By Abiodun Salako
Introduction
Virtually all African countries are considered at risk of severe public health impacts from climate change, with 17 out of the 20 countries worldwide most threatened by the impacts of climate change are located in Africa. According to AfDB, health topped number three in 32 countries’ Nationally Determined Contributions (NDCs) in over 45 African countries, a clear indicator that adaptation in sectors such as water, agriculture, and energy directly affects health outcomes.
The current health emergency is fundamentally defining the lives of Africa’s 1.56 billion people in catastrophic ways. As a matter of climate justice, substantial, coordinated climate finance from developed countries is the resource African nations need most urgently. The World Health Organisation (WHO) deems climate change the single biggest health threat facing humanity, increasing morbidity and mortality risk by compromising fundamental health prerequisites.
At the recently concluded COP30 in Belém, where the E Co. team was present, world leaders adopted the “Global Mutirão” declaration. The final text had no explicit mention of health systems resilience, no commitments on air quality, and did not include a timeline to transition away from fossil fuels. However, COP30 did deliver the Belém Health Action Plan (BHAP), a voluntary initiative launched by the WHO and COP30 Presidency.
The climate-health crisis Africa faces
The WHO projects climate change will cause approximately 250,000 extra deaths annually between 2030 and 2050 from malnutrition, malaria, diarrhoea, and heat stress- a burden African countries without resilient health systems will struggle to manage. Climate change affects vulnerable groups unequally but women are 14 times more likely to die in natural disasters and by 2050, over 21% of the global population will be older people, mostly in low and middle-income countries, facing higher disaster risks. Moreover, climate stressors, such as flooding amplify waterborne and foodborne disease transmission, overwhelming already-fragile public health facilities as seen in Northeastern Nigeria, Chad, Niger, Mali, and Cameroon.
Prior to the launch of the BHAP, the WHO released a COP30 Special Report on Health and Climate Change revealing that direct health sector adaptation interventions will require over USD 22 billion per year by 2035, approximately 7% of total adaptation financing needs in climate-vulnerable countries and emerging economies.
At E Co., our work across the Global South has shown us that climate health is a constant battle fought by people of all ages and genders. In countries such as Rwanda and the Central African Republic, we have supported climate vulnerability analyses and strategic development of project pipelines, that strengthen healthcare resilience against malaria, cardiovascular and respiratory diseases, and respiratory diseases and sanitation. Health and climate change are completely inseparable and must thus be addressed within the same ecosystem of interventions.
As Senior consultant and Health lead at E Co., Giorgos Gkiouzepas reflects: “E Co. is dedicated to developing effective and innovative interventions to safeguard health outcomes against climate impacts and strengthen the public health system. We actively support communities, health professionals, and health authorities, ensuring they have the resilience and adaptive capacity needed to face the challenges ahead.”
What COP30 delivered and what it means for Africa
The text’s most notable point is the call to at least triple adaptation finance by 2035 from 2025 levels. As health is a key adaptation need, this could direct resources toward climate-resilient African health systems, building on the COP26 commitment to double adaptation finance by 2025.
Building on this, the outcome also commits to scaling up total climate finance for developing countries to at least USD 1.3 trillion annually by 2035, a figure anchored in the new Baku to Belém Roadmap to 1.3T. For Africa, which requires an estimated USD 2.5 trillion between now and 2030 for climate action, moving the needle on the continent’s financing needs.
The health benefits of emissions mitigation were acknowledged, supported by the Belém Health Action Plan. Endorsed by over 30 countries and 50 organisations, the plan makes health a frontline climate priority. The Climate and Health Funders Coalition committed USD 300 million to bolster climate-resilient health systems, surveillance, and disease prevention, especially in the Global South.
The text’s explicit recognition of Indigenous Peoples’ land rights and traditional knowledge is vital, particularly for Africa’s indigenous communities. Their knowledge of agroforestry, water management, and seasonal patterns has long supported community well-being, making this acknowledgment crucial for practical implementation. E Co’s consultant, Felipe Arenas Gallo, who was in Belém, noted: “Traditional knowledge is a cornerstone of effective adaptation. Integrating Indigenous voices doesn’t make projects go slow; it makes them go strong. The next critical step is ensuring that this recognition translates into real locally-led influence over how climate solutions are designed and delivered in the Global South.’’
E Co. has been privileged to facilitate participatory consultation workshops and Free, Prior, and Informed Consent Processes (FPIC) internationally, collaborating with Indigenous Peoples and Local Communities (IPLCs). These participatory approaches assist clients in designing and expanding projects that are appropriate for local contexts and align with the priorities of IPLCs.
Major gaps from COP30 outcomes for Africa
Despite the positives, the agreement lacked a timeline for fossil fuels, the primary source of greenhouse gas emissions and a major contributor to ambient air pollution. By doing so, a critical opportunity was missed at COP30 to directly strengthen the link between global climate policy and immediate public health outcomes for the continent.
The adaptation finance commitment, though welcome, is unclear as no baseline figures were provided, making “tripling” unmeasurable. After all, the commitment is voluntary, not binding. And there’s no specification that adaptation finance should prioritise health systems resilience, meaning that funds could flow to infrastructure while healthcare facilities remain vulnerable.
In our work supporting countries to strengthen their NDCs, we have identified that health ministries need support to access global climate finance, maximise the efficiency and create strategic synergies between funding streams to deliver integrated, resilient health outcomes. According to E Co’s GCF’s insight #23, only 13.3% of global climate finance (USD 49 billion of USD 653 billion in 2020) was allocated to adaptation. The COP30 text doesn’t collapse the gap. Without explicit mechanisms to ensure health considerations in climate finance allocation, adaptation funds will continue flowing to sectors with stronger institutional capacity to access them, typically not health.
A health emergency, not a future risk
The unequivocal truth is that the climate health crisis isn’t waiting for better international agreements. Human fatalities are increasing from climate-amplified health threats. COP30’s progress on finance architecture and transparency matters. But lacking overt commitments to health systems resilience, air quality improvements, and fossil fuel transitions, these structures remain hollow for African communities most affected.
As we prepare for COP31 in Türkiye, E Co. remains devoted to bridging the divide between global climate ambition and local health outcomes. Our project experience repeatedly demonstrates that when climate adaptation is designed with health at the centre, communities become more resilient, health outcomes improve, and climate goals are achieved more effectively.
