Malawi’s Climate Health Crisis: The Rising Threats and Urgent Need for Action

Malawi faces critical health risks due to climate change, with rising temperatures, shifting precipitation patterns, and extreme weather events impacting health outcomes. The Climate and Health Vulnerability Assessment (CHVA) highlights the urgent need for coordinated action to strengthen Malawi’s health system against these challenges.

Malawi is on the frontline of climate change, grappling with a host of environmental challenges that are directly and indirectly impacting the health of its citizens. The Climate and Health Vulnerability Assessment (CHVA) by the World Bank reveals the extent of these challenges, highlighting the interplay between climate hazards and health outcomes in Malawi. With rising temperatures, shifting precipitation patterns, and an increase in extreme weather events, the country's health system is under unprecedented strain.

A Nation at Risk

Over the past 50 years, Malawi has seen its mean annual temperature rise by 0.64°C. This seemingly small increase has significant health implications, especially in a country where the health system is already fragile. The rise in both minimum and maximum temperatures exacerbates conditions such as heat stress and respiratory illnesses. Meanwhile, average annual rainfall has decreased by nearly 100 mm since the 1960s, with the dry season becoming drier and extreme precipitation events becoming more frequent. These changes are projected to continue, leading to more frequent and severe floods and droughts.

Floods, particularly in the low-lying areas along the Lake Malawi lakeshore, are a recurring hazard, affecting around 100,000 people annually. The most devastating floods occurred in 2015, affecting 1.1 million people, displacing 230,000, and causing 106 deaths. On the other hand, droughts are a persistent issue, with the Southern and Central Regions being the most vulnerable. These climate extremes threaten food security, increase the prevalence of waterborne diseases, and strain the already limited health infrastructure.

Health Risks Multiply

The CHVA identifies several health risks that are being exacerbated by climate change. Among the most pressing are nutrition risks, vector-borne diseases, waterborne diseases, heat-related illnesses, air quality issues, and mental health challenges. Malawi’s heavy reliance on rainfed agriculture makes it particularly vulnerable to climate variability. Warmer temperatures and water deficits are likely to worsen food insecurity and nutritional deficiencies. The 2015/2016 droughts, for example, led to a 42% decline in maize production, affecting nearly 40% of the population. Malaria remains a significant health burden, with the CHVA projecting that climate change will alter the transmission dynamics of malaria. While the Southern Region might see a decline in malaria risk by the 2050s, the overall threat remains high.

High rates of waterborne diseases like cholera and diarrhea are exacerbated by extreme weather events. Increased flooding can contaminate water supplies, while droughts can limit access to clean water, both scenarios leading to outbreaks. Rising temperatures are likely to increase cases of heat stress, dehydration, and related health issues. Vulnerable populations, including children and the elderly, are at particular risk. Pollution from airborne particulates is already a major health issue, causing respiratory diseases and deaths. Climate change can worsen air quality, especially in urban areas. The mental health impact of climate-related disasters is significant. Extreme weather events, such as floods and droughts, not only affect physical health but also lead to anxiety, depression, and other mental health issues.

Strengthening the Health System

The CHVA underscores the urgent need to strengthen Malawi’s health system to cope with these growing challenges. The health system faces numerous issues, including staffing shortages, inadequate financing, weak infrastructure, and supply chain disruptions. To build resilience, the report recommends several measures. These include enhanced coordination mechanisms for climate action and the integration of climate-health actions into subnational plans. Creating retention packages for health workers and scaling up training on climate and health are also essential. Improving communication networks for early warning systems and disaster response is another critical step. Supporting community-led initiatives to improve sanitation and hygiene practices to prevent waterborne diseases is vital. Lastly, ensuring strategic purchasing guided by detailed, subnational climate information is necessary for targeted interventions.

Moving Forward

Addressing the intertwined challenges of climate change and health requires a concerted effort from all sectors of society. The findings of the CHVA serve as a critical call to action for policymakers, health practitioners, and communities to work together to build a more resilient health system. With the right strategies and investments, Malawi can better protect its population from the looming threats of climate change.