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It’s not that Judith Beveridge’s poetic eye is without compassion – but it is, has
always been, unblinking. She continues to stare even when the sight is shocking,
and she tells us exactly what she sees.

The title poem of her first collection, The Domesticity of Giraffes (1987), has
served my classes for years as a teaching example for writing non-human creatures.
The poem does not resist some anthropomorphism, but it does succeed in making a powerful comment. Its description of a pair of giraffes trapped in a zoo enclosure is strong. This is especially true of its concluding image: one desolate giraffe lapping the urine stream of the other.

So from the beginning of her publishing career, Beveridge has refused to allow us off the hook. Always, some readers in my classes recoil from this moment, finding it abject – more offensive than the giraffes’ ongoing plight.

Review: Tintinnabulum – Judith Beveridge (Giramondo)

Twenty-seven years and seven collections on, Beveridge’s empathy is clear. Her most recent collection Tintinnabulum – tintinnabulum meaning the sound of tiny (often temple) bells – begins with a section that focuses just as squarely on other-than-human creatures. Butterflies, possums, kittens and cuttlefish all receive the work of that same unflinching gaze.

In the first poem, we watch as a butterfly struggles from its cocoon. The poem closes with:

                                                I offer you honey-water –your proboscis, thin as a human hair, sips from my hand
                                                                                  … Soonyou’ll die in my palm, the only small holding you’ll know.

The heart-wrench of that final phrase both draws us back to re-read the poem and carries us into the next one, Dead Possum. Here, the narrator lifts the carcass “away with a spade”, but can escape neither the flies,

a frenzied paparazzi, assembling and re-assembling,eager to make a maggot-mass in the possum’s flesh,

nor the foreseeing of her own death:

                                   thousands and thousands of maggotscreaming, risotto-like, inside my own half-eaten head.

This stark vision prepares our imaginations and our hearts – if at all possible – for the next two poems: Animals in our Suburb, 1960s and Cuttlefish. These poems revisit the rampant, ritualised cruelty with which we treat other creatures. Yet they are delivered in a disarmingly conversational style:

                                                                                  Who’dever heard of a Lhasa Apso, Shih Tzu, or a Bichon Frizé?

(Animals in our Suburbs, 1960s)

just before the man stuck a knife into it and its gills                     leaked green blood

(Cuttlefish)

The strict six-line stanzas of the former mirror the brutal management of domestic
animals. In the latter, lines trail down the page to make a shape reminiscent of the creature’s tentacles or the flow of water.

Walking to the bizarre bazzar

The focus is on other species, but the human is always present. In much of
the book’s second section, Walking with the Poet, human consciousness – let’s call it the poet’s here – is located (finely, consistently, insistently) within small spaces in the natural world: in gaps, cracks, crevices. This close attention to small spaces, and what is embedded in them, brings into stark relief just how much space we human animals take up, how much of the world we devour.

For me, two of the most moving poems of this section are the prize-winning Two Houses and the devastating Two Brothers. In both, the other-than-human acts as a metaphor for human experience.

The meditative tone of Two Houses, its sustained reflection, counterpoints the events it describes: the upheaval of ending a marriage, beginning another relationship, moving interstate. We are introduced early to the poem’s extended metaphors – owls and a freight train passing through. The owl – nocturnal, mysterious, elusive, largely silent, steeped in mythologies of war, protection, wisdom – reappears years later, reminding the narrator of the freight train she used to hear at 3am on Fridays, and of

                                   how far we’d come – all the actions,workings, means, and mechanisms across time and distanceto pull to its destinations this rich consignment of love.

In Two Brothers, cats belonging to immigrant brothers Bibo and Jakov also act as
metaphors. Named, as loving acts of remembrance, after family members killed in war – Nada, Jamina, Enas, Ferez, Malika – these beloved pets are also killed (the beloved family killed again). They are made into conduits of xenophobic hate and unbearable grief, found by the brothers returning from work hung “by their tails from the clothesline”.

If we think about poetry – indeed, all creative writing – as a centuries-long
conversation between texts, then Beveridge is at her most loquacious in the third section, The Bizarre Bazaar. She riffs on lines by Wallace Stevens, an American poet intensely interested in the nexus of creative imagination and so-called objective reality.

It’s here that the intense focus on sound – the possibilities for play that language offers – evident in earlier poems like Dead Possum (“fervid satanic twanging, / demonic tremolos musing”) finds its place. Beveridge lets loose her own passion for sound in response to Wallace’s, and the resulting poems are wild, thrilling, fun.

Judith Beveridge.
Giramondo

But in my view, it is in the final section, the aptly titled Choirwood, that the poetic, ethical and philosophical concerns of the previous sections best combine. It achieves the aim of any choir, simultaneously sweeping us up and along in its blended stream, and maintaining for the audience the clear presence of each part.

Life – its multiplicity and minutiae, transience and eternity, its repetitions and patterns, velocity and change – is here in abundance. The sheer number of named birds is uncommon. In one poem alone – At the Lake – we find egret, heron, coot, little grebe, crow, noisy miner, wren, brush turkey, cockatoo, sparrow hawk. Elsewhere in the section: corolla, magpie, robin, fantail, butcherbird, currawong, silvereye, kookaburra, channel-billed cuckoo.

In a form as small as poetry, with every word crucial, it is reasonable to ask why so much naming is necessary. The answer, of course, is in the ethics. Every species, each creature, matters. Particular bird voices are described – as “choriambs”, “bubblings”, “up-talk”, “vocal fry” – or rendered: “chin-cher-inchee / chin-cher-inchee”. So are the sounds of different tree species in the wind. This is the blue gums: “Sibelius Sibelius it seems to say – then Sisyphus Sisyphus”; and this, casuarinas: “sassafras sassafras – then when the wind changes susurrus susurrus”.

This world bursts with sensory detail. The human narrator is so closely embedded as
to seem stitched in, and we readers are equally immersed. Everywhere is light on water. On lakes and creeks – “The light now is loose and yellow like spooned honey” – on rivers and seas, in sky and clouds. Living creatures flit through, intent on their own practices, and we become part of it all. Creatures of memory also flit through the narrator, as in “ghost-horses, spirit-mares / the soft canter of foals”.

The exquisite cover of Tintinnabulum, with its delicate ghost-image of what seem to be the bones of hands, suggests both the living and the dead: the human, creaturely, mortal, hidden; the timeless and enduring.

