Direct and indirect effects of climate change on health in Africa can be estimated through its implications for undernourishment, diarrhoea, heat-related mortalities and vector-borne diseases such as malaria, dengue fever, malaria, lymphatic filariasis, onchocerciasis, schistosomiasis, African trypanosomiasis, Rift Valley fever and yellow fever. Research indicates that temperature rise, and high rainfall strongly facilitate the transmission, frequency, severity, and geographical presence of infectious diseases, and the emergence of new diseases in the region. This explains the high prevalence of such diseases which also directly bear on tropical climate areas, typical of the SubSaharan African climate. About 93% of global malaria deaths in 2017, occurred in Africa, with children and pregnant women most affected. Moreover, projections show that between 2030 and 2050, climate change will claim an additional 250,000 lives annually due to infectious diseases, undernutrition, diarrhoea, and heat stress; a majority of whom will be in Africa. Map of Sub-Saharan Countries by Climate and Health Hotspot. 88% (42 of 48) of Sub-Saharan countries rank amongst the most at-risk for negative health outcomes associated with climate change. Source: World Bank, 2017. Climate change also plays and important role in food insecurity and malnutrition-driven health risks in the region. For instance, studies have indicated that temperature and moisture influence fungal growth and aflatoxin production in cereals and legumes. Consumption of these food contaminants inhibits growth in infants. Furthermore, UNICEF has indicated climate risks in Kenya and Somalia have put over 6.4 million children at risk due to malnutrition and diseases. The World Food Program projected that climate-effect on food insecurity and malnutrition at household, national and regional levels will be much higher in the region by the end of the 21st century, with climate risks causing a 20% rise in hunger and malnutrition risks by 2050 if the global community fails to urgently address climate risks.

National and Regional Efforts to Mainstream Health in Climate Action in Africa

Africa, through its Agenda 2063, identifies health, nutrition, and agriculture as some of the priority areas to help realize its aspiration for inclusive growth and sustainable development. The African Development Bank in its Climate Change and Green Growth Strategic Framework (2021-2025) has also identified the health sector to be highly vulnerable to climate risks. The framework stresses the need to scale-up investment in public health systems, research capacities, pharmaceutical development in a manner that mainstreams climate change in the entire health systems. At the national level, African countries are appreciating the need to mainstream health in climate action, including policies. Most countries in their Nationally Determined Contributions (NDCs) have more strongly integrated health. This is important in enabling them to identify climate impacts on health, map and prioritize health adaptation action and demonstrate potential co-benefits of mainstreaming health in climate mitigation. Many African country NDCs identify priority health adaptation action areas, some of which include strengthening climate resilience of healthcare systems and facilities, supporting research and evidence-based policy action on climate driven health risks.

Health in the International Climate Diplomacy

There are growing efforts to prioritise health in global climate negotiations, particularly by African parties. Prior to COP28, for instance, a Regional Summit on Health and Climate Change for Africa was held in Lilongwe to discuss African position on health. Similarly, the inaugural African Climate Summit facilitated the Health Ministerial Meeting with the aim to catalyse institutionalization of health negotiation within UNFCCC at COP28 and to formulate Africa’s common position on health in climate change negotiations. Health Day Opening Session at Al Waha Theatre during the UN Climate Change Conference COP28 at Expo City Dubai on December 3, 2023, in Dubai, United Arab Emirates. (Photo by COP28) In the UN Climate Change Conference (COPs) 26, 27 and 28, we have seen more action on climate change and health, including UN High-level side events. Arguably, COP28 in UAE raised the political profile of climate-health nexus and contributed to mainstreaming health in the global climate change agenda. COP28 Presidency, World Health Organization and other partners, collaboratively organized the first ever Health Day and climate-health ministerial. The increasing interests in international dialogue on climate-health nexus led to COP28 Declaration on Climate and Health that was endorsed by 149 countries. While is voluntary and nonbinding, the Declaration does not only reflect the common views and aspirations of the countries but also provides new impetus for mainstreaming health in climate action. It is necessary for Africa to catalysis this momentum, being the most vulnerable region to climatedriven health risks. This requires enhanced understanding of the intricate interplay and connectedness of climate change and health, especially considering contextual and geographical dynamics of their drivers and implications. This will not only more effectively inform country and regional level planning and building climate-resilient health systems but also ensure more strategic positioning and engagements in the international climate dialogues. The multi-faced and intricate nature of climate-health linkages call for more multi-stakeholder approaches in shaping policy actions towards climate resilient health systems in Africa.