Can EU-Africa pledges translate into resilient health systems?

As climate shocks intensify across Africa, health systems are feeling the strain. From heat-related illness to climate-related infectious diseases like malaria, dengue, cholera and Zika, underfunded and collapsing health systems face a raft of challenges.

At the 7th European Union-African Unio summit held in Luanda, Angola in late November, the two blocs committed to working together to boost climate-resilient health systems, as well as better preparedness for climate shocks on the continent.

For the past half a decade, health has been a central topic not only at the Luanda summit but at several regional and global summits and conferences.

But the EU-AU summit's latest pledges raises a critical question: can diplomacy translate into resilience on the ground?

Health elevated as a climate priority

The two blocs agreed to strengthen pandemic preparedness, prevention and response and supporting the development of local manufacturing of medical products in Africa.

"We support the Africa Pooled Procurement Mechanism in the health sector and health financing that is predictable, domestic, innovative and blended, to ensure sustainability," reads part of the communique.

Building a more self-reliant, resilient health system in Africa and health partnerships between African health institutions like the Africa Centres for Disease Control and Prevention (Africa CDC) and European institutions is a priority for the two blocs.

A climate-resilient health system in Africa

Hajar Chams Eddine, senior researcher in the Resilience Programme, IMAL Initiative for Climate and Development, a think tank based in Rabat, Morocco, says a strong African climate-resilient health system prioritises workforce development to achieve effective implementation within a wide geographical coverage.

"It ensures health sovereignty with robust data systems owned and managed by relevant African and national institutions," she tells African Business.

"It enhances connected early warning systems across the continent and benefits from experience sharing across countries in terms of health surveillance, readiness, and preparedness for disasters."

Eddine says it also embeds indigenous communities' practices in policy and programme designs and respects local contexts and existing systems.

Mattias Soderberg, a global climate lead at DanChurchAid, a Danish humanitarian organisation, says a resilient health system in Africa must go far beyond clinics and hospitals.

"Firstly, we need mitigation to avoid many future diseases and health-related challenges. Science shows clear links between many types of illness and increasing temperatures and thus mitigation is crucial," he says.

"Secondly, we need adaptation to secure livelihoods and people. Without adequate adaptation people will face loss and damage which may force them to leave their homes. And we know migrants face increasing health-related risks."

Soderberg says without proper adaptation risks will rise - for example, a lack of efficient waste water management in relation to flooding could lead to cholera outbreaks and diarrhea.

"That means that buildings, infrastructure and supply chains are adapted to the effects of climate change," says Soderberg.

Making pledges a reality

The WHO estimates the direct cost of health damage to be between $2-4bn per year by 2030 in vulnerable countries.

African countries lost up to 5% of their gross domestic product on average, with many of them forced to allocate 9% of their budgets to deal with climate extremes, according to the World Meteorological Organization report.

Yet Africa receives a paltry 5% of global climate finance and just a fraction of it is towards the medical sector.

The EU is providing funding to medical systems in Africa through the Global Gateway Africa-Europe Investment Package, which is being implemented through Team Europe Initiatives. This initiative has mobilised €150bn for sustainable projects in key areas including green energy, digital connectivity, education and job creation.

Africa's health systems have been largely affected by United States funding cuts in January 2025, followed by funding cuts from some European countries.

Soderberg says to build a climate resilient health system in Africa, more funding is needed.

"That is one of the key challenges when we talk about climate action. Most countries have national climate plans to ensure a green and resilient transition but money is missing," he says.

Many African countries have national adaptation plans (NAPs) which recognises health as a critical and vulnerable sector and the need to build climate resilient systems, but without funding these plans cannot be implemented.

At the EU-Africa summit in Luanda, marking the 25th anniversary of the AU-EU partnership since the inaugural Summit held in 2000, in Cairo, the EU committed to support these NAPs emphasising on climate resilient health systems and better preparedness for climate shocks.

Eddine says in parallel, EU-AU cooperation should address structural constraints through joint innovative finance efforts to deliver outcomes.

"Moreover, there is an important need for climate-resilient health commodity manufacturing support on African soil, where fair technological transfer is necessary to build long-term sustainable capacity," she says.