Climate Change

The World Health Organization has labelled climate change as the defining issue for public health in the 21st century. Climate change is a major concern for asthma which can be caused by, and exacerbated by, conditions and events related to the warming climate. These include more frequent and prolonged bushfires which create smoke pollution, increased ozone at ground level, increased pollen production, rainfall and flooding events which cause mould growth and greater likelihood of thunderstorm asthma events.   

The impacts of declining air quality are being experienced now making strong action to mitigate climate change an urgent priority. Adaptation actions are equally important because the impacts of past and current emissions are locked in. Failing to take robust action now will contribute to ongoing deterioration and make it harder—if not impossible—to mitigate or adapt to climate change impacts in the future.  

People with asthma have told us that climate change is a priority for our advocacy. We now call on governments around Australia to accelerate their efforts to protect people with asthma by slashing greenhouse gas emissions and boosting adaptation efforts.  

Read more about Asthma Australia’s policy recommendations in our policy position statement on climate change.

Click here to tell us what action you’d like us to take to address climate change. 

The National Sustainable Asthma Care Roadmap – Roundtable Report

The National Health and Climate Strategy, released in December 2023, seeks to increase resilience to the health impacts of climate change and reduce greenhouse gas emissions from the Australian health system. Recognising the relationship between health and climate outcomes, it proposes a whole-of-government approach with four objectives: health system resilience, health system decarbonisation, international collaboration and health in all policies. 

The health system decarbonisation objective commits to building ‘a sustainable, high-quality, net zero health system’ with a series of actions to reduce greenhouse gas emissions associated with care delivery. Action 4.14 commits to improving respiratory health outcomes and reducing emissions from respiratory inhalers by working with consumers, the health sector and industry peak bodies. 

Asthma Australia engaged Deakin University’s Institute for Health Transformation to conduct two roundtables, engaging representatives from 50 key organisations, representing consumers, health care professionals, research, industry, peak organisations and government, who contributed to a collaborative and systematic approach to identify actions for reducing health sector emissions. This deliberate and consultative approach put people living with asthma at the centre of the conversation and prioritised improving their asthma with emissions reduction as a co-benefit. 

The roundtable discussions were structured to understand the current drivers of asthma care’s disproportionately large climate footprint and identified the opportunities and barriers to improving care and reducing emissions and developed collaborative goals and actions. The resulting National Sustainable Asthma Care Roadmap can support the development of a national implementation plan, with input from health professionals, industry and consumers to improve asthma management, while concurrently transitioning to low greenhouse gas emission inhalers. 

Asthma Australia supports action across all sectors to reduce greenhouse gas emissions, including the additional actions in the National Climate and Health Strategy. The Roadmap presents a consultative, strategic and feasible approach to delivering improved asthma outcomes and environmental co-benefits. 

Hydrofluorocarbon propellants used in current ‘asthma puffers’, called pressurised metered-dose inhalers (pMDI), are potent greenhouse gases, responsible for around 90% of the asthma healthcare footprint in the UK. While a comprehensive assessment of Australia’s total asthma care footprint is required, the greenhouse impact of the approximately 25 million inhalers sold in Australia each year, of which around 80% are high global warming potential pMDIs, can be estimated at over 600,000 tonnes CO2e – similar to the emissions of 350,000 vehicles. 

Reducing the high rate of poorly controlled asthma and mitigating the environmental impact of pMDIs used to treat asthma represents a major unmet need. Compelling evidence shows that transitioning to anti-inflammatory asthma medication regimens delivered using low-carbon devices can improve person-centred asthma outcomes while simultaneously reducing greenhouse gas emissions. A coordinated and strategic approach is required to expedite the translation of this evidence into policy and practice. 

The National Sustainable Asthma Care Roadmap – Roundtable Report presents eight goals that provide a process for transitioning asthma care in Australia to a higher quality and more environmentally sustainable model.  

Goal 1: Establish a data dashboard to display the national indicators of high-quality asthma care and decarbonisation trends – to monitor and evaluate progress towards improved asthma care quality and reduced associated greenhouse gas emissions. 

