COP 31: Why global climate finance cuts could make Africa sicker

Tanzania's President Samia Suluhu Hassan delivers a speech during the High-Level Segment for Heads of State and Government at COP31 at the Antalya Expo Center in Antalya, Türkiye, on November 11, 2026. [AFP]

As you read this, somewhere in Moyale, northern Kenya, a mother is struggling to feed her malnourished child, unsure where the next meal will come from.

The immediate food crisis in Moyale has several contributing factors, including the raging conflict across the Ethiopian border. The region's exposure to climate shocks is also making an already difficult situation worse.

Thousands of kilometres away, in Antalya, Türkiye, this is increasingly becoming one of the most important conversations at the 31st United Nations Climate Change Conference, COP31.

For two weeks, world leaders, climate negotiators, scientists and public health experts are gathered to confront a crisis that is increasingly being understood not just as an environmental emergency, but also as a public health threat.

According to the World Health Organisation (WHO), approximately 3.5 billion people live in areas highly vulnerable to climate change.

On November 9, the opening day of the conference, the Turkish COP31 Presidency, working with the WHO, convened a dedicated Health Day specifically to examine the growing intersection between climate change and public health.

The programme featured high-level discussions and a ministerial roundtable on strengthening health systems against climate-related risks, improving disease preparedness and mobilising financing for climate-resilient healthcare.

One of the key outcomes in Antalya is the launch of the Antalya Initiative for Health Resilience, which seeks to help countries translate scientific evidence and experience into practical policies and actions to strengthen health systems against climate-related risks.

The health discussions are building on the Belém Health Action Plan adopted at COP30, with the WHO pushing governments to strengthen climate-resilient healthcare systems and improve disease surveillance.

Increasingly, in Kenya and many parts of Africa, climate change is altering the conditions in which people live including the diseases they are exposed to and the state of health systems expected to respond to emergencies.

This year's COP discussions come when Kenya is bracing for another potentially disruptive rainy season. The October–December short-rains season is already underway, with the Kenya Meteorological Department forecasting above-normal rainfall across much of the country due to El Niño and other climate drivers.

The Ministry of Health has repeatedly sounded warnings that flooding could contaminate water sources, increase mosquito breeding and expose communities to diseases including cholera, typhoid, malaria and Rift Valley fever.

In the 2023–2024 El Niño emergency, 43 of Kenya's 47 counties were affected, with 175 people dying and more than 384,000 displaced.

“Climate action must be urgently stepped up to reflect the scale of the emergency. The window of opportunity to avoid a potentially catastrophic future is rapidly closing,” says Dr Maria Guevara of Médecins Sans Frontières (MSF), also known as Doctors Without Borders.

“The health and humanitarian impacts of climate change are real, and they will grow as the world heats up. Every fraction of a degree of warming is a matter of life or death for people in many places in the world,” says Dr Guevara.

At COP31, organisations like MSF are calling for ambitious action to cut greenhouse gas emissions and provide urgent support to enable the most affected countries to adapt and cope with the increasing health impacts.

Dr Guevara says that already vulnerable communities are hit the hardest.

“They are paying with their health and their lives for a problem they did not create. This is a profoundly unjust situation, as the people most affected are not the ones who created this problem in the first place.”

One of the major concerns hanging over the negotiations in Antalya is the growing likelihood that the world will overshoot the 1.5°C temperature limit that countries are striving to keep within under the Paris Agreement.

Dr Yewande Alimi, an expert in surveillance and disease intelligence at Africa CDC attending COP31, stresses the connection between health and climate change.

“As humans, we don't exist in silos; we exist in shared ecosystems. Think about the floods, the droughts and the heatwaves. They all have a way of affecting our health. This is why you cannot divorce health from climate change, and the worst part is that it affects the most vulnerable populations,” notes Dr Alimi.

In its latest Emissions Gap Report, released in October 2026, the United Nations Environment Programme warns that exceeding this threshold is now increasingly unavoidable, although the body says the scale and duration of that overshoot can still be limited through deep and rapid cuts in greenhouse gas emissions.

