Africa’s climate crisis is a health crisis

DAKAR — The planet is losing its ability to support life as we know it, and nowhere is this clearer than in Africa — the continent that is most vulnerable to climate change despite having contributed the least to atmospheric concentrations of greenhouse-gas emissions. Beyond the increasingly frequent extreme weather, Africans are also facing increased risks to their health. As World Health Organisation (WHO) Director General Tedros Adhanom Ghebreyesus noted just before the United Nations Climate Change Conference (COP27) last month, “The climate crisis is a health crisis. Climate change is already impacting health in many ways, through more frequent and extreme weather events [and] more disease outbreaks.”

Climate change is a “threat multiplier” for diseases that are disproportionately prevalent in Africa. For example, the region accounts for over 90 per cent of the global malaria burden, and the WHO estimates that climate change will lead to an additional 60,000 deaths per year between 2030 and 2050, almost a 15 per cent increase, from an entirely preventable and treatable disease. Warmer temperatures and more rainfall will expand the habitat for malaria-carrying mosquitoes, creating new potential hotspots for infections. In 2007, the United Nations Framework Convention on Climate Change projected that, by 2030, developing countries would need an additional $5 billion per year to treat “increased cases of diarrhoeal disease, malnutrition and malaria due to climate change”.

The risks hardly stop there. Africans account for over one-third of all people affected by neglected tropical diseases, a diverse group of 20 conditions that disproportionately affect women and children. The prevalence of NTDs is often related to environmental conditions. Much like malaria, these diseases are directly influenced by temperature, rainfall, relative humidity and climatic changes. Small fluctuations in temperature can increase transmission and spread, with potentially devastating effects. Visceral leishmaniasis, for example, is often fatal if left untreated, and higher temperatures are known to accelerate its development within sand flies.

Despite these known risks, global leaders attending COP27 this year paid scant attention to the climate-health nexus, offering only a cursory mention of it in the final outcomes document. Most of the discussion centred around adaptation, even though Africans cannot simply “adapt” to rising rates of malaria, NTDs, and other infectious diseases. Mitigation through rapid global decarbonisation is crucial.

But beyond that, we must continue to direct financing and other resources towards those areas that offer the best opportunities for preventing illness and saving lives. To that end, more governments need to embrace the principle of “One Health”, a cross-cutting approach that involves developing programmes, policies, legislation, and research projects in which sectors and ministries work together to improve public-health outcomes. This represents a break from the norm of siloing public health in just one government department.

For example, in 2006, Kenya established a new framework to facilitate multi-sectoral collaboration on health issues, and then created a central coordination office (the Zoonotic Disease Unit) to bring together the ministry of health and the ministry of agriculture, livestock and fisheries. As a result, the country’s preparedness and responses to outbreaks have improved, yielding benefits for global health security more broadly.

A One Health approach can help us shift from focusing always on crisis response to placing a greater emphasis on prevention. We have already begun this process in my home country, Senegal, where the ministries in charge of human, animal and environmental health have all been brought together to execute an integrated zoonoses surveillance plan. During the Francophonie Summit this past November, we convened regional and global leaders on NTDs, as well as representatives from health ministries, the media, and international organisations, to discuss how best to integrate climate-driven health issues into One Health strategies in the future.

African governments and their people will continue to face natural disasters and new barriers in the ongoing fight against malaria and NTDs, especially if major economies fail to do more to reduce their emissions. The international community would do well to remember that leaving vulnerable populations at the mercy of environmental and zoonotic shocks ultimately will undermine health security everywhere. We should all know by now that no one is safe until everyone is safe.

Yacine Djibo, former Senegal country director for Malaria No More, is founder of Speak Up Africa