Goal 2: Establish processes and resources to support annual/regular updating of the national asthma guidelines and for harmonising secondary recommendations and clinical tools in consultation with peak asthma bodies – to inform and facilitate a national implementation strategy. 

Goal 3: Increased clinician education and digital enablement to implement evidence-based guideline-concordant, low-carbon asthma care, particularly the use of AIR regimens – to increase clinician knowledge and adoption of best practice in asthma care and sustainability, enabled by digital clinical decision-making, management and prescribing tools, in order to avoid SABA overuse and reduce asthma exacerbations.  

Goal 4: Inform people with asthma about how to improve their asthma control and options to reduce greenhouse gas emissions from inhalers where suitable devices are available – to increase patient/consumer knowledge, empowerment and shared decision-making. 

Goal 5: Reduce the imbalance between cost and ease of access to SABA compared with more effective medications – to support the implementation of evidence-based guidelines and thereby improve safety and disease control. 

Goal 6: Support research to implement and evaluate high-quality sustainable asthma care – to inform a national implementation of evidence-based, guideline-concordant, low-carbon asthma care, with continuous improvement in asthma care delivery and environmental sustainability. 

Goal 7: Reduce greenhouse gas emissions by minimising residual hydrofluorocarbon leakage from discarded asthma inhalers – specifically targeting propellant leakage from pMDIs disposed of in household waste. 

Goal 8: Support governments in developing a ‘health in all policies’ approach to reducing the modifiable inducers and triggers of asthma – to improve air quality and reduce asthma triggers while also improving respiratory health for all. 

This Roadmap presents a compelling vision for the future of asthma care in Australia. We urge government stakeholders to acknowledge the significance of this work, to partner with the peak asthma bodies, and invest in the necessary resources to translate these recommendations into a national implementation strategy that will deliver measurable impacts to improve the quality of life for people with asthma while reducing the associated carbon footprint. 

The actions provided below are intended to progress the Roadmap goals and recommendations into a comprehensive implementation strategy and plan. 

Action 1: Establish a collaborative body to develop a detailed implementation plan 

To initiate this process, a stakeholder body would be formed, consisting of stakeholders who contributed to the roundtables and other identified groups. It would establish a committee to foster communication and ensure a collaborative and efficient process. The body would partner with relevant government departments to develop a comprehensive implementation plan for the Roadmap goals and recommendations. Leadership from peak bodies, including strong consumer representation, is important to this process. Funding could be sourced from government (federal, state and territory), research grants and philanthropic contributions. 

Action 2: Undertake a detailed economic evaluation to assess the likely return on investment 

Stakeholders and governments should prioritise undertaking an economic evaluation of the costs and potential savings for the health sector and broader community in making a transition to high-value care, including assessment of the associated social, health and environmental benefits. 

This economic evaluation will provide estimates of the potential expenditure required to fund a national implementation of the Roadmap’s goals for guideline-concordant, low-carbon care, while also detailing the potential return on investment and identifying opportunities to reduce ongoing health system costs and improve efficiency. 

Action 3: Provide governance and resources to deliver a collaborative national sustainable asthma implementation plan 

Funding and resources will be required to deliver a collaborative national implementation plan and to realise the health, environmental and economic benefits. Effective implementation will require continued collaboration between consumers, the asthma care sector (including Roadmap stakeholders), governments, and regulatory bodies. A partnership approach would build on the Roadmap’s momentum and consensus for change. It would also facilitate targeted investment in key initiatives, which is critical to achieving the shared goals of improving the quality of care and the wellbeing of all Australians with asthma, while reducing the associated greenhouse emissions. 

The National Sustainable Asthma Care Roadmap can be downloaded here.

In compliance with Medications Australia’s code of conduct, Asthma Australia secured funding for this initiative through unrestricted grants from AstraZeneca, Chiesi Australia, GSK and Orion Pharma Australia. 

The National Sustainable Asthma Care Roadmap – Roundtable Report launch 

The report was launched on 18 September by the Hon Ged Kearney, Assistant Minister for Health and Aged Care. 

Asthma Australia wishes to thank all those who were involved in the process to produce the Roadmap across government, industry, health professional organisations and peaks, researchers and individuals.