From Australia to Bangladesh and Beyond: Mobilizing Local Communities Is Key to Breaking Down Climate and Health Silos
Dharriwaa Elders Group staff and Elders protesting the need to buy bottled water given the poor quality of Walgett’s tap water.

A project born from community advocacy and Indigenous leadership has catalysed a unique partnership between a small, rural Australian community and global health experts, shining a light on the link between climate, health and the power of community-driven change.   

Systematic water mismanagement combined with droughts and floods exacerbated by climate change has led to unreliable town water supplies for residents of Walgett in New South Wales.

Early this year, a survey led by local Aboriginal community-controlled organisations conducted in the Aboriginal community found that 43% of people were experiencing moderate to severe water insecurity. The drinking water supplied to the town from bores was found to be so high in sodium that it posed a threat to the many community members living with high blood pressure, heart disease, kidney disease and diabetes.

The survey showed the levels of water insecurity in Walgett were even worse than those recorded in Bangladesh’s capital, Dhaka; a city of 23 million people struggling to cope with the impacts of extreme heat. A rise in the salinity of drinking water in Bangladesh has been linked to increases in hypertension and chronic kidney disease and elevated rates of pre-eclampsia and gestational hypertension in pregnant women.

The George Institute partners with communities in both these contexts, and we are keenly aware that for the people most impacted by the interlinked threats of environmental change and chronic disease, the climate crisis is a health crisis and vice versa.

Indeed, to separate the two is incompatible with Indigenous peoples’ holistic understanding of health, which encompasses not only the physical, social, emotional and spiritual well-being of the whole community, but also its connection to Land and Country, including the earth, waterways and skies.

As we prepare for the first-ever ‘Health Day’ at this year’s UN Climate Change Conference (COP28) in the United Arab Emirates, we argue that progress in breaking down siloes between climate and health is welcome, but far too slow. To accelerate urgently needed inter-sectoral action, we need to put affected communities at the heart of decision-making processes.

Integrating climate in health priorities

World Health Assembly 76 in progress.

At the World Health Assembly in May, the climate crisis made an appearance in several official agenda items, as well as multiple side events.

The links between environmental change and health were at least nodded to in resolutions to address the health challenges faced by Indigenous peoples; the burden of drowning; and actions for the prevention and control of non-communicable diseases. In addition, the first-ever resolution on the impacts of chemicals, waste, and pollution on human health was approved at the Assembly – ironically, without naming fossil fuels. 

The integration of environmental considerations across multiple health priorities was a positive step, as is progress towards the adoption of a resolution on climate change and health in 2024, supported by the Global Climate and Health Alliance and partners. Nevertheless, the visibility of the climate crisis at the World Health Assembly was by no means congruent with its status as one of the greatest threats to health this century. 

Integrating health in climate priorities

World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus delivered his first speech at COP28 on the eve of ‘Health Day’, which will take place on December 3.

The inclusion of a ‘Health Day’ on this year’s COP agenda aims to signal a shift in focus, highlighting the recognition of health as a central pillar in climate discussions at the highest level.

Last year’s conference laid some foundations to build on. For example, with the launch of the Sharm El-Sheikh Adaptation Agenda, which aims to enhance resilience for four billion people living in the most climate-vulnerable communities by 2030.

This year, a set of new ‘Health Outcomes’ will be integrated into the Agenda, comprising a plan to address the increasing impacts of climate change on human health and health systems. COP28 will also feature a Health Pavilion for the third time.

In addition, COP28 will see the inaugural Health and Climate Ministerial meeting, at which governments will be asked to endorse a Declaration on Climate and Health. The Declaration has been developed with the WHO, and is ‘intended as a clear signal of ambition and unity on health’, according to the COP28 Presidency.

However, the Declaration is a voluntary call to action which sits outside the formal conference negotiations, raising concerns that it may become just another commitment for which governments can’t be held to account. It also overlooks the importance of reducing emissions to limit health hazards and alleviate pressure on strained health systems.

