By Michael Gwarisa
For a long time, discourse on climate change has revolved around the effects of Climate Change on the environment in particular air pollution, an issue most prevalent in the Global North. Very little focus was being given to the impact of climate change on the health and well-being of the human population.
However, for the first time in many years, African health Ministers and their counterparts from around the world converged in Dubai for the COP28 where they delivered a strong message regarding the impact climate change is having on healthcare. In response, a total of 124 countries endorsed the Declaration of Climate and Health. The political declaration marks the first time climate change’s health impacts have taken centre stage in 28 years of UN climate discussions.
A week before COP28, African Health Ministers and governments gathered in Lusaka, Zambia for the Africa Centre for Diseases Control (Africa CDC) International Conference on Public Health in Africa (CPHIA 2023). One of the subjects that dominated the CPHI talks was climate change and its impact on healthcare on the continent.
This comes hot on the heels of numerous Climate catastrophes that have ravaged the continent and disrupted healthcare services since the beginning of the year. In 2023, several African countries have been hit by climate change-related disasters that have resulted in the emergence and resurgence of disease outbreaks. Disaster Data combined by Carbon Brief shows at least 15,700 people on the African continent who have been killed since the beginning of 2023 in extreme weather disasters in Africa. A further 34 million people have been affected by extremes.
In an interview with HealthTimes on the side-lines of the CPHIA in Lusaka, Desta Lakew, the Group Director of Partnerships and External Affairs at AMREF Health Africa said the picture was not looking good and the time to act was now.
Climate Change is the biggest challenge we face as a generation and multi-generations. We are seeing the effects of climate change. If you check in the last 20 years, for example, climate has been the key issue that has affected human health. In Africa itself, when we look at 2000 to 2021, we see that more than 50 percent of nearly 2000 public health events were climate-related and we are seeing that increasing,” said Lakew.
Since January 1, 2022, a cumulative total of 241 606 cholera cases have been reported to the World Health Organisation (WHO) Regional Office for Africa (AFRO), including 4 374 deaths with a case-fatality ratio (CFR) of 1.8 percent as of 24 September 2023.
An excess of 3,000 people were also killed in flash floods in the Democratic Republic of the Congo and Rwanda in May. Approximately 860 people were killed in floods and mudslides in February during Tropical Cyclone Freddy, the longest-lasting cyclone on record affecting Madagascar, Mozambique, Mauritius, Malawi, Réunion and Zimbabwe. More than 29 million people continue to face unrelenting drought conditions across Ethiopia, Somalia, Kenya, Djibouti, Mauritania and Niger.
Lakew added that Africa has regressed in terms of strides made in healthcare service delivery as a result of Climate Change.
“We have major climate conditions that are impacting either directly through deaths, or directly either in Agriculture, either in health, the number of Vector-borne diseases going up, Malaria and all those things that are coming up. Those are direct impacts of Climate Change, so whatever progress we have made over the years for example Malaria, has gone backwards because of the way climate change has been affecting our systems.”
Why Africa’s Healthcare is vulnerable to Climate Change Effects?
While climate is a big issue, for Africa there are a myriad of factors at play that result in healthcare suffering major losses in the event of climate-related emergency. Lakew said Africa’s biggest challenge was weak health systems in the face of climate change.
“For us as Africa, it’s not just about climate change being a problem, it is a crisis and that our health system is so fragile. We have very fragile health systems."
“We need to invest in strengthening our health systems so no matter what climate incidence happens, we can survive, we can provide the care, we have to provide the interventions that are needed and provide the essential public health services. One of our big challenges here in Africa is we have fragile, weak health systems, we don’t have sufficient human resources to address some of these issues,” added Lakew.
She said Africa was not ready to deal with the effects of climate change as yet and more still needs to be done. Apart from weak health systems, Africa has conflicts, and the rate of displaced populations keeps going up by the day.
“We are in a situation whereby where we are not the emitters, we emit less than 4 percent but we are the recipients of the effects of what others have done. We are not ready, we don’t have the financing that is needed, we haven’t made the appropriate investments that are needed and the climate conversation as a whole has not been focused on health even though health is the human face of climate.”
One-Health Approach In Addressing Climate Change-Linked Health Challenges:
Public health data has linked fluctuating temperatures to the increase in Zoonotic diseases. Data shows that as the planet heats up, infectious diseases that were once confined to warmer latitudes are slowly expanding their range. In particular, zoonotic diseases or diseases that spread from non-human animals to humans. Due to climet change, they end up taking advantage of the greater range made available by climate change.
“The way we live in communities with our people and our animals. The One-Health approach simply means looking at health, animals, human beings, and the environment collectively to develop interventions that work. This is an approach that works and if this is something that we can incorporate and consider then that would be great. There is no foolproof solution to climate change but our solution should be tailored to the needs and realities of our people.”
What needs to be done?
It is a known fact by now that Africa is battling a myriad of challenges that could impact negatively on the continent’s capacity to deal with Climate change-induced health challenges. Despite all the challenges that need to be addressed, Lakew said Africa could start by investing towards strengthening the fragile health systems.
“We need to do is to invest in strengthening the health systems. We need to train the health workforce appropriately. We need to also negotiate in addition to adaptation, how we adapt our health systems. We also have to do work on medications. Right now, our immediate crises in adaption. Are our health systems strong enough, if you look at Malawi, recently they had Cyclone Freddy. They lost more due to Cyclone Freddy than they did in the entire period of COVID-19. Why? It’s because systems are not strong enough,” said Lakew.
She added that Africa needs to speak with one mobilise financial resources to address climate change and the effects it has on healthcare. Even though there is some funding for climate change in the form of the Greene Climate Fund, Lakew sais it is difficult to access. Africa needs to have immediate funding available to boost the continent’s capacity to deal with Climate Change. Surveillance systems need to be in place to enhance disaster preparedness and response.
Meanwhile, at COP28, the health policy watch reported that the UAE announced an “aggregated” financing commitment of $1 billion, facilitated by the Green Climate Fund, the Asian Development Bank, The Global Fund, and the Rockefeller Foundation.
The funding is meant to back up the political commitments made by the 124 signatory nations. This financing will be crucial, particularly for low- and middle-income countries. The declaration underscores the need to “better leverage synergies at the intersection of climate change and health to improve the efficiency and effectiveness of finance flows.
