A One Health Approach to Climate-Driven Infectious Diseases in Sub-Saharan Africa: Strengthening Cross-Sectoral Responses for Resilient Health Systems
Source abstract
Abstract
Background: Climate change is increasingly altering the distribution and burden of infectious diseases in Sub-Saharan Africa, where ecological diversity, fragile health systems, and widespread poverty heighten vulnerability. The One Health approach, which integrates human, animal, and environmental health, provides a useful framework for addressing these climate-sensitive health challenges; its application in the region remains limited. Methods: This review was conducted in accordance with PRISMA-ScR guidelines and synthesized evidence from 30 peer-reviewed studies published between 2019 and 2025, identified through PubMed, Scopus, Web of Science, and the Cochrane Library. Results: Studies consistently showed that rising temperatures, altered rainfall patterns, and extreme weather events shifted malaria transmission into highland zones, modified schistosomiasis risk through changes in snail habitats, and drove diarrheal outbreaks following flooding. While One Health initiatives such as Ghana’s Climate-Smart One Health framework and university-led programmes in East Africa demonstrated promise, their impact remained constrained by donor dependence, institutional silos, and limited policy integration. Conclusions: To enhance climate resilience, national strategies need to integrate climate-informed surveillance, predictive modelling, and One Health governance. Future research should extend beyond malaria and schistosomiasis, incorporate longitudinal data, and establish standardized metrics for assessing One Health interventions.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Zoonotic diseases and public health · Climate Change and Health Impacts · Parasites and Host Interactions
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Climate Change and Health Division, Research and Transfer Centre “Climate Change and Sustainable Development”, Hamburg University of Applied Sciences, Ulmenliet 20, 21033 Hamburg, Germany
Faculty of Life Sciences, Hamburg University of Applied Sciences, Ulmenliet 20, 21033 Hamburg, Germany
References (68)
Show source-provided references
1. The 2021 report of the Lancet Countdown on health and climate change: Code red for a healthy future10.1016/S0140-6736(21)01787-6 ↗
2. Understanding Compound, Interconnected, Interacting, and Cascading Risks: A Holistic Framework10.1111/risa.13128 ↗
3. Intergovernmental Panel on Climate Change (IPCC) (2022). The Ocean and Cryosphere in a Changing Climate: Special Report of the Intergovernmental Panel on Climate Change, Cambridge University Press.10.1017/9781009157964 ↗
4. Global Change and Emerging Infectious Diseases10.1146/annurev-resource-111820-024214 ↗
5. IPCC (2025, September 12). Chapter 9: Africa. Intergovernmental Panel on Climate Change. Available online: https://www.ipcc.ch/report/ar6/wg2/chapter/chapter-9/.
6. Understanding drivers and uncertainty in projected African precipitation10.1038/s41612-025-01123-8 ↗
7. (2025, October 16). World Malaria Report 2023. Available online: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2023.
8. Megersa, D.M., and Luo, X.-S. (2025). Effects of Climate Change on Malaria Risk to Human Health: A Review. Atmosphere, 16.10.3390/atmos16010071 ↗
9. Yang, G.-J., and Bergquist, R. (2018). Potential Impact of Climate Change on Schistosomiasis: A Global Assessment Attempt. Trop. Med. Infect. Dis., 3.10.3390/tropicalmed3040117 ↗
10. Hydrological Extremes Heighten Vulnerability to Schistosomiasis10.1029/2024EF004659 ↗
11. Climate change and nutrition-associated diseases10.1038/s41572-021-00329-3 ↗
12. Associations between long-term drought and diarrhea among children under five in low- and middle-income countries10.1038/s41467-022-31291-7 ↗
13. Prevalence and associated factors of diarrhea among children under five years of age in the Western Province of Rwanda: Analysis of the Rwanda Demographic and Health Survey (RDHS) 2019–2020
14. Morales, F., Montserrat-de la Paz, S., Leon, M.J., and Rivero-Pino, F. (2023). Effects of Malnutrition on the Immune System and Infection and the Role of Nutritional Strategies Regarding Improvements in Children’s Health Status: A Literature Review. Nutrients, 16.10.3390/nu16010001 ↗
15. Impact of climate change on diarrhoea risk in low- and middle-income countries10.1016/j.envres.2025.122412 ↗
16. Climate Change, Fragility, and Child Mortality; Understanding the Role of Water Access and Diarrheal Disease Amongst Children Under Five During the MDG Era10.1007/s10935-023-00732-4 ↗
17. A generalizable one health framework for the control of zoonotic diseases10.1038/s41598-022-12619-1 ↗
18. The components of “One World—One Health” approach10.1111/tbed.12145 ↗
19. Africa needs to prioritize One Health approaches that focus on the environment, animal health and human health10.1038/s41591-021-01375-w ↗
20. The one health landscape in Sub-Saharan African countries10.1016/j.onehlt.2021.100325 ↗
21. Steps for Conducting a Scoping Review10.4300/JGME-D-22-00621.1 ↗
22. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation10.7326/M18-0850 ↗
23. Munn, Z., Peters, M.D.J., Stern, C., Tufanaru, C., McArthur, A., and Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med. Res. Methodol., 18.10.1186/s12874-018-0611-x ↗
24. Comparison of PubMed, Scopus, Web of Science, and Google Scholar: Strengths and weaknesses10.1096/fj.07-9492LSF ↗
25. Optimal database combinations for literature searches in systematic reviews: A prospective exploratory study10.1186/s13643-017-0644-y ↗
26. Refining Boolean queries to identify relevant studies for systematic review updates10.1093/jamia/ocaa148 ↗
27. Direction and impact of language bias in meta-analyses of controlled trials: Empirical study10.1093/ije/31.1.115 ↗
28. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: Audit of primary sources10.1136/bmj.38636.593461.68 ↗
