Cyclone Idai disrupted the drug supply of more than 185,000 Zimbabweans living with the Human Immunodeficiency Virus (HIV) in 2019. 

• Roads were flooded and bridges destroyed. Almost a fifth of the clinics where patients receive vital antiretroviral therapy were unreachable in affected areas. 

Why this matters – to everyone: It shows the continent needs a pharma response to climate change as much as it needs an energy transition. 

• But so far, few solutions are available. 

Where to focus: The challenge for the drugs sector is threefold: 

• Changes in the natural world threaten the sourcing of pharma ingredients.

• Climate change drives the spread of diseases and undermines food security. 

• Distribution of drugs in cold chains by road and in clinics is made harder.

First challenge: Climate change impacts drug ingredients from plants and animals. Temperature and precipitation changes may lower the potency and yield. 

• Medicinal ingredients, such as the fever tree – a source of quinine used in antimalarial drugs – are undermined by the growing loss of African forests.  

• Climate-related habitat loss endangers black mamba populations, whose venom includes three-finger toxins that could act as powerful new painkillers rivalling morphine. 

• Omega-3 fatty acids (to combat heart disease, improve brain function, reduce inflammation) are threatened by marine heat waves – which have increased by more than half in the past 30 years, threatening fish stocks rich in Omega-3.

Second challenge: Illness is taking new paths in Africa. Changing weather patterns create new breeding grounds for disease-carrying insects and allow existing maladies to reach new regions. 

• Countless studies show that malaria and dengue fever rise in line with temperatures. 

• More than a million Africans now die every year prematurely from air pollution. 

• Ever increasing floods in Lagos cause 50% of the hospitalisations due to water-borne diseases such as cholera and typhoid. 

Food insecurity: Missing pharma and fertiliser solutions are evident from growing malnutrition and weakened immune systems due to climate-related droughts and harvest failures. 

• At least 45 million children are at risk of poor health and malnutrition in eastern and southern Africa due to the climate crisis. 

• More than 3 million livestock died in Somalia in a single year from prolonged drought, exacerbating food insecurity and contributing to malnutrition.  

Third challenge: Perhaps nowhere is the climate impact on medicine more obvious than in distribution. High temperatures require more refrigeration in supply chains and dispensaries. 

• Cold chain infrastructure is underdeveloped on the continent, already leading to over 40% in loss of produce between harvesting and consumption. 

• Sub-Saharan regions require more than 250 additional Cooling Degrees Days (CDD), a measure of the efforts needed. 

Natural disasters: On top of rising temperatures, extreme weather events such as floods and hurricanes will also disrupt pharma supply chains. Damaged infrastructure and disrupted transport networks hinder the delivery of raw materials as well as finished drugs.

• Long stretches of roads and rail lines in Tanzania are exposed to extreme flooding. 

• Climate-related supply chain issues contribute to $35 billion in annual losses experienced already by the global drug industry 

Hospitals hit: Just as supply chains are increasingly impacted by climate disasters, so will be dispensaries. Especially clinics in areas with already limited resources face disruption. 

• Cyclone Freddy destroyed more than 300 health facilities in southern Africa.

• Storm Daniel flooded multiple hospitals in the Libyan city of Derna in addition to killing thousands of inhabitants, hindering the treatment of survivours. 

Solutions needed: Pharma revenue is rising in Africa (see chart above). But limited thinking has so far gone into solving climate-related challenges. Here are the most obvious steps:

• Find alternative sources or synthetic substitutes for endangered ingredients.

• Develop treatments for the changing spread of diseases and malnutrition.

• Upgrade cold chains to refrigerate drugs in the face of rising temperatures.