Report on the Ora Taiao Annual Meeting

Patrick Medlicott - 1 September 2025

I recently attended the yearly meeting of Ora Taiao: The Aotearoa New Zealand Climate and Health Council. This is a body made up of health professionals, organisations, and supporters who advocate for equitable, rapid, and regenerative climate action. The society is a not-for-profit politically nonpartisan incorporated society. Its objective is to lead by example in advocating for health-enhancing climate action.

The society has been in existence for some years, and normally has a yearly two-day meeting in association with the University of Otago medical school in Wellington. It also has Zoom outreach hubs for the meetings (in Auckland and Christchurch). I have been to four meetings over the years, missing only one during Covid. Ora Taiao has a strong Māori focus, and a focus on Te Tiriti O Waitangi. Registrations in person (Wellington) and on Zoom hubs combined would total over 100.

1. The first presentation was from Lani Kereopa of the Te Arawa climate change working group. They have a vision and strategy to ensure the health and survival of future generations in this time of climate breakdown. She made the point that Māori are, and have been, resilient, and their communities can pull together quickly in times of need. The cultural infrastructure allows them to house, feed, clean and support multitudes of people as necessary on the Marae. This has been important during recent natural disasters, including Covid and Cyclone Gabrielle. The rights of Hapu and Iwi have recently been degraded, especially by the present government, but if Tikanga was allowed they would be able to meet the needs of their own people in their own way, as well as supporting all in time of need.

2. Dr Simon Wright of the New Zealand College of Gen practitioners discussed the Porirua assembly on climate.

This was a collaboration, over five sessions, between the Porirua community leaders’ forum and all sections of the community, including the youth. They developed ideas that will be presented to the greater Wellington Regional Council, and this was an example of community-based climate action with the community taking the lead rather than the politicians.

3. The next presentation, with multiple authors from the University of Canterbury, discussed mental health perspectives and well-being in a changing climate. The authors noted, of course, that the people most likely to be affected by climate change are children and those not in the voting population. These groups have been largely excluded from participation in climate change adaptation. The impact of the climate crisis is often most felt on the poor, indigenous, migrant, disabled and displaced youth. They believe that those groups, if allowed to take part in the process of understanding and adapting to climate change, will develop resilience that will support their agency, leadership, mental health and well-being.

4. Caroline Shaw discussed policy approaches to decarbonising the transport sector in New Zealand. Health co-benefits are a key potential advantage of transport decarbonisation. Her interpretation was that the decarbonising of transport might improve overall population health, save the health system money, and reduce health inequities between Māori and non-Māori. Pathways that increase physical activity have a larger effect on population health than those that rely on low emissions vehicles. In other words, active methods of transport such as walking and cycling are likely to increase health outcomes somewhat more than simply using low emissions vehicles which, despite low carbon dioxide emissions, have other impacts on health from sedentary behaviour and the vehicles’ non-CO2 emissions (tire wear particles, which cause significant air pollution).

5. Angus Rodney and Aidan Smith discussed “Work ride” - an initiative supporting healthcare employees across the country.

This is a ride to work benefit program enabling employees the ability to cost-offset between 30 and 60% of their chosen bicycle, e-bicycle and e-scooter through a pre-tax salary sacrifice program.

The employers provide a free to offer, cost-neutral benefit program that improves staff retention, well-being, and engagement, all while reducing scope three emissions and encouraging and incentivising staff to travel actively for their daily commute.

They gave examples of aged care providers, and other health providers and medical centres, who have joined the program. They intend to roll out the program to give a public transport benefit to employees where biking is not viable.

6. Johanna Birrell from the University of Sydney gave a paper on geospatial carbon “foot printing” of dialysis travel. This identified where dialysis units should be placed within communities to minimise travel and its associated carbon footprint with benefits to patients. The establishment of 10 new sites was predicted to reduce travel time by 24%, and emissions by 31%.

7. Associate Prof Stuti Misa of the University of Auckland discussed the effects of climate fluctuations on asthma, allergic rhinitis and eye allergies. Lung health is highly susceptible to the effects of climate change, especially allergic respiratory diseases. Discussion was had about the retrospective effect of the environment on these diseases, and how this has changed over the last two decades. The development of a prospective program to individualise risk profiles in the future may allow for better treatment strategies.

8. Isabella Lenihan-Ikin from the University of Oxford gave a paper on climate change and its effect on outdoor labour and health.

Climate change and temperature change is likely to have significant effects on those working in outside occupations. Strategies for mitigation and coping are being developed.

9. A group from Whariki research centre discussed “Matauranga Maori and climate change: Making sense of a Western Environmental Construct”.

“In Aotearoa, the discourse and concept of climate change is largely driven by colonial values and norms. These reflect the same philosophical, ideological, and theoretical frameworks that underpin the colonial, capitalist systems that have been responsible for driving the ecological crisis we currently face.”

The Māori concept of man’s relationship to nature is different, and requires consideration of the land and environment - not just the people alone. This is a more holistic way of looking at the climate and its effects than the Western mindset of viewing everything in a capitalist monetarist perspective. Both viewpoints need to be better integrated to deal with climate change and its effects.