29. WHO Regional Office for Africa (2023). Climate and Health in Africa Outlook Report 2023, WHO.
30. Strengthening coordination and collaboration of one health approach for zoonotic diseases in Africa10.1186/s42522-023-00082-5 ↗
31. One Health Economics approach to prevention and control of zoonotic and animal diseases—Considerations for South Africa10.1186/s42522-025-00142-y ↗
32. Tepa-Yotto, G.T., Tonnang, H.E.Z., Yeboah, S., Osae, M.Y., Gariba, A.A., Dalaa, M., Adomaa, F.O., Damba, O.T., Kyere, R., and Moutouama, F.T. (2024). Implementation Outline of Climate-Smart One Health: A System-Thinking Approach. Sustainability, 16.10.3390/su16156652 ↗
33. Zoonotic disease preparedness in sub-Saharan African countries10.1186/s42522-021-00037-8 ↗
34. Adekiya, T.A., Aruleba, R.T., Oyinloye, B.E., Okosun, K.O., and Kappo, A.P. (2020). The Effect of Climate Change and the Snail-Schistosome Cycle in Transmission and Bio-Control of Schistosomiasis in Sub-Saharan Africa. Int. J. Environ. Res. Public Health, 17.10.3390/ijerph17010181 ↗
35. Yao, T., Yang, X., Ye, H., Wang, Y., Yu, X., Huang, Y., and Xu, M. (2025). Spatiotemporal patterns and climate-induced macroeconomic burden of malaria in sub-Saharan Africa. BMC Public Health, 25.10.1186/s12889-025-23190-5 ↗
36. Shifting transmission risk for malaria in Africa with climate change: A framework for planning and intervention10.1186/s12936-020-03224-6 ↗
37. Seasonal malaria chemoprevention in Africa and China’s upgraded role as a contributor: A scoping review10.1186/s40249-023-01115-x ↗
38. Schistosomes, snails and climate change: Current trends and future expectations10.1016/j.actatropica.2018.09.013 ↗
39. One Health interventions and challenges under rural African smallholder farmer settings: A scoping review10.1016/j.onehlt.2024.100959 ↗
40. Asare, K.K., Mohammed, M.-D.W., Aboagye, Y.O., Arndts, K., and Ritter, M. (2025). Impact of Climate Change on Schistosomiasis Transmission and Distribution—Scoping Review. Int. J. Environ. Res. Public Health, 22.10.3390/ijerph22050812 ↗
41. How are health systems in sub-Saharan Africa adapting to protect human health from climate change threats? A scoping review and case study10.1016/S2542-5196(24)00075-5 ↗
42. Future directions for One Health research: Regional and sectoral gaps10.1016/j.onehlt.2023.100584 ↗
43. From concept to action: A united, holistic and One Health approach to respond to the climate change crisis10.1186/s40249-022-00941-9 ↗
44. Fever, bacterial zoonoses, and One Health in sub-Saharan Africa10.7861/clinmed.2019-0180 ↗
45. Exploring the interplay between climate change and schistosomiasis transmission dynamics
46. Climate change, malaria and neglected tropical diseases: A scoping review10.1093/trstmh/trae026 ↗
47. Climate change could shift disease burden from malaria to arboviruses in Africa10.1016/S2542-5196(20)30178-9 ↗
48. Agyarko, R.K.D., Kithinji, D., and Nsarhaza, K.B. (2025). Climate Change and the Rise of Emerging and Re-Emerging Infectious Diseases in Africa: A Literature Review. Int. J. Environ. Res. Public Health, 22.10.3390/ijerph22060903 ↗
49. Climate change and malaria: Some recent trends of malaria incidence rates and average annual temperature in selected sub-Saharan African countries from 2000 to 201810.1186/s12936-023-04682-4 ↗