The final poem, from which the section’s title is drawn, closes with a summary. From all her close observations of the minute and specific in the world, Beveridge’s vision deepens as it unfolds:

                                                    and I think aboutthe intoning, harmonising, buzzing and quaveringI can’t hear: the bonding of molecules, pairingsand transfers of particles, electrons and photonsspeeding around the globe, quarks popping inand out of existence, neutrinos zipping throughbodies, asteroids, planets, all the infrasonicsymphonies of the vast and vibrating invisible fields.

Tintinnabulum is a beautiful, onomatopoeic word. Say it aloud. It is the sound of
tinkling temple bells, the voices of trees and birds, and all the sounds of the world that we don’t and can’t hear. Läs mer…

On October 10, NASA is launching a hotly anticipated new mission to Jupiter’s fourth-largest moon, Europa.

Called Europa Clipper, the spacecraft will conduct a detailed study of the moon, looking for potential places where Europa might host alien life.

It’s the largest planetary exploration spacecraft NASA has ever made: as wide as a basketball court when its solar sails are unfolded. It has a mass of about 6,000 kilograms – the weight of a large African elephant.

But why are we sending a hulking spacecraft all the way to Europa?

Looking for life away from Earth

The search for life in places other than Earth usually focuses on our neighbour Mars, a planet that’s technically in the “habitable zone” of our Solar System. But Mars is not an attractive place to live, due to its lack of atmosphere and high levels of radiation. However, it’s close to Earth, making it relatively easy to send missions to explore it.

But there are other places in the Solar System that could support life – some of the moons of Jupiter and Saturn. Why? They have liquid water.

Here on Earth, water is the solvent of life: water dissolves salts and sugars, and facilitates the chemical reactions needed for life on Earth to proceed. It’s possible life forms exist elsewhere that rely on liquid methane or carbon dioxide or something else, but life as we know it uses water.

The reason there’s liquid water so far out in the Solar System is because Jupiter and Saturn, the gas giants, wield immense gravitational power over their moons.

Saturn’s moons, Titan and Enceladus, are stretched and compressed by gravity as they go around their host planet. This movement results in vast underground oceans with a surface of solid ice, with plumes of water vapour exploding 9,600 kilometres from the surface.

It is strongly suspected that Europa is the same. While we know a lot about Europa from more than four centuries of observation, we have not confirmed it has an under-ice liquid ocean like Titan and Enceladus.

But all clues point to yes. Europa has a smooth surface despite being hit by many meteors, suggesting the surface is young, recently replaced. Ice volcanoes raining down water over the surface would make sense.

It also has a magnetic field, suggesting that like Earth, Europa has a liquid layer inside (on Earth, this liquid is molten rock).

This artist’s concept (not to scale) shows what Europa’s insides might look like: an outer shell of ice, perhaps with plumes venting out; a deep layer of liquid water; and a rocky interior, potentially with hydrothermal vents on the seafloor.
NASA/JPL-Caltech

What will Europa Clipper do?

At the surface, Europa is bombarded by high levels of space radiation, concentrated by Jupiter. But deeper down, the thick ice sheet could be protecting life in the liquid subsurface ocean.

This means it would be difficult for us to find concrete evidence for life without drilling down deep. But where to look? Through flybys of the icy moon, Europa Clipper will be looking at areas where life could be dwelling under the icy shell.

To achieve this, Europa Clipper has nine scientific instruments. These include a wide-angle camera to study geologic activity and a thermal imaging system to measure surface texture and detect warmer regions on the surface.

There’s also a spectrometer for looking at the chemical composition of the gases and surface of Europa, and for any explosive plumes of water from the surface. The mission also has tools for mapping the moon’s surface.

Other instruments will measure the depth and salt levels of the moon’s ocean and the thickness of its ice shell, and also how Europa flexes within the strong gravitational pull of Jupiter.

Excitingly, a mass spectrometer will analyse the gases of the moon’s faint atmosphere and potential plumes of water. By examining the material ejected from the plumes, we can understand what is hidden within the under-ice oceans of Europa.

A dust analyser will also look at matter that has been ejected from Europa’s surface by tiny meteorites or released from the plumes.

Unfortunately, we will have to wait a while for any discoveries. Europa Clipper will take more than five years to reach Jupiter. And the mission is only equipped to look for the potential of life, not life itself. If we see evidence that might point towards life, we will need future missions to return and explore Europa in depth.

So we must be patient. But this is an exciting opportunity for humanity to get one step closer to find life beyond our own home planet. Läs mer…

One of the political ironies of the race for the White House is that the foreign policy interests of New Zealand’s centre-right government are probably best served by Democratic candidate Kamala Harris winning.

Since the end of World War II, all New Zealand governments have supported multilateralism and an international rules-based order enshrined in the institutions of the United Nations.

The relationship with the United States has reflected that, and tends to outlast the periodic fluctuations associated with changes in government and policy in Wellington or Washington.

New Zealand’s current National-led coalition inherited close relations with the US, too. American visitor numbers were second only to Australians last year. The US is our third largest export market. And the two countries remain strategically linked within the Five Eyes intelligence sharing arrangement.

Nevertheless, one of the key foreign policy goals of the coalition is to strengthen alignment with traditional allies such as the US. Given the very different worldviews of Kamala Harris and Donald Trump, the November 5 election will have a large bearing on how successful any push for closer relations with the US can be.

Closer relations in the balance

On the one hand, Republican candidate Trump is opposed to multilateral institutions, unless they explicitly serve US national interests. And he wants to reverse the impact of globalisation by constraining immigration, free trade and global governance.

Nationalist slogans like “America First” promise a return to a so-called golden era of patriotism and sovereignty: a top-down world where the greatest power of all is unencumbered and free to assert its dominance.

On the other hand, Harris would seem to support a more traditional US foreign policy agenda. This recognises the importance of international institutions and alliances in a world where “isolation is not insulation”.

Whoever occupies the White House next, then, is likely to have a significant impact on New Zealand foreign policy.

Isolation and dominance: Trump plays the immigration card at Republican National Convention in July 18.
Getty Images

Power plays and the Pacific

First, Trump’s belief in an international system run by great powers would seem to be a recipe for depriving smaller states like New Zealand of a voice on international issues that affect them.

Second, New Zealand’s regional focus on ties with Pacific Island nations – underpinned by close people-to-people links and a significant proportion of the country’s overseas development aid programme – is more likely to be complemented by a Harris foreign policy.