Communities as catalysts for integrated approaches

Yuwaya Ngarra-li is a community-led partnership between the Dharriwaa Elders Group, an Aboriginal Community Controlled Organisation working for cultural management and community development in Walgett for more than 23 years, and partners at the University of New South Wales.

There will likely be many more health-focused civil society organisations at COP28 than there were climate-focused groups at the World Health Assembly. However, there is still much room for greater intersectorality in advocacy, as well as policymaking. For example, those seeking tighter regulation of fossil fuels may have something to learn from advocates with decades of experience in battling tobacco and other health-harming industries. 

However, to really shift the dial on intersectoral action, we need to centre the voices of people who are experiencing every day the dire health consequences of environmental degradation; from increased heatwaves to the spread of vector-borne diseases, from failed food systems to rising drinking water salinity.

Moreover, it is imperative that we hear from and listen to Indigenous voices, which are often relegated to the margins yet hold sophisticated knowledge in climate mitigation and adaptation strategies that are land-informed, community-driven and holistic.

Through the Yuwaya Ngarra-li partnership between the Walgett Dharriwaa Elders Group and UNSW researchers, advocacy around ongoing water crises and the important cultural connection to Country (lands and waters) has led to significant media coverage and a ministerial commitment to a long-term water solution.

The partnership has also led to innovative, community-driven actions, including the employment of a local food and water coordinator, the installation of a safe drinking water kiosk by the Dharriwaa Elders Group, and a drought-proof micro-farm at the Walgett Aboriginal Medical Service.

In Bangladesh, as part of our work on non-communicable diseases and environmental change, we are in the process of setting up a Public Advisory Board, as we have in India and Indonesia. Comprised of members with diverse backgrounds and lived experiences, the Board is a platform for community members to provide input and participate in decision-making processes. ensuring that their voices are prioritised in shaping interventions to reduce water salinity.  

Further examples of putting community voices at the heart of discussions to set policy agendas and allocate resources can be found in ongoing efforts to establish mechanisms for social participation in health, and the critical role played by communities in progress towards ending AIDS. 

Success will be rewarded with intersectoral policies and services that build on the Traditional Knowledges of Indigenous peoples and respond to community needs; particularly those of women, girls, young people and other groups who experience the impacts of the climate crisis disproportionately.

By mobilising local communities as communicators, advocates and agents of change – from Australia to Bangladesh and beyond – we can prioritise action that directly improves health outcomes for both people and planet, ensuring a more equitable and resilient future for us all.

About the authors

Chhavi Bhandari is the head of Impact and Engagement for India and Multilaterals at The George Institute for Global Health, working from India on a programme of multilateral, regional and national advocacy and engagement. She is the Community Engagement and Involvement (CEI) lead for the National Institute for Health and Care Research (NIHR) Global Health Research Centre for Non-Communicable Diseases (NCDs) and Environmental Change and a member of the WHO-Civil Society Working Group to Advance Action on Climate & Health.

Keziah Bennett-Brook is a Torres Strait Islander woman and Program Head of Guunu-maana (Heal) Aboriginal and Torres Strait Islander Health Program at The George Institute for Global Health, Executive Member of the Australasian Injury Prevention Network, and Indigenous Committee lead. Keziah has chaired the Research Committee for Aboriginal and Torres Strait Islander Health since 2017 and leads the development and implementation of Aboriginal and Torres Strait Islander health research strategy, policy, stakeholder partnerships and Indigenous research coordination within a global research institute. 

Emma Feeney is the Director of Impact & Engagement at The George Institute for Global Health, where she leads a global programme of activities including advocacy, policy engagement and thought leadership to help increase the impact of the institute’s health and medical research. Emma co-chairs the WHO’s NCD Lab on Women and Girls and the NCD Alliance Supporters’ Group.

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