Looking Back—Australia’s Sustainable Development and Climate Change Policy Agendas

: In November 2022, a climate change performance index report released at the COP27 United Nations conference in Egypt, ranked Australia 55th on a list of 63 countries and country groupings in addressing the climate crisis. Australia is a leading development partner in the Paciﬁc region; a region economically, environmentally, socially, and culturally impacted by climate change and global warming in the form of (e.g.,) rapid sea level rises, alarming shifts in marine ecosystems, and extreme weather events. How did Australia, a high-income country situated in the Paciﬁc, become a nation that trails other developed countries in addressing climate change? Why has there been a lack of urgency for uptake of sustainable development policy and planning? A new Federal Government, elected in May 2022, has indicated willingness to meaningfully progress Australia’s interconnected climate change, wellbeing, and sustainability policy agendas, in which futures public health policy is inextricably linked. This change in government provides an important moment to review Australia’s sustainable-development climate change policy landscape over a 35-year period. By examining this landscape through a health lens, this paper can provide one of many critical perspectives tracing Australia’s slippage to the bottom of the global climate rankings today.


Background
The need for cogent and consistent sustainable development policy at all levels of government, with focused overarching national leadership and investment, is increasingly urgent given the acute climate change impacts threatening the vast Australian continent and the health and wellbeing of its diverse peoples, animals, skies, lands, and waterways.This is exemplified by the devastating impacts of climate change on the Torres Strait Islands, peoples, and cultures [1], the bushfires that burnt across around 74,000 square kilometres of mostly forest over the summer of 2019-2020 [2,3], and the catastrophic floods of early 2022 in New South Wales and Queensland [4].Some of these events can also accelerate climate change: the 2019-2020 bushfires damaged the ozone layer and caused the highest temperatures in the stratosphere in 30 years [5].
A new Australian Government led by Prime Minister Anthony Albanese was elected to begin its three-year term in May 2022.By mid-2022, the new government had signaled its willingness to lean into and substantively progress Australia's climate change and wellbeing policy agendas.The full extent of the Albanese government's support for climate change and sustainability policy agendas, and those agendas' interconnection for improving the health and wellbeing of current and future generations of Australians, remains to be seen.Nonetheless, the election outcome of 2022 provides opportunity to reflect on the history and status of Australia's health and interrelated sustainable development and climate-change policy and planning.
Therefore, this paper will provide a succinct overview of Australia's health-sustainable development climate change policy landscape over a 35-year period.The reflective views expressed in this paper are provided by an Australian-based researcher who, for some 10 plus years, has specialized in examining the history, formulation, and subsequent implementation of the Sustainable Development Goal (SDG) agenda in the context of that agenda's effective impact on the promotion of global (and national-level) health and human rights (see, e.g., [6][7][8][9][10][11]).The paper will begin by reviewing Australia's uptake of the World Commission on Environment and Development's report of 1987 and conclude with the change of Federal government in the first half of 2022.Importantly, the review will provide contextual understanding of how the political determinants of health shaped the country's broader commitment to implementing the crosscutting international Sustainable Development Goal and planetary health policy agendas.Such contextual insight can assist future health policy scholars who may rue Australia's political inaction on health and climate change in the first two decades of the new millennium.

Tracing the Sustainability Policy Agenda in Australia: From the Brundtland Report in 1987 to the Sustainable Development Goals in 2015
In 1983, the United Nations (UN) General Assembly established the independent World Commission on Environment and Development with three objectives: to review and formulate pragmatic proposals to deal with environment and development issues; to propose new forms of international cooperation on these issues; and to raise multistakeholder commitment to action in and beyond government [12].The World Commission on Environment and Development also became known as the Brundtland Commission after its chair, a future World Health Organization (WHO) Director-General (1998)(1999)(2000)(2001)(2002)(2003), Gro Harlem Brundtland.The Brundtland Commission released its ground-breaking report in 1987, which pressed that all countries seek to achieve the global goal of sustainable development regardless of their stage of development (Box 1) [12].Although the Brundtland Commission report was not without its deficiencies and criticism (see, e.g.,: [13][14][15]).Similar to many countries, Australia demonstrated its support for the report through its active participation at the 1992 Earth Summit in Brazil [16,17].
