By Joyce Chimbi

Since the outbreak of the COVID-19 pandemic in December 2019, health systems around the world have struggled with unprecedented shocks arising from the pandemic disease. Africa’s health systems have faced the additional strain of lean health financing.

The World Health Organization (WHO) estimates show that with 25 percent of the global disease burden, sub-Saharan Africa has three percent of the world’s health manpower. In all, one in three Africans, or approximately 422 million people are estimated to earn below $1 a day in rural areas.

Within a context of low health financing, fears, and concerns are rife that Africa is ill-prepared to tackle the monumental challenges expected to face Africa’s health system due to the additional burden of disease as a result of the climate change crisis.

“I belong to the cluster that deals with climate change but also other determinants of health. We do not look at issues in silos. We are looking at many different factors, how they interlink and how different sectors contribute to the challenges that we see. We consider all these factors to be determinants of health,” said Dr Adelheid Onyango is the Director of the Universal Health Coverage/ Healthier Populations Cluster at the World Health Organization Regional Office for Africa.

As such, at the Africa Health Agenda International Conference (AHAIC) 2023 in Kigali, Rwanda, conference speakers explained the interlinkages between climate change, conflict, health and how these issues were likely to shape the future of Africa’s health systems.

“When we think about addressing the threat of climate change, it is not about health sectors alone, it is about the whole of society, the whole government and not leaving behind communities. When we think about the bodies of people that are supposed to be here at this very conference, a lot of times we talk about Civil Society Organizations, and we forgot communities. There is a lot in the communities that are going to be determining factors in the delivery of primary health care. We must ensure that community voices are heard. These are stakeholders that should never be left behind,” she expounded.

“When we also think about the destructions that come from the drought, cyclones, floods and all other issues related to climate change, these are society-wide. The necessity of co-acting and working together with other sectors such as agriculture, urban planning, and environmental safety, cannot be over-emphasized.”

Dr. Onyango said that for climate change, solutions involve looking at factors that are contributing to the ongoing climate crisis such as greenhouse emissions. According to the Intergovernmental Panel on Climate Change (IPCC) to avert catastrophic health impacts and prevent millions of climate change-related deaths, the world must limit temperature rise to 1.5°C.

IPCC finds that “past emissions have already made a certain level of global temperature rise and other changes to the climate inevitable. Global heating of even 1.5°C is not considered safe, however; every additional tenth of a degree of warming will take a serious toll on people’s lives and health. The climate crisis threatens to undo the last fifty years of progress in development, global health, and poverty reduction, and to further widen existing health inequalities between and within populations.

“It severely jeopardizes the realization of universal health coverage (UHC) in various ways – including by compounding the existing burden of disease and by exacerbating existing barriers to accessing health services, often at the times when they are most needed. Over 930 million people – around 12 percent of the world’s population – spend at least 10 percent of their household budget to pay for health care. With the poorest people largely uninsured, health shocks and stresses already currently push around 100 million people into poverty every year, with the impacts of climate change worsening this trend.”

Experts at the conference acknowledged that the people whose health is being harmed first and worst by the climate crisis are the people who contribute least to its causes, and who are least able to protect themselves and their families against it – people in low-income and disadvantaged countries and communities, many of them living on the African continent.

“On climate change adaptation, what do we do because the problem of climate change is already upon us? The health system cannot continue to protect the health of a population in an unstable and changing climate. So we go by the classic system of how we have defined the health system pillars to be and work on those different levels,”  Dr. Onyango expounds.

“For instance, when you look at governance, this is where we are advocating for the political commitment. Urging government ministries to integrate climate change into their health policies and strategies. Starting from COP 26 when health gained a place on the climate agenda, we have been working on commitments from the health sector to reduce their carbon emissions and to build climate-resilient health systems.”

As climate change continues to impact health systems in a myriad of ways, participants and speakers at the AHAIC 2023, have set the ball rolling toward practical and sustainable solutions that will build a climate-resilient health system.