Climate change is increasingly destabilising the planetary systems and environmental conditions on which human health and life depend. The 2025 Lancet Countdown on Health and Climate Change report, published recently, shows that increasing global temperatures and the growing size of vulnerable populations – infants younger than one year and adults older than 65 years – have led to a 63% increase in heat-related deaths since the 1990s. Between 2012 and 2021, heat-related fatalities reached an average of 546,000 deaths a year, most of which occurred in Africa.
This is the reality for millions who live and work in the hottest regions on the continent. For African communities, where subsistence agriculture and outdoor labour are central to income and survival, the exposure is unavoidable. Long days in the sun, limited access to water and sanitation, and poor housing conditions converge to amplify heat-related harm.
More concerning is the impact on children. Extreme heat can slow down cognitive development and weaken concentration, affecting early childhood development. The cost of this will reverberate for generations, creating vicious cycles of generational poverty as children’s futures hang in the balance during early development.
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The economic consequences are just as alarming. The report shows that heat exposure resulted in a record high of 639 billion potential work hours being lost in 2024 alone. This resulted in probable losses of more than $1-trillion (R16.9-trillion), which is close to 1% of the global domestic product.
On a continent where many households rely on manual labour and informal work, this loss is a direct blow to food security, household stability, and community resilience and threatens to undo decades of developmental efforts in Africa. The continent is entering a cycle where rising temperatures, worsening droughts, and more frequent extreme weather events reinforce one another. On average, Africa is warming up at twice the global average.
We’ve reached record levels of climate-linked hazards, where extreme weather conditions threaten water quality and food production, creating fertile ground for water- and vector-borne disease outbreaks. Parts of Africa are already experiencing a 50% increase in the incidence of waterborne diseases, overwhelming the capacity of health systems. The interaction of hazards, exposure, and socio-economic vulnerability places African populations at the sharpest end of the crisis – with real and direct implications for health systems.
Clinics in rural areas lose power during extreme weather, labour wards operate without reliable electricity, and diarrhoeal disease outbreaks spread faster through water contamination after floods. The report shows that public spending continues to exacerbate the risks that African populations face. The slow transition away from fossil fuels has also come at a major financial cost.
After Russia’s invasion of Ukraine triggered a global spike in fuel prices, most countries, still heavily dependent on fossil energy, turned to subsidies to keep power affordable and prevent rising energy poverty. Of the 87 countries reviewed, 73 – representing 93% of global greenhouse gas emissions – provided fossil fuel subsidies in 2023. Together, they allocated a net total of $956bn.
In addition, because Africa is a developing continent, national agendas tend to focus on infrastructure, such as roads, bridges and industrial capacity. These are seen as the engines of development and transformation, and dominate planning and spending.
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