The MJA-Lancet Countdown on health and climate change in Australia was established in 2017 and produced its first national assessment in 2018 and annual updates in 2019, 2020, 2021, 2022 and 2023. It examines five broad domains: health hazards, exposures and impacts; adaptation, planning and resilience for health; mitigation actions and health co-benefits; economics and finance; and public and political engagement. In this, the seventh report of the MJA-Lancet Countdown, we track progress on an extensive suite of indicators across these five domains, accessing and presenting the latest data and further refining and developing our analyses. We also examine selected indicators of trends in health and climate change in New Zealand. Our analyses show the exposure to heatwaves is growing in Australia, increasing the risk of heat stress and other health threats such as bushfires and drought. Our analyses also highlight continuing deficiencies in Australia's response to the health and climate change threat. A key component of Australia's capacity to respond to bushfires, its number of firefighting volunteers, is in decline, dropping by 38 442 people (17%) in just seven years. Australia's total energy supply remains dominated by fossil fuels (coal, oil and natural gas), and although energy from coal decreased from 2021 to 2023, energy from oil increased, and transport energy from petrol grew substantially in 2021-22 (the most recent year for which data are available). Greenhouse gas emissions from Australia's health care sector in 2021 rose to their highest level since 2010. In other areas some progress is being made. The Australian Government completed the first pass of the National Climate Risk Assessment, which included health and social support as one of the eleven priority risks, based in part on the assessed severity of impact. Renewable sources such as wind and solar now provide almost 40% of Australia's electricity, with growth in both large-scale and small-scale (eg, household) renewable generation and battery storage systems. The sale of electric vehicles reached an all-time high in 2023 of 98 436, accounting for 8.47% of all new vehicle sales. Although Australia had a reprieve from major catastrophic climate events in 2023, New Zealand experienced cyclone Gabrielle and unprecedented floods, which contributed to the highest displacement of people and insured economic losses over the period of our analyses (ie, since the year 2010 and 2000 respectively). Nationally, regionally and globally, the next five years are pivotal in reducing greenhouse gas emissions and transitioning energy production to renewables. Australia is now making progress in this direction. This progress must continue and accelerate, and the remaining deficiencies in Australia's response to the health and climate change threat must be addressed. There are strong signs that Australians are increasingly engaged and acting on health and climate change, and our new indicator on health and climate change litigation in Australia demonstrates the legal system is active on this issue in this country. Our 2022 and 2023 reports signalled our intentions to introduce indicators on Aboriginal and Torres Strait Islander health and climate change, and mental health and climate change in Australia. Although the development of appropriate indicators is challenging, these are key areas and we expect our reporting on them will commence in our next report.
