From the Arctic to Europe, the Americas and Australia, the impacts of the climate crisis are wide-ranging and evident, including harmful bushfire smoke and the spread of infectious diseases. The Health Wrap also brings the latest on the Trump Administration’s failures in infectious disease control, public health and women’s health.
Our columnist, Adjunct Associate Professor Lesley Russell, brings news of a restructuring at the Department of Health, Disability and Ageing, and some recommended reading: an award-winning novel based on Yolŋu oral history
The quotable?
As always, the private sector – private hospitals and private health strategy – has sections to look after its interests, but there is nothing to look after the financial and equity interests of patients.”
Lesley Russell writes:
The Health Wrap is back after a few weeks’ hiatus while we joined Aurora Expeditions in the Arctic (on the same ship that we took to the Antarctic last year).
It was a marvellous two-week trip around Iceland, to Svalbard and then to North Cape and Tromso at the top of Norway, with another week exploring Norway.
Thanks to an adventurous expedition team leader, an enthusiastic captain and some good weather with relatively calm seas, we were able to land on tiny Jan Mayen and Bjørnøya (Bear) Islands – places where people rarely go.
We saw polar bears, whales, puffins, cliffs full of nesting seabirds, seals, walruses, arctic foxes, reindeer, dinosaur prints, and glaciers (but no Northern Lights).
There are constant reminders of attempts at exploration, exploitation of natural resources, and settlement, although the take-home message is that usually nature wins and these efforts have rarely succeeded – although there are places where people have lived for over 1,000 years.
The Arctic is maybe not as awe-inspiring as the Antarctic, but it is amazing. And, like Antarctica, you come away completely convinced and quite fearful about the impacts of global warming and climate change.
Human-caused global warming is particularly amplified in the Arctic, causing the climate in the Arctic to warm more quickly than the rest of the Earth. Svalbard is warming at six to seven times the global average rate.
Yes, it was late summer when we were there, but we saw no sea ice, and places like Bear Island are transitioning from an Arctic climate to a North Atlantic climate.
This photo tells a story. This was taken at Kapp Lee, the northwestern-most point of Edgeøya, a southeastern island in the Svalbard archipelago. There are huts here, one built by trappers in 1904, and two others built in the 1960s as outposts for oil explorations.
We were to land here and hike along the coastline, but the presence of a (mostly sleeping) polar bear rendered that impossible (for all our shore landings on Svalbard we were accompanied by expedition team members with rifles and bear spray).
So we quietly toured around the bay in Zodiacs, taking endless photos for several hours.
The polar bear (they are generally solitary except for mothers with cubs) was unperturbed by the noisy colony of walrus on the beach; the walruses found our Zodiacs fascinating and quickly slid into the water to join us. I plan to write more about this wonderful trip soon.
Climate change, mosquitoes and disease
Vector-borne diseases such as dengue, malaria, West Nile, Zika, leishmaniasis, chikungunya, yellow fever and Chagas disease cause millions of infections and deaths each year, particularly in low- and middle-income regions of South America and Africa.
Climate change is profoundly altering the distribution and behaviour of mosquito vectors, facilitating their expansion into new ecological niches.
In South America, Colombia, Ecuador, Peru, and Bolivia have reported outbreaks of dengue and malaria in populations living in the high-altitude areas of the Andes once considered unsuitable for transmission.
European countries are reporting outbreaks of various mosquito-borne diseases once considered restricted to tropical areas.
In Australia, warmer temperatures and more frequent heavy rainfall due to climate change are expanding the geographic range of mosquito-borne diseases in Australia.
Recent surveillance data indicates national case numbers for mosquito-borne diseases nearly doubling between 2023 and 2024. The increasing transmission of Ross River virus is a particular public health concern.
The United States is also seeing an increase in both the number of cases of these diseases and the range. Western states are seeing a rise in West Nile virus and southern states have a surge in dengue fever.
In October last year, Iceland recorded the presence of mosquitoes for the first time in the nation’s history.
A recent article in MedPage Today refers to mosquitoes as “humanity’s apex predator” and outlines how the developed world is unprepared for the return of the diseases they carry.
Closer to home, an article from scientists at the Monash Biomedicine Discovery Institute calls mosquitoes “the world’s deadliest animal” and makes the case for urgent and continued investment in planning and research toward interventions geared to the control of mosquito-borne infectious diseases, which are a major threat to public health.
See also this 2024 discussion paper from CSIRO on Climate and Communicable Disease.
