Adapting to a changing environment: inspiration for planetary health from east African communities

The 2021 Lancet Countdown gives a code red for health, as people's health worldwide is increasingly affected by climate change.1Romanello M McGushin A Di Napoli et al.The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future.Lancet. 2021; 398: 1619-1662Google Scholar Trends of environmental degradation and existing health and social inequalities are continuously worsening.The African continent is highly vulnerable to climate change and its related risks. For example, although 2020 marked an alarmingly warm year globally, ranking between the third and eighth warmest year on record,2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar Africa is heating up more and at a faster rate than the global mean.One reason that Africa is particularly vulnerable to climate variability and change is because of the substantial contribution of agriculture to most African economies. For example, almost half of the sub-Saharan African population lives below the poverty line and depends on weather-sensitive activities, such as rain-fed agriculture, herding, and fishing, for their livelihoods.2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar These activities are threatened as climate change continues to increase the frequency, intensity, and duration of extreme weather events that affect food productivity and water security.1Romanello M McGushin A Di Napoli et al.The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future.Lancet. 2021; 398: 1619-1662Google ScholarUndermined food security poses risks to millions of lives in Africa. Compared with the previous year, food insecurity increased by 40% in 2020 and increases by 5–20 percentage points with each flood or drought.2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar The Horn of Africa is particularly affected by recurrent extreme droughts.1Romanello M McGushin A Di Napoli et al.The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future.Lancet. 2021; 398: 1619-1662Google ScholarExtreme weather events, such as floods, droughts, and storms, not only affect food security but also contribute to internal and cross-border displacement. In 2020, around 12% of all new population displace­ments happened in east Africa and the Horn of Africa, with more than 1·2 million displacements related to disasters.2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar These regions are already struggling with conflict and food insecurity, and displacement related to climate change functions as a multiplier of these issues.In addition to climate vulnerability, Africa's adaptive capacity to climate change is considered to be low. Initiatives are largely isolated, autonomous, and reactive to short-term motivation, such as the promotion of drought-resistant crop varieties, solar-powered irrigation schemes, and environmentally friendly heating mechanisms.3Niang I Ruppel OC Abdrabo MA et al.Africa.https://www.ipcc.ch/site/assets/uploads/2018/02/WGIIAR5-Chap22_FINAL.pdfDate: 2014Date accessed: September 22, 2022Google Scholar Incomplete, under-resourced, and fragmented institutional frame­works further inhibit the progress of policy implementation.3Niang I Ruppel OC Abdrabo MA et al.Africa.https://www.ipcc.ch/site/assets/uploads/2018/02/WGIIAR5-Chap22_FINAL.pdfDate: 2014Date accessed: September 22, 2022Google ScholarAlthough this narrative of Africa's vulnerability to and low adaptive capacity for climate change has a degree of truth, it is only part of the story. The dominant global narratives tend to overlook the solutions and innovations coming from Africa. As part of our activities with the Planetary Health Eastern Africa Hub, we encounter many such solutions. For example communities in the urban townships of Lusaka, Zambia, are supporting the use of environmentally friendly and renewable sources of energy for cooking and heating. Their initiative aims to provide a sustainable source of energy through the production and use of improved cook stoves based on saw dust pellets. The use of saw dust pellets reduces pressure on wood fuel (ie, charcoal), which has greatly contributed to unsustainable forest harvesting. The communities are motivated to drive the project forwards through local solutions in an effort to contribute to the reduction of greenhouse gas emissions. At the national level, the Zambian Government has committed to combat the climate crisis through the development of the National Policy on Climate Change, pledging to reduce greenhouse gas emissions by 25% by 2030, relative to 2010 levels.4Lee S Paavola J Dessai S Towards a deeper understanding of barriers to national climate change adaptation policy: a systematic review.Clim Risk Manag. 