By Endashaw Aderie
As global leaders prepare for the Africa Climate Summit and set their sights on the upcoming United Nations Climate Change Conference (COP30) this November, the public discourse will be dominated by high-level negotiations and bold commitments.
But for communities in our own backyard in Eastern Africa, the climate crisis is not a distant future threat; it is a present-day health emergency, increasingly visible in the surge of forgotten diseases across our region.
Every day, in some of the most climate-stressed and conflict-affected parts of Africa, we witness a silent yet devastating reality: climate change is not only intensifying emergencies, but also accelerating the spread of deadly, neglected tropical diseases (NTDs).
These diseases have long plagued the world’s most vulnerable communities, but today, rising temperatures, erratic rainfall, and extreme weather are reshaping their geography and increasing their impact.
These growing issues related to climate and health coincide with a significant, devastating reduction in humanitarian and development aid that will further exacerbate existing health issues in the region.
Médecins Sans Frontières / Doctors Without Borders (MSF) teams on the ground are witnessing this reality unfold in real time. Climate shocks and fragile health systems are combining to create a deadly cycle of illness and neglect.
In the arid landscapes of northern Kenya, prolonged droughts and unpredictable rainfall force pastoralist communities to travel further for water and grazing land, bringing them into closer contact with disease vectors such as sandflies, which transmit kala azar. In flood-prone wetlands of South Sudan, severe flooding has expanded the habitats of freshwater snails that transmit schistosomiasis.
Spike in cases
In late 2024, a significant surge in kala azar (visceral leishmaniasis) swept through Marsabit and Wajir counties in Kenya. By mid-May 2025, there were 347 cases of kala azar, and five deaths recorded in Marsabit, while Wajir documented 994 cases and 40 deaths, with children under five accounting for most of the cases.
Kala azar is a deadly parasitic disease transmitted by sandflies that thrive in hot, dry conditions, conditions which are intensified by climate change.
It causes prolonged fever, severe weight loss and spleen enlargement, and is fatal in over 95 per cent of cases if left untreated; kala azar is second only to malaria among parasitic diseases.
The disease is difficult to detect, poorly understood by many communities, and often faces delays in treatment due to a global shortage of test kits and medication.
Even where MSF can provide treatment for patients and training for health staff, underlying drivers such as environmental change, poor vector control, and lack of health system capacity continue to fuel the spread.
Schistosomiasis
Just across the border, in the remote town of Old Fangak in Jonglei state, South Sudan, another neglected disease is widespread: schistosomiasis.
Old Fangak is prone to frequent and severe flooding, creating ideal conditions for the disease, which is caused by parasites found in freshwater snails living in lakes and rivers.
A 2022 MSF survey revealed that at least 84% of schoolchildren in Old Fangak carry eggs of the parasite.
Despite the high prevalence, there have been few mass drug administration campaigns in the region, mainly due to its inaccessibility.
MSF teams suspect that many women and girls in Old Fangak may be suffering from advanced schistosomiasis, specifically female genital schistosomiasis, a severe and neglected form of an already neglected disease.
MSF teams provided care at the Old Fangak hospital until it was bombed by two gunship helicopters this May, destroying the pharmacy and vital medical resources, rendering provision of medical care in the facility impossible.
The situation in Jonglei is a microcosm of a broader issue across Eastern Africa. Climate change is creating the ideal conditions for neglected diseases to thrive; however, conflict and a global lack of attention prevent an adequate response.
The most vulnerable people, pastoralists, women, and children continue to bear the brunt of this neglect. Neglected diseases remain absent from the climate policy agenda and are barely mentioned in climate-health plans and even less in climate adaptation funding.
Ripple effects
Climate-related events, whether floods, droughts, or heatwaves, are rarely single crises. They trigger cascading effects: crop failure, water scarcity, malnutrition, and ultimately, a surge in diseases that prey on weakened bodies.
In our work, we see kala azar and schistosomiasis emerge alongside cholera, malaria, and acute malnutrition.
We deploy mobile medical teams to reach isolated villages, integrate water, sanitation, and hygiene measures into our medical response, and train local health workers to detect and treat these diseases early.
But these life-saving interventions are not enough without systemic change.
Neglected tropical diseases are highly climate-sensitive and underfunded. Excluding them from climate strategies misses chances to protect vulnerable populations, with costs including loss of lives, livelihoods, schooling, and increased poverty.
Ignoring these diseases also threatens global health security as climate change expands habitats and NTDs spread to new areas. We cannot afford to wait for this expansion before acting.
The need for integrated, climate-resilient health systems is urgent.
At MSF, we are incorporating climate risk into our operational planning. This means pre-positioning medical supplies before floods cut off communities, tracking environmental indicators that may signal an outbreak, and pushing for NTDs to be recognised as frontline indicators of climate impact.
We know that treating the sick today is essential, but unless we address the structural and environmental conditions driving these outbreaks, tomorrow will bring more of the same, only worse.
The Africa Climate Summit and COP30 offer a rare opportunity to alter our course. We call on leaders, negotiators, and donors to acknowledge that climate change is not merely an environmental issue; it is a public health emergency, and NTDs are among its most urgent warning signs.
combating climate-health crisis
The solutions are evident, but they demand a fundamental shift in perspective. We must move past considering these as "diseases of poverty" and recognise them as symptoms of a deepening climate-health crisis.
1. Inclusion of NTDs in climate adaptation strategies — National adaptation plans must account for climate-sensitive diseases, with dedicated funding for surveillance, prevention, and treatment.
2. Investment in resilient health systems — Facilities in climate-vulnerable regions must have the capacity, staff, and resources to respond to multiple overlapping crises.
3. Cross-sector collaboration — Health, water, sanitation, and climate policies must be aligned. Medicines alone cannot stop NTDs; they require clean water, improved housing, and stable health infrastructure.
Climate change is reshaping the landscape of diseases. The stories from Marsabit, Wajir, and Old Fangak are warning signs of what is to come if we do not take action. For Eastern Africa’s most vulnerable communities, NTDs are also a measure of our collective readiness for the crises ahead.
By integrating climate and public health action, focusing on the diseases most susceptible to environmental change, we can safeguard more communities. It is time to act now, before these silent crises escalate into uncontrollable disasters.
If we fail to act, we will witness more frequent outbreaks, increased human suffering, and a heavier humanitarian burden in the years to come.
The author Endashaw Aderie, is a Senior Health Advisor, Médecins Sans Frontières / Doctors Without Borders (MSF)
Disclaimer: The views expressed by the author do not necessarily reflect the opinions, viewpoints and editorial policies of TRT Afrika.
