
A new report on health and climate change paints the grimmest picture yet about what’s going on – not just that 2024 was the hottest year on record, but evidence that many governments have stopped even pretending to try to do anything about it.
The 2025 Lancet Countdown on Health and Climate Change finds that more than half a million people die every year from heat-related causes, up 23 percent since the 1990s. Air pollution just from wildfire smoke was linked to 154,000 deaths in 2024. And 2.5 million people die every year because of the continued burning of fossil fuels, the report says.
But Dr. Tafadzwa Mabhaudhi, Professor of Climate Change, Food Systems, and Health at the London School of Hygiene and Tropical Medicine, and Director of the Lancet Countdown in Africa, says it’s not all bad news. Communities, people acting in groups, city governments, and others can make a difference.
“We do have the power,” says Tafadzwa, who joins One World, One Health host Maggie Fox in this episode to talk about the report and what he sees for the future.
African nations, especially, have the opportunity to show the way as they build cities that take advantage of clean energy, says Tafadzwa, who is also a professor in the Department of Plant and Soil Sciences, Future Africa, at the University of Pretoria in South Africa.
The report finds hope in this trend, and estimates 160,000 lives are being saved annually as communities shift away from coal and enjoy cleaner air.
Listen as Tafadzwa describes some of the successes in fighting climate change and what people and communities can do to encourage their governments to act.
Maggie Fox 00:03
Hello and welcome to One World, One Health, with bite-sized insights from people working to solve some of the biggest problems facing our planet. I’m Maggie Fox. One Health means we’re all one — animals, plants, and people, and the climate and environment.
A new report on climate change and health paints a scary picture. The Lancet Countdown on health and climate change notes that 2024 was the hottest year on record. More and more people are dying because of this extra heat, more than half a million a year now, since 2012. Wildfires and droughts are killing even more people, and the changes are helping the spread of insects that carry diseases from malaria to dengue, but governments are doing shockingly little to stop this.
In 2023, governments around the world spent nearly a trillion U.S. dollars to subsidize fossil fuels. Fossil fuel companies are increasing production, not cutting back. The U.S. withdrew from the Paris Climate Agreement, which was steering countries towards at least some efforts to stop the trend, and the U.S. pulled its membership of the World Health Organization, badly damaging efforts to fight the health effects of climate change. This report calls for immediate and old action. It doesn’t look like it’s coming, but some of the report’s authors do see some hope. City governments have some control, the report finds. So do individuals and communities.
In this episode, we’re chatting with Dr. Tafadzwa Mabhaudhi, professor of climate change, food systems, and health at the London School of Hygiene and Tropical Medicine, and he’s the director of the Lancet Countdown in Africa. He sees action on climate change as an opportunity to drive development and create jobs. Professor Tafadzwa, thank you for joining us.
Tafadzwa Mabhaudhi 02:00
Thank you very much for having me, Maggie.
Maggie Fox 02:04
This is a really dire report. It’s also broad, and we don’t want to get into all its details in our conversation today, but can you very quickly run us through some of the top lines of what it says?
Tafadzwa Mabhaudhi 02:16
I think the top lines for what it says, pretty much you mentioned the dire state that we find ourselves, especially in terms of the impacts on human health, the rising mortality from climate change, the agency to act, especially on issues of heat health and increasing mortality linked to heat health and increasing mortality linked to air pollution, which is then quite critical In terms of energy generation, and the shift to renewables.
Maggie Fox 02:44
But it sounds like most governments are not taking nearly enough action. And this is despite years and years of quite specific warnings about what needs to happen!
Tafadzwa Mabhaudhi 02:57
Very correct. We are seeing an issue where governments and many governments are backtracking commitments. There’s a regression in terms of commitments that have been made, or a lack of political will to fulfill certain commitments or even undoing them altogether. So that’s quite frightening, given the agency that we need to be acting in. But then, now the sudden lack of commitment.
Maggie Fox 03:20
So, this report calls for some opportunities for individual people and for city governments. That’s intriguing. Can you tell us a little bit about that? What can cities do?
Tafadzwa Mabhaudhi 03:33
Cities can do a lot, because cities are actually where people live. It’s actually the space in which people interact with climate change, it’s the space where issues such as heat health are experienced by people, air pollution is experienced by people, and land use change in terms of loss of green spaces and so forth, is experienced by people. So it’s got that direct interface with people experiencing climate change, and in that regard, cities within their town planning remit, within their climate action remit, have a lot of actions that they can take in terms of, for example, protecting and encouraging green spaces to both address the issue of human well-being from a mental health perspective, as well as also addressing the issue of heat islands in cities, in terms of sensitive special plan, cities can also come up with very health centered action plans to a lot of things, transport, decarbonization, encouraging the use of public transportation, which then they can also support public transportation in the form of electric transportation to reduce air pollution in the city area. So, cities have a lot of power in this space.
Maggie Fox 04:44
Do they have enough power to balance some of the inactions of national governments?
