Climate resilience is a key sub-theme of the World Health Summit’s regional meeting in Nairobi next month that is bringing leaders together to address the structural realities of health security across the continent and advance a transformative reform agenda.

In some parts of Africa, like Ghana, December marked the beginning of Harmattan with its dusty cooler winds. However, over the past few years, changes in climate have interfered with the season; temperatures are sometimes too high, whereas in different regions, there are sudden storms, and extended dry spells are becoming more frequent. These changes can be deceptive, but they are already causing grave health effects.

Climate change has been far too frequently conceptualized as an environmental or economic problem, a matter that can be handled by government agencies alone. In Africa, climate shocks are already redefining the disease patterns, essential health services and the vulnerabilities of health systems. 

Climate change is no longer a future health threat but an escalating challenge today. The challenge that policymakers and health leaders are facing today is not only the climate change impacts on health, but also whether the African health systems in are able to absorb, adapt, and respond to the increasingly frequent and intensifying climate shocks.

Increasing temperatures, extended droughts, and floods are changing the epidemiology of disease on the continent. This includes the spread of the diseases into new geographies through vectors, whereas water scarcity and flooding contribute to the regular outbreak of cholera and other waterborne diseases. 

In addition, heat stress exacerbates cardiovascular and respiratory health complications, especially among vulnerable groups.

Exposing the fragility of health systems. 

Health systems are grappling with the most significant effects of climate change. Floods are damaging or rendering health facilities unusable, disrupting essential medicine supplies and breaking supply chains. 

Climate emergencies are widening service delivery gaps by increasing the workload of already overstretched health workers. More broadly, climate change is exposing the fragility of health systems designed for stability in an increasingly dynamic environment.

Many African health systems remain organized around vertical programs and short-term interventions. While these approaches have improved outcomes in specific disease areas, they are poorly suited to respond to climate-related shocks. As a result, these crises increase operational costs when core functions such as disease surveillance, emergency preparedness, infrastructure planning, and primary care are managed in silos.

Climate change increases fragmentation tax – the accrued cost of fragmented systems. In the case of climate-related emergencies, this fragmentation often translates into slower responses, preventable sicknesses, and the loss of trust by the population. 

Integration is fundamental to resilience and requires interoperable systems and governance structures that enable flexible service delivery models, allowing rapid adaptation to changing conditions.

Adaptation as an imperative

Climate change adaptation is not a nice-to-have feature of health systems but an essential capability of health security. 

This implies a shift from the largely reactive emergency response approaches to anticipatory system design. Health systems that are climate-resilient incorporate climate risk in all their planning and investment decisions. 

This involves climate-proofed health infrastructure, enhancing early warning systems, responsive and adaptive supply chains, and providing health workers with the skills needed to address climate-sensitive health threats.

Crucially, it also requires aligning health policy with broader national adaptation strategies to ensure health is fully integrated into climate planning.

Africa’s leadership moment

Despite its vulnerability to climate risks, Africa is at the forefront in developing health models that are resilient and responsive in nature. Locally led initiatives are emerging across the continent, from community-based surveillance to climate-informed primary healthcare. These approaches show that adaptation is most effective when context-specific and nationally driven.

What is needed is scale, coordination, and political commitment. Climate adaptation must be integrated into health financing systems, regulatory frameworks, and regional collaboration mechanisms.

This is not only about protecting populations, but also about safeguarding economic stability, institutional credibility, and long-term development trajectories.

Climate change has introduced a new and increasingly fragile context for health service delivery and the process of reframing it as a health systems issue is at a critical juncture. 

It requires the health leaders to be front and centre in climate decision-making and climate resilience to become a performance indicator for health systems. This will also be a key issue at the upcoming WHS regional meeting hosted by the Aga Khan University in Nairobi from 27-29 April. 

Framing climate adaptation as a health systems strengthening pillar will help in shifting the discussion from awareness to implementation. Africa’s future depends on shifting from fragmented responses to coherent, self-reliant health systems. Our resilience in this age of disruption will be defined not by what we promise for tomorrow, but by what we do today.

Professor Anthony Ngugi is Associate Dean of Research at the Aga Khan University Medical College East Africa, in Kenya and chairperson of the programme committee of the World Health Summit regional meeting.

Image Credits: Bureau National de Gestion des Risques et des Catastrophes (BNGRC), The Salvation Army, WHO.