Outgoing president Joe Biden reversed decades of US neglect of much of the Pacific, which had played to the advantage of other external powers – notably China.

The Biden team launched the annual US-Pacific Islands Summit in 2022. And Kamala Harris played an active role in delivering US$800 million in development and climate assistance to Pacific Island nations in 2022-23.

Whether Trump will maintain this enhanced diplomatic and economic engagement in the Pacific (and elsewhere) is questionable. Similarly, after Biden rejoined the Paris Climate Accord, Trump will probably quit it for a second time.

Kamala Harris hosts Ukraine’s Volodymyr Zelenskyy at the White House in September.
Getty Images

AUKUS and Ukraine

Third, the New Zealand government faces the delicate task of navigating relations with an increasingly assertive China – the country’s biggest trade partner – while pursuing its goal of moving closer to the US.

Since March 2023, successive New Zealand governments have been considering joining an arrangement to share advanced defence technologies under pillar two of the AUKUS security partnership that aims to deter a rising China in the Indo-Pacific region.

It remains to be seen how China would react if New Zealand did join. But Trump’s insistence on US primacy in any multilateral agreement could make it more difficult for the government to win domestic support for pillar two membership.

Even outside the AUKUS debate, Trump is more likely to insist allies spend more on defence than they did traditionally.

Fourth, New Zealand has a big stake in the failure of Russia’s attempted annexation of Ukraine. Wellington’s interests are clearly more in line with Harris’ pledge to maintain support for Ukraine to restore its territorial integrity.

Trump’s promise to end the war within 24 hours, on the other hand, could probably only be achieved by giving Vladimir Putin what he wants.

The Middle East and the UN

Finally, there do not seem to be substantive policy differences between Trump and Harris on the catastrophic situation in Gaza, and increasingly Lebanon.

There remains a slim possibility a Harris administration might recognise unconditional support for the Israeli government of Benjamin Netanyahu is not sustainable for a superpower whose foreign policy is supposed to be driven by universal values and respect for international law.

But this would be near impossible for Trump. Indeed, he would probably provide Netanyahu with even greater support.

Overall, the foreign policy interests of the National-led coalition seem to align more with a Harris presidency than one led by Trump.

But even if Harris wins, the alignment of interests will not be perfect. US exceptionalism – an informal ideology that claims the nation is a political exemplar for the rest of the world – and Washington’s veto power in the UN security Council are likely to remain constraining factors on the New Zealand-US relationship. Läs mer…

As the brewing industry expands and new beer styles, such as hazy pale ales, emerge, brewers are constantly looking for new ways to analyze the composition of their beers to preserve the carefully crafted sensory quality of their products.

However, analyzing how the molecules in beer affect its flavour is challenging because of the sheer amount of different types of molecules present in the beverage. To address this issue, our research team at the University of Victoria has developed a user-friendly lab-on-a-chip device to investigate how we can add more hop flavours to beer by making oil-in-beer emulsions.

Lab-on-a-chip, or microfluidic, technologies are tiny devices usually made from a transparent, rubbery material that can be used to transport and analyze liquids in pipes the size of a human hair.

While these technologies are not commonly used in the food sciences, they are perfectly suited for the creation of emulsions, which are widely used in the food industry. Emulsions are formed by creating tiny drops of one liquid in another immiscible liquid.

Read more:
Microfluidics: The tiny, beautiful tech hidden all around you

For example, salad dressing is usually made by mixing oil and vinegar, a water-like liquid. Oil and water do not mix, so to create an oil-in-vinegar emulsion, a stabilizer like mustard or egg is added. This allows tiny oil drops to be suspended in the vinegar, giving a pleasant texture to the salad dressing.

Similarly, in beer, hop oils (essential oils from hops) are stabilized in the water-like beer. Understanding the type of molecule responsible for this stabilization could help brewers create more highly hop-flavoured beers.

Katherine Elvira explains how her lab makes and uses microfluidic devices. Video by Julian Sketchley.

Creating a new method

Brewing beer requires a precise understanding of four main ingredients: malted barley, hops, water and yeast. Each of these ingredients contains a complex mixture of components, and their interactions, while used by humans for thousands of years, are still not well-understood chemically.

The wealth of ingredients in beer makes it hard to tease out the behaviour and interactions of specific molecules, and how these relate to the flavour and composition of the beverage. Each ingredient interacts with others in complex ways, influencing the brewing process and the final product.

Read more:
Brewing Mesopotamian beer brings a sip of this vibrant ancient drinking culture back to life

This is where our lab-on-a-chip device comes in. Our research, conducted in lead author Katherine Elvira’s laboratory at the University of Victoria’s Department of Chemistry, was done in collaboration with local microbrewery Phillips Brewing and Malting Co.

The new method for making oil-in-beer emulsions was developed by undergraduate students Danielle Hanke, Jaling Kersen, Alexandra Schauman, Caitland Stagg and Nicole York, and graduate students Alex McDonald, Jaime Korner and Kaitlyn Ramsay.

Together, they created a simple microfluidic platform designed to be usable by non-experts in the academic and industrial sectors, making it a valuable tool for advancing the science of brewing.

University of Victoria chemist Katherine Elvira and her research group use microfluidic devices to investigate emulsions in beer.
(University of Victoria Photos Services)

Unlocking new possibilities

Our research explored the role of gluten, a protein present in beer, in stablizing hop oil emulsions. By gaining a better understanding of this, brewers can fine-tune the composition of their ingredients to influence the final visual and sensory quality of beer.

We tested two different hop oils, alpha-terpene and linalool, that are commonly present in hoppy beers. The two hop oils differed in droplet stability with protein and enzyme treatment, suggesting this effect may also be dependent on the type of hop oils present.

This research could help brewers decide which types of grains and hops to include in their hazy beers — a style characterized by their cloudy appearance and strong hop flavour — to create the most shelf-stable and flavoursome beers.

A brewer measures out a sample of wort while brewing a German-style Pilsner at Von Ebert Brewing in Portland, Ore., in October 2023.
(AP Photo/Amanda Loman)

The future of brewing

Our beer-on-a-chip platform can be used to generate experimental conditions that reflect full-scale brewing operations on a smaller, more manageable scale. By doing this, we can gain better insight into the brewing process, which still contains many chemical mysteries.