Box 1. Description of 'sustainable development' in the Report of the World Commission on Environment and Development: Our Common Future (1987) [12]."[M]eet[ing] the needs of the present without compromising the ability of future generations to meet their own needs . . .sustainable development requires meeting the basic needs of all and extending to all the opportunity to fulfil their aspirations for a better life.A world in which poverty is endemic will always be prone to ecological and other catastrophes . . .Sustainable global development requires that those who are more affluent adopt life-styles within the planet's ecological means-in their use of energy, for example . . .[S]ustainable development is not a fixed state of harmony, but rather a process of change in which the exploitation of resources, the direction of investments, the orientation of technological development, and institutional change are made consistent with future as well as present needs.We do not pretend that the process is easy or straightforward.Painful choices have to be made . . .sustainable development must rest on political will" The Earth Summit was not only seminal in activating the international climate-change agenda, but also in its identification that development challenges (including emerging climate change challenges) were interconnected and indivisible; "so that necessarily integrated responses could be developed, rather [than] only sector-or issue-specific approaches . . .[that are] a prime cause of unsustainability" [18].Consequently, Australia's Commonwealth government "shifted to a new phase of intervention in the 1990s and attempted to construct new policy goals by adapting this discourse to Australia's domestic situation" [19].In 1992, the Australian Government released a National Strategy for Ecologically Sustainable Development (the National Strategy) that married the Earth Summit's new approach to development [20] with the political interests of the Hawke-led Australian Government's National Conservation Strategy [19].The National Strategy defined ecologically sustainable development as "Using, conserving and enhancing the community's resources so that ecological processes, on which life depends, are maintained, and the total quality of life, now and in the future, can be increased" [20].The National Strategy aimed to foster " [d]evelopment that improves the total quality of life, both now and in the future, in a way that maintains the ecological processes on which life depends", as well as for ecologically sustainable development to become "an active national policy and an integrated agenda" [20].
The National Strategy's definition of economically sustainable development was brief and much more narrowly defined than the Brundtland report's concept of sustainable development, with government focus "very much on reconciling economic and ecological goals" [19].Although the National Strategy policy agenda enjoyed bipartisan support on its release [19], effort to promote the health and ecologically sustainable development overlap was minimal and came by way of a handful of Australian National Health and Medical Research Council (NHRMC) papers (e.g., see: [21]).In fact, the National Strategy and its intergovernmental committee ceased to exist by 1997 following the change to a Howard-led Commonwealth government in 1996 [19].
Australia's 1992 National Strategy for Ecologically Sustainable Development reflected international calls for "a new public health practice" that combined with sustainable development [22]."Such calls were linked to the Brundtland Commission report, the Earth Summit, and the Ottawa Charter for Health Promotion, which set out the interconnection between supportive, healthy environments for health and health promotion to achieve WHO's Health for All Strategy" ( [6]; and see the Ottawa Charter [23]).In 1993, the Goals and Targets for Australia's Health in the Year 2000 and Beyond framework was released after broad consultation that built on the Ottawa Charter's Vision and the Australian Government's previously established health goals [24].The Goals and Targets for Australia's Health in the Year 2000 and Beyond framework put forward four health goals, which included new goals and targets on Healthy Environments [24,25].However, similarly to the National Strategy, "that framework faded despite initial positive response from government and guidance available for its achievement" [6].
The importance of incorporating sustainable development into public health and all facets of life again gained traction in Australia in the new millennium [26,27].International factors undoubtedly influenced domestic uptake, such as the Intergovernmental Panel on Climate Change's (IPCC) Fourth Assessment Report in 2007 that noted the clear association between sustainable development and climate change [28].Following that report's release, the World Health Assembly in 2008 committed the WHO member countries to strengthen action to protect health from climate change threats, building on a 1998 World Health Assembly resolution on the protection of human health from threats related to climate change and stratospheric ozone [29].In turn, in 2008 a joint Lancet Commission was established to report on the health-related dimensions of climate change [30,31].