2022; 35100414Google ScholarIn Kenya, the indigenous communities of Lake Bogoria have shown autonomous adaptive measures to severe flooding.5Puzyreva M Roy D Adaptive and inclusive watershed management: assessing policy and institutional support in Kenya.https://www.iisd.org/system/files/publications/adaptive-inclusive-watershed-management-kenya.pdfDate: August, 2018Date accessed: September 21, 2022Google Scholar Their efforts include awareness and educational programmes on vector-borne diseases, the initiation of natural mosquito and tsetse fly control mechanisms, and the protection of endangered medicinal plants. Community members have further shifted to increased income diversification and resilient food production techniques to counter increasing food insecurity. Formulation, publishing, and implementation of the Kenya National Adaptation Plan 2015–2030 and the Kenya Climate Change Act 2016 and the development of Kenya's second climate change action plan, the National Climate Change Action Plan 2018–2022, together with other strategies and plans related to climate change, continue to guide Kenya's response in adapting to the impact of climate change and reducing greenhouse gas emissions.6Ministry of Environment and ForestryNational climate change adaptation plan 2018–2022.https://www.environment.go.ke/wp-content/uploads/2020/03/NCCAP_2018-2022_ExecutiveSummary-Compressed-1.pdfDate: Aug 17, 2018Date accessed: August 17, 2018Google Scholar In 2020, Kenya revised its commitment on the contribution to abate greenhouse gas emissions by 30% by 2030 by setting out priority actions to reduce greenhouse gas emissions. These actions included policies, programmes, and technologies that would help to drive the country to low carbon emissions.7Asokan SM Obando J Kwena BF Luwesi CN Climate change adaptation through sustainable water resources management in Kenya: challenges and opportunities.https://link.springer.com/referenceworkentry/10.1007/978-3-030-45106-6_148Date: May 21, 2021Date accessed: September 21, 2022Google ScholarAlthough the east African region has made substantial progress in its commitments to address the climate crisis, particularly among local and indigenous communities, moving to implementation is a crucial step.8Jegede AO Human rights implications of the climate change regulatory framework on indigenous peoples' lands in Africa. University of Pretoria, 2014: 3-11Google Scholar Policies at the sector level are needed to meet these commitments. However, insufficient technical capacity to develop multisectoral transformative policy frameworks is a challenge. East Africa continues to face many climatic threats. Communities, policy makers, and government figures are starting to address the climate crisis.9Boyle AD Leggat G Morikawa L Pappas Y Stephens JC Green new deal proposals: comparing emerging transformational climate policies at multiple scales.Energy Res Soc Sci. 2021; 81102259Google Scholar As a result, there is an opportunity to enact policies and laws that increase local communities' adaptive capacity, promote sustainable development, and implement a long-term climate strategy.10Foxon TJ Reed MS Stringer LC Governing long-term social–ecological change: what can the adaptive management and transition management approaches learn from each other?.Environ Policy Gov. 2009; 19: 3-20Google ScholarWe declare no competing interests. The 2021 Lancet Countdown gives a code red for health, as people's health worldwide is increasingly affected by climate change.1Romanello M McGushin A Di Napoli et al.The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future.Lancet. 2021; 398: 1619-1662Google Scholar Trends of environmental degradation and existing health and social inequalities are continuously worsening. The African continent is highly vulnerable to climate change and its related risks. For example, although 2020 marked an alarmingly warm year globally, ranking between the third and eighth warmest year on record,2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar Africa is heating up more and at a faster rate than the global mean. One reason that Africa is particularly vulnerable to climate variability and change is because of the substantial contribution of agriculture to most African economies. For example, almost half of the sub-Saharan African population lives below the poverty line and depends on weather-sensitive activities, such as rain-fed agriculture, herding, and fishing, for their livelihoods.2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar These activities are threatened as climate change continues to increase the frequency, intensity, and duration of extreme weather events that affect food productivity and water security.1Romanello M McGushin A Di Napoli et al.The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future.Lancet. 2021; 398: 1619-1662Google Scholar Undermined food security poses risks to millions of lives in Africa. Compared with the previous year, food insecurity increased by 40% in 2020 and increases by 5–20 percentage points with each flood or drought.2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar The Horn of Africa is particularly affected by recurrent extreme droughts.1Romanello M McGushin A Di Napoli et al.The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future.Lancet. 