10. Matthew Jenkins and Sabine Egger from the National Hauora Coalition talked about cultural and ecological pathways for mental health in the climate crisis. They note the psychological consequences of eco-anxiety and ecological grief are becoming more common. There is a deeper rupture also, which is the loss of our attachment to the natural world. Industrialisation and colonisation have disrupted ancestral relationships with the land, water, and sky, generating forms of collective distress.

They argue that reconnecting with nature is not a lifestyle enhancement but a form of psychological repair and cultural recovery.

Ko Au te Whenua, Ko Au te Whenua ko au - I am the land, the land is me.

11. Rick Lomax from Health New Zealand Te Whatu Ora gave a paper on embedding sustainability and Health New Zealand: Priorities, progress, and the way ahead. He noted that health New Zealand was one of New Zealand’s largest employers, and a major public sector greenhouse gas emitter. The healthcare system must not only care for people, but also protect the planet that sustains people. There are four strategic priorities:

A. Embedding sustainability in decision making and culture.

B. Decarbonisation. The results of decarbonisation are that there has been a 14% reduction in total measured emissions, and a 24% reduction in scope one and two emissions, from 2022 to 2024. He notes the fleet is now 17% electric. $60 million has been allocated in co-funding for energy transition and efficiency projects, and a $12 million coal boiler replacement program has begun.

C. Environment in all practice. This includes waste diversion, sustainable procurement, waste minimisation and recycling and reducing reliance on single-issue devices.

D. Climate adaptation.

This was followed by a panel discussion on sustainability in various clinical specialties. There were nine participants in this discussion.

12. An interesting paper from Hannah Sherratt on recovering resources from metered dose inhalers, a trial in the Bay of Plenty. She noted that nearly 3 million metered dose inhalers were prescribed in New Zealand annually. The residual gases in these devices were not recovered or destroyed, allowing potent greenhouse gases to escape into the atmosphere. The trial demonstrated the technical feasibility of safely dismantling devices and recovering both propellants and materials. Extrapolating from this, recycling 1000 metered dose inhalers could prevent approximately 8800 kg of CO2 emissions.

13. Simon Wright from the Royal New Zealand College of General practitioners discussed SMART asthma therapies. New 2020 national asthma guidelines have suggested the use of dry powder inhalers instead of those mentioned above. With an education program for general practitioners’, considerable savings, better control of asthma, and less gas emissions are possible. Speeding the uptake of the 2020 asthma guidelines will be of considerable help.

14. Kaeden Watts from the Ministry of health; Institute for Commonwealth studies presented on the national health adaptation plan: 2024 to 2027. The National health adaptation plan is setting the strategic direction and providing national level priority actions for health-focused adaptation to climate change. Key findings reveal changes in vulnerability to climate change from 2018 to 2023, including population ageing, increased rates of household crowding, children experiencing household food insecurity, and adult psychological distress. Social vulnerability indicators can help inform and provide insights on local climate related risks, to build resilience and adaptation to change.

15. Darcy Glenn and Tom Logan from the University of Canterbury discussed primary health care access in the face of climate change. They note there is a global physician shortage. They noted that the ability to get a timely appointment is the number one barrier to primary care access in New Zealand. They calculated the travel times between the GP’s office and residence of the patient. This allowed better coordination and access for patients subject to the effects of climate change.

16. Siddhartha Mehta from the Ministry of Health public health agency spoke on Developing New Zealand’s first vulnerability and adaptation assessment. The assessment includes: a comprehensive review of local and regional evidence on climate related health risks; the development of a conceptual framework for factors that modify these risks; and creation of a reusable updatable climate health model tailored to New Zealand’s unique demographic geographic and sociocultural context.

17. Kylie Mason from Massey University spoke on social vulnerability to climate related hazards. She noted that not everyone will be equally affected by the negative impacts.

18. A group from the Institute for population research at the University of Waikato New Zealand, in collaboration with Deakin rural health Australia presented on examining climate change impacts in New Zealand. This was in reference to Cyclone Gabrielle. Exploratory results revealed the extent of service access disruption due to related road closures causing isolation from a GP or any hospital services. The aim is for health service providers to enhance care coordination in times of crisis, such as the cyclone.

19. Dr Robin Barraclough presented on wilderness medicine: utility in an uncertain future.

He made the point that the healthcare system was already under considerable stress in times of increased natural disasters, supercharged by the climate emergency. It is necessary for practitioners and primary care providers to have different skills taught to cope with lack of office and hospital access. These skills are not taught in medical schools, and he had instituted a six-week course for practitioners to teach how to work with minimal hi-tech support.

My impression was that this was a good meeting. It discussed health aspects of climate change in a holistic manner with reference to all New Zealanders, and it was evident that a lot of good work is being done both to decrease greenhouse gas emissions in the health sector. Obviously more can be done, and certainly needs to be done, in adaptation to the consequences of the climate crisis - in particular the impacts of severe weather events which have increased worldwide. New Zealand, despite being a long way away from the most major greenhouse gas emitters, still has its part to play - and this needs to be remembered. Paraphrasing Tina from the Turner’s TV Ad, “The Climate is everywhere” (her phrase was “The Internet is everywhere”). Too many New Zealanders, including many politicians, believe that because we are small and far away, we can continue with “Business as Usual”.