Several pieces of information make it possible to end this section on a positive note:
- The release of mosquitoes that carry the Wolbachia bacteria, which can neutralise the dengue virus and is passed down to future generations, can control the spread of the disease. In North Queensland, Wolbachia mosquitoes have been regularly released since 2011 and long-term monitoring shows this region is now essentially dengue free.
- Faced with one of its worst outbreaks of dengue in years, Sri Lanka is using military drones to scan rooftops and find mosquito breeding grounds for elimination.
- A paper in New Scientist suggests that gobal warming may make it too hot for malaria-carrying mosquitoes to survive in West and Central Africa (but could shift the problem to areas that are currently less affected).
- Research co-led by the Walter and Eliza Hall Institute and Burnet Institute has uncovered how the human immune system fights malaria (Plasmodium vivax), paving the way for the first effective vaccine against the most widespread form of malaria.
- At the same time, scientists at the Walter and Eliza Hall Institute have turned an experimental drug into a kind of chemical vaccine that allows the malaria parasite to grow within the body before killing it right before it causes disease. This allows the body to build up key antibodies and immune cells to tackle any future infection.
Meanwhile, you might enjoy this blast from the past – a 2018 Croakey article where Melissa Sweet and others opine on how to use the (then newly-released) mosquito emoji in public health social media posts. A wide range of Croakey articles on climate and health can be accessed here.
Reports from the United States
1. Continuing disease control failures
Recent editions of The Health Wrap have made consistent references to growing measles cases in the United States, the failures of federal health agencies to manage these, and the role that anti-vaccination sentiments and their consequences have played in these continuing outbreaks.
The United States is enduring its worst year for measles since 1991 and there have been seven reported measles-associated deaths in the last two years. This is more than the combined total of reported deaths over the previous three decades.
The current focus is on Pennsylvania where a fourth death from measles, all in infants and adults who were unvaccinated, has been reported.
Pennsylvania’s measles outbreak is continuing to grow, with nearly 700 illnesses reported so far this year. The measles-associated deaths are the first reported in the state in 35 years,
Health Secretary, Robert F Kennedy Jr, has suggested the infant deaths may have been fabricated and he has engaged in a nasty political and public health clash with Pennsylvania Governor Josh Shapiro (a Democrat) over the reporting of measles fatalities.
There are reports that Kennedy asked the new Director of the Centers for Disease Control and Prevention, Dr Erica Schwartz, to remove Pennsylvania cases from the agency’s web page tracking measles cases and deaths.
This is seen as Schwartz failing her first test of independence, despite the commitment she made during her Senate confirmation hearing to “speak truth to power”.
Public health experts have expressed concern that having the CDC question state reports will lead to a further erosion of the critical partnership between states and the federal government.
Now comes the news that the United States is seeing a spike in rabies exposure, resulting in an increase in the use of rabies immune globulin products used for post-exposure prophylaxis of 76 percent from July through August compared with the same period in 2025.
The CDC rabies laboratory has lost approximately half its staff and now has just one qualified expert. This forced a pause earlier this year in rabies testing and consultations with the states, although diagnostic testing has now been restored.
2. Emerging infectious diseases
As my reporting on American public health issues relentlessly highlights, there is plenty of evidence that the United States needs to beef up its surveillance of emerging infectious diseases.
The Government Accountability Office (GAO) has somehow managed to preserve its independence as a nonpartisan watchdog during the second Trump administration, tracking major federal spending, workforce reductions, and executive authority. It has released a report calling for a comprehensive national strategy for surveillance of emerging infectious disease threats.
The report also cites proper public messaging as being key to this network, saying, “a lack of communication professionals and trusted messengers … is one of the reasons why public health and surveillance messaging continues to fall short.”
A report just out from Trust for America’s Health makes similar findings: decades of chronic underinvestment, compounded by workforce reductions, funding disruptions, and institutional uncertainty during 2025 and 2026, have weakened the US public health system’s capacity to protect communities from preventable disease and injury.
Trust for America’s Health has also launched the Public Health Programs Monitor, with an interactive dashboard that tracks selected federal health-promoting programs and operational activities across HHS.
Meanwhile, even as Republican efforts to punish Dr Anthony Fauci have stalled, the National Institute of Allergy and Infectious Diseases, which Fauci once led (and which still only has an acting Director), has released its Strategic Plan 2026-2030.
The strategy is seen as pivoting sharply away from historical priorities like broad pandemic preparedness and biodefence to focus heavily on domestic infectious and immune-mediated diseases.
An article in The Washington Post finds that the Trump Administration is realising that staffing cuts to the White House biodefence team (now a mere handful of people down from 30 during the Biden Administration) leaves the Unites States vulnerable, especially as artificial intelligence could make it easier to create deadly pathogens.