Africa Centres for Disease Control and Prevention (Africa CDC) says over 50 per cent of pathogenic diseases on the continent are aggravated by climate change, including cholera and malaria.

“While Africa is the least contributor to global warming, it is the most affected continent when it comes to the consequences. This is why we have no option but to make health central to this year's COP31 discussions,” states Dr Wessam Mankoula, Director of Public Health Emergency at Africa CDC.

“It's a good thing that health has been brought to the centre of COP31, but unfortunately, we are still at the talking phase. We need to move beyond declarations, from commitment to actual implementation. This is the real gap we are talking about,” asserts Dr Mankoula.

Climate financing is turning out to be the hottest subject in Antalya, with the WHO saying that more than 90 per cent of countries surveyed identified inadequate financing as a major obstacle to implementing their climate and health plans.

The United States, historically one of the world's largest cumulative greenhouse gas emitters and a major player in climate finance, has withdrawn from the Paris Agreement, with the withdrawal taking effect in January 2026. It has also initiated its withdrawal from the UN Framework Convention on Climate Change, although that move is not due to take legal effect until February 2027. The decision to step back from international climate institutions has raised further questions about the future of US leadership and climate financing.

At the opening of the Antalya Leaders' Summit on November 11, some of the world's most consequential political figures were missing. The leaders of the United States, China and India, three countries central to the global emissions debate, were notably absent from the gathering.

A November 11 analysis by Carbon Brief estimates that annualised public climate-finance pledges from developed countries have fallen by about 70 per cent in 2026, to approximately US$11.7 billion, compared with previous pledged levels of around US$40 billion. The analysis points to the expiry of earlier commitments and the lack of replacement pledges from several major donors, including the United States.

For developing countries already struggling to finance adaptation and healthcare resilience, this raises a major concern over whether the international community can deliver the resources required when some of its most influential players are stepping back.

Soenke Kreft, a senior expert at the United Nations University Institute for Environment and Human Security, says this is another reason why countries like Kenya must stay on the pedals.

“Over the past years, we have seen a drop in assistance and commitments being withdrawn. I think this is all the more reason why it is necessary for developing and African countries to push even harder on the climate-finance agenda,” notes Kreft.

“Africa is not looking for climate sympathy; we are keen on climate justice. We need more resources from the countries that are contributing the most to global warming to support countries that are more vulnerable,” adds Dr Mankoula.

The WHO estimates that climate change could cause approximately 250,000 additional deaths annually between 2030 and 2050 from undernutrition, malaria, diarrhoea and heat stress alone.

The WHO continues to call for deliberate investment in climate-resilient healthcare, which could save millions of lives while generating substantial economic returns.

At COP31, the World Meteorological Organization has also urged closer integration between weather forecasting and public health systems to help ensure that climate information translates into practical medical preparedness.

“It is vividly clear that health cannot be just a side event but must be central to the ongoing COP31 negotiations,” asserts Dr Alimi.

Beyond the effects of extreme weather, another dimension of the climate-health crisis being debated at COP31 is the human cost of air pollution, with the WHO estimating that air pollution contributes to approximately seven million deaths globally each year.

Calls are being made for countries to transition away from highly polluting energy sources to safer alternatives as a matter of urgent public health intervention.

In an earlier address in Antalya, WHO Director-General Dr Tedros Adhanom Ghebreyesus warned about the risk of fragmentation, where each COP presidency introduces new health initiatives while earlier commitments remain underfunded or inadequately monitored.

“But declarations do not protect people. Implementation does,” stated Dr Ghebreyesus at the Ministerial Roundtable on Monday.

For the mother in Moyale, therefore, the discussions in Antalya may seem distant, and she may never know the details of the agreements being debated here.

But the outcomes could determine whether communities like hers have stronger nutrition programmes, more resilient health facilities, better access to clean water and the capacity to respond before a food crisis becomes a wider health emergency.

This story was produced as part of the COP31 Climate Change Media Partnership, a journalism fellowship organized by Internews' Earth Journalism Network, Informed Earth and the Stanley Center for Peace and Security.