Traditionally, these technologies have not been widely used in the brewing industry, but our research shows how microfluidic platforms can be more widely used in the food sciences to study emulsions.

Whether it’s developing new beer styles, improving the shelf life of existing ones or enhancing flavour profiles, this technology could become an invaluable tool for brewers worldwide. Future work on microfluidic brewing may yet reveal more interesting and delicious insights into brewing.

Alex McDonald, a graduate of the Master of Science in Chemistry program from the University of Victoria, co-authored this story. Läs mer…

Cardiovascular disease remains a leading cause of death worldwide, and managing it effectively requires more than just medical intervention: what you eat plays a crucial role in your heart’s health.

For cardiac patients, following nutritional recommendations isn’t just a suggestion; it’s a lifeline. A heart-healthy diet can help control risk factors like high blood pressure, cholesterol levels and obesity, all of which are key contributors to heart disease.

For cardiac patients, following nutritional recommendations isn’t just a suggestion; it’s a lifeline.
(Shutterstock)

A healthy diet will help you prevent new heart problems, which is called secondary prevention, and it will help improve functional capacity and quality of life, giving you more independence for daily activities. But for many patients, adhering to these dietary guidelines can be a significant challenge even while they are in a cardiac rehabilitation program. This is especially challenging for those who live in low-resourced settings (areas or communities with few resources and little support for health and wellness).

Read more:
Cardiac rehab is a proven but underused therapy in women, but tailored resources aim to change that

Cardiac rehab is an interdisciplinary approach focused on interventions for secondary prevention and improving cardiovascular prognosis, to reduce the global impact of cardiovascular disease. We recently conducted a study aimed at understanding the barriers and facilitators that low-resourced patients face when trying to follow nutritional recommendations in cardiac rehab.

The findings underscore how critical, yet complex, it is for patients to maintain a heart-healthy diet. The results of this study are not just informative — they are a call to action for health-care providers, policymakers and communities alike.

The cost of healthy eating

Many heart-healthy foods — like fresh fruits, vegetables, and lean proteins — can be expensive, especially for individuals or families living on a tight budget.
(Shutterstock)

One of the primary barriers we identified is the cost of healthy foods. Many heart-healthy foods — like fresh fruits, vegetables, and lean proteins — can be expensive, especially for individuals or families living on a tight budget. In low-income areas, access to these foods is often limited, with more affordable but less healthy options readily available.

Read more:
Why are grocery bills so high? A new study looks at the science behind food price reporting

This economic reality makes it difficult for patients to consistently choose foods that support their heart health. In the last few years the cost of healthy food in Canada, a high-income setting, has been rising due to high food inflation. Despite that, the current Canada’s Food Guide is less expensive for adults to follow compared to the previous ones.

Another significant barrier is the complexity of nutritional information. Patients are often bombarded with a wealth of dietary guidelines, which can be confusing and overwhelming. Without proper guidance, including education and individualization, it’s easy for someone to feel lost or discouraged, particularly if they lack basic nutritional knowledge. This can lead to frustration and, ultimately, poor adherence to dietary recommendations.

Cultural factors also play a role. In many cases, traditional diets may not align with the standard dietary guidelines recommended for heart health. Patients may find it challenging to adapt their eating habits without feeling like they are losing an important part of their cultural identity. This disconnect can make it even harder for patients to stick to a heart-healthy diet.

Empowering patients to eat better

Despite these challenges, our study also highlighted several facilitators that can make a significant difference. One of the most effective is community support. Programs that provide affordable access to healthy foods, like food banks or community gardens, can help alleviate some of the financial pressures.

Additionally, accessible information sources that break down complex nutritional advice into simple, actionable steps can empower patients to make healthier choices.

Programs that provide affordable access to healthy foods, like food banks or community gardens, can help alleviate some of the financial pressures of healthy eating.
(Shutterstock)

Importantly, incorporating culturally relevant foods into dietary plans can make the transition to a heart-healthy diet more manageable and acceptable. When patients see that their traditional foods can be part of their diet, they are more likely to embrace and maintain the recommended changes.

Our findings emphasize the importance of a tailored approach to nutritional guidance in cardiac rehab, especially for low-resourced patients. It’s not enough to simply tell patients what to eat — health-care providers need to listen and understand the unique challenges patients face and provide practical, sustainable solutions. This means working closely with patients, offering personalized advice that considers their financial situation, providing access to resources and considering cultural preferences.

Making heart-healthy diets accessible

The implications of our research extend beyond individual patient care. They highlight the need for systemic changes that make healthy eating more accessible for everyone. This could include policies that subsidize healthy foods, increase the availability of fresh produce in underserved areas or create educational programs that are accessible to all.

Following nutritional recommendations is vital for managing cardiovascular disease, but it’s not always easy, especially for those with limited resources. Identifying and addressing the specific barriers these patients face can help them make lasting, positive changes to their diet and, ultimately, their heart health.

This research underscores the need for a more equitable approach to health care, one that ensures all patients have the support they need to live healthier, longer lives. Läs mer…

The federal government will soon announce its immigration plan and immigration levels for the next three years. Prime Minister Justin Trudeau’s Liberals have already signalled, however, that the number of immigrants will decline from the levels of the past several years.

The government has been under fire for its immigration policy and must move carefully with a federal election likely next year. The increase in housing costs is cited by critics as consequence of too many immigrants arriving in Canada over a short period of time.

Read more:
What’s behind the dramatic shift in Canadian public opinion about immigration levels?

Sharp increases and decreases in the number of immigrants are nothing new in Canada’s history. Historically, immigration policy has been “tap on, tap off,” with immigration levels increased when the unemployment rate falls and reduced when unemployment rises. Immigration has always been thinly veiled labour market policy; that is, a way to fill jobs.

Influx of immigrants

In 1913, an estimated 400,900 immigrants arrived in Canada, accounting for five per cent of the country’s population. At that time, the government sought farmers to settle the Prairies and allow the western expansion of Canada.

It took more than a century — until 2021 under Trudeau — before a larger number of immigrants was accepted in a single year; 406,000 were admitted.

But those who came in 2021 accounted for only one per cent of the nation’s much larger population, rather than five per cent in 1913.

When the Liberals came to power in late 2015, the national unemployment rate was seven per cent and dropping. By 2019, it was under six per cent, a level not experienced for nearly half a century.