Trump revoked a Biden Executive Order on AI calling for stronger biological safeguards, promising a revised biosecurity framework by August 2025. More than a year later, this has yet to appear.
This even as AI companies say their most advanced models are gaining increasingly sophisticated biological capabilities and the ability to produce biological weapons alongside the hacking skills that have alarmed officials this year.
3. Vaccine chaos continues
I keep returning to the seemingly never-ending issues with vaccines in the United States because I worry that at least some of these will affect Australia – not just the anti-vaxx sentiments but the manufacture, availability and cost of essential vaccines.
First, there is some good news. Despite Kennedy’s opposition to mRNA vaccines, in August the Food and Drug Administration approved Moderna’s mRNA-based flu vaccine.
Moderna says the faster process could end the practice of selecting a single flu strain for an entire hemisphere each season, letting individual countries pick the best match.
The FDA has also approved four updated COVID-19 vaccines for the 2026-2027 season targeting the SARS-C0V-2 variant XFG that dominated last season.
However, neither the CDC nor the Advisory Committee on Immunization Practices (ACIP), which remains in legal limbo and has not met this year, have issued new 2026-2027 season-specific federal recommendations.
Because of this federal guidance gap, professional medical societies have stepped in to provide evidence-based recommendations for the fall respiratory virus season.
Sadly there is plenty of disturbingly bad news on this front.
Last week Health Secretary Kennedy, in a keynote address to the Children’s Health Defense, the anti-vaccine organisation he once led, gave a full-throated defence of vaccine scepticism.
Kennedy said he feels the public has “no idea” about the risk profile of vaccines which he has endlessly linked to the rise in chronic illnesses, autism and allergies. (He greatly exaggerated the number of shots children get: he says it’s 94 doses of 28 vaccines when in fact a child who receives every recommended vaccine dose before age 18 will have had about 33 doses of 18 or 19 vaccines)
“We have preserved access, but we have started to ask the questions that you and millions of American parents have been asking for years,” he told the audience.
And people asking those questions have a friend in the White House, he assured them. “If anyone in this room doubts the President’s commitment, put those doubts to rest. He has directed us to pursue answers to strengthen vaccine safety.”
“Let me be clear. You have a strong and steadfast friend in the White House,” he added.
In August the Trump Administration issued an Executive Order to separate the measles, mumps and rubella (MMR) vaccine into separate doses, a move that experts fear will increase vaccine hesitancy and affect full vaccination rates.
At that time Trump said that the combined MMR vaccine could be “quite lethal”, without citing scientific evidence.
Now he has indicated that he will demand that manufacturers split childhood vaccine doses into five separate shots, each with a “small amount of the vaccine.”
These “20 percent doses” would each be given six months apart, he said.
Meanwhile, the National Institutes of Health (NIH) is preparing to launch a new research centre and a clinical research program to study people who believe they were harmed by vaccines, including COVID-19 vaccines.
4. Trump et al still pushing to control research
I have written previously (see The Health Wrap, 23 June 2026) about attempts by the Trump Administration (specifically the Office of Management and Budget (OMB)) to control research funding in the United States.
The controversial OMB proposal (it attracted some 500,000 comments in opposition) to subject federal research grants, including National Institutes of Health (NIH) funding, to political review has been temporarily paused by Congressional action that blocks any implementation until December 11.
There are reports that the head of OMB, Russell Vought (who thinks the NIH is funding “woke” priorities), and NIH Director Dr Jay Bhattacharya have been fighting for months over this issue.
Now Trump plans to issue an Executive Order that would require NIH grants to be reviewed by an outside panel.
The New York Times reports that Trump is driven to do this because he is upset at the perceived slowdown in the Administration’s attempt to force conservative cultural changes on academia, and on Harvard University in particular.
The proposed board would include Bhattacharya and Vought and would be required to reach unanimous decisions on grant awards. This arrangement would give Vought a direct role in determining how NIH distributes its US$48 billion in congressionally-appropriated funds.
You can imagine how researchers feel about that! And Members of Congress are not pleased either (NIH funding is a relatively bi-partisan issue in the Congress). You can read more here.
This is an issue that matters to many Australian biomedical researchers – to the order of some US$13 million currently. See this overview of 2026 NIH research funds to Australian universities and research institutes, from the NIH data base.
And if you think things can’t get much worse for biomedical research, now comes the news that the NIH is restricting research that evaluates how public policy impacts human health, on the grounds that the agency no longer considers policy-makers to be “mission relevant”.
