about this will do no good either.

Postscript 1 (added February 5, 2017)

In 2017 an article was published in Nature Climate Change also complaining of the lack of NHMRC support for this area. See also a good report in the Sydney Morning Herald.

In late 2014 I became the first Australian IPCC contributor to be arrested for climate disobedience. I explained some of my reasons here. As a result I can no longer go the US. I am still without a grant. The world is burning, from Chile to Syria. And the leader of the free world is a practitioner of "truthful hyperbole", in other words deliberately exaggerating for pride, profit or power.

Climate Change and Global Health was released as a paperback in mid-2016, with an additional chapter. There is more about it, here.

Postscript 2 (added January 15, 2019)

One of our 15 research projects was to consider the possible effect  to the Australian blood supply, in conjunction with the Red Cross, from heatstress and "batfall". Understanding this issue remains vital, and ever more urgent. It is prudent to advise animal rescuers and others to avoid contact with stressed and injured bats, but much more than this is needed.

Postscript 3 (added October 12, 2021)

I'm speaking on October 16, 2021 at the 20th anniversary conference of Drs for the Environment (Australia)* https://www.dea.org.au/event/save-the-date-idea-conference/
 

My talk says in part "Heat and humidity may also have a “long tail” of adverse effects, including on chronic diseases – not just MS, but conditions such as organ failure and even dementia. This is plausible because extreme heat and humidity cause excess mortality. What happens to people who are vulnerable, eg from a chronic illness – but who do not die? It is unlikely that all will return to their previous level of function. I’ve tried several times to win research funds to study this question, so far without success. The question is under-explored."

For the record, this hypothesis (conceived and witten by me) was in NHMRC grant applications I submitted in 2012, 2013, 2014 and 2015. None of these attempts were funded.

* Drs for the Environment Australia now has over 2,500 members; I recall when there were fewer than ten.

Clive Hamilton vs Andy Revkin (Earth Poisoning diary 18 months)

I just read the debate between the distinguished and prolific Australian public intellectual Professor Clive Hamilton and Andrew Revkin, the New York Times environmental journalist who is the driving force behind "Dot Earth". There are several discussions on the internet, here is an extract from one:

Hamilton: "I guess this is my essential message: Carry on as we are, even with quite good outcomes from the incremental approach, and we're screwed. My argument in Requiem for a Species is that we can either face up to this, or we don't. We can choose not to think about it, we can tell stories to ourselves about how it must just be exaggerated, or we can imagine that some technology will come along and everything will be okay. Or we can look at it with open eyes, and allow it to blast away all our utopian imaginings, and say, well, we are in really deep trouble, and it's extremely unlikely that we are going to get out of it unscathed. So what do we do in that situation? And what does it mean for how we act? Does it mean we go for the muddle-through approach even though we know the consequences are likely to be catastrophic? Or do we fundamentally try to rethink and change strategies?"

"... Mind you, I've got much more time for those engaged in civil disobedience who are really trying to take on the system."

Elsewhere, Hamilton writes: "So the 'good Anthropocene' is a story about the world that could have been written by the powerful interests that have got us into this mess and who are fighting so effectively to prevent us from getting out of it. In the long term this kind of thinking will prove more insidious than climate science denial."


I think Hamilton won this debate hands down, though Revkin stood his ground. For me it was interesting how Revkin revealed his thinking about his own sons:

Revkin: "Over the last three years - in having this shift in my focus from goals that are numbers to goals that are qualities - there's this resonant metaphor I used in my talk: I have two boys, one 16, one 23, and when they were little I could have watched them sleeping in their beds and thought "I'd really like them to be doctors making $400,000 a year." More recently I think I would look at them and think what are the traits I would want to have in these two kids to maximize their chances of thriving and being productive and collaborative and generous ... This shift from "I want to make this kid's life good," to "I want this kid to have good qualities," requires letting go. And it's really scary that".

**

I took heart from this. (I am a medical doctor but such a salary seems astronomical to me, and could only be achieved in this country by taking advantage of vulnerable people). It made me think that Revkin has in more recent times become a bit less materialistic and more altruistic. As one of the most influential environmental journalists on the planet that is important. I thought for him to say that this apparent shift was "really scary" particularly interesting and revealing.

About six years ago I managed to correspond briefly with Andy Revkin, attempting to interest him in the poverty (and indeed famine) alleviating benefits of slower population growth in low-income countries, but in the end without success.

My own impending arrest

My own plans to be arrested to protest the reckless scale of Australian coal exports continue to strengthen and develop, but the exact circumstances are currently on hold due to personal circumstances that I can't explain here. I am however greatly heartened by the growth of this movement, such as recent arrests of students at Harvard and North Western Universities, in order to encourage that their campuses divest from investment in fossil fuels. I am also encouraged by the leadership of Archbishop Desmond Tutu, the World Council of Churches, and Pope Francis concerning the crucial challenge of climate change. My edited book, Climate Change and Global Health, is now in the final proof stage and will, I hope, be available in September 2014. Meantime, surface melt in Greenland continues to be too high and rising sea levels are contributing to flooding on the US East Coast. These events erode health determinants, and must be reversed while there is time.