Joy Phumaphi is no stranger to daunting challenges in public health. As the Executive Secretary of the African Leaders Malaria Alliance (ALMA), former Assistant Director General of the World Health Organization (WHO), and former Minister of Health in Botswana, she has spent decades navigating the complexities of both national and global health systems. Today, she is sounding the alarm on an increasingly urgent threat: the catastrophic rise in vector-borne and neglected diseases, driven by climate change.
During a recent webinar co-hosted by Panorama Strategy and the END Fund, Phumaphi did not mince words. “The economic impacts of neglected tropical diseases (NTDs) and malaria are dramatic,” she said. “You can actually increase economic growth by over 5% per year by simply eliminating neglected tropical diseases, and if you eliminate malaria, you can double that.” Yet, as she pointed out, these potential gains are being snatched away from communities by a warming planet.
The Dual Burden of Climate Change and Neglected Diseases
In an era when floods, droughts, and rising temperatures are accelerating at an alarming rate, diseases that were once contained are finding fertile ground to expand. Climate change doesn’t just disrupt weather patterns; it disrupts entire health systems. And the people who bear the brunt of these shifts are often the ones least equipped to adapt. Phumaphi has a stark warning for stakeholders that if we fail to integrate climate considerations into health systems and health related investments, we risk weakening our ability to respond to disease outbreaks, which could reverse the progress we’ve made in eliminating NTDs and malaria and strengthening health infrastructure. This changing landscape is increasing the risk to people of lost livelihoods, vector-borne diseases, respiratory diseases, and malnutrition. The intersection of these crises is most evident in sub-Saharan Africa, where communities are grappling with the triple burdens of climate change, poverty, and disease.
The morbidity and mortality numbers are as grim as they are clear: without targeted action, the African continent stands to lose more lives and economic potential than any other region due to climate-sensitive diseases like malaria and schistosomiasis. According to the African Union Climate Change and Resilient Development Plan, the impact on human health will be severe, with Africa experiencing a death rate from climate change that is 60 to 80% higher than Southeast Asia due to existing vulnerabilities and limited adaptive capacity. Without targeted action, these compounded pressures could lead to 70,000 additional deaths in Africa by 2030. The WHO’s report on Climate change, malaria and neglected tropical diseases: a scoping review further underscores the urgency, noting that “climate change will perturb human health in profound and long-lasting ways,” with more than half of all known human infectious diseases already being amplified by climate change. The economic and health toll from diseases like malaria, dengue, and schistosomiasis will continue to rise, threatening to unravel decades of progress if swift, integrated action is not taken.
A Blueprint for Resilience: The “One Health” Approach
Phumaphi is not one to dwell solely on the problem; she also shares actionable recommendations and solutions. Central to her approach is the “One Health” framework, which recognizes that human health is deeply interconnected with the health of animals and ecosystems. In Botswana, this strategy is already bearing fruit. By coordinating efforts between the ministries of agriculture and health, the country is tackling vector-borne diseases more holistically, leveraging lessons from animal health to bolster human health systems.
“Climate change isn’t just an environmental issue—it is a health crisis,” Phumaphi emphasized during the discussion. For her, protecting health systems from the shocks of climate change isn’t just a matter of building hospitals or training doctors. It’s about rethinking how we approach the problem altogether, breaking down the silos between sectors like agriculture, environment, water management, and public health.
Investing in the Future: A Call to Donors at COP29
As world leaders gather in Baku Azerbaijan for COP29, Phumaphi emphasizes the critical need for targeted financing to combat neglected diseases and malaria. She advocates for the establishment of a dedicated funding mechanism, stating, "We need to have a special funding window that is focused on eliminating diseases like NTDs and malaria, to address the impact of climate change." Phumaphi underscores the importance of empowering youth and local communities, advocating for more inclusive engagement: "We must develop mechanisms to engage with the heads of state and government, ministers and parliaments, youth and women’s groups, religious and community leaders, as well as the private sector—empowering these critical stakeholders." By prioritizing country-led, context-specific funding strategies integrated across ministerial budgets, global leaders can enable those most affected to lead in developing and implementing solutions tailored to their unique needs. This approach not only addresses immediate health concerns but also strengthens health systems to be more resilient against future threats.
According to the brief prepared by the END Fund and Panorama Strategy, aligning investments with country-specific needs will accelerate progress in both health and climate resilience. The brief urges global donors to focus on two main areas: accelerating investment in high-impact regions and strengthening climate-resilient health infrastructure through multisectoral partnerships.
The Path Forward: Country-Led Solutions and Data-Driven Strategies
The message from Phumaphi and her peers is clear: we can no longer afford to approach health and climate as separate challenges—we must all work together in an integrated manner. Country-led solutions are essential, and nations most vulnerable to climate impacts are uniquely positioned to lead the global climate-health agenda. Phumaphi believes it is vital to amplify these voices. African leaders—whether in government, political, private sector, civil society, youth organizations, or among religious and traditional leaders—must be at the heart of this work to ensure the continent’s priorities are reflected in global policies.
Phumaphi also emphasizes the importance of Africa’s regional collaboration to address cross-border climate and health challenges. By building local capacity, she advocates for supporting innovative programs and community-based adaptation efforts.
Data gaps remain a significant barrier, particularly in low-income regions where climate-sensitive diseases are on the rise. Phumaphi emphasized the need for better tools, including integrated data collection and surveillance systems equipped with effective monitoring and accountability mechanisms. “We must not only develop the tools to monitor,” she says, “but also ensure that our policies, plans and programs reflect this integrated approach.” She highlights that building robust data surveillance systems is crucial for effective decision-making, urging countries to prioritize integrating human, animal, environmental, and other data to better predict and respond to disease transmission driven by climate change.
Phumaphi’s vision extends beyond the immediate future. She sees the potential for a new model of health resilience that is both adaptive and equitable. However, this will only happen if all stakeholders, national and international; rally around the priorities set by countries.
Looking Ahead: What’s Needed Now
To close the conversation, we asked Ms. Phumaphi what it would take to move the needle at COP29 and beyond.
She shared: “To start, all country climate action plans must include a strong health component, with both adaptation and mitigation actions—real-world solutions to address the increasing burden of NTDs and malaria. Moving the needle at COP29 is not just about securing pledges; it’s about achieving real, substantive change that will transform our economies and our societies. Nations must deliver stronger actionable pledges with clear pathways for reaching net-zero by 2050. Even as health is placed at the center of climate discussions—especially given that extreme weather events are increasing the number of people susceptible to malaria—global parties must scale up health and climate financing to ensure health systems are equipped to respond to climate-driven health threats. We need a stronger monitoring mechanism linked to national development plans, budgets, and frameworks, including parliaments and Ombudsman offices to enhance citizen engagement.”
As the world looks to the future, Phumaphi’s words serve as both a warning and a guide. If we are serious about tackling the dual threats of climate change and infectious disease spread, we must prioritize local solutions, invest in resilience, and above all, commit to a more integrated equitable and inclusive approach that leaves no one behind.
