Effects of Climate Change on Healthcare Access

Climate change represents one of the most pressing global challenges today, with far-reaching implications for human health and healthcare systems. This impact is particularly pronounced in developing nations, Uganda and East Africa inclusive, where healthcare infrastructure is often already strained. This article explores the complex relationship between climate change and healthcare access, with a focus on East and West African nations.

Understanding Climate Change

Climate change refers to significant changes in global temperature, precipitation, wind patterns, and other measures of climate that occur over several decades or longer. These changes are largely connected to rising levels of carbon dioxide and other greenhouse gases in the Earth’s atmosphere, often resulting from human activities (shout out to mass industrialization).

The effects of climate change are already evident worldwide. Rising sea levels threaten coastal communities, food security is increasingly compromised, and ecosystems are undergoing dramatic transformations (consider the rising numbers of extinct species of flora and fauna). Of the top 10 most disaster affected countries in the world, Africa is home to six of these countries with climate change manifesting through increased frequency and intensity of extreme weather events including floods, droughts, landslides, and rising temperatures. In 2023 alone, extreme weather events killed more than 15,000 people, with droughts reportedly affecting more than 88 million people across six African countries.

Healthcare Access as a Human Right

Healthcare access is defined as “the timely use of personal health services to achieve the best possible health outcomes.” This access is critical for overall physical, social, and mental wellbeing, disease prevention, detection and treatment of illness, quality of life, avoiding preventable deaths, and increasing life expectancy.

Now, in Uganda and East Africa, healthcare access faces numerous baseline challenges including workforce shortages, limited to no health insurance coverage, transportation difficulties, and inadequate healthcare infrastructure. These challenges create a precarious foundation upon which climate change impacts are increasingly superimposed.

The relationship between climate change and healthcare access represents an emerging human rights issue. Uganda’s recently launched Climate Change Health National Adaptation Plan (H-NAP) 2025–2030 formally acknowledges the significant threat climate change poses to public health and healthcare delivery in the country. This recognition highlights how climate change directly affects the availability, accessibility, and quality of healthcare services across developing nations.

Climate Change Impacts on Healthcare Access

Increased Disease Burden and Shifting Disease Patterns

Climate change significantly contributes to the spread and intensity of various diseases across African nations. In Uganda alone, climate-related impacts like floods, droughts, landslides, and temperature changes are driving increases in waterborne diseases, vector-borne diseases, malnutrition, and mental health problems often going undocumented.

Vector-borne diseases such as malaria and dengue fever are expanding their geographical range due to warming temperatures, while changing rainfall patterns affect the prevalence of waterborne illnesses like cholera. A cross-sectional study across six African countries (Ghana, Nigeria, South Africa, Namibia, Ethiopia, and Kenya) confirmed high levels of climate-related health impacts as perceived by healthcare professionals. This shifting and expanding disease burden overwhelms already strained healthcare systems, reducing access to timely and quality care for vulnerable populations.

Destruction of Healthcare Infrastructure and Service Disruption

Extreme weather events directly damage healthcare facilities and disrupt essential services across developing nations. Floods damage roads, bridges, and healthcare infrastructure, making it difficult for patients to reach medical facilities and for medical supplies to be delivered. Of course, it goes without saying that most African countries have scarcely built their infrastructure with extreme weather conditions in mind and without proper adaptation mechanisms, this remains a growing challenge.

In West African countries like Ghana and Nigeria, floods have extensively affected healthcare delivery systems, with Nigerian respondents reporting the highest levels of climate change impacts (67.7%) in a regional comparative study. Similarly, droughts in East African countries, particularly Ethiopia and Kenya, have led to resource scarcity that impacts healthcare delivery. These climate-related disruptions disproportionately affect rural and marginalized communities, widening existing healthcare access disparities.

Solutions to Climate-Related Healthcare Access Challenges

Building Climate-Resilient Health Systems

On paper, Uganda’s H-NAP offers a model for building climate-resilient health systems by establishing climate-smart governance structures, enhancing health workforce training, integrating climate information into health programs, and promoting innovative partnerships for resource mobilization. This plan was developed after a Climate Change Vulnerability and Adaptation Assessment conducted across 716 selected health facilities in Uganda, providing an evidence-based approach to climate adaptation in the health sector. This notwithstanding, after close to 2 years, Uganda’s Ministry of Health under the H-NAP protocols is yet to finalise construction of its first Climate Change-Safe Hospital even with the funds having been availed at the get-go. This implies that we might be fighting worse monsters than climate change.

The health sector must prepare its systems, infrastructure, and the communities it serves to build resilience to a changing climate. This includes developing capacity to withstand extreme weather events, deal with rising sea levels, respond to the shifting burden of disease, and deliver essential services to the most vulnerable populations.

Sustainable Financing and Regional Collaboration

Health development assistance, climate finance mechanisms, national health budgets, and private investment must integrate the development of climate-resilient, low-carbon health systems into their financing models. Once again, on paper Uganda’s H-NAP exemplifies this approach, having been developed with financial support from The Rockefeller Foundation and in collaboration with the World Health Organization, demonstrating the importance of international partnerships in addressing climate-related healthcare challenges.

Regional collaboration is also essential, as evidenced by initiatives like the five-year strategic plan for the African region agreed upon by over 80 health and climate change experts in Senegal in 2024. The Clim-HEALTH Africa consortium brings together African technical institutions and international partners to strengthen public health resilience to climate change through evidence-based planning, capacity building, and knowledge sharing.

Conclusion

Climate change poses significant and escalating threats to healthcare access in developing nations, disproportionately affecting vulnerable populations, including low-income earners, ‘omuntu wa’wansi’ as referred to in Luganda, a local language. These impacts are evident in the increased disease burden, infrastructure damage, and resource constraints that further strain already fragile healthcare systems.

Addressing these challenges requires multifaceted approaches, including building climate-resilient health systems, developing sustainable healthcare infrastructure, and strengthening regional collaboration and financing mechanisms.

As climate change continues to intensify, prioritizing the intersection of climate action and healthcare access becomes not just a matter of public health but a fundamental human rights issue/concern. Ensuring equitable healthcare access in the face of climate change requires immediate attention, substantial investment, and coordinated action at local, national, and international levels.

Ricky M. Kasheija