2021; 398: 1619-1662Google Scholar Extreme weather events, such as floods, droughts, and storms, not only affect food security but also contribute to internal and cross-border displacement. In 2020, around 12% of all new population displace­ments happened in east Africa and the Horn of Africa, with more than 1·2 million displacements related to disasters.2World Meteorological OrganizationState of the climate in Africa 2020.https://library.wmo.int/doc_num.php?explnum_id=10929Date: Nov 22, 2021Date accessed: November 22, 2021Google Scholar These regions are already struggling with conflict and food insecurity, and displacement related to climate change functions as a multiplier of these issues. In addition to climate vulnerability, Africa's adaptive capacity to climate change is considered to be low. Initiatives are largely isolated, autonomous, and reactive to short-term motivation, such as the promotion of drought-resistant crop varieties, solar-powered irrigation schemes, and environmentally friendly heating mechanisms.3Niang I Ruppel OC Abdrabo MA et al.Africa.https://www.ipcc.ch/site/assets/uploads/2018/02/WGIIAR5-Chap22_FINAL.pdfDate: 2014Date accessed: September 22, 2022Google Scholar Incomplete, under-resourced, and fragmented institutional frame­works further inhibit the progress of policy implementation.3Niang I Ruppel OC Abdrabo MA et al.Africa.https://www.ipcc.ch/site/assets/uploads/2018/02/WGIIAR5-Chap22_FINAL.pdfDate: 2014Date accessed: September 22, 2022Google Scholar Although this narrative of Africa's vulnerability to and low adaptive capacity for climate change has a degree of truth, it is only part of the story. The dominant global narratives tend to overlook the solutions and innovations coming from Africa. As part of our activities with the Planetary Health Eastern Africa Hub, we encounter many such solutions. For example communities in the urban townships of Lusaka, Zambia, are supporting the use of environmentally friendly and renewable sources of energy for cooking and heating. Their initiative aims to provide a sustainable source of energy through the production and use of improved cook stoves based on saw dust pellets. The use of saw dust pellets reduces pressure on wood fuel (ie, charcoal), which has greatly contributed to unsustainable forest harvesting. The communities are motivated to drive the project forwards through local solutions in an effort to contribute to the reduction of greenhouse gas emissions. At the national level, the Zambian Government has committed to combat the climate crisis through the development of the National Policy on Climate Change, pledging to reduce greenhouse gas emissions by 25% by 2030, relative to 2010 levels.4Lee S Paavola J Dessai S Towards a deeper understanding of barriers to national climate change adaptation policy: a systematic review.Clim Risk Manag. 2022; 35100414Google Scholar In Kenya, the indigenous communities of Lake Bogoria have shown autonomous adaptive measures to severe flooding.5Puzyreva M Roy D Adaptive and inclusive watershed management: assessing policy and institutional support in Kenya.https://www.iisd.org/system/files/publications/adaptive-inclusive-watershed-management-kenya.pdfDate: August, 2018Date accessed: September 21, 2022Google Scholar Their efforts include awareness and educational programmes on vector-borne diseases, the initiation of natural mosquito and tsetse fly control mechanisms, and the protection of endangered medicinal plants. Community members have further shifted to increased income diversification and resilient food production techniques to counter increasing food insecurity. Formulation, publishing, and implementation of the Kenya National Adaptation Plan 2015–2030 and the Kenya Climate Change Act 2016 and the development of Kenya's second climate change action plan, the National Climate Change Action Plan 2018–2022, together with other strategies and plans related to climate change, continue to guide Kenya's response in adapting to the impact of climate change and reducing greenhouse gas emissions.6Ministry of Environment and ForestryNational climate change adaptation plan 2018–2022.https://www.environment.go.ke/wp-content/uploads/2020/03/NCCAP_2018-2022_ExecutiveSummary-Compressed-1.pdfDate: Aug 17, 2018Date accessed: August 17, 2018Google Scholar In 2020, Kenya revised its commitment on the contribution to abate greenhouse gas emissions by 30% by 2030 by setting out priority actions to reduce greenhouse gas emissions. These actions included policies, programmes, and technologies that would help to drive the country to low carbon emissions.7Asokan SM Obando J Kwena BF Luwesi CN Climate change adaptation through sustainable water resources management in Kenya: challenges and opportunities.https://link.springer.com/referenceworkentry/10.1007/978-3-030-45106-6_148Date: May 21, 2021Date accessed: September 21, 2022Google Scholar Although the east African region has made substantial progress in its commitments to address the climate crisis, particularly among local and indigenous communities, moving to implementation is a crucial step.8Jegede AO Human rights implications of the climate change regulatory framework on indigenous peoples' lands in Africa. University of Pretoria, 2014: 3-11Google Scholar Policies at the sector level are needed to meet these commitments. However, insufficient technical capacity to develop multisectoral transformative policy frameworks is a challenge. East Africa continues to face many climatic threats. Communities, policy makers, and government figures are starting to address the climate crisis.9Boyle AD Leggat G Morikawa L Pappas Y Stephens JC Green new deal proposals: comparing emerging transformational climate policies at multiple scales.Energy Res Soc Sci. 2021; 81102259Google Scholar As a result, there is an opportunity to enact policies and laws that increase local communities' adaptive capacity, promote sustainable development, and implement a long-term climate strategy.10Foxon TJ Reed MS Stringer LC Governing long-term social–ecological change: what can the adaptive management and transition management approaches learn from each other?.Environ Policy Gov. 2009; 19: 3-20Google Scholar We declare no competing interests.