COP27 Climate Change Conference: urgent action needed for Africa and the world
Editorial Commentary

COP27 Climate Change Conference: urgent action needed for Africa and the world

Lukoye Atwoli1, Gregory E. Erhabor2, Aiah A. Gbakima3, Abraham Haileamlak4, Jean-Marie Kayembe Ntumba5, James Kigera6, Laurie Laybourn-Langton7, Robert Mash8, Joy Muhia9, Fhumulani Mavis Mulaudzi10, David Ofori-Adjei11, Friday Okonofua12, Arash Rashidian13, Maha El-Adawy13, Siaka Sidibé14, Abdelmadjid Snouber15, James Tumwine16, Mohammad Sahar Yassien17, Paul Yonga18, Lilia Zakhama19, Chris Zielinski20

1East African Medical Journal;2West African Journal of Medicine; 3Sierra Leone Journal of Biomedical Research;4Ethiopian Journal of Health Sciences; 5Annales Africaines de Medecine; 6Annals of African Surgery; 7University of Exeter, Devon, UK; 8African Journal of Primary Health Care & Family Medicine; 9London School of Medicine and Tropical Hygiene, London, UK; 10Curationis; 11Ghana Medical Journal;12African Journal of Reproductive Health; 13Eastern Mediterranean Health Journal; 14Mali Médical; 15Journal de la Faculté de Médecine d’Oran;16African Health Sciences; 17Evidence-Based Nursing Research; 18East African Medical Journal;19La Tunisie Médicale; 20University of Winchester, Hampshire, UK

Correspondence to: Chris Zielinski. University of Winchester, Sparkford Road, Winchester, Hampshire SO22 4NR, UK. Email:

Received: 01 October 2022; Accepted: 31 October 2022; Published: 30 December 2022.

doi: 10.21037/jxym-2022-5

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change.

The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods (1). These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5 ℃ compared with pre-industrial levels.

While the Paris Agreement of 2015 outlines a global action framework that incorporates providing climate finance to developing countries, this support has yet to materialise (2). COP27 is the fifth Conference of the Parties (COP) to be organised in Africa since its inception in 1995. Ahead of this meeting, we—as health journal editors from across the continent—call for urgent action to ensure it is the COP that finally delivers climate justice for Africa and vulnerable countries. This is essential not just for the health of those countries, but for the health of the whole world.

Africa has suffered disproportionately although it has done little to cause the crisis

The climate crisis has had an impact on the environmental and social determinants of health across Africa, leading to devastating health effects (3). Impacts on health can result directly from environmental shocks and indirectly through socially mediated effects (4). Climate change-related risks in Africa include flooding, drought, heatwaves, reduced food production, and reduced labour productivity (5).

Droughts in sub-Saharan Africa have tripled between 1970–1979 and 2010–2019 (6). In 2018, devastating cyclones impacted three million people in Malawi, Mozambique and Zimbabwe (6). In west and central Africa, severe flooding resulted in mortality and forced migration from loss of shelter, cultivated land, and livestock (7). Changes in vector ecology brought about by floods and damage to environmental hygiene have led to increases in diseases across sub-Saharan Africa, with rises in malaria, dengue fever, Lassa fever, Rift Valley fever, Lyme disease, Ebola virus, West Nile virus and other infections (8,9). Rising sea levels reduce water quality, leading to water-borne diseases, including diarrhoeal diseases, a leading cause of mortality in Africa (8). Extreme weather damages water and food supply, increasing food insecurity and malnutrition, which causes 1.7 million deaths annually in Africa (10). According to the Food and Agriculture Organization of the United Nations, malnutrition has increased by almost 50% since 2012, owing to the central role agriculture plays in African economies (11). Environmental shocks and their knock-on effects also cause severe harm to mental health (12). 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 (13).

The damage to Africa should be of supreme concern to all nations. This is partly for moral reasons. It is highly unjust that the most impacted nations have contributed the least to global cumulative emissions, which are driving the climate crisis and its increasingly severe effects. North America and Europe have contributed 62% of carbon dioxide emissions since the Industrial Revolution, whereas Africa has contributed only 3% (14).

The fight against the climate crisis needs all hands on deck

Yet it is not just for moral reasons that all nations should be concerned for Africa. The acute and chronic impacts of the climate crisis create problems like poverty, infectious disease, forced migration, and conflict that spread through globalised systems (6,15). These knock-on impacts affect all nations. COVID-19 served as a wake-up call to these global dynamics and it is no coincidence that health professionals have been active in identifying and responding to the consequences of growing systemic risks to health. But the lessons of the COVID-19 pandemic should not be limited to pandemic risk (16,17). Instead, it is imperative that the suffering of frontline nations, including those in Africa, be the core consideration at COP27: in an interconnected world, leaving countries to the mercy of environmental shocks creates instability that has severe consequences for all nations.

The primary focus of climate summits remains to rapidly reduce emissions so that global temperature rises are kept to below 1.5 ℃. This will limit the harm. But, for Africa and other vulnerable regions, this harm is already severe. Achieving the promised target of providing $100 bn of climate finance a year is now globally critical if we are to forestall the systemic risks of leaving societies in crisis. This can be done by ensuring these resources focus on increasing resilience to the existing and inevitable future impacts of the climate crisis, as well as on supporting vulnerable nations to reduce their greenhouse gas emissions: a parity of esteem between adaptation and mitigation. These resources should come through grants not loans, and be urgently scaled up before the current review period of 2025. They must put health system resilience at the forefront, as the compounding crises caused by the climate crisis often manifest in acute health problems. Financing adaptation will be more cost-effective than relying on disaster relief.

Some progress has been made on adaptation in Africa and around the world, including early warning systems and infrastructure to defend against extremes. But 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. A financing facility for loss and damage must now be introduced, providing additional resources beyond those given for mitigation and adaptation. This must go beyond the failures of COP26 where the suggestion of such a facility was downgraded to “a dialogue” (18).

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. 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.


This Comment is being published simultaneously in multiple journals. For the full list of journals see:

Funding: None.


Provenance and Peer Review: This article was a standard submission to the journal. The article did not undergo external peer review.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at JK is the Ex-Officio, President and Secretary of the Kenya Orthopedic Association and serves as the Editor-in-Chief of Annals of African Surgery; PY has been paid to speak or participate at events by Novartis, bioMerieux and Pfizer, paid to serve on the DSMB of the NHLBI-funded STRENGTHS trial focusing on hypertension, and paid to serve as a Chair on a Pfizer Advisory Board on pneumococcal vaccinations in adults; CZ is a paid consultant for the UK Health Alliance on Climate Change; JM is unpaid board member of the International Working Group for Health Systems Strengthening, and a current employee of London school of Hygiene & Tropical Medicine; DOA has a relationship with GLICO Healthcare Ltd. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:


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doi: 10.21037/jxym-2022-5
Cite this article as: Atwoli L, Erhabor GE, Gbakima AA, Haileamlak A, Ntumba JMK, Kigera J, Laybourn-Langton L, Mash R, Muhia J, Mulaudzi FM, Ofori-Adjei D, Okonofua F, Rashidian A, El-Adawy M, Sidibé S, Snouber A, Tumwine J, Yassien MS, Yonga P, Zakhama L, Zielinski C. COP27 Climate Change Conference: urgent action needed for Africa and the world. J Xiangya Med 2022;7:26.

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