The economy was humming with low unemployment and inflation, allowing the immigration tap to be turned on. From 2017-19, 300,000 immigrants were accepted each year, but from 2021 to 2023, that increased to a record high of about 430,000 annually.

In the past decade, employers have benefited from high levels of immigration and voiced few complaints. Businesses know that labour costs are kept low when immigrants flood into the job market.

People line up to take part in a Canada Day citizenship ceremony before the start of a game between the Toronto Blue Jays and the Boston Red Sox in Toronto on Canada Day, 2023.
THE CANADIAN PRESS/Frank Gunn

International students

What has made the nation’s immigration policy distinct under Trudeau is that the tap has also been turned on for international students. These students are not immigrants, but rather are allowed to enter Canada and, initially, remain only during the time they are studying.

In the past several decades Canada, Australia, the United Kingdom and the United States have become extraordinarily attractive for college and university students.

Middle-class families in China, India, Brazil and other countries are willing to spend what is required to send their children to study abroad.

Universities and colleges covet international students as a source of income since they pay twice or more what local students pay in tuition.

The additional income earned by post-secondary institutions from international students has allowed provincial governments to limit tuition fee increases for Canadian students. For example, the Ontario government reduced tuition fees by 10 per cent in 2019 and has kept tuition frozen for local students ever since.

Graduates listen during a convocation ceremony at Simon Fraser University, in Burnaby, B.C., in May 2022.
THE CANADIAN PRESS/Darryl Dyck

Permanent citizenship pathways

When the Liberals came to power, there were about 300,000 international students in Canada. Last year, that number reached one million. Immigration rules were tweaked in the past decade to open paths to permanent citizenship for some international students and their families.

Some believe the combination of high immigration rates and a large number of international students has created an unsustainable situation as housing costs in many parts of Canada increase significantly over the past several years.

Read more:
International students are not to blame for Canada’s housing crisis

Suddenly, earlier this year, the federal government placed limits on the number of student visas it would issue annually to reduce the flow of students coming from abroad. Provinces and educational institutions were furious, especially by the lack of advance notice and the loss of expected revenues.

However, rapid swings in immigration policy are a feature of Canada’s history. After welcoming 400,000 immigrants in 1913, only 10 per cent of that number were granted entry five years later.

A Ukrainian immigrant with his team of oxen in Smuts, Sask., in 1912.
(National Archives of Canada)

Sharp U-turns

The causes that necessitated the recent sharp U-turn in the number of international student visas — and limiting the pathways to students and their dependants to become immigrants — are instructive.

The federal government ignored the fact that colleges and universities were not equipped for the massive ramp-up of foreign student enrolment. Some post-secondary institutions, particularly those operated for profit, took advantage of incoming students by providing sub-standard education.

A closer monitoring of the impact of high numbers of international students would have allowed the federal government to more gradually adjust the visa tap. More consultation between all levels of government would have permitted problems to quickly reach the appropriate decision-makers.

Moving forward, the federal government would do well to better monitor the impacts of immigration levels. More consultation with other levels of government, employers and stakeholders will result in more gradual adjustments to the number of newcomers who are — and always have been — critical to Canada’s economic and cultural successes. Läs mer…

There is a disturbing trend of people travelling to the sadder places of the world: sites of military attacks, war zones and disasters. Dark tourism is now a phenomenon, with its own website and dedicated tour guides. People visit these places to mourn, or to remember and honour the dead. But sometimes they just want to look, and sometimes they want to delight in the pain of others.

Of course, people have long visited places like the Auschwitz-Birkenau Memorial, the site of the Twin Towers destroyed in the 9/11 attacks, Robben Island Prison, where Nelson Mandela and others spent many years, and more recently, the Chernobyl nuclear power plant. But there are more recent destinations, connected to active wars and aggression.

Nelson Mandela’s former prison cell at Robben Island is one of the places visited by ‘dark tourists’.
South African Tourism/AAP

Since the Hamas military attacks of October 7 2023, in which around 1,200 people were killed and more than 250 taken hostage, celebrities and tourists have visited the related sites of the Nova music festival and the Nir Oz Kibbutz in Palestine/Israel.

The kibbutz tours, guided by former residents, allow people to view and be guided through houses of the dead, to be shown photographs and bullet holes. Sderot, the biggest city targeted by Hamas, is offering what it describes as “resilience tours”, connecting tourists with October 7 survivors.

Similar places are visited in Ukraine. The “popular” Donbas war tour, for instance, takes visitors to the front lines of the conflict and offers “a firsthand look at the impact of the war on the local population”, introducing them to displaced locals, soldiers and volunteer fighters. There’s also a Kyiv tour, which takes in destroyed military equipment and what remains of missile strikes.

Southern Israel’s Nir Oz Kibbutz is a new ‘dark tourism’ site.
Francisco Seco/AAP

Solidarity tours

These tours have various names, but one Israeli company calls them “solidarity tours”. The idea of solidarity lessens the presumption of voyeurism, or the accusation of ghoulish enjoyment of pain or suffering. It suggests an affinity with those who have died or those who have lost loved ones.

But solidarity is a political affiliation too. These tours are not only therapeutic. They are not only about “bearing witness”, as many guides and visitors attest. They are also about solidarity with the struggle.

What is this struggle? Genocide scholar Dirk Moses has written thoughtfully on this after October 7. Colonial states seek not just security, but “permanent security”. This makes them hyper-defensive of their borders. Israel was created as a nation by the newly formed United Nations in 1947, two years after the end of World War II and in the shadow of the Holocaust: it was an inevitable product of the Balfour Declaration (1917) that carved up the Middle East.

The creation of the Israeli state turned relationships between Palestinians and Jewish people into borders to navigate and police, producing a line of security to defend.

The creation of the Israeli state turned relationships between Palestinians and Jewish people into borders to navigate and police.
Abir Sultan/AAP

These borders have long been sites of humiliation and denigration toward Palestinians, whose homelands have been now occupied for many generations. Israeli Defense Force soldiers themselves have spoken passionately about the brutal and arbitrary violence that occurs there, including “creative punishments”. These were the borders that protected the sites targeted by Hamas. The Nova music festival was five kilometres from one of these borders.

For many Israelis, any breach of those borders, any sense of loss of control, courts the terrors of the past. It raises the spectre of the Holocaust: the destruction of European Jewry, the loss of sovereignty over family, home, and over life, the loss of millions of lives, again. For Israel, as for any colonial state, security is a permanent aspiration, in Moses’s terms. The stakes are high.