50. Opoku, S.K., Filho, W.L., Hubert, F., and Adejumo, O. (2021). Climate Change and Health Preparedness in Africa: Analysing Trends in Six African Countries. Int. J. Environ. Res. Public Health, 18.10.3390/ijerph18094672 ↗
51. Cham, D., Barrow, A., Shah-Rohlfs, R., and Standley, C.J. (2024). Can global health security frameworks measure One Health implementation in West Africa? A mixed-methods study. BMC Public Health, 24.10.1186/s12889-024-19617-0 ↗
52. An Overview of Climate Changes and Its Effects on Health: From Mechanisms to One Health10.1016/j.jaip.2024.12.025 ↗
53. A One-Health approach to non-native species, aquaculture, and food security10.1016/j.watbs.2024.100250 ↗
54. Chapter Two—Food- and vector-borne parasitic zoonoses: Global burden and impacts10.1016/bs.apar.2023.02.001 ↗
55. Prata, J.C., Ribeiro, A.I., and Rocha-Santos, T. (2022). Epidemiology of disease through the interactions between humans, domestic animals, and wildlife. One Health, Academic Press.
56. Climate change and contagion: The emerging threat of zoonotic diseases in Africa
57. Massengo, N.R.B., Tinto, B., and Simonin, Y. (2023). One Health Approach to Arbovirus Control in Africa: Interests, Challenges, and Difficulties. Microorganisms, 11.10.3390/microorganisms11061496 ↗
58. Temperature and transmission of chikungunya, dengue, and Zika viruses: A systematic review of experimental studies on Aedes aegypti and Aedes albopictus10.1016/j.crpvbd.2023.100139 ↗
59. Lupu, A., Gavrilovici, C., Lupu, V.V., Cianga, A.L., Cernomaz, A.T., Starcea, I.M., Mihai, C.M., Tarca, E., Mocanu, A., and Fotea, S. (2023). Helicobacter pylori Infection in Children: A Possible Reason for Headache?. Diagnostics, 13.10.3390/diagnostics13071293 ↗
60. Environmental Impacts on COVID-19: Mechanisms of Increased Susceptibility10.5334/aogh.3907 ↗
61. Milici, A., and Talavera, K. (2021). TRP Channels as Cellular Targets of Particulate Matter. Int. J. Mol. Sci., 22.10.3390/ijms22052783 ↗
62. Molecular Mechanism of TRP Channels10.1002/j.2040-4603.2013.tb00486.x ↗
63. Romero-Mesones, C., de Homdedeu, M., Soler-Segovia, D., Gómez-Ollés, C., Espejo-Castellanos, D., Ojanguren, I., Saez-Gimenez, B., Cruz, M.-J., and Munoz, X. (2024). The Impact of the Reduction in Environmental Pollution during COVID-19 Lockdown on Healthy Individuals. Toxics, 12.10.3390/toxics12070492 ↗
64. Africa CDC (2025). Climate Change and Health: Strategic Framework 2025, Africa CDC.
65. Brink, N., Mansoor, K., Swiers, J., Lakhoo, D.P., Parker, C., Nakstad, B., Sawry, S., Aunan, K., Otto, I.M., and Chersich, M.F. (2024). Scoping Review of Climate Change Adaptation Interventions for Health: Implications for Policy and Practice. Int. J. Environ. Res. Public Health, 21.10.20944/preprints202411.0542.v1 ↗
66. Facilitators and Barriers in the Implementation of a Digital Surveillance and Outbreak Response System in Ghana Before and During the COVID-19 Pandemic: Qualitative Analysis of Stakeholder Interviews10.2196/45715 ↗
67. Richards, S., Knight-Jones, T., Angombe, S., Becker, J., Bukachi, S., Chirenda, J., Araujo, L., De Nys, H., Desta, H., and Fafetine, J. (2024). Towards Institutionalization of One Health in Eastern and Southern Africa. One Health Cases, ohcs20240007.10.1079/onehealthcases.2024.0007 ↗
68. Enhancing Global Health Security in Sub-Saharan Africa: The case for integrated One Health surveillance against zoonotic diseases and environmental threats10.1016/j.onehlt.2025.101136 ↗