Not peer-reviewed / Editorial
- Africa has suffered disproportionately although it has done little to cause the crisis.
- The damage to Africa should be of supreme concern to all nations, warn editors.
Over 250 health journals across the world have come together to simultaneously publish an editorial urging world leaders to deliver climate justice for Africa ahead of the UN Climate Change Conference (COP27) taking place in Cairo, Egypt in November.
The editorial, which is authored by 16 editors of leading biomedical journals across Africa, including African Health Sciences, the African Journal of Primary Health Care & Family Medicine, and the East African Medical Journal, is simultaneously being published in 50 African journals and other leading international medical journals such as The BMJ, The Lancet, the New England Journal of Medicine, the National Medical Journal of India, and the Medical Journal of Australia.
Never have so many journals come together to make the same call, reflecting the severity of the climate change emergency now facing the world.
The authors say Africa has suffered disproportionately although it has done little to cause the crisis, and urges wealthy nations to step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change. The climate crisis has had an impact on the environmental and social determinants of health across Africa, leading to devastating health effects, explain the authors.
In West and Central Africa, for example, severe flooding resulted in mortality and forced migration from loss of shelter, cultivated land, and livestock, while extreme weather damages water and food supply, increasing food insecurity and malnutrition, which causes 1.7 million deaths annually in Africa.
Changes in vector ecology brought about by floods and damage to environmental hygiene has also led to increases in malaria, dengue fever, Ebola virus, and other infectious diseases across sub-Saharan Africa.
In all, it is estimated that the climate crisis has destroyed a fifth of the gross domestic product (GDP) of the countries most vulnerable to climate shocks.
The damage to Africa should be of supreme concern to all nations, they write, because in an interconnected world, leaving countries to the mercy of environmental shocks creates instability that has severe consequences for all nations.
They argue that achieving the $100bn a year climate finance target is now “globally critical if we are to forestall the systemic risks of leaving societies in crisis,” and say additional resources for loss and damage must now also be introduced.
They acknowledge that some progress has already been made, including early warning systems and infrastructure to defend against extremes, but point out that frontline nations are not compensated for impacts from a crisis they did not cause.
This is not only unfair, but also drives the spiral of global destabilisation, as nations pour money into responding to disasters, but can no longer afford to pay for greater resilience or to reduce the root problem through emissions reductions, they warn.
“The climate crisis is a product of global inaction, and comes at great cost not only to disproportionately impacted African countries, but to the whole world,” they write. “Africa is united with other frontline regions in urging wealthy nations to finally step up, if for no other reason than that the crises in Africa will sooner rather than later spread and engulf all corners of the globe, by which time it may be too late to effectively respond.
“If so far they have failed to be persuaded by moral arguments, then hopefully their self-interest will now prevail,” they conclude.
Lukoye Atwoli, Professor and Dean of Medical College East Africa and Associate Director of Brain and Mind Institute said: “It is time the global community acknowledges that the climate crisis, while disproportionately affecting the continent, is a global crisis. Action must begin now, and begin where it is hurting most, in Africa. Failure to act will make the crisis everyone’s problem very soon.” 
Bob Mash, Editor of the African Journal of Primary Health Care and Family Medicine and President of the South African Academy of Family Physicians said: “In Africa we are already seeing the devastating effects of climate change on people’s health and the need to strengthen community-oriented primary health care is now more than ever.” 
NOTES TO EDITORS
The editorial has been coordinated by the UK Health Alliance on Climate Change (UKHACC), a coalition of leading UK health bodies that advocates on behalf of health professionals for responses to climate change which simultaneously protect and promote public health.
This Comment is being published simultaneously in multiple journals (appendix). The full list of journals and supporting journals can be found on the BMJ website.
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COP27 Climate Change Conference: urgent action needed for Africa and the world
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CZ receives consulting fees from the UK Health Alliance on Climate Change. PY receives honoraria from Novartis, bioMérieux, and Pfizer and receives advisory board fees from Pfizer and fees for serving on a DSMB from the US National Heart, Lung, and Blood Institute all unrelated to the topic of this Comment. JM is an unpaid Board member of the International Working Group for Health systems strengthening unrelated to the topic of this Comment. DO-A receives advisory board fees from Inovio Pharmaceuticals and is a member of the Board of Directors of GLICO Healthcare all unrelated to the topic of this Comment. The other authors declare no competing interests.