Dark tourism, seen in this light, is not only solidarity with those who have lost loved ones on October 7. It is solidarity with the border, with those who have lost that security. And that loss is profound, traumatic and, at least psychologically, can provoke violent reactions in an effort to have the borders – geographical and psychological – reasserted.

‘I stand with you’

Nelson Mandela dances in celebration at the end of a ceremony to mark the handover of the final report of the Truth and Reconciliation Commission.
Tim Zielenbach/AAP

Transitional justice mechanisms such as the truth commissions in South Africa, Timor Leste and Argentina apply legal frameworks to heal nations from the trauma of crimes against humanity. These mechanisms are one choice after experiences of mass violence. Ironically, their catchphrase is Nunca Mas (never again), which was the title of the 1984 report by Argentina’s National Commission on the Dissappeared.

Permanent security of the kind Israel is seeking is another choice – and its catchphrase might well be the same. Never again will Israel’s borders be breached, never again will Jewish life be subjected to mass destruction with impunity.

This is what solidarity can mean: not only grieving alongside those who have suffered, but attachment to an identity and borders, which are reinforced through participation. “I stand with you” is perhaps what the visits are for. I stand with you on this land, at this time, and perhaps for all time.

But stand beside you in what now? In grief, yes. But also in rage, in pain, in vengeance and, for some, in making Israel great again.

The hashtag #standwithus accompanies some calls for visits to the October 7 sites, for this form of tourism. It means stand with us at Israel’s border. From there, you can hear the sound of bombs falling: in Gaza, a place where no solidarity tour will go. Yet.

Memorials, grief and understanding

Dark tourism is not always for those associated with the events. Some people visit sites of disaster and loss because they want to understand the greater sadnesses of the world and its formidable brutalities. Some want to show their respect to others. It’s not dissimilar to visiting memorials.

Memorials collate the disparate parts of grief and reflect it as public memory. They offer fragments of historical pain that can be borne in more than one mind, to create a shared reality.

In Pretoria, South Africa, a memorial called Freedom Park depicts the names of every person who died in every war fought in South Africa, as well as those South Africans who died in the world wars. The names are written on a wall that circles the park. It is impossibly long and circular, and you cannot measure it with your own stride. It is disorientating and interminable, like grief.

Former Indian president Pratibha Devisingh Patil at South Africa’s Freedom Park, with South African president Jacob Zuma.
President’s Secretariat (GODL-India)/Wikimedia Commons

In this memorial-metaphor, you are unable to comprehend – and at the same time are awash with – a history of loss, represented by the names. The walls contain you, and then they cannot. Grief and even solidarity is not always about comprehension or containment. Sometimes it is about proximity. Sometimes, it is about sitting with not knowing. Sometimes, it is about solidarity with something that cannot be made sense of.

Trauma, psychoanalysis tells us, is an experience of what we cannot assimilate. If you sit in proximity to people and places where traumatic events have happened, you can learn something. If you see the bullet holes at a site of loss, you can comprehend something. But not everything. Bullet holes in a wall are the very definition of a partial story.

People visit memorials and sites of loss to learn and to unlearn. Dark tourism has this quality.

Obscenity of understanding

In my field, criminology and trauma studies, we try to understand why people do the violent things they do. Holocaust filmmaker and commentator Claude Lanzmann has said we must not indulge in what he calls the “obscenity of the project of understanding” in relation to Nazi perpetrators of the Holocaust.

He regards curiosity about the minds of perpetrators and the rationale for violence as a violence in itself. Of the Holocaust, he says you cannot ask “Why were the Jews killed?”. It is the result that matters. But it is also the reaction that matters. The state of Israel itself – permanent security and its attendant horrors – is part of that reaction.

But understanding can influence the reaction to violence, and contribute something to the promise of Never Again. Understanding allows us to hold more than one story in mind. It allows us to do more than count the more than 1,200 killed in Israel, or the 41,689 (plus) Palestinians killed in Gaza. Bodies are always more than numbers. But explanation is one thing, justification another. Justification is best left to the courts, international or otherwise, after the violence has ceased.

Palestinians in the Gaza Strip, November 2023.
Getty Images

It is hard to hear about dark tourism in Israel/Palestine and in Ukraine and try to understand it. It is hard not to condemn the tourists. But we are quick to condemn at this time – and even quicker to demand others do the same. Perhaps we should not be so righteous, and we should resist the urge to easily condemn, from our homes in what Tim Rowse has called the “ongoing colonial encounter sometimes called ‘Australia’”.

Indigenous people here speak of the lack of memorials on this land. But every bordered property is a site for dark tourism in Australia. Dark tourism is the effort to seek out destinations of violence and devastation, but it is not hard to see genocide from our front door in this country. Läs mer…

On October 7 2023, Hamas launched a savage attack on southern Israel, massacring around 1,200 people, mostly civilians, and abducting another 240 people. The following day, I wrote in an analysis for The Conversation:

For many Palestinians, this weekend’s events offered Israelis a small taste of what their own lives have been like under decades of occupation. However, the early celebrations will likely soon turn into anger and frustration as the numbers of Palestinian civilian casualties will continue to rise. Violence begets violence.

As the Israeli retaliation had only just begun, no one could have imagined how devastating it would end up being for the people of Gaza. There are now well over 40,000 Palestinians dead, mostly civilians, and countless wounded. Nearly 2 million people have been displaced within the coastal strip.

The ferociousness of the Israel Defence Forces’ aerial bombings – and its subsequent ground invasion of Gaza – triggered intense global pressure to stop the violence. This was coupled with a worldwide campaign to end Israel’s decades-long illegal occupation of Palestinian territories.

This popular movement was able to place its agenda at the forefront of the international media’s attention and sustain it there for many months.

A year later, however, concern for the people of Gaza – and for the dozens of Israeli hostages still locked up in Hamas’ tunnels – has begun to wane. The world’s focus is shifting to the fast-expanding misery along the Israel–Lebanon border, and to a possible full-scale war between Israel and Iran.

As the fighting in Gaza grinds on with no end in sight, the prospects for resolving the most intractable conflict in the world between Israeli-Jews and Palestinians seem ever dimmer. But is it so?

