Climate change, health and environmental policy in Africa: structural constraints, regional disparities and global inequities.

Africa experiences a disproportionate burden of climate-related health impacts. Yet it contributes minimally to cumulative global greenhouse gas emissions. Rising temperatures, ocean acidification, sea level rise, ecosystem degradation, and environmental pollution increasingly shape food insecurity, infectious disease risk, and population wellbeing. In the last decade, global policies have advanced ambitious agendas to mitigate the impacts of climate change. However, those strategies are mainly defined by high-income countries, which depend on institutional, infrastructural, and financial capacities that are unevenly distributed between the so-called "Global North" and "Global South." Hence, the direct transfer of global policies to African settings often misaligns with local realities, reinforcing vulnerabilities rather than promoting resilience. This review provides an African perspective of climate-related health impacts, highlighting structural constraints that compromise the capacity of this continent to effectively respond. The increasing prevalence of food insecurity, nutritional deficits and vector-borne disease outbreaks reveals fundamental differences in the buffering capacity and the feasibility of climate strategy implementation in relation to advanced economies. The need to formulate and operationalize policy frameworks grounded in African realities becomes essential to protect population health, enable effective adaptation to climate-related alterations and impact, in addition to support the sustainable development of this continent.