Just a few months ago, we were reporting from Nigeria, Niger and Chad on the most severe droughts in years. In the meantime, the situation has gone to the other extreme: These very countries are now affected by severe flooding. For people, there is hardly a breather between one crisis and the next.

Most such climate hotspots are the countries where we operate. Many of them are on the African continent, where this year's World Climate Conference (COP 27) is also taking place. In our projects, we see people experiencing the health impacts of the climate crisis firsthand.

Environmental injustice needed

Humanitarian needs will grow beyond what Medecins Sans Frontieres (MSF) and other humanitarian actors can handle. Ambitious climate action, sustainable adaptation measures, and concrete and comprehensive support for dealing with damage and loss are needed.

We demand from the political representatives at COP 27, who are making decisions in Sharm el-Sheikh that will affect the health of millions of people:

1. Sufficient financial and technical support to address damage and loss, especially for those countries and people most affected. This must not involve the use of humanitarian aid funds.


2. More ambitious and binding commitments from states, companies, and sectors primarily responsible for historical, current, and future emissions to keep global warming below 1.5 C.

The climate crisis must not be allowed to become an even greater humanitarian crisis. We need real climate justice for our patients now.

The climate crisis is a threat to human health. But not all people are affected equally.

As is so often the case, the people whose behavior contributes least to the climate crisis bear the greatest burden of the consequences. They pay with their health and, in some cases, with their lives.

More often than not, the climate crisis is hitting the most vulnerable. The difference between 1.5 C and 2 C or even 2.7 C global warming by 2030, as projected last year by the U.N. Environment Program, is life-threatening for many people around the world:

Drought means malnutrition

According to The Lancet Countdown on Health and Climate Change, the policy brief for MSF 2022, in 2020 heat waves resulted in more than 98 million people experiencing moderate to severe food insecurity. Prolonged droughts, such as those in the Sahel region in Burkina Faso this year, mean that there is neither enough drinking water for people and animals nor sufficient irrigation for fields, so the soil dries out and harvests are smaller.

Food supplies are then depleted early in the year, which can lead to malnutrition. Due to changing rainfall and a rise in temperature, the infection period of malaria, for example, is extended. Today, in some parts of Mozambique, there is a year-round risk of contracting malaria, rather than just during the rainy season.

Destruction by extreme weather

Tropical cyclones can become more frequent and stronger, as was the case in Madagascar at the beginning of the year with two successive cyclones. Hospitals were destroyed and many patients temporarily had no access to healthcare.

Sometimes, however, people have no choice but to flee, as in southern Somalia, where many have been forced to leave their homes due to drought and prolonged conflict.

Particularly for those living in poverty and conflict contexts, people without social protection, and people who lack access to or are excluded from basic health care — in other words, our patients — a life-changing difference can be made here.

Every fraction of warming averted reduces death and suffering in the humanitarian contexts in which we work.

Act now

Here, the consequences of the climate crisis are already a reality: many human lives, (health) infrastructures, houses, schools, farmland, cultural and spiritual places have been destroyed.

There, it is no longer just a matter of stopping climate change. Where we can, we must mitigate the consequences for people and their health. Especially through simple adaptation measures, such as building a dam or cleaning up water sources.

But if it's too late for that, we have to pay for the reconstruction after the destruction. Here we see mainly the countries that contribute most to the climate crisis, the G7 countries for example, as being responsible.

Elisa de Siqueira is a Humanitarian Advocacy Officer working on climate crisis for MSF office in Germany.