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In 2003, I was hired by the National Environment Authority (NEMA) in Uganda to coordinate an effort to integrate environmental concerns into policies, plans and budgets of all government agencies. It was a tough job. Agencies face overstretched budgets and there were no incentives for the agencies to take on another issue.


Nevertheless, my colleagues and I lobbied hard. In the end, we managed to get an Environment Desk Officer placed at the Ministry of Finance. It was a first. Over the years, the Desk officer succeeded in not only mainstreaming environmental issues into the overall budget framework, but in increasing funding allocations for the Environment. Most recently, the 2019/20 budget includes US$ $53.3 million for conservation of wildlife and tourism up from $8.67 million the year before—more than a six fold increase.


Uganda is not alone in this effort.  When I joined the United Nations Development Programme in 2010, the Poverty and Environment Initiative (PEI) was supporting seven African countries to bring together poverty and environmental programming. Ten years later, the initiative published its results, featuring stories from policy makers in Burkina Faso, Malawi, Mali, Mauritania, Mozambique, Rwanda and Tanzania. These countries have successfully connected the dots between poverty reduction, job generation, inequality, climate change, environmental stress, water energy and food security—and this work highlights what’s possible when integrated thinking overcomes development silos.


We know what happens when this siloed thinking remains: opportunities are missed and efforts are duplicated.


Yet, such progress is far from universal. On September 23rd the UN will be hosting two high-level meetings – one on Universal Health Coverage (UHC) and one on Climate Action. Both meetings will bring together heads of state, political leaders, policy-makers, and champions for their respective issues. One will advocate and plan for health for all, and the other will discuss concrete plans to reduce greenhouse gas emissions by 45 percent over the next decade, to net zero by 2050. One wonders why we need two separate, competing meetings when we know that their central concerns are closely interrelated. Climate change and health are deeply intertwined.


Fortunately, the Access Challenge initiative, which works with national leaders to advocate for equal access to healthcare and education for the world’s most underserved populations will be bridging this gap by focusing its annual high-level conference on the nexus between UHC and climate action. I am excited to participate in this conference on the sidelines of the UN General Assembly, and to hear leaders from across Africa address this crucial nexus


Indeed, the impact of climate change on health becomes clearer by the day. The deadly disease of malaria vividly illustrates the rising health risks of climate change. The Ugandan Health Ministry attributes the rapid rise to prolonged June rains creating an even more fertile breeding environment for the mosquitoes, and mild temperatures causing the disease to appear in regions that were previously malaria-free. Burundi, another East African country, is also currently battling a malaria epidemic.


Malaria kills almost 600,000 people every year – mainly African children under 5 years old—and the number of cases are rising due to climate change. In 2017 there were 219 million cases, up from 217 million in 2016. According to BBC News, there have been nearly six million malaria cases reported by the UN since January this year. In Uganda, one million have been reported in the last two months, which is a 40 percent increase from the same period last year!


The good news is there is increasing evidence of multiple health benefits from addressing climate change, whether through reducing air pollution, changing diets (to more plant-based foods) or other solutions.


For example, the International Energy Agency estimates that a seven percent increase in investments in clean energy could avert three million premature deaths worldwide in 2040! Reductions in methane, a climate pollutant which damages crop growth, could increase annual crop yields by 30–135 million, decreasing the hunger and malnutrition that undermines health!


One PEI case study from Tanzania illustrates how a health solution can deliver climate and education benefits. In Sengerema district, the replacement of wood-burning stoves with biogas plants and modern cook stoves reduced eye infections and coughs originally caused by cooking smoke. The health of women and girls improved, and rather than spend three hours a day gathering fuel wood, they had time for earning income and for education. Meanwhile, the reduction of pressure on the forest supports Tanzania’s action plan to mitigate climate change.


One could argue that it will not be easy to break down the barriers to integration.  These ‘development silos’ have evolved over time and are baked in to government funding structures and planning approaches. But it’s a challenge we must tackle if we are to successfully tackle the twin global challenges of climate change and health.


I am proud that Africa is championing the integrated approach. I hope the global community will emulate its example and that of Access Challenge to seize this opportunity to encourage Health, Environment and Education Ministries to ‘mainstream’ each other’s priority issues in their plans and budgets. And I hope that next year’s Climate Summit will have Universal Health Care as a key agenda item.

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