The Covid-19 pandemic has already laid bare the vulnerabilities of global health systems, but for Africa, an even larger threat looms on the horizon – the existential danger posed by climate change. As the Cop28 climate conference begins in Dubai, it is imperative to recognise the profound impact of climate change on health, especially in Africa. The climate crisis is, unequivocally, a health crisis. In Africa, climate change is not a distant threat but a present and alarming reality. It's reshaping our environment, economies and, most critically, our health. According to the African Development Bank, the continent loses 5 to 15 per cent of its GDP annually due to climate change impacts. This economic strain translates directly into severe health consequences, including rising cases of malnutrition and stunted growth in future generations, along with a host of other health problems. One of the less recognised, yet significant, impacts of climate change is its exacerbation of infectious diseases. More than half of known human pathogens are aggravated by climate change. This includes diseases like malaria, dengue, and monkey pox, which are seeing a rise due to changing ecological conditions. The phenomena of rising sea levels, desertification and extreme weather events are not just environmental challenges – they are catalysts for burgeoning health crises. For Africa, Cop28 is more than just a summit; it represents a lifeline. The continent, bearing the brunt of climate change, is witnessing the devastation of lives, livelihoods and infrastructure. The Nairobi Declaration, emerging from the inaugural Africa Climate Summit, is a testament to Africa's unified stance. This declaration is a call to action, emphasising Africa's commitment to green growth and a transformed climate finance environment. The toll of climate change on Africa is evident in the increasing frequency and intensity of extreme weather events. Annually, the continent reports over 150 health emergency events, with 85 per cent being infectious disease outbreaks. Diseases like cholera, dengue and malaria are becoming more prevalent as their ecological niches expand due to climate change. This not only poses a significant threat to the affected populations but also to global health security. In Africa, we are witnessing the direct consequences of climate change. Tropical Cyclone Freddy and prolonged droughts in the Horn of Africa and the Sahel region have devastated communities, wiping out developmental gains and posing a severe threat to achieving the Agenda 2063 goals, Africa's blueprint for transformation. In this context, the role of early warning systems is vital. These systems are essential for guiding decision-makers during crises and should be a key focus at Cop28. The call to action by UN Secretary General Antonio Guterres to protect everyone with early warning systems within five years is a step in the right direction. However, it requires significant investment and international co-operation to be realised. As Africa transitions from the acute phase of the Covid-19 pandemic to recovery, a multi-sectoral response incorporating innovative health