The governments current public consultation about climate change presents a rare opportunity for health and wellbeing to enter the public discourse around climate targets and action.In December, countries will meet in Paris to establish a critical new international climate change agreement.1 This agreement will strongly influence whether we have a safe planet to live on in the not-too-distant future, and whether our children and grandchildren will be able to enjoy the same level of health and wellbeing as is possible today.2Before Paris, countries are expected to announce their level of commitment to reducing greenhouse gas (GHG) emissions globally their Intended Nationally Determined Contributions (INDCs). The New Zealand Government is currently consulting with the public as to what our fair contribution should be.3 The INDC is expected to include specific targets for reducing our carbon and total greenhouse pollutants between now and 2030, longer-term commitments, and specific policy mechanisms to achieve the targets.A paper published in the New Zealand Medical Journal of November last year summarised the current scientific thinking about climate change and its health and health equity implications.4 It was clear then that there are limits to the amount of average warming that Earth systems can tolerate before thresholds for irreversable change are reached. Average warming of 2oC or more needs to be avoided to safeguard human health and wellbeing for current and future generations. But without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world is on a trajectory towards high levels of warming, of 4-7oC on average or even higher by 2100.4 This would lead to uncontrollable levels of climate change for many future generations and pose severe and possibly insurmountable risks to human health and wellbeing.2All New Zealanders will face direct impacts on health in a +4oC climate (floods, storms, heatwaves, infectious diseases), and we will also have to deal with enormous new health and social challenges such as mass population migrations and resource-related global conflict.4,5 Those that are vulnerable already Mori, Pacific people, children, the elderly, and those on low incomes will face the greatest impacts in the short term, but very few people will be immune to the widespread social and health threats.4However, it doesnt have to be that way. A strong global climate deal, if enacted with sufficient urgency, can still avert the most serious consequences of climate change. Swift, decisive health- and equity-centred policies to reduce GHG emissions are not only necessary to limit future climate change, but could also enhance the health, fairness and resilience of our communities today.4,6 There are significant short- and medium-term health co-benefits to be gained, especially by shifting from cars to active and public transport;7,8 improving housing energy efficiency and heating;9 reducing red meat and dairy intake in our diets;10 and phasing out fossil fuel mining and burning.11,12The governments INDC consultation document presents climate action as a net cost to our economy.13 While there are likely to be costs for some groups and industries, the document fails to account for the economic opportunities that are widely acknowledged as societies adapt to a low-carbon world.14Furthermore, Ministry for the Environment officials during the recent public consultation meetings have acknowledged their failure to account for either the health costs of inaction, or the substantial and measurable cost savings for the health sector that could accrue from the health co-benefits of well-designed action. These health benefits need to be included in calculations of costs and benefits of action. The costs of making the needed transition also need to be borne fairly. Policy mechanisms will be crucial for recycling the payments of wealthy climate polluters into support for a healthy transition to a low-carbon world, especially for low-income households.15Climate change is a global issue that requires a collective response. The response must recognise historical contribution to climate change and capability to act, as well as fair sharing of costs. Many of the nations that will be worst affected by climate change have contributed almost nothing to cumulative global GHG emissions, whereas New Zealand has long been one of the highest per capita GHG emitters.16 As a wealthy, democratic nation with a robust economy and much of the infrastructure needed to further increase our renewable energy generation, New Zealand is in a strong position to make ambitious INDC commitments.On the basis of contribution, capability and cost, New Zealand has global obligations to set ambitious targets a total GHG reduction target of at least 40% on 1990 levels by 2030, and a target of zero carbon emissions before 2050. These are the targets determined by the Earths environmental physics, not by what is seen as politically popular.17 However, distant targets have little worth unless they are coupled with commitment across the political spectrum and include annual targets and actions. They therefore need to be underpinned by sector-specific policies for meeting the targets that have human wellbeing and social equity at their heart.This health-centredness of climate policy needs to extend to the global negotiations. We therefore urge the Minister of Health to join other health officials in Paris in December, to attend the Climate and Health Summit that is planned alongside the climate negotiations, and to call for human health and wellbeing to be at the centre of negotiations. This would signal that New Zealand, like other countries, has made the critical link between climate change and health, and is willing to act to protect and promote the health and wellbeing of New Zealanders.18We also urge all health professionals to get engaged in the climate-health issue, and if possible to make a short submission to the Government by the 3 June.3 A health-focused submission guide provides some suggested key messages to assist health professionals and organisations to make submissions.19 We have a responsibility to our patients and communities to push for strong, health-centred climate action. In doing so we have the opportunity to turn one of our greatest health threats into positive action to create a healthy, fair and resilient nation.