Chairs representing hostages held by Hamas militants in the Gaza Strip, displayed beneath the Hebrew word ‘Now!’ in Tel Aviv.
Tsafrir Abayov/AP

One conflict, two peoples and many onlookers

In a century-long struggle between two societies over the same small parcel of land, the cycle of violence has barely stopped.

The challenges today remain frustratingly robust – entrenched territorial claims, grave errors by leaders on both sides and many missed opportunities. Years of polarising narratives have also bred mistrust, competing accounts of victimisation, debilitating fears and animosity — to the point of mutual dehumanisation.

On the Israeli-Jewish side, there’s a strong sense of an existential security threat, compounded by the inter-generational trauma of the Holocaust and ongoing fears of terrorist attacks. This sharply contrasts with Palestinians’ experiences of decades of dispossession, humiliation, continuous rights violations and feelings of abandonment by the world.

To further undermine a solution to the conflict, religious and radical nationalist influences – on both sides – have turned an already complex, asymmetric conflict into an unyielding impasse.

Over the years, international failures to help resolve the conflict drove many states to recalibrate their foreign policies away from constructive engagement. Arguably, this was to avoid harmful impacts to their reputations over future failures, or accusations of bias, from one or both sides.

Fear, victimhood and tit-for-tat revenge

The 1948 Nakba, or “catastrophe”, followed by decades of oppressive Israeli occupation, have inflicted immeasurable suffering on Palestinians. In turn, this occupation has also inflicted significant and often unappreciated damage to Israel’s social fabric, cohesion, economy, international standing, security and moral stature.

Hamas’ brutal massacres and Israel’s vicious retaliations have only exacerbated these effects, for both sides. And they are now threatening to extinguish what tiny hope may have existed before October 2023 for a path towards a liveable future for both people.

Should the tit-for-tat cycle of violence continue, the blowback will hurt not only Israel’s efforts to attain safety and security for its citizens, but the prospects for a political future for the Palestinians, as well.

Destroyed buildings in Khan Yunis, southern Gaza Strip, in September 2024.
Mohammed Saber/EPA

Arguably, existential fear may be the most underappreciated and damaging element behind the conflict’s intractability.

Outside observers tend to view security concerns rationally, and as a national concern, based on the threat to the state or to the people as a whole.

But in the Israel-Palestine conflict, people react to such fears emotionally, focusing first on their own safety. And the fear is ever-present – a rocket exploding in my house, or my child being shot at by a sniper on the way to school.

These worries and experiences have been etched in the minds of generations of Palestinians and Israelis. We need to appreciate this fact to make sense of how both sides have dehumanised one another and excluded the “other” from their spheres of moral concern, particularly following the October 7 attack and in the weeks and months after.

The late Israeli Prime Minister Yitzhak Rabin, assassinated in 1995 by a Jewish extremist for engaging in peace efforts, once said you don’t make peace with friends, but with enemies.

However, absent a minimum sense of safety and trust – if not in the other side, than at least in the mediators and future outside guarantors – the security arrangements required to sustain a peace agreement would be difficult, if not impossible, for both sides to agree on.

Read more:
10 books to help you understand Israel and Palestine, recommended by experts

Entrenched views and dangerous simplifications

As the war in Gaza has not yet ended, a detailed assessment of the successes and failures of the campaign for a Palestinian state is still ahead of us.

During the fighting, misinformation and disinformation have been rife. With both sides waging a propaganda war, the manipulation of facts ratcheted up divisions and increased polarisation between “pro-Israel” and “pro-Palestine” groups across the globe.

Selectively embracing information that could validate one’s own position and omitting or rejecting everything else have become the norm.

Once we choose a side, we can go to great lengths to defend its actions. Our conditioned responses challenge or cast doubt on any claim or information put forth by the other side. And the more emotionally invested we become, the harder it is for us to empathise with the suffering of the “other”.

Simplistic misconceptions, for example, that an aggressor cannot also be a victim or vice versa, have added fuel to the fire and to the conflict’s polarisation. This has had negative consequences for empathy, reconciliation, trust and peace-building.

We could debate without end who has suffered more. But how useful would that be, at this stage, for the prospects of a future peace?

People participating in a ‘Stand with Israel’ rally shout at counter-protestors in New York in April 2024.
Justin Lane/EPA

Despite the strong emphasis in the global debate on the “pro-Palestinian” versus “pro-Israeli” dichotomy, an important reality is that meeting the basic needs of one side could never be achieved without addressing those of the other.

These needs for peace, safety, security and dignity are mutual. As such, they should be promoted in the public debate over the incompatible needs ramped up by minorities in the two camps.

Rather than taking sides, efforts should focus on reconciling both parties’ objectives: a ceasefire in Gaza, an end to the unjust occupation, self-determination for Palestinians, and safety and security for Israelis.

As the future welfare of one side is inextricably linked to the security needs of the other, zero-sum solutions won’t achieve anything. Rather, they will only fan the suspicions, animosities and victimhood grievances on both sides, and lead to more violence.

Read more:
Why is the Gaza war tearing us apart?

It’s the world’s turn

Most Palestinians and Israelis have lost what little desire or capacity they had prior to October 7 for trusting or empathising with the misery of the other. The anger, fear and suffering today are too overwhelming.

In the short term, meaningful solutions must come from the outside.

In addition to a critically needed change of leadership on both sides, it is time for more sincere collaborative efforts by key states in the international community.

It is time to replace years of empty condemnations with more meaningful and sustained commitments.

It is time to help both societies, through carrots but also strong sticks, to free themselves from the chokeholds of illusory, all-or-nothing radical ideologies that have brought so much suffering and devastation to all.

It is time for a better future for both Palestinian and Israeli children, even at the price of painful concessions. And concessions will have to be made on both sides for the promise of a lasting peace.

To pressure governments to do more, protests should continue, but their voices should call for peace for all and against harming innocents on all sides, regardless of who they are.

Peace, or at this stage an end to violence, has to come first – even if this would slow down (not prevent!) accountability and justice for all victims.

Hate comes easily in the face of injustices. It is hard to empathise with the misfortunes of “others” who may or may not have brought their miseries upon themselves. But selective denunciation of crimes perpetrated by the other side, based on one’s support or rejection of a cause, is not only morally flawed, but counterproductive.

Those who have been severely aggrieved by this human tragedy may struggle to apply the same yardstick to others, certainly in the near future. But the rest of us can, and should, do better. Läs mer…

This week, Australia hosts the inaugural Global Nature Positive Summit in Sydney. It comes at a crucial time: biodiversity loss and ecosystem collapse is one of the biggest risks the world faces in the next decade.

