From Loss and Damage to Health and Justice
The fight for climate justice
For decades, nations vulnerable to climate change championed the fight for climate justice. They led the charge to ensure that the world recognise, and compensate for, the irreversible harm that climate change has already inflicted on lives, livelihoods, and ecosystems in their countries.
Their persistence in gathering evidence of climate-driven losses to lives, livelihoods, and ecosystems and their solidarity in advocating for Loss and Damage to be recognised globally was a political and moral breakthrough.
After nearly three decades of advocacy, at COP27 in 2022, the UN Framework Convention on Climate Change (UNFCCC) formally agreed to establish a Loss and Damage Fund. This idea was operationalised in COP28 with the Fund for Responding to Loss and Damage. As of early 2025, around $700m has been pledged to that fund, although disbursements are far lower.
Health can learn from Loss and Damage
Human, animal and environmental health are inextricably linked; climate change inflicts its most direct and measurable harm across this nexus. From heat-related deaths to disease outbreaks, from malnutrition to mental distress, health is the human face of loss and damage. Yet, while climate negotiators now speak fluently of carbon budgets and adaptation finance, health still lingers on the periphery of policy, finance and negotiation tables.
Africa is leading the way to change this, with the four imperatives for climate x health action.
Equip negotiators with the tools to speak health
Amref Health Africa, together with the Amref International University (AMIU), the African Group of Negotiators Expert Support (AGNES), and with support from the Wellcome Trust, launched the Climate Change and Health Negotiators’ Curriculum — the first of its kind globally.
This curriculum represents the most concrete step yet toward embedding health in climate discourse. It equips African negotiators with the scientific, policy, and advocacy tools needed to make health a priority within UNFCCC processes such as at the upcoming COP30 Belém and in climate finance mechanisms.
As Dr Richard Muyungi, Chair of the African Group of Negotiators, noted during the rollout in Dar es Salaam, the health impacts of floods, droughts, and changing ecosystems are already reshaping lives across Africa — and negotiators must now treat them with the same urgency as loss and damage to infrastructure or livelihoods.
The curriculum’s four modules — Climate-Health Nexus, Communication and Climate Action, Negotiation and Advocacy, and Climate Justice and Health — together build the technical and diplomatic confidence for African negotiators to advocate for health-centred outcomes. In essence, it trains negotiators to make the case that loss and damage to health systems is loss and damage to nations. Read more about the curriculum.
Build the Evidence through Practice
Recognition begins with evidence — and Africa already has powerful examples of how climate action and health protection intersect.
In Pangani District, Tanzania, Amref’s Afya Himilivu Project offers a model of what climate-resilient health systems can look like. Supported by the Irish Embassy, the project integrates climate intelligence into primary healthcare delivery. Community Health Workers are trained in climate-smart interventions and data collection, linked with the Tanzania Meteorological Authority (TMA) for real-time weather and climate information. This empowers communities to anticipate floods, droughts, or high-wind events and adapt health responses accordingly — from preventing waterborne disease outbreaks to maintaining nutrition resilience.
Projects like Afya Himilivu demonstrate how loss and damage to health can be mitigated or prevented — and how targeted investment can transform vulnerability into preparedness.
Pictured left: A community sensitisation session on reproductive, maternal, child and adolescent health, nutrition and climate change in Pangani district, Tanzania (c) Amref Health Africa in Tanzania
Make Health a Negotiating Pillar
Technical training and field evidence must translate into political outcomes. Health should now feature as a standalone pillar in Africa’s negotiation agenda, alongside mitigation, adaptation, and loss and damage. This means:
- Advocating for dedicated financing mechanisms for climate-related health impacts.
- Including health focal points within national climate delegations.
- Integrating health indicators into monitoring and reporting in reporting frameworks including Nationally Determined Contributions (NDCs), National Adaptation Plans, and in loss and damage discussions.
As Dr Francis Namisi of Amref International University (AMIU) notes, Africa’s new curriculum is “a declaration that our negotiators will no longer speak from the margins.”
Health, like loss and damage, must be recognised not as an afterthought but as an obligation for justice.
Anchor the Movement in Justice and Equity
The journey of Loss and Damage taught us that recognition is not enough — it must be anchored in justice.
That means ensuring equitable financing, capacity building, and technology transfer for climate-health resilience. It means global frameworks that treat loss of health as loss of life and dignity, not merely an economic variable.
Pictured left: Destruction in the aftermath of devastating floods in Nairobi, Kenya in 2024 (c) Amref Health Africa/Linda Mwendwa Kariuki
The Climate Change and Health Negotiators’ Curriculum is not just a training tool — it is a turning point. It gives Africa the evidence, language, and leadership to make health the next Loss and Damage. In the next few months it will be put into practice at the 2025 Pan-African Conference on Climate and Health in Kenya, and then in Brazil at COP30 Belém.
If the Loss and Damage Fund recognises what we have already lost, the Climate × Health agenda shows us what we still can save. And by acting now — through curricula, partnerships, and community-centred models like Afya Himilivu — Africa is leading the way to reshape global climate justice.
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