MMillions of people in my country, Malawi, are facing unprecedented existential crises caused by climate change. The frequency of extreme weather events and the enormous impact they have on communities has left government officials like me in a huge dilemma about how to act quickly enough to save lives. In the past three years, we have gone from the worst flooding in recent memory to the worst drought in a decade. The impact has been devastating for communities across the country.
When Cyclone Freddy hit us in March 2023It more than 600 people killedThe cyclone injured many more people, tore families apart, destroyed lives and the long-term effects of disease were even worse. Just over a year later we were in the in the midst of a raging droughtwhich President Lazarus McCarthy Chakwera declared a national disaster in March. Millions of people are facing acute food insecurity, leading to malnutrition and health problems that are endangering lives, not least those receiving long-term treatment for conditions such as tuberculosis and HIV.
NCDs are just that; unlike, say, a virus, you can’t catch them. Instead, they’re caused by a combination of genetic, physiological, environmental, and behavioral factors. The main types are cancer, chronic respiratory disease, diabetes, and cardiovascular disease – heart attacks and strokes. About 80% are preventable, and they’re all increasing, spreading inexorably around the world as aging populations and lifestyles fueled by economic growth and urbanization make unhealthy living a global phenomenon.
NCDs, once seen as diseases of the rich, now have a hold on the poor. Disease, disability and death are perfectly designed to create and increase inequality – and being poor makes you less likely to be diagnosed and treated correctly.
There is a staggeringly low investment in tackling these common and chronic diseases, which kill 71% of the population, yet the costs to families, economies and communities are staggering.
In low-income countries, NCDs – typically slow and debilitating diseases – receive only a fraction of the funding needed to treat them. Attention remains focused on the threats of communicable diseases, but cancer mortality rates have long surpassed the death toll from malaria, TB and HIV/AIDS combined.
‘A common condition’ is a Guardian series reporting on non-communicable diseases in developing countries: their prevalence, solutions, causes and consequences, and the stories of people living with them.
Tracy McVeigh, Editor
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Quick guide A common condition
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The human toll of noncommunicable diseases (NCDs) is enormous and rising. These diseases end the lives of about 41 million of the 56 million people who die each year – and three-quarters of them are in developing countries.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they’re caused by a combination of genetic, physiological, environmental, and behavioral factors. The main types are cancer, chronic respiratory disease, diabetes, and cardiovascular disease – heart attacks and strokes. About 80% are preventable, and they’re all increasing, spreading inexorably around the world as aging populations and lifestyles fueled by economic growth and urbanization make unhealthy living a global phenomenon.
NCDs, once seen as diseases of the rich, now have a hold on the poor. Disease, disability and death are perfectly designed to create and increase inequality – and being poor makes you less likely to be diagnosed and treated correctly.
There is a staggeringly low investment in tackling these common and chronic diseases, which kill 71% of the population, yet the costs to families, economies and communities are staggering.
In low-income countries, NCDs – typically slow and debilitating diseases – receive only a fraction of the funding needed to treat them. Attention remains focused on the threats of communicable diseases, but cancer mortality rates have long surpassed the death toll from malaria, TB and HIV/AIDS combined.
‘A common condition’ is a Guardian series reporting on non-communicable diseases in developing countries: their prevalence, solutions, causes and consequences, and the stories of people living with them.
Tracy McVeigh, Editor
Climate stress is leading to increased displacement and migration to urban areas, putting more pressure on health systems and people’s mental health. Extreme weather events are burdening our health systems with injuries and an increase in diseases such as cholera and malaria. There are also long-term complications in prevention and treatment in health programs due to the loss of essential medical supplies, equipment and infrastructure. The number of deaths is increasing due to these factors. After Cyclone Freddy, we had the worst cholera outbreak ever, which lasted for over a year and more than 1,700 people killed. This year we are fighting malaria, which now accounts for almost 25% of hospital admissions. Women and girls, who already face challenges in terms of equality, access to resources and control over decision-making processes, are disproportionately affected.
But we are fighting back, accelerating our interventions against the most climate-sensitive diseases while building agile and climate-resilient health systems that can withstand the shocks caused by these extreme weather events. We are accelerating the recruitment of health workers and equipping them with tools to address emerging challenges. We are building more health centres, bringing much-needed services closer to the most vulnerable communities. We are using mobile clinics, which can be deployed after emergencies to ensure life-saving health care is available.
As weather patterns change and become more unpredictable and severe, information will be critical. We cannot plan, respond, and be at our best if we cannot identify the challenges we face. Furthermore, existing paper systems pose a significant risk. When Cyclone Freddy flooded through villages in southern Malawi, they took away books and health passports containing citizens’ health data. This has taught us that digitalization is an urgent need in our country. In addition to protecting data, electronic health records will allow us to use vast amounts of information to identify trends and build knowledge that can help us innovate health care, improve the efficiency and quality of care, and better prepare for future disease outbreaks.
We recognize that the people most affected by extreme weather and climate events in places like Malawi and across Africa are also the least responsible for the climate crisis. But I don’t think people understand how serious this is. Those affected live in communities with the least capacity to adapt and mitigate climate impacts, and are often in countries with high disease burdens. These countries and communities, which have contributed almost nothing to the warming of the planet, are paying the highest price: they are paying for that impact now, and they are paying with their lives. It is getting worse, and some of the changes, like migration, are having irreversible and significant impacts on people and their livelihoods.
The biggest emitters must invest more to limit their contribution to the climate emergency. They must also invest more in adaptation measures in areas such as global health, to support countries already suffering the severe impacts of climate change.
Perhaps the gravity of it is not yet clear to those who fund global development. Cop28 had the first ever Health Day, which I hope marked a shift in the global health community to recognise that the impact of the climate crisis is here and will only get worse for the most vulnerable. On the margins of the 79th UN General Assemblytaking place now, it is the first year that Climate Week has health as its main theme. The connection between climate and health has never been more important. While this awareness is a positive step forward, we need to move from talk to action, to funding that allows us to respond now and build climate-resilient systems for the future.
Rich countries can step up efforts to protect health systems and continue progress in the fight against climate-sensitive diseases in countries that are disproportionately affected.
We cannot address the increased risks of the climate crisis alone, and mitigate its exacerbated impacts on vulnerable populations. If we act together now, based on the facts we have, it is possible to avert the worst impacts, support the most vulnerable, and create a fair world for all.