A call for health to be centred in global climate negotiations, the implications of extreme heat for human rights, justice and equity, and climate adaptation lessons for health systems from Aotearoa New Zealand were among the topics discussed yesterday at the Healthy Environments and Lives (HEAL) Network conference.
Marie McInerney reports for the Croakey Conference News Service.
Marie McInerney writes:
Health must be at the centre of all climate policy development around the world, including at the upcoming COP31, which begins in Türkiye on 9 November, an international conference was told in Australia this week.
Former Spanish Vice-Minister of Health Dr María Neria, who is one of seven candidates running to become Director-General of the World Health Organization, said the COP31 “is a very critical moment” for people working in health.
“We need to make sure that everybody understands that what they are discussing at COP is not just the proportion of greenhouse gas emissions that we are reducing or not reducing; that they are not just discussing different energy policies, but they are discussing our health,” she told the Healthy Environments and Lives (HEAL) Network conference.
“This is a difficult time but, at the same time, it is a critical one,” she said.
If global leaders take the right decisions, global health will benefit from it, she said. But if they don’t, then people’s health will pay for it.
“Make sure that the messages are very clear why adaptation is important for health, why our health systems needs to be better prepared, more climate resilient,” she said.
“And please make sure that everybody understands that mitigation of climate change is nothing else than public health interventions, and we need to be ready to quantify and benefit from all of those health outcomes,” she said.
Neira was speaking, at 2am Madrid time, to open the final day of the sixth International HEAL 2026, with the theme, ‘Time to Listen, Learn and Act for Lasting Impact on Healthy Environments and Lives’.
The four-day hybrid event brought together more than 100 presenters, many of them First Nations researchers, from across Australia and around the world to share research, exchange ideas and explore solutions for healthier environments.
The event was timely, coinciding with COP31 preparations, landslide United States mid-term elections, and the 7 November national election in Aotearoa New Zealand, where the ruling centre-right National Coalition Government has been eroding global health security, and Māori and health rights.
#HEAL2026 was told that the main health risks from climate change in Aotearoa New Zealand are for Māori people and from the growing incidence of landslides, which have claimed five lives this year.
Experts are warning that the record-strength El Niño event currently being experienced across the Pacific threatens many regions.
“Coming as countries slash foreign aid and war chokes supplies of energy and fertiliser, the climate phenomenon could leave millions more people in vulnerable countries without enough to eat,” says an article published this week by the Yale School for the Environment.
From top L: Adrienne Walls-Nichols, Professor Sotiris Vardoulakis, Dr María Neira, and Dr Mara West. Photo by Marie McInerney
Extreme heat
At HEAL2026, Intergovernmental Panel on Climate Change (IPCC) Coordinating Lead Author and University of Queensland Associate Professor Nina Lansbury outlined likely direct, indirect and compounding health effects, and called for a focus on the priority populations who will struggle to access protective and adaptive factors.
She talked about the need to challenge existing institutional capabilities, to understand climate change adaptation in the context of human rights, justice and equity, and to address cascading impacts of extreme heat.
Extreme heat is defined in Australia as temperatures over 35 degrees Celsius, which can impact the human body in multiple ways: first as heat exhaustion or stress, ultimately leading to organ failure, depending on underlying health conditions, she said.
What is more critical than just the temperature is the “continued exposure, the repeat exposure” of a heatwave, putting the body under prolonged heat stress.
“So a lot of heatwave-related research looks at day three, [which] is really when deaths start occurring and the presentations to hospital peak,” Lansbury said.
Beyond that is a growing need to consider the indirect impacts of extreme heat, including on the natural system and on social systems that affect health.
Lansbury, pictured in Tennant Creek. Photo provided
Researchers and policy makers are investigating the relationship between heat and violence, including family violence, as people find it difficult to get cool in crowded environments or are “operating a little on edge, in kind of survival mode, so the emotional regulation is not as strong”, she said.
Lansbury has been looking into the compounding effects of a serious combination of heat and humidity, which stops people from sweating, “so the body’s usual technique of cooling itself down doesn’t actually work”, she said.
Research is showing humid heat events have doubled in frequency over most land areas in recent decades, and are “pushing the boundaries of human physiological tolerance”, particularly for people who may be on kidney dialysis or live with asthma or other respiratory conditions.
Lansbury is also known for her work in remote Indigenous communities, particularly on Warumungu country in central Australia.
She told the conference that people living in and around Tennant Creek already now experience around 143 days a year of temperatures above 35 degrees Celsius. By the 20250s, this is predicted to rise to 170 days per year – an extra 27 days of dangerous heat.
In terms of assessing priority populations and their access to protective factors, she compared them with people living in Bondi, who experience an average of four days a year over 35 degrees. This is predicted to rise to seven days in the 2050s.
She raised the comparison in the context of a quote from the scoping outline for the IPCC Working Group Two, which required: “distributional nature of effects, including consideration of human rights, equity and justice, Indigenous peoples, local communities, gender, disability, informality and intergenerational justice and other vulnerable groups”.
At the heart of Tennant Creek’s concerns, alongside heat, is housing, she said, pointing to class actions currently underway in the Northern Territory and being considered in Western Australian about poorly maintained public housing being rented to First Nations people.
Showing a photo of one type of housing in use, she said it did not take much imagination to “think how hot that would be in over 35 degrees, and potentially for 170 days per year”.
Housing in community living areas in Tennant Creek. Photos by Associate Professor Nina Lansbury, shown at #HEAL2026
Indigenous Knowledges
In considering civil and societal governance aspects that need to change in response to extreme heat, Lansbury highlighted work being done in western Sydney, by the Western Sydney Regional Organisation of Councils (WSROC).