In addition to international initiatives, release of relevant national technical reports by respected scientific and climate health authorities (among others) furthered growing interest and discourse on crosscutting health, sustainable development, and climate-change policy issues for multi-stakeholder action in Australia (e.g., [32][33][34][35][36]).Adding to the momentum was the Australian Parliamentary Inquiry into the adoption of a Sustainability Charter in 2006-2007 following on from the House of Representatives Standing Committee's tabling the Sustainable Cities report in September 2005 [37,38], and the Federal Government's establishment of the Australian Climate Commission in 2011 [39].Much of this occurred in the context of a different Federal political environment, ushered in by the Howard government's removal in 2007.

Health Policy in the New Sustainable Development Goal Era
Good health and wellbeing feature prominently across the 17 SDGs: explicitly through the global health goal SDG 3 (Good Health and Wellbeing: To ensure healthy lives and promote wellbeing for all at all ages) and its 13 targets and subsidiary targets; SDG 5 (Gender Equality) Target 6 on universal access to sexual and reproductive health and rights; as well as through the underlying determinants of health found in many other goals and targets.Human health, environmental health, and planetary health are interlinked preconditions and outcomes of the 2030 Agenda [7], with health equity (grounded in human rights) a crosscutting theme because it "resonates with the SDGs' overarching principle of ehind and the implicit moral imperative of social justice" [76].
Australia signed onto the 2030 Agenda for Sustainable Development and its SDG implementation framework in September 2015, thereby committing on paper to localize and implement the SDGs in national sustainable development policy, planning, and implementation.Driven by civil society, the inaugural Australian SDG Summit was held in September 2016, with the first National SDG Youth Summit held in October 2016.The Australian Government signaled its initial support for the SDGs through its Overseas Development Aid (ODA) program in 2017 [77] and established an Interdepartmental Committee on the SDGs in the Department of Prime Minister and Cabinet (PMAC), led by PMAC in partnership with the Department of Foreign Affairs and Trade (DFAT).Australian government departments were tasked to take lead responsibility on each of the 17 SDGs, especially for informing government preparation of Australia's first Voluntary National Review (VNR) on SDG implementation.
Australia's first VNR on the SDGs was delivered to the high-level political forum in June 2018 [78].Therein, the Australian Government affirmed its pledge to achieve the SDGs especially for Aboriginal and Torres Strait Islander peoples and for those 'furthest behind', as well as to support SDG achievement in the Indo-Pacific region through Australia's ODA program.Yet Australia's VNR is problematic: it does not critically or overtly engage with SDG 3's targets and indicators or the underlying determinants of health across the goal framework, nor acknowledge that a national SDG policy action plan (that includes SDG health-related planning and implementation) has been developed upon which the VNR can report against; or is in development so government and its partners can report against to the Australian public or in future VNRs [79].Australia's first VNR on the SDGs "merely aligns the Federal Government's existing domestic and ODA policy agendas to each SDG without committing to new initiatives" [8].
With neither the guidance nor mandate of a national SDG policy roadmap that includes local targets and indicators, Australia's sustainability planning has been akin to a "rudderless ship" [80].The country is 'off track' to achieve the SDGs and other related international climate change targets [81,82].Without localized SDG 3 targets and indicators (and their robust monitoring and review), Australia is also 'off track' in achieving good health and wellbeing for all Australians, wherein No One is Left Behind per the 2030 Agenda.While an authoritative 2020 SDG dashboards (levels and trends) report for OECD countries gave Australia the 'green light' for successful SDG 3 (Health and Wellbeing) achievement [83], this is misleading [79].Australia's SDG 3 green light obfuscates the major challenges for meaningfully achieving (for example) Aboriginal and Torres Strait Islander health equity and wellbeing (e.g., see: [84]) and the health and human rights of Australians with disability (e.g., see: [85]).