Tafadzwa Mabhaudhi 04:51
I think it’s accumulative action that if cities act together in unison, the aggregate effect of the cities can be quite significant if they all follow on each other, especially transitions, terms of public transportation, green spaces, heat action plans and things like that that can aggregate, we know for a certain that the national government usually responds to things that have public support.
So, cities are key in galvanizing massive public support; they are key in terms of providing case studies of what can work and the aggregated impact of that can then force the national government to respond in terms of policy and then support those interventions.
Maggie Fox 05:35
So how do the cities get organized to act together?
Tafadzwa Mabhaudhi 05:38
I think there are already several bodies of cities globally coming together, progressive cities that are coming together under the resilient cities umbrella.
Maggie Fox 05:50
Are there other organizations that can do something about this? I know there’s, you know, the Paris Climate Agreement. There are these annual Conference of the Parties (COP) meetings that people talk about, are there functions there?
Tafadzwa Mabhaudhi 06:03
I think COP is a separate base on its own. You know that has evolved into something else, too, very relevant in terms of guiding global disclosure, but the action needs to be local. So, we are talking a lot about locally led actions, responding to global challenges, and that is where cities and individuals become champions, in this context.
Maggie Fox 06:26
The report also talks about litigation, and I thought that was interesting. People, especially youth-led groups, are suing governments to get them to do the right thing. Can you talk a little bit about that?
Tafadzwa Mabhaudhi 06:29
So, in July this year, the International Court of Justice passed a landmark advisory opinion, basically reinforcing the obligations of national governments to prevent significant harm from climate change for their citizens. And that case was brought by a group of young law students, youth in particular. So, it was not championed by anyone with a very high profile. It was young people taking matters into their own hands, leading to what has now become a globally significant landmark judgment.
Maggie Fox 07:13
And then there was also a case in South Africa, the South African “Cancel Coal” case, and that was a youth-led group that challenged the South African government’s plan to add some more coal-fired power stations to the national grid. Briefly, was that kind of action useful, too? Because they won, right?
Tafadzwa Mabhaudhi 07:34
Yes, they won. So that was also significant, because that reinforced the constitutional provision in South Africa that citizens have the right to a safe and healthy environment, of which the coal mining expansion was then undermining that right to a healthy environment. So again, it shifted power back to the people to ensure that, through advocacy and collective action of individuals, they can even challenge the state, where the state is no longer acting in the best interests of its own citizens.
Maggie Fox 08:06
What are some other examples of opportunities in Africa, specifically?
Tafadzwa Mabhaudhi 08:13
The opportunities in Africa in terms of transitioning to renewables, so we’ve got very high mortality from air pollution linked to fossil fuels. South Africa, in particular, has the highest rates of fossil fuel-based air pollution mortality. So the transition from fossil fuels to renewable energies could have significant implications on the quality of air; the quality of health of people; as well as creating new green and sustainable jobs, there is also significant potential for agriculture in Africa, which is heavily impacted by climate change, and we know that rising creatures and increasing dryness is creating cycles of food insecurity, which have implications on people’s health. We could transform the agri-food system in Africa to become healthier, more resilient, both for people and for the planet, and decarbonize the footprint of greenhouse gas emissions, which is also increasing, in a way.
There’s also opportunity in terms of how Africa, which is still urbanizing, builds its new cities. Europe has already built its cities. Africa is still building its cities, and we could build our cities in a way that integrates nature and people in a more sustainable way that mitigates issues such as heat, issues such as land use change, loss of trees, and so forth.
Maggie Fox 09:37
What exactly would that look like? Can you give some examples of what a more sustainable city might look like?
Tafadzwa Mabhaudhi 09:42
I’ll give you an example of what has been happening in South Africa, in Durban. One example is that long back they set up what is called the Durban’s Metropolitan Open Space System or D’MOSS. This system protects and preserves natural Areas just for the benefit of nature and people. And these natural areas are quite huge, and if you live within or close to those areas, you cannot order land use. You cannot change the function of the land so that it protects nature, and then the ecosystem services that nature provides benefit people. In many ways,
There’s also massive land use restoration, where old land fields are being converted and rehabilitated, planting indigenous trees, reintroducing or extending them to what the original land use was. In those areas, there’s reclamation of riparian zones, again, tree planting in riparian zones, and introduction of agroecology within the urban and peri-urban space to be able to produce food in terms of agriculture, but sustainably, in a way that balances the environment and the need for people to access healthy food within the spaces where they are located.
So, it’s small, it’s happening in one place, but they are very good examples that with more effort and deliberate action could actually be scaled. Again, they are good examples of lessons coming out of Cape Town following their near experience with Day Zero, and now they’ve progressed since that issue of Day Zero and are almost running dry. The lessons in terms of water conservation, responsible citizens in terms of conserving water. So, I think there’s a lot that is happening that we can galvanize and learn from each other and scale.
Maggie Fox 11:32
Tell us a little bit more about “Day Zero” in Cape Town. I’m not sure if I’m familiar with it.