The governments current public consultation about climate change presents a rare opportunity for health and wellbeing to enter the public discourse around climate targets and action.In December, countries will meet in Paris to establish a critical new international climate change agreement.1 This agreement will strongly influence whether we have a safe planet to live on in the not-too-distant future, and whether our children and grandchildren will be able to enjoy the same level of health and wellbeing as is possible today.2Before Paris, countries are expected to announce their level of commitment to reducing greenhouse gas (GHG) emissions globally their Intended Nationally Determined Contributions (INDCs). The New Zealand Government is currently consulting with the public as to what our fair contribution should be.3 The INDC is expected to include specific targets for reducing our carbon and total greenhouse pollutants between now and 2030, longer-term commitments, and specific policy mechanisms to achieve the targets.A paper published in the New Zealand Medical Journal of November last year summarised the current scientific thinking about climate change and its health and health equity implications.4 It was clear then that there are limits to the amount of average warming that Earth systems can tolerate before thresholds for irreversable change are reached. Average warming of 2oC or more needs to be avoided to safeguard human health and wellbeing for current and future generations. But without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world is on a trajectory towards high levels of warming, of 4-7oC on average or even higher by 2100.4 This would lead to uncontrollable levels of climate change for many future generations and pose severe and possibly insurmountable risks to human health and wellbeing.2All New Zealanders will face direct impacts on health in a +4oC climate (floods, storms, heatwaves, infectious diseases), and we will also have to deal with enormous new health and social challenges such as mass population migrations and resource-related global conflict.4,5 Those that are vulnerable already Mori, Pacific people, children, the elderly, and those on low incomes will face the greatest impacts in the short term, but very few people will be immune to the widespread social and health threats.4However, it doesnt have to be that way. A strong global climate deal, if enacted with sufficient urgency, can still avert the most serious consequences of climate change. Swift, decisive health- and equity-centred policies to reduce GHG emissions are not only necessary to limit future climate change, but could also enhance the health, fairness and resilience of our communities today.4,6 There are significant short- and medium-term health co-benefits to be gained, especially by shifting from cars to active and public transport;7,8 improving housing energy efficiency and heating;9 reducing red meat and dairy intake in our diets;10 and phasing out fossil fuel mining and burning.11,12The governments INDC consultation document presents climate action as a net cost to our economy.13 While there are likely to be costs for some groups and industries, the document fails to account for the economic opportunities that are widely acknowledged as societies adapt to a low-carbon world.14Furthermore, Ministry for the Environment officials during the recent public consultation meetings have acknowledged their failure to account for either the health costs of inaction, or the substantial and measurable cost savings for the health sector that could accrue from the health co-benefits of well-designed action. These health benefits need to be included in calculations of costs and benefits of action. The costs of making the needed transition also need to be borne fairly. Policy mechanisms will be crucial for recycling the payments of wealthy climate polluters into support for a healthy transition to a low-carbon world, especially for low-income households.15Climate change is a global issue that requires a collective response. The response must recognise historical contribution to climate change and capability to act, as well as fair sharing of costs. Many of the nations that will be worst affected by climate change have contributed almost nothing to cumulative global GHG emissions, whereas New Zealand has long been one of the highest per capita GHG emitters.16 As a wealthy, democratic nation with a robust economy and much of the infrastructure needed to further increase our renewable energy generation, New Zealand is in a strong position to make ambitious INDC commitments.On the basis of contribution, capability and cost, New Zealand has global obligations to set ambitious targets a total GHG reduction target of at least 40% on 1990 levels by 2030, and a target of zero carbon emissions before 2050. These are the targets determined by the Earths environmental physics, not by what is seen as politically popular.17 However, distant targets have little worth unless they are coupled with commitment across the political spectrum and include annual targets and actions. They therefore need to be underpinned by sector-specific policies for meeting the targets that have human wellbeing and social equity at their heart.This health-centredness of climate policy needs to extend to the global negotiations. We therefore urge the Minister of Health to join other health officials in Paris in December, to attend the Climate and Health Summit that is planned alongside the climate negotiations, and to call for human health and wellbeing to be at the centre of negotiations. This would signal that New Zealand, like other countries, has made the critical link between climate change and health, and is willing to act to protect and promote the health and wellbeing of New Zealanders.18We also urge all health professionals to get engaged in the climate-health issue, and if possible to make a short submission to the Government by the 3 June.3 A health-focused submission guide provides some suggested key messages to assist health professionals and organisations to make submissions.19 We have a responsibility to our patients and communities to push for strong, health-centred climate action. In doing so we have the opportunity to turn one of our greatest health threats into positive action to create a healthy, fair and resilient nation.