The Australian Senate's Foreign Affairs and Trade References Committee (FATRC) Parliamentary Inquiry into the SDGs in 2018 signaled that Federal government commitment to implementing the SDG agenda may be back on course.The FATRC held public hearings in three Australian cities and received 164 submissions from a range of community, Indigenous, health, environmental, private sector, government, and non-government voices [86].The breadth and depth of the submissions offer rich instruction on the priorities and needs for both in-country and ODA intersectoral health and sustainable development governance and planning, monitoring, and review [9,87].Examples of these are found in Box 2.
While the FATRC's report on the Parliamentary Inquiry of February 2019 noted many of the ways the submission content could guide Australia's SDG response to address pressing human and environmental health priorities moving forward [88], none of the Inquiry's 18 recommendations for SDG implementation were convincingly taken up by the Commonwealth [8].Indeed, in the FATRC's aftermath, none of the major political parties at the Federal level indicated serious intent to pursue a sustainable development policy agenda that is streamlined and cogently linked to Australia's SDG and overlapping international commitments under the UN Framework Convention on Climate Change, the Paris Agreement, and the Sendai Framework for Disaster Risk Reduction.
The Federal government's sidelining of the SDG policy agenda under Prime Minister Scott Morrison's leadership (2018-2022) mirrored its similar unwillingness to develop and implement a comprehensive policy and planning strategy on addressing climate change.In 2015, a National Climate Resilience and Adaptation Strategy was released by the Australian Government [89] and a 2021-2025 strategy later released [90].However, both strategies seek to better manage and adapt Australia's response to climate change impacts, with a strong emphasis on disaster and emergency management, as opposed to proactively enabling a holistic sustainable development agenda that addresses the deeply embedded economic, social and environment drivers of climate change, poor health, poverty, and inequity.For example, in 2017 the Climate and Health Alliance and its partners developed a Framework for a National Strategy on Climate, Health and Well-being for Australia [91].However, it was not adopted by the Australian Government, thus "making action at the state-and territory-level even more important" [92].The latest policy released by the former Federal government's Minister for the Environment, National Climate Resilience and Adaptation Strategy 2021-2025, mainly focuses on climate change mitigation and adaption rather than taking actions toward reducing the environmental footprint of, for instance, the healthcare system.
Australian states and territories have progressively stepped up to address the ongoing policy vacuum at the national level, which has included progressing health and interconnected sustainable development and climate change policy and planning.In 2008, Western Australia produced Australia's first climate change adaptation report specific to the health sector [92].Ten years later, the Queensland Government was the first Australian government to release a comprehensive Human Health and Wellbeing Climate Change Adaptation Plan (H-CAP).The H-CAP reflects Australia's international commitments to address climate change in the Paris Agreement, the Sendai Framework, and SDG 3 (Good Health and Wellbeing) and SDG 13 (Climate Action) [93].Other jurisdictions are taking similar policy and planning action.For instance, the Northern Territory (NT) Department of Health has established a Climate Change Health Advisory Group to provide oversight of human health impacts of climate change and appropriate responses [94]; the Victorian Department of Health and Human Services has a Health and Human Services Climate Change Adaptation Action Plan 2022-2026 [95]; and Tasmania held a Roundtable to identify priority policies, programs and research to move forward in climate change and health [96].Meanwhile, authoritative bodies such as the Australian Medical Association (AMA), Royal Australian College of General Practice, Royal Australasian College of Physicians, Australian College of Nursing, and Public Health Association of Australia continued to release climate policies and position statements, as well as press government to prioritize addressing climate change for sustainable, climate-friendly medical and healthcare, and for broader population and environmental health improvements [97][98][99][100][101].For instance, an Open Letter to Prime Minister Morrison in September 2021 signed by the AMA and many medical colleges, called for Australia to significantly lift its climate change commitments to save lives and protect health [102].Australia's health sector is also an active part of the Global Green and Healthy Hospitals (GGHH) initiative, which in the Pacific region is coordinated by the Climate and Health Alliance [103].The GGHH is an international network of hospitals, health and aged care facilities and health organizations committed to environmentally sustainable and climate-ready health systems and services [104].Considering it is estimated Australia's health sector contributes around 7% of greenhouse gas emissions [97,98], it is crucial Australia's GGHH network builds and thrives including among allied health actors and community pharmacies [105][106][107][108][109][110][111][112][113].For Barratt et al. [114], a key intervention is the removal of "low value care", which "alone would save Australia over 8000 kilotonnes of carbon dioxide equivalent emissions per year".

