Editor's note: Hester Mkwinda Nyasulu is the country manager for Amref Health Africa in Malawi. Ndasowa Chitule is the deputy country director of Malawi at the global health organization VillageReach. The article reflects the authors' opinions and not necessarily the views of CGTN.

The reality of climate change continues to intensify, not only as an environmental issue, but a public health crisis that threatens the well-being of millions of people across the globe.

Climate change is already driving extreme weather events, natural disasters and ecosystem disruptions around the world, and Cyclone Freddy is just the latest example. The cyclone has unleashed its wrath on Mozambique, Malawi and Madagascar, destroying thousands of homes, displacing over half a million people, and battering health systems already weakened by the COVID-19 pandemic. Flooding from the cyclone is also exacerbating an ongoing cholera epidemic. The death toll has risen to over 600, with many more missing and feared dead.

Without immediate, well-coordinated and sustained climate action, disasters like Cyclone Freddy will only become more common, and their impacts on human health more dangerous. To mitigate the impacts of the climate crisis on health, we must urgently mainstream climate in our response to health and strengthen the fundamental pillar of our health systems – primary healthcare (PHC) – to withstand and respond to the realities of the climate emergency.

We can do this by building responsive PHC systems.

A responsive PHC system is one that can anticipate challenges and needs, and quickly change course to deliver consistent and high-quality care to people no matter where they live, allowing the health system to withstand everyday shocks and major crises. This requires that community health workers have the resources and training they need to reach people, that supply chains are flexible and adaptable, that services are designed to be delivered beyond the walls of facilities, and that we collect, analyze and act on new data and insights around the changing needs, preferences and values of the community.    

Governments are already working with climate experts and health organizations to deliver on this goal. For example, governments in Malawi and Mozambique are partnering with organizations like ours, Amref Health Africa and VillageReach, to provide emergency healthcare services and rebuild primary healthcare systems following Cyclone Freddy, building on partnerships established when responding to Cyclone Idai in March 2019.

But strong health systems aren't built during a disaster; they are built with extensive investment over time.

At the heart of Africa's fragile health systems is the inability by governments to prioritize health and allocate adequate resources. More than two decades after African governments signed The Abuja Declaration, which aimed to address this issue by raising health sector allocations to at least 15 percent of national budgets, less than five countries have been able to meet this target, making it difficult to improve and sustain the continent's health systems.

To address the fragility of health systems in Africa, it is crucial to have strong political will backed by visionary African leadership, multisectoral collaboration and continued financial commitment to catalyze investment in responsive primary healthcare systems. This requires strategic financing to bolster and expand health infrastructure and supply chains, build the capacity of health workers, and leverage digital solutions to improve access to health services – all before the next crisis hits. Ultimately, healthcare should be viewed as an investment, rather than a cost, that benefits society as a whole.

Despite the challenges we face, there are reasons to be optimistic. There is now strong consensus among the global community to integrate health into climate change policies and vice versa. At the fifth Africa Health Agenda International Conference recently held in Kigali, Rwanda, stakeholders from the health, development and climate sectors convened to identify ways to mainstream climate into global health policy and strategy. These discussions will continue at the 78th session of the United Nations General Assembly in September and the 28th session of the Conference of the Parties taking place in November this year.

These crucial conversations are just the beginning, but urgent action is needed to strengthen the current state of PHC systems in Africa to adequately respond to the health effects of climate change.

African health development organizations like Amref Health Africa and global health partners like VillageReach are ready to tackle this challenge. It's time to mobilize the broader ecosystem of African governments, private sector companies, development partners, civil society and academia to jointly take action to protect our planet and its inhabitants from the disastrous consequences of climate change.

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