Africa: Catalyzing Momentum for Health Negotiations at COP28

guest column
By Dr. Githinji Gitahi and Dr. Martin Muchangi

By now, there is no doubt that the climate crisis is a significant health crisis affecting people across the globe. This might be obvious to some but to others, the impacts haven’t hit home yet.

With the increase of extreme weather events, waterborne and vector-borne diseases, malnutrition, heat stress, mental illness, and the growing burden of care for people suffering from diseases triggered by climate episodes and disasters, the health implications of climate change are becoming more apparent across the globe worsening the population health indicators.

The recent Lancet Countdown Report shows escalating health impacts of climate change. Adults over 65 and infants under one experience double the heatwave exposure compared to 1986-2005. Severe weather endangers water and food supply, leading to malnutrition. In 2021 for instance, 127 million people in 122 countries faced increased food insecurity, compared to 1981-2010. Climate shift expands pathogens risking billions of people health with infectious diseases.

In addition, according to World Health Organization (WHO),56% of public health events since 2001 have been linked to climate change. Africa accounted for 94% of the world’s malaria cases in 2019 and it underscores the urgent need for health-centric climate policies, especially as Africa’s population is set to nearly double by 2050.

Talk to anyone in the streets of major capitals of Africa and they are acutely aware of how climate change is changing their day-to-day lives. Your taxi driver in Nairobi is likely to mention the current threat of El Niño and elsewhere you’ll hear plenty of examples of how people’s daily lives have been directly impacted by climate change.

Malawi has recently experienced its worst cholera outbreak in two decades, caused by flooding in the southern region before spreading to the rest of the county. Over 40,000 people were diagnosed with cholera, and at least 1300 deaths recorded. The people most affected were those living in poor rural communities relying mainly on subsistence agriculture and lacking access to health facilities to protect themselves.

While the “right to health” is enshrined in the Paris Agreement as a fundamental requirement for climate action, and despite the glaring health challenges, only 5% of climate funds go to adaptation and only 1% of the adaptation funds are dedicated to health. The recently concluded African Climate Summit (ACS) in Nairobi called for a collective approach to tackle climate change, with commitments equating to nearly USD$26 billion. However, none of this was allocated to support climate and health mitigation and adaptation interventions.

The ACS was a significant milestone in the quest to prioritize health at the forthcoming 2023 UN Climate Change Conference COP28. Although health was not addressed in the Nairobi Declaration, various stakeholders gathered under the auspices of Amref Health Africa to ensure Africa takes the lead as the only continent with a unified position to climate and health ahead of COP28. This a huge win and no small feat.

The position calls for a collaborative, global approach to tackling climate change and creating solutions. It is not a North or South issue, but a collective challenge that requires a unified response. Convening alongside ACS started a critical conversation about the importance of health in climate action, and now it is up to global leaders to take note and implement the continent’s ambitions. ACS was the first step in taking control of the continent’s destiny, with a focus on solutions and calls to action by Africans, for Africans. It’s no longer about what the world can do to help Africa, but what Africa can do for the world.

Political momentum is building up, and this year, for the very first time, world leaders gathering at the COP28 will engage in an official program focused on climate and health. We welcome the initiative of the COP28 Presidency in organizing the inaugural Health Day and call for dedicated health days in subsequent COPs.This has the potential to be a watershed moment for global health and a positive indication of the growing political recognition of the climate crisis as a health crisis.

The COP28 Presidency, in collaboration with the World Health Organization (WHO) and other partners, developed the COP28 Declaration on Climate and Health prior to the conference. This is a voluntary call to action that lies outside the formal UNFCCC negotiations. It captures countries’ shared views and aspirations towards safeguarding and investing in the health of populations worldwide. While a number of countries have endorsed the Declaration, we urge countries, especially African nations, to support the Declaration which is in concordance with Africa’s unified stance on climate and health.

These are great steps and the time has come for global leaders to recognize the impact of climate change on health and take action to make a real difference in people’s health.  The climate negotiations must prioritize adaptation and mitigation efforts, as well as prevention of loss and damage while maximizing health benefits and minimizing inadvertent risks to human health.

It is crucial that we support the African Group of Negotiators to effectively carry out their duties.  Africa is a key voice in global climate negotiations, which needs to be equipped with evidence to drive global and national policy reforms. It is also imperative to put countries most affected by climate change at the center of decision-making processes and prioritize solutions that build the necessary resilience to climate change.

This calls for prioritization of health in global climate adaptation and mitigation financing. We cannot afford to wait any longer.

It is essential that everyone takes an active role in combating climate change and takes responsibility for their individual actions. We demand that policymakers review and implement existing policies to aggressively implement a worldwide equitable transition from fossil fuels to renewable energy sources in alignment with the Paris Agreement, recognizing the inherent public health benefits.

Furthermore, we must urgently strengthen and adapt health systems, including robust early warning systems to address climate-related health risks, including timely alerts for extreme heat, vector-borne diseases, and other health threats linked to climatic changes, and ensure no community is left behind, no matter how remote.

Dr. Githinji Gitahi is Group CEO of Amref Health Africa and Special Envoy for Climate and Health for COP28. Dr. Martin Muchangi is Director of Population Health and Environment at Amref Health Africa.