The Role of Corporate Australia in Actioning the Sustainable Development Goal Agenda
Finally, it is important to note the role of Australia's corporate and private sectors in driving forward SDG and climate change momentum.For example, the Global Compact Network Australia's active promotion of environmental and social governance (ESG) and corporate sustainability [115], the launch of the Australian Sustainable Finance Initiative in 2019 and its 2020 Roadmap [116], combined with growing ESG demand for business accountability and transparency from consumers and investors (especially impact investors) (e.g., see: [117][118][119]).Many large Australian corporations, and increasingly small to medium business enterprises, are thus integrating the SDG vision and framework into their ESG and corporate social responsibility (CSR) plans and benchmarks, and reporting on their SDG-related opportunities, challenges, and achievements.
The overarching regulatory environment and emerging international norms on sustainable business practice have encouraged the domestic shift.Particularly compelling have been the initiatives of the Task Force on Climate-related Financial Disclosures (TCFD) [120].The TCFD framework was endorsed by the Australian Securities Exchange (ASX) in October 2019, and similarly garnered early support from the Australian Prudential Regulation Authority (APRA).There has been discussion over the new climate vulnerability assessment rolled out by APRA becoming law [121], while the aims of the new Taskforce on Naturerelated Financial Disclosures (TNFD), modelled on the TCFD, are also instructive [122].The UN Guiding Principles on Business and Human Rights, released in 2011, also have had positive domestic impact [123].
However, there is no compulsory sustainability reporting among corporate Australia.Moreover, Australia lacks "an all-embracing act that integrates ESG factors into a single reporting compared to other jurisdictions" [124].de Orte Júlvez elaborates: "Similar to what happens in the US, companies are required to disclose any information that shareholders would reasonably need to make an informed assessment of an entity's operations and business strategies.There are also recommendations on corporate governance practices around environmental and social risks for publicly listed companies in Australia.The current legal requirements for certain entities in terms of disclosing nonfinancial information are related to specific federal acts, such as the Modern Slavery Act, the Workplace Gender Equality Act, or the National Greenhouse and Energy Reporting Act" [124].
Without adequate governance structures, policy or legislative interventions and monitoring and oversight mechanisms, there is concern that companies operating in Australia can misuse the language of ESG, CSR, and sustainable development to legitimize business practices that harm human and environmental health.The tobacco industry is a case in point.Of the 164 submissions to the Parliamentary Inquiry into the SDGs of 2018, the lengthiest submission was lodged by the transnational tobacco company Philip Morris International (PMI) [9].PMI encouraged the Australian Government to implement the SDGs and appoint an independent SDG representative to transparently monitor and report on Australia's SDG performance.PMI stated it is committed to: (1) SDG 3 achievement: "we believe the greatest contribution PMI can make to society is to replace cigarettes with less harmful alternatives".(2) Broader SDG achievement, with its operations particularly promoting SDG 3, SDG 2 (Zero Hunger), SDG 8 (Decent Work and Economic Growth), SDG 12 (Responsible Production and Consumption), SDG 16 (Peace, Justice, and Strong Institutions) and SDG 17 (Partnerships for the Goals).(3) Respecting and upholding human rights in all global operations and in its value chain; respect for human rights being fundamental to the sustainability of PMI's business strategy [125].
