East Africa: Climate Crisis in the Greater Horn of Africa is Biggest Health Threat Causing Disease Outbreaks #AfricaClimateCrisis

The link between the climate crisis and global health has become clearer with every extreme weather event, with the number of reported disease outbreaks and climate-related health emergencies reaching their highest-ever level this century. The World Health Organization (WHO)’s analysis of the seven countries in the greater Horn of Africa – Djibouti, Ethiopia, Kenya, Somalia, South Sudan, Sudan, and Uganda – found that there have been 39 reported outbreaks, as well as flooding, and other acute public health events between 1 January and 30 October 2022.

Climate-related emergencies in the region have jumped by 30% between 2011 and 2021. In 2021, they accounted for 72% of all recorded public health events that have been substantiated. This is an increase from 58% in 2011. One major climate-related health emergency is the ongoing drought in the greater Horn of Africa.

“Climate change is having an impact here and now on the health of Africans in the greater Horn of Africa. The failure of five consecutive rainy seasons has scorched the earth and pushed people out of their homes in search of food and water. As a continent, we are the least responsible for global warming, but among the first to experience its tragic impact,” said Matshidiso Moeti, WHO Regional Director for Africa.

According to the State of the Climate in Africa 2021 report, Africa is the hardest hit continent by climate change despite being only responsible for only about 3% of global carbon emissions. The continent continues to face disrupted rainfall patterns, shrinking lakes, heatwaves, heavy rainfall, droughts, and destructive changes to continental water bodies that are destroying agriculture, ecosystems, and biodiversity further exacerbating the food security crisis.

This November, all eyes were on the world leaders that gathered in Sharm el-Sheikh, Egypt at the 27th Conference of the Parties (COP 27) to take bold decisions and make commitments to deal with the impact of the climate crisis. The conference ended with countries reaching a historic decision to establish a loss and damage fund, particularly for nations most vulnerable to the climate emergency.

Many countries in the horn of Africa are still dealing with the effects of the Covid-19 pandemic, soaring inflation, rising debt, and now extreme weather. With continuing harsh weather conditions, WHO estimates that currently, there are 47 million people facing crisis levels of food insecurity in the greater horn of Africa. This is due to the worst droughts in 40 years and the fifth failed rainy season, while at the same time, South Sudan and Sudan are experiencing very severe floods. In Ethiopia conflict is causing some food insecurity.

“The main message that we want to convey as WHO is that the food and security crisis is also a health crisis. Often people when they think of what’s needed in the Horn of Africa, they rightly think of food, clean water, and livelihoods, and indeed they are essential. But at the same time, the health impacts of the crisis are huge. Malnourished, people become sick more easily, and sick people become malnourished more easily. The outcomes when disease and malnutrition are combined are worse. We know this about the combination of cholera and malnutrition, measles and malnutrition, and common childhood diseases and malnutrition. There is a more severe disease and more deaths. We know globally already that 45% of all child deaths are linked to malnutrition”.

“Food insecurity also means that people are on the move. Already, the region has 18 million refugees and internally displaced people (IDPs) and the numbers continue to rise. Displacement means interruption of life-saving health care such as immunisation, and maternal and child care, but also increased risks such as poor water and sanitation, overcrowding, malnutrition, risky coping behaviors, and loss of livelihoods,” said Egmond Evers, Acting Incident Manager for  the Greater Horn of Africa Food Insecurity and Health.

To respond to these health emergencies, Evers said the WHO is supplying millions of dollars worth of life-saving medicines, conducting vaccination campaigns, and training 1000s of healthcare workers to treat severe acute malnutrition with medical complications.

“In several countries, we have community health workers going door to door, providing commodities sharing crucial health information, and collecting information on disease and deaths. Across all of the countries, we are investing in surveillance, disease surveillance, but crucially, also nutritional surveillance, and mortality surveillance, where this does not exist, and it does not exist in most of the countries of the great horn of Africa. This is essential to make sure that we make the best use of the limited resources that we have. We have asked for U.S.$124 million for six months, across the seven countries of the greater Horn of Africa, and we have managed to find only 1/3 of that. And that means very plainly that there will be life-saving interventions that will not happen,” he said.

Flooding in South Sudan

South Sudan is facing a fourth consecutive severe flooding season this year. This is one of the main drivers of humanitarian needs in the country besides the ongoing conflict. Over one million people across 37 of the 80 counties in the country are disrupted and affected as floods have swept away homes and livestock contributing to food insecurity. The impact of this severe flooding includes a direct toll on human lives. Latrines have been submerged, contaminating water sources and risking outbreaks of diseases.

“Recorded data shows that there were 62 deaths due to drowning trauma or injuries and snake bites. There are increased cases of snake bites reported from flooded areas, and also there is an impact on health services like the 45 health facilities, and 25 nutrition facilities, an unknown number of boreholes have been affected, either submerged, cut off or structural damage are sustained. Also, there is an increased caseload of diseases like malaria, diarrheal diseases, respiratory tract infection, and so forth. There is a depletion of essential drug supplies in health facilities owing to increasing needs and demands,” said John Rumunu, Director-General of Preventive Health Services, Ministry of Health, South Sudan.

In addition, he said the health ministry is providing emergency supplies including snake antivenom in the agency emergency health kits, reproductive health kits, and severe acute malnutrition kits, among others. Other supplies include the distribution of malaria supplies, including drugs and diagnostics, and the distribution of mosquito nets. There is an ongoing pre-emptive oral cholera vaccination campaign, which the ministry is conducting in cholera hotspot areas and flooded flood-prone areas this year. Three rounds of hepatitis E virus vaccination also has been conducted in Bentiu, one of the largest internally displaced person camps in the country.

“We have challenges, which include limited availability of essential supplies, logistical challenges impacting access to flood affected locations, interruption of care for chronic communicable and noncommunicable diseases, including lack of implementation of some preventive and control measures for malaria, as well as optimal scaling and timely distribution of mosquito nets ahead of the rainy season,” he said.

There have been other climate-related health outbreaks in other parts of the African continent including the cholera outbreak in Malawi.

“On January 24th, we had tropical storm Ana that hit the country and resulted in flooding. And this flooding then affected mostly the southern part of the country, damaging homes, water systems, and latrines. So it is after that impact of the flooding that we had the first cholera cases reported in March and the cholera outbreak then spread from initially the southern part to the northern part. And I think now most of the districts have been reporting cases. So the initial trigger of this was, was a climate-related event that disrupted the water and sanitation systems in the country. And then that predisposed the country to have an outbreak. And after that initial outbreak, the movement of people has now resulted in diffuse transmission across the country,” said Patrick Otim, Incident Manager for the Uganda Ebola outbreak.

In efforts to address these health emergencies in the greater Horn of Africa WHO has mobilised over U.S.$7 million in supplies and equipment including US.$3 million in kits for severe malnutrition, or diseases such as cholera and measles. Thousands of health workers across the region have also been trained on the management of acute malnutrition.

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