The event, which begins tomorrow, brings together leaders from government, business, academia, environment groups and Indigenous Peoples. Together, they will seek ways to drive investment in nature and improve its protection and repair.

More than half the world’s economy directly depends on nature. Biodiversity loss threatens global financial stability, putting at least US$44 trillion (A$64 trillion) of economic value at risk.

Industries such as agriculture, fishing, forestry, tourism, water and resources rely heavily on nature. But ultimately, all of humanity depends on the natural world – for clean air, water, food, and a liveable climate.

In Australia significant investment is needed to reverse the decline in our natural environment. It will require action from governments, landholders and the private sector.

That’s why this week’s summit is so important. Nature conservation and restoration is expensive and often difficult. The task is beyond the capacity of governments alone.

What’s going on at the summit?

According to the World Economic Forum, “nature positive” is an economic worldview that goes beyond limiting environmental damage and aims to actually improve ecosystems.

Under the Kunming-Montreal Global Biodiversity Framework, to which almost 200 countries have signed up, at least 30% of land and waters must be protected or restored by 2030. The summit is exploring ways to realise this global commitment, which is also known as the 30×30 target.

The federal and New South Wales governments are co-hosting the event.

Federal Environment Minister Tanya Plibersek will address the summit on day one, outlining her government’s Nature Positive Plan. It commits to the 30×30 target as well as “zero new extinctions”. Achieving these commitments involves environmental law reform, setting up a Nature Repair Market and establishing a national Environment Protection Agency.

Delegates are expected to demonstrate their commitment and progress towards the 30×30 goal. They will then turn to the main point of the summit: building consensus on the economic settings needed to increase private investment in nature.

Finance models and corporate partnerships are on the agenda, along with how to make this work, including how to measure, monitor and report on progress and manage risk.

Sessions will focus on specific sectors of the environment such as agriculture and farming, cities, oceans and forests. On Thursday, delegates will visit nature sites around Sydney.

Creating a market to incentivise biodiversity investment | 7.30.

Investing in a market for nature repair

Substantial co-investment from the private sector, including landholders, will be required to repair and protect nature at the scale required.

Market-based approaches can drive private investment in natural resources. But most existing environmental markets focus on water and carbon. A more holistic approach, including nature repair, is needed.

Australia’s Nature Positive Plan includes building a nature repair market. This world-first measure is a legislated, national, voluntary biodiversity market in which individuals and organisations undertake nature repair projects to generate a tradeable certificate. The certificate can be sold to generate income. Demand for certificates is expected to grow over time.

But the role the government will take remains unclear. For example, will the government both regulate market prices and decide what, in a scientific sense, amounts to repairing nature?

On day two, the summit explores how nature markets can unlock new sources of finance. We can expect this discussion to include ways carbon and biodiversity markets can work together: so-called “carbon-plus” outcomes.

For example, when landholders conserve vegetation, the plants can both draw carbon dioxide from the atmosphere and provide habitat for animals, preventing biodiversity loss. Markets could be designed so landholders are rewarded for achieving these dual results.

Significant economic returns

Under optimistic estimates, the global nature-positive transition will unlock business opportunities worth an estimated US$10 trillion (almost A$15 trillion) a year and create 395 million jobs by 2030.

The potential benefits for Australia are also substantial. They include benefits to nature such as restoring habitat for wildlife, while storing carbon. It can also provide returns for agriculture, by improving land value, yield and quality.

A strong nature-positive stance from Australia will also help safeguard our access to global markets. For example, the European Union has already established trade barriers to imports that damage forests. This could have serious consequences for the Australian beef industry.

So the potential benefits have to be weighed against the risks of not doing anything. The summit is a chance to get a wide range of people on board, working towards a shared vision of a more positive future.

It’s time for a nature-positive mindset

The Albanese Labor government came to power promising to overhaul Australia’s national environment laws, following a scathing independent review.

When the summit was conceived, the government may have envisaged having cause for celebration by now. But some proposed reforms stalled in the Senate.

Nonetheless, the Nature Repair Market, a significant government win, is taking shape.

This week’s summit offers Australia an opportunity to show the world we have embraced the nature-positive mindset. There really is no time to waste.

Australia, the sixth most biodiverse country in the world, has listed 2,224 species and ecological communities as threatened with extinction. These losses are predicted to escalate if we continue business as usual and allow continued decline of ecosystems.

Despite having pledged to end deforestation by 2030, Australia is the only deforestation hotspot among developed nations. Land clearing continues apace in northern Australia, often without being assessed under national environmental laws.

We desperately need to reverse the decline in nature, once and for all. Läs mer…

Medical experts recommend antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID.

But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable.

Who missed out?

We analysed COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds.

Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities.

How stark are the differences?

Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script.

People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely.

Dispensing rates by group.
Grattan Institute

Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west.

Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west.

Antiviral dispensing by geography.
Grattan Institute

Why are people missing out?

COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often don’t realise they would benefit from the medication. They wait until symptoms get worse and it is too late.

Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral.

Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell.

Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% fewer GPs, see their GP about half as often, and are 30% more likely to report waiting too long for an appointment.

Just like for vaccination, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds.

Care should go those who need it

Since the period we looked at, evidence has emerged that raises doubts about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals.

But all Australians who are eligible for antivirals should have the same chance of getting them.

These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than 30,000 packs of COVID antivirals were dispensed in August, costing about $35 million.

Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most.

Getting antivirals shouldn’t depend on who your GP is.
National Cancer Institute/Unsplash

People born overseas have been 40% more likely to die from COVID than those born here. Indigenous Australians have been 60% more likely to die from COVID than non-Indigenous people. And the most disadvantaged people have been 2.8 times more likely to die from COVID than those in the wealthiest areas.

All those at-risk groups have been more likely to miss out on antivirals.

It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID vaccination, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as cancer screening.

A 3-step plan to meet patients’ needs

The federal government should do three things to close these gaps in preventive care.

First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out.

Second, the government should extend its MyMedicare reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be expanded to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick.

Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also work for medications for chronic diseases, such as cardiovascular disease.

COVID antivirals, unlike vaccines, have been keeping up with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast.

In the meantime, fairer access to care will help close the big and persistent gaps in health between different groups of Australians. Läs mer…