Wildfire smoke and health
The dreadful summer wildfires in Europe, Canada and the United States have once again highlighted the health toll involved.
The danger comes not just from the flames but from the smoke, which can travel across regions, countries and even continents, worsening the air quality of down-wind communities with both physical and psychological impacts.
Wildfire smoke contains a unique mix of pollutants, with toxicity varying by fuel type and combustion conditions, and its long-term health effects, including cumulative exposure effects, remain unclear.
Two recently published, large-scale studies show that wildfire smoke poses greater health risks than other sources of air pollution, with higher risks of hospitalisation for cardiovascular and respiratory disease. It is particularly harmful to people with lung cancer.
There is a great video here, from the TH Chan School of Public Health at Harvard, on the health and environmental impacts of wildfire smoke.
The World Health Organization sees wildfire smoke as a health risk that is frequently under-estimated. An editorial in The Lancet calls for health to be at the centre of wildfire preparedness and climate policy.
I have previously written about this issue from the Australian perspective. Back in 2020 I was advocating for research on the long-term effects of bushfire smoke.
Croakey has a great archive of articles to explore here. Recent articles include:
- Watching the Northern Hemisphere burn, Australia cannot afford business as usual.
- As climate change is declared a national emergency in Europe, Australian scientists say these wildfires are off the charts.
- Tackling bushfire smoke effects on volunteer fire fighters, the unborn and new babies
This social media post from 2023 sums it up:
Specialists’ fees and private health costs
Health Minister Mark Butler Health Minister Mark Butler has put excessive specialist fees in his sights (again) as part of Labor’s efforts to ease the persistent cost of living pressures on Australians.
As The Zap reported this week, the passage of the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 will allow the Government to publish the fees and associated out-of-pocket costs for common medical services provided by individual specialists.
Don’t get too excited about this. Back in April Butler was saying reining in “out of control” medical specialist fees would be one of the problems he would turn to after the overhaul of the NDIS (and can we say that task is done, especially when Thriving Children is still not up and running?).
A consultation paper released by Butler’s Department finds huge growth in patients’ out-of-pocket costs: out-of-hospital specialist fees last year were $458 more than they were in 2019. And in-hospital gap fees for those with private health insurance also rose sharply over the same period.
Specialist healthcare cost more than five times the benchmark price on 1.24 million occasions last year. Another six million services were billed at between three to five times the schedule fee.
Progress on the departmental consultation on specialist access and affordability is slow – a specialist affordability roundtable was held in October 2025 – although quick responses are demanded on the consultation papers (the current public consultation on options to address excessive fees opened on 9 September and will close on 19 October).
The consultation paper outlines six potential options to tackle extremely high specialist fees. These range from greater transparency via the planned Medical Costs Finder updates to introducing a maximum allowable out-of-pocket fee attached to specific Medicare items.
The paper did not settle on a single definition of an extreme fee, the proportion of doctors charging a fee which was three to five times the Medicare rebate was around 3.9 percent for in-hospital services and 1.8 percent for out-of-hospital services.
The House of Representatives Standing Committee on Health, Aged Care and Disability is also undertaking an inquiry into access to and affordability of medical specialists. The Committee is accepting submissions until 16 October.
Back in late August, Independent Member of Parliament, Dr Monique Ryan, who is the deputy chair of this committee, told the annual conference of the Australian Medical Association not to “dig in its heels” on this inquiry.
“What I’d ask for the AMA to do is not to defend existing fee-for-service arrangements, not to push back against the review into specialist healthcare, but to embrace it and to lead it,” she said.
The private health insurance funds are calling on the Government not to pull punches when it comes to reining in out-of-pocket patient costs, urged it to “go further to address the broader rise … not just the extreme outliers”.
Restructuring at Department of Health, Disability and Ageing
It’s never easy to figure out what the organisational structure is for the Department of Health, Disability and Ageing and why units sit where they do.
It appears that some recent changes have slipped by both me and my colleague Charles Maskell-Knight.
Back in August Health Services Daily reported (article is paywalled) that the Health Resourcing Group withing DoHDA was being disbanded, with its responsibilities, including workforce, emergency preparedness, and Medicare benefits and digital health, to be allocated elsewhere.
So that has happened and the new organisational chart is here.
Now workforce issues are under Systems Strategy. Medicare benefits and digital health remain together under Prevention, Primary Care & Medicare. I am intrigued to see that there are two areas managing MBS – one headed MBS policy and specialist programs and another designated MBS policy and reviews (is this because Medicare is subject to endless reviews?)
