Prioritising climate change and infectious diseases: An interview with Yewande Alimi, One Health Unit Lead at Africa CDC

How does Africa CDC implement a One-Health approach to mitigate the impact of climate change on infectious diseases, and what specific strategies are being prioritised to build climate-resilient health systems in Africa? 

It's important to understand that there is a need for a collaborative approach when it comes to mitigating the impact of climate change on infectious diseases through a One-Health approach. We need to move beyond human health and focus on the impact on agriculture, animal health and, most importantly, the environment. 

At Africa CDC, we apply a One-Health approach to these issues. We prioritise several critical areas as our niche focus. The first is building resilience and adaptation. Despite being the lowest contributor to greenhouse gas emissions, Africa is the most exposed. In addition, Africa is unique because it has many low- and middle-income countries already facing significant health challenges, and these are being exacerbated by climate change. 

When we talk about building effective resilience and adaptation strategies, it’s about making a strong case for developing climate-resilient health systems. For example, with outbreaks resulting from increased rainfall, how can we ensure our WASH services are available? How do we ensure that hospitals implement green practices, especially in waste management? How do we make sure all health systems are climate-resilient? 

I believe early warning systems are crucial, as they offer significant benefits in preventing outbreaks before they affect populations. Strong early warning systems can save both resources and lives. At Africa CDC, we focus on early warning systems and identifying climate triggers that policymakers should be aware of. This includes advising on interventions that could address health challenges arising from climate change.

As regards waterborne diseases such as cholera, strengthening health systems can include stockpiling vaccines and ensuring they are readily available. Enhancing IPC (Infection Prevention and Control) and WASH facilities is also essential to ensure resources are in place. We work closely with partner countries to support the development of vulnerability assessments and adaptation strategies, tying these to our policy recommendations.

In Africa CDC we also focus on research and innovation. During my presentation here in Egypt I highlighted the fact that Africa is quite unique in this context because we have 55 Member States with very different biodiversity and weather conditions. It is therefore really important for us to develop home-grown solutions to be able to address the challenges of climate change and infectious diseases. We have to develop solutions that are equitable, affordable, and accessible to our populations. We are working with Member States to better understand who the most vulnerable populations are, where our policymakers should prioritise their investments and how we can ensure that we use evidence to drive well-informed policies.

Looking at advocacy and awareness, Africa CDC is raising these issues to the highest levels of governance. We are able to address the heads of state and governments of the African Union. Our goal is to ensure that scientific evidence and vulnerability findings are synthesised into policies that can guide our heads of state in prioritising interventions, resources, and policies. This meeting has been fantastic in highlighting the importance of partnerships and collaboration to effectively address climate change issues which impact health.

The COVID-19 pandemic has highlighted the importance of data-driven responses in public health. How does Africa CDC leverage data and surveillance systems to monitor and mitigate the impacts of climate change across the continent?

We have learned from COVID-19 that no one is fully prepared for global events like the COVID-19 pandemic.  We are currently facing climate change, with every day bringing news of record-high temperatures, flash floods, and cyclones in previously unaffected areas. Therefore, we emphasise the importance of preparedness. It is crucial to prepare countries to handle emergencies driven by extreme weather events.

One way we have addressed this is through early warning surveillance systems. The earlier we detect and predict outcomes, the faster we can act to prevent, control, or reduce their impact on the population. Our efforts to strengthen surveillance systems focus on two key areas: event-based surveillance and genomics surveillance.

Event-based surveillance is critical due to challenges with laboratory-based surveillance across the African continent, where there is often insufficient capacity. Our team at Africa CDC has supported countries in improving their event-based surveillance systems. This enhancement allows us to detect signals across human, agricultural, and environmental sectors, verify these signals, and guide countries on how to respond to potential events.

In addition, we are strengthening our genomics surveillance. Climate change affects pathogen evolution, so understanding how pathogens work through genomic sequencing is essential to stay ahead of outbreaks and disease spillovers from animals to humans. At Africa CDC, we aim to link climate events to infectious diseases and outbreaks to inform policy and interventions.

We are currently creating models that combine epidemiological data from our epidemic intelligence team with genomic shifts observed in pathogens and meteorological data. This approach helps us identify the greatest vulnerabilities and determine the most cost-effective interventions for policymakers.

Given your extensive experience in public health leadership, could you share a personal perspective on the challenges and opportunities you see in addressing the dual threats of climate change and infectious diseases in Africa?

In the One-Health space, it is clear that we often approach global challenges unilaterally and in silos. For example, when discussing climate change, we tend to focus solely on its impact on humans, neglecting the interconnectedness of our ecosystem. Healthy humans need healthy plants and animals, as well as a toxin-free environment.

This issue requires a collaborative, multisectoral, and transdisciplinary approach. We have not fully estimated the impact of climate change because it is a moving target, and we are moving with it. We need to work together across sectors, countries, and regions since diseases and climate change do not respect borders.

Learning from the antimicrobial resistance crisis, which disproportionately affects Africa, we have realised that no single solution exists. Addressing such issues requires a collective effort. Conferences like this are crucial. They allow us to share best practices and develop collaborative approaches to tackling climate change.

This type of collaborative approach also offers significant opportunities. We have human and technical resources across countries and regions. Working together, we can build climate-resilient health systems that meet future needs. In addition, this challenge offers a learning opportunity. By documenting and projecting the impacts of climate change, we can highlight the cost of inaction and prepare for potential future scenarios.

Climate change and health provide unique opportunities to communicate technical messages to the public. For instance, promoting the use of recycled products, ensuring proper waste disposal, and educating healthcare workers on effective waste management are key areas where we can engage communities. 

I think that because climate change is so real — you see the floods, you are affected by the floods, you see the drought, your plants are dying — it is more relatable. This is where we can encourage communities to become invested by empowering them with the right messaging. They are our foot soldiers in reducing the impact of climate change. We really need to work with communities because climate change is a clear and visible issue that anyone can understand.

The fact that everyone is witnessing the impact of climate change makes it easier for our technical workers to communicate their messages. It makes our technical messages easy for communities to understand, allowing us to work very closely together. 

The interview took place during a workshop on the impact of climate change on the spread of infectious diseases  organised by ECDC in collaboration with the Egyptian Ministry for Health and Population, held from 21 – 23 May 2024.