Tafadzwa Mabhaudhi 11:39
So, Day Zero refers to when Cape Town went through a successive series of droughts, which meant that the city’s dams and reservoirs were almost at the point of running dry, and we had a national countdown towards that Day Zero, when the city would have no water. And what happened was a massive collaboration between the citizens in the city, between civil societies, and all groups, to raise awareness. People improved their water use conservation, reduced their water use household water use levels, and prolonged or delayed day zero until the rains came, and since then, even though they escaped that fate, the citizens have not shifted from that response and that responsibility, and understanding of their role in mitigating the crisis.
Maggie Fox 12:33
So, it was literally collective action, people just being more responsible. It wasn’t some big technology that came in. It was just people learning how to manage water better.
Tafadzwa Mabhaudhi 12:46
Exactly! So it was not technology, it was not policy. It was just people acting collectively for the common good.
Maggie Fox 12:53
Wow. That’s kind of astonishing that it had that big effect. How long a period was this over?
Tafadzwa Mabhaudhi 12:59
This drought is progressive. So, it was for a progressive period of almost two years or so that they were moving towards Day Zero.
Maggie Fox 13:08
And tell me a little bit about what renewable energy in Africa would look like. Are we talking about solar panels? Are we talking water? Are we talking wind? Are we talking about all of these things?
Tafadzwa Mabhaudhi 13:18
We’re talking about all of these things. We have good water and hydroelectricity in many parts of Africa. We’ve got huge potential for solar, which is very underexploited, and we also have very good potential for wind in many parts of Africa, which we could grow and even then use to replace fossil fuels.
Maggie Fox 13:39
So, the report mentions that individuals in Cape Town seem like a really, really good example of that. Can you give some other examples of what individuals can do?
Tafadzwa Mabhaudhi 13:51
So, there are examples of individuals in different countries taking responsibility. For example, you’ve got examples of individuals in countries such as Zimbabwe taking responsibility for waste management, with the government failing to manage waste; we dispose of it safely, and individuals coming into that space and acting to support waste disposal, waste reuse, waste recycling, and pretty much establishing an informal circular economy. So, we talk a lot about the circular economy, reuse, recycle, and all of those, but it’s a different thing when citizens themselves step in and start to do those actions without anyone organizing them.
We also have good examples of citizen science where citizens have contributed to monitoring things such as water quality in rivers using simple toolkits that allow them to monitor water quality in rivers and then be able to take responsibility for water pollution in their own rivers that they use for domestic water use, and so forth. So, there are pockets of examples of people doing good things or taking individual action to protect lives and to protect the environment.
Maggie Fox 15:07
This sounds very empowering. It sounds like you’re telling people there are lots of things you can still do. You don’t have to sit back and wait for the governments, because it doesn’t look like the governments are going to do it.
Tafadzwa Mabhaudhi 15:17
I always say personally that the government responds to things that have public support. So, as individuals, we take individual actions and build those into community action, which then creates public support; the government does not have an incentive to act otherwise in that regard. So, we do have the power to build public support.
Maggie Fox 15:42
Well, that is a very positive message. Where do you take it from here?
Tafadzwa Mabhaudhi 15:47
I think from here it’s around the message of building greater awareness. Again, sometimes you don’t act because you don’t know. And one of the biggest challenges that we have in Africa is the lack of agency. People are unaware that they have to change their circumstances. So, we need to build awareness and build agencies so that people can make those decisions. We need more science, such as what the countdown is doing, to be able to better track the impacts of climate change on health, and then be able to translate that science into messages and formats that people can engage with and act upon within their different localities. And even though we might say governments are not acting, we cannot abandon engaging governments in that respect, but we need to be armed with data. We need to be armed with case studies, examples of what works, where, and how it can be scaled. And we also need the finance, especially in the African context, to drive some of these solutions at scale.
Maggie Fox 16:51
Wonderful. This has been such a positive message in the context of such a frightening report. Tafadzwa, thank you so much for joining us.
Tafadzwa Mabhaudhi 17:00
Thank you very much, Maggie, for having me on the show. It’s been a pleasure.
Maggie Fox 17:04
Listeners, if you enjoyed this podcast, please share it. And please have a look at the website at onehealthtrust.org, and if you have ideas for subjects you’d like us to cover, please share them at owoh@onehealth trust.org. Thanks for joining us.
Guest

Dr. Tafadzwa Mabhaudhi is a Professor of Climate Change, Food Systems & Health at The London School of Hygiene & Tropical Medicine (LSHTM), and Director of the Lancet Countdown Africa Centre. He applies a systems‑approach at the intersection of water, energy, food, environmental, and health systems, also known as the WEF+ nexus, leading research, teaching, and policy-relevant work to strengthen sustainable, climate-resilient food systems. In addition to his role at LSHTM, Tafadzwa is the Lead for the Water-Energy-Food-Environment Nexus for the United Nations University Institute for Water, Environment and Health and Director of the Institute of Natural Resources. He is an Extraordinary Professor at the University of Pretoria and the University of KwaZulu-Natal.
Credits
Hosted and written by Maggie Fox
Special guest: Tafadzwa Mabhaudhi
Produced and edited by Samantha Serrano
Music composed and sound edited by Raquel Krügel
Transcript edited by Namitha Prabhu