She cited the regional grouping’s work on the Greater Sydney Heat Taskforce, and particularly that it raises the need to “challenge existing institutional capabilities”.
Lansbury said another critical part of the IPCC assessment report and broader responses to extreme heat will be what can be learnt from Indigenous and other diverse knowledges.
She highlighted new research led by the Menzies Centre in Darwin which found that, despite a substantial body of heat-health research in Australia, there is limited evidence on hot weather-specific impacts on First Nations people living in remote communities.
It also points to gaps in mainstream learning from Indigenous knowledges about adaptation, she said.
Traditional heat adaptive behaviours by Central Australian communities include:
sitting under temporary shade structures or under trees and sleeping outside
at night
swimming in water holes or digging and sitting in soakage holes in creek beds
shifting outdoor activities to cooler periods of the day
drinking hot teas, an evaporative cooling strategy
consuming locally available bush tucker to cool down (witchetty grub, honeypot ants, bush bananas, bush honey, bush berries, and bush orange).
Lansbury has been among many scholars, both Indigenous and non-Indigenous, who have highlighted that the IPCC had historically under-represented Indigenous Knowledges in its assessment reports, thus “overlooking valuable insights for managing ecosystems, freshwater systems, food security, and community health in the face of climate change”.
In a paper published in June in AlterNative: An International Journal of Indigenous Peoples, she and her majority Indigenous co-authors highlight contributions from Indigenous-gathered advice to the Australian Government, showcasing what Indigenous Knowledge can bring to climate monitoring, adaptation, and mitigation.
This paper opens with a quote from an un-named Australian Aboriginal knowledge holder who was asked in 2023 about his community’s knowledge and concerns regarding climate change.
“His response was sceptical: there is limited recognition regarding First Nations’ peoples other than relegating us to ‘vulnerable communities’ in the context of climate change. This disregards our over-65,000 years of sustainable practices and customary knowledge of the natural environment and thus our significant contribution to policy. First Nations need a voice.”
Pacific region
Also in the El Nino session, Emeritus Professor Mark Howden, who is Vice Chair of the IPCC and was until recently Director of the ANU Institute for Climate, Energy and Disaster Solutions, discussed the potential impacts for the Pacific region over the coming months, which will be highly varied, with implications for Australia.
In Papua New Guinea, they will likely include drought and frost, which will raise significant food security issues, he said.
Howden warned that changes to floods, storms and cyclones elsewhere in the Pacific would have significant implications for water quality and hygiene and would require different human disaster responses from nations like Australia.
He listed a number of likely impacts:
drought and heat (lowlands) and frost (highlands) in Papua New Guinea
increased drought likelihood in south west Pacific nations
increase likelihood of floods and storms/cyclones in Central Pacific, with implications of the above for water and hygiene
increased coral bleaching risk in Central Pacific
changes in fishery productivity and fish distributions
sea level changes, with interaction with increased wave energy.
The session highlighted other changing patterns; for example, that California, not a place usually associated with tropical weather, is “taking a beating in 2026 from one of the most active eastern Pacific hurricane seasons in modern history”, according to a recent article at The Conversation.
Lessons from New Zealand
Aotearoa New Zealand is also facing unprecedented climate risks.
James Renwick, Professor of Physical Geography (Climate Science) at Te Herenga Waka – Victoria University of Wellington, wrote recently that the record-strength El Niño event now being experienced is forming against a backdrop of warming that’s pushed Aotearoa New Zealand’s climate into “uncharted territory”.
Its two main areas of risk from extreme weather are the impact on Māori populations and the increasing risk of landslides, the country’s deadliest natural hazard, which have killed five people this year, #HEAL2026 heard in an adaptation session convened by Australia’s Centre for Disease Control (CDC).
Vicktoria Blake, Principal Advisor, Climate Risk and Resilience from Te Whatu Ora Health New Zealand, talked about cascading impacts of climate change and the need to listen to the concerns of local health workforce members.
Being a geographically dispersed country, in some parts of New Zealand “relatively small disruptions to power, communications, or supply chains can quickly become health service continuity issues”, she said.
The country wants climate resilience embedded across five domains: population health; finance, funding and investment; infrastructure and asset management; service provision; and emergency management and business continuity.
The aim is to move climate resilience from being seen as a specialist program into “routine health system decision-making”.
Under that, Health New Zealand is beginning to roll out localised climate change risk assessments, which include surveys of local people employed in the broader health system.
Vicktoria Blake presented on lessons from NZ
Blake said a survey of Health New Zealand staff, primary care representatives, and Māori health providers in one area that was severely impacted by the 2023 Cyclone Gabriel shows how national climate risks are being experienced locally.
Respondents described where “geographic isolation turns individual failures into cascading disruption, road closures, bridge failures, power loss, and communication outages that can affect patients, staff, supplies, specialist services, and tertiary transfers all at the same time”.
They also reflected on the personal impacts of extreme events: increased workload and redeployment, childcare and caregiving pressures, inability to travel, communication problems, property and financial impacts, ongoing stress and fatigue.
“The key point is that workforce resilience cannot be separated from community infrastructure and service resilience,” she said.
National frameworks can provide consistency, “but resilience has to be grounded in local experience and local capability”.
The pilot showed that climate risks interact across infrastructure, service delivery, communities, and the workforce.
“Effective adaptation, therefore, requires coordinated planning, strong local partnerships, resilient infrastructure, and explicit support for health professionals and their whanau (family),” she said.
“Our task is to create a nationally coherent approach that remains flexible enough to respond to local realities.”
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