PMI's detailed submission emphasizes that company's strategy to symbolically align with the global SDG initiative and human rights [118].However, it serves to remind of the tobacco industry's corporate makeover by positioning itself as a good corporate citizen that purportedly engages in rights-based, CSR behaviors and actions that generate and enhance health and sustainable development worldwide [126][127][128][129][130][131][132][133].The tobacco industry's collective focus on harm reduction is part of its CSR ploy to secure reputational benefits and to establish (or re-establish) access and influence among policy elites, researchers, and public health groups [134,135].

Conclusions
The Intergovernmental Panel on Climate Change's Sixth Assessment Report of 2022 calls for countries to integrate their climate change commitments with their SDG responsibilities for advancing intersectoral action [136].The many policy and legislative initiatives occurring in the Australian states and territories and among the business community, combined with the persistence of the Climate and Health Alliance and GGHH Australia network, is to be lauded.Impacts of climate change on citizens' health (that directly relates to SDG 3), preparedness of the healthcare system to meet population needs considering climate change and sustainable development challenges, and responsibility of healthcare as a sector in reducing its environmental footprint, are different but overlapping public health concerns that each require all-of-government, cross-sectoral and interdisciplinary policy interventions.However, as this 35-year overview of Australia's climate change and sustainable development policy agendas demonstrate, up until May 2022 no compelling Federal sustainable development policy or law has existed to respond to the complex health system impacts of climate change on population wellbeing and environmental health.Up until May 2022, the lack of national climate-change policy or law similarly ensures Australia remains without dedicated sustainability and climate change governance structures; a key reason Australia is without a national Sustainable Development Unit or equivalent to lead more effective, efficient, and focused sustainable healthcare planning and investment [137][138][139].
Only time will tell if in May 2022, under the leadership of a new Federal Government, Australia has finally entered a new policy era that prioritizes the health, sustainability, and climate change policy nexus and its intergenerational ramification.Looking ahead, the political determinants of health will remain key to unlocking the Australian Government's 35-year policy inertia.So too will the knowledge, wisdom, and leadership of Aboriginal and Torres Strait Islander peoples and communities who have very successfully engaged in human, environmental, and planetary health and sustainable development lore and practice on the land now known as Australia since time immemorial [140][141][142].

Funding:
The author is a part-time Senior Research Fellow in the School of Public Health, The University of Queensland-led NHMRC Centre for Research Excellence in Achieving the Tobacco Endgame (NHMRC grant ref: GNT1198301).In this role, the author has examined how the tobacco industry uses sustainability, the Sustainable Development Goals, and human rights frameworks and language to advance Big Tobacco's policy influence.The author gratefully acknowledges her parttime Senior Research Fellow appointment at the Centre for Research Excellence, and the mentorship of the Centre for Research Excellence's Director, Coral Gartner.Institutional Review Board Statement: Not applicable.Informed Consent Statement: Not applicable.

Box 2 .
Sample of suggestions offered by respondents to the FATRC-led Parliamentary Inquiry into the SDGs in 2018 to increase country-level action for accountable sustainable development policy momentum.Policy coherence-establish independent body to assess policies and provide advice on SDG coherence: Plan International; Australian Council for International Development (ACFID); • All new legislation to be assessed in terms of legal impacts and consequences for the SDGs like Denmark: UnitingCare Australia; • The Australian Treasury's intergenerational report could form opportunity and basis to align and build on as a budgetary plan for SDG implementation: Doctors for the Environment Australia; • Enact legislation to embed the SDG agenda into law-for example, a similar Wellbeing of Future Generations policy and law introduced by Wales: Doctors for the Environment Australia; • Introduce legislation aimed at addressing child poverty, as New Zealand has as part of its SDG response: The Smith Family; • Introduce Justice Impact Tests similar to the UK Model connected to Australia's SDG commitments: Law Council of Australia; • Adopt VIC Health Equity Policy for intersectoral SDG planning and implementation: VICHealth; •