I can’t find emergency preparedness anywhere, but perhaps it’s covered under Health Security and Immunisation? And nothing that refers to allied health.
As always, the private sector – private hospitals and private health strategy – has sections to look after its interests, but there is nothing to look after the financial and equity interests of patients.
In case you missed it
Climate disasters
Last week Croakey reported on calls for the World Health Organization to formally declare climate change as a Public Health Emergency of International Concern, its highest level of alert for a health emergency.
A report just published from World Weather Attribution in London finds that rising temperatures due to industrial emissions that have significantly warmed the Himalayas very likely contributed to the devastating floods in Nepal and Tibet last month by destabilising the ice and permafrost that underlay the mountain slopes.
In a report in The Lancet, experts warn that the catastrophic flooding that has killed thousands carries a great risk of communicable diseases, malnutrition, and mental health conditions.
And even as these findings are published, the Trump Administration has acted to gut the Clean Air Act and end limits on coal and gas plant emissions, thus removing a key tool to fight the climate crisis.
Wild polio is still circulating
As of 13 September, a cumulative total of 29 wild poliovirus type 1 cases have been confirmed for this year to date: 25 from Afghanistan and four from Pakistan.
These countries are the only two countries in the world with ongoing endemic wild polio virus transmission, with children under age five are the primary population at risk.
Structural barriers to vaccination in Afghanistan include Taliban restrictions on female health workers, insecurity in the eastern and southern provinces, difficult terrain, and community resistance fuelled by misinformation.
Japan’s ever-aging population
Japan now has 107,677 centenarians, a record for a country famous for its longevity. This is an increase of nearly 8,000 since last year, with women making up the vast majority of the group (88 percent).
The oldest woman is 114 and the oldest man is 112. You can read more here.
And as an addendum: an interesting little academic stoush is happening about Blue Zones – places like Okinawa in Japan that have great longevity. You can read more in this article from ABC News.
Deaths from ecotopic pregnancies spike in American states that limit abortion
It appears that a dreadful corollary of the growing restrictions on abortion in the United States is an increase in deaths involving ectopic pregnancies.
An analysis of CDC data finds what experts call a “stark and baffling increase”: almost 200 women with an ectopic pregnancy died from 2020 to 2025, compared with about 100 in the previous six years.
To treat an ectopic pregnancy, which is almost never viable, doctors must terminate it. But lawsuits and federal complaints now allege that some medical providers are hesitating or even refusing to do that in those states where they face criminal penalties for performing an abortion.
Maternal mortality rates are shockingly high in the United States. Clearly more research is needed to understand and address this issue.
Prime Minister’s Literary Award for Fiction
A novel based on Yolŋu oral history has taken out the nation’s richest literary prize, in a result being celebrated as a milestone for Aboriginal-led storytelling.
‘A Piece of Red Cloth’, written collectively by four authors: Yolŋu knowledge holders Merrkiyawuy Ganambarr-Stubbs, Djawa Burarrwanga and Djawundil Maymuru, together with novelist Leonie Norrington, was described by the award’s judges as a “landmark achievement in fiction” that sets “a high benchmark for collaboration between Aboriginal and non-Aboriginal writers”.
The novel is set in a coastal north-east Arnhem Land community in the 1600s and is grounded in the pre-colonial history of centuries of wet-season trade between Yolŋu people and Makassan trepang fishers from the port of Makassar, in eastern Indonesia.
Best of Croakey
Croakey has been covering the current threats to health, healthcare, research, and social justice from the rise of populism and the extreme right. This included hosting a recent online roundtable on Tackling the far right as a health threat – what will it take?
See also:
- Get organised and be brave: lessons from the United States on fighting back against populism.
- Injecting public health perspectives into discussions about migration, workforce and regional communities.
- On changing demographics, political shifts and insights to inform advocacy.
See Croakey’s archives on the political determinants of health, and on populism.
The good news story
I loved a recent story (backed by at least some scientific evidence) in The Washington Post (apologies, it’s paywalled) about how drawing, even for ten minutes, can reset your nervous system.
There are some more articles on this topic here:
- Why Draw? The Amazing Benefits of Drawing for Your Brain
- The Research-Backed Benefits of Drawing for Your Brain and Creativity
- Feeling Artsy? Here’s How Making Art Helps Your Brain
- The Neural Bases of Drawing. A Meta-analysis and a Systematic Literature Review of Neurofunctional Studies in Healthy Individuals.
Croakey thanks and acknowledges Dr Lesley Russell for providing this column as a probono service to our readers. Follow her on Twitter at @LRussellWolpe.
Previous editions of The Health Wrap can be read here.
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