Health workers in Africa warn of communities pushed to the edge by the intersection of collapsing ecosystems and under-resourced health systems. Photo: Reuters
Every year, on 22 April, Earth Day is marked around the world with climate pledges, tree plantings and appeals for sustainability. But here in Africa, Earth Day is not only about the environment, it is about survival, health and justice.
The Earth is sick, and so are we. The climate crisis is not a distant or abstract threat for Africa, it is a daily health emergency.
Rising temperatures are fuelling the spread of malaria, cholera and dengue. A 2022 study published in Nature Climate Change found more than 1 000 ways the effects of climate change lead to illness.
Droughts and floods are devastating food systems, pushing malnutrition to new highs.
Displacement from climate disasters is collapsing the fragile continuity of care for millions.
In the tropical parts of the continent, heat waves contribute to declining mental health, an increase in miscarriages and a higher risk of being admitted to hospital with a heart ailment, according to a review of a 100 heat studies published in the International Journal of Biometeorology.
For Africa, the climate crisis is a health crisis.
If we are serious about protecting the planet, we must be equally serious about protecting the people who live on it, especially those bearing the brunt of a crisis they did not create.
Although Africa is no longer considered a “carbon sink” and now produces more carbon than it absorbs, the continent still contributes less than 4% of global greenhouse gas emissions.
Yet we are hit hardest and earliest by climate impacts. From the Sahel to the Horn of Africa to the southern coasts, our people are choking on unclean air, drinking from contaminated water sources and burying loved ones lost to preventable, climate-exacerbated diseases.
Health workers across the continent are sounding the alarm. They are witnessing communities pushed to the edge by the intersection of collapsing ecosystems and under-resourced health systems. Clinics flood. Vaccines spoil in heat waves. Vector-borne diseases spread in once-immune areas. Mental health deteriorates under the weight of displacement and hunger.
This is not a future threat. It is happening now.
Climate justice must be framed, funded and fought for as a health justice imperative.
Across Africa, we are told to “adapt” to the crisis or face the consequences that inaction deserves.
But have we really thought about what adaptation means in a rural community where the health centre has no electricity, cold chain, clean water or trained nurses? What does adaptation mean to a woman giving birth in a flood-stricken district where ambulances can’t reach her?
We don’t need saviours, we need a systems change. Indigenous knowledge is an as-yet untapped source of climate resilience.
Africa’s indigenous communities — guardians of land, water, and seed — hold knowledge that has sustained ecological balance and human well-being for generations.
Traditional healers understand the deep interconnection between bodies and ecosystems. Indigenous farmers know how to conserve water, regenerate soil, and feed communities.
But these knowledge systems are routinely excluded from national climate and health policy. They are ridiculed, undervalued and underfunded. Yet when formal systems collapse during climate disasters, who do communities turn to? Their elders. Their herbalists. Their neighbours.
It’s time we recognised this: indigenous knowledge is not “alternative”, it is essential. Incorporating these systems into our formal climate and health response is not only about respect, it is about resilience.
African governments must centre lived experience and Indigenous knowledge in their national climate and health strategies — not as token additions, but as foundational wisdom. This requires political will and a radical shift in worldview: from dominance over nature to relationship with it; from charity to justice; from global compliance to local liberation
The vast majority of global climate finance is still engineered for mitigation, designed to reduce future emissions, not to heal the people already paying the price.
While mitigation matters, it does little for the child breathing toxic air today, for the mother giving birth in a drought-stricken village or for the front line health worker trying to deliver care with no electricity and no clean water.
Adaptation, which is the true priority for most African nations already reeling from floods, heatwaves, crop failures and climate-fuelled epidemics, is consistently underfunded. A 2024 UNDP report confirms the injustice: despite our urgent need, Africa continues to receive more financing for long-term emission reductions than for immediate survival.
This is climate colonialism disguised as strategy.
We do not need more global promises. We need African-led, African-owned solutions, starting with the urgent call to fully fund and capacitate the African Risk Capacity (ARC), a specialised agency of the African Union designed to help our states anticipate, prepare for, and respond to climate shocks. The ARC exists for us. But it cannot do its job if it is kept on the margins of donor priorities and buried under bureaucratic neglect.
A fully resourced ARC is not a luxury, it is a lifeline.
It is time for climate finance to stop flowing through institutions that ignore our realities and begin to empower African mechanisms built for our context.
The future of adaptation is not in Geneva or Washington; it is in Addis Ababa, Dakar and every African village on the front lines of this fight.
We cannot treat the Earth while ignoring its healers.
Climate and health justice are Pan-African struggles. This is not a fight any one country can win alone. Just as colonial borders divided our land and our people, they now fragment our policy responses. But the air we breathe, the water we drink, the heat we endure — these know no borders.
Our response must be equally borderless.
From community health workers in rural Kenya to agroecology networks in Burkina Faso to traditional medicine advocates in South Africa, Africa is already leading. The challenge is not innovation. It is recognition, resourcing, and political courage.
On this Earth Day, Africa must not only participate in global climate and health discourse but also lead it
Healing the planet cannot happen without first restoring power to the communities that have been most harmed and least heard.
Africa’s future depends on how we respond to this moment. Will we continue to treat climate and health as separate silos, or will we embrace their intersection as the ground zero of justice?
Will we let outsiders define our path, or will we reclaim the knowledge that has always guided us? The answer will define not only the fate of Africa but the fate of the world. Because make no mistake: if Africa cannot breathe, the Earth cannot survive.
This Earth Day, stand with us — not as allies, but as co-liberators.
Tian Johnson is founder of the Pan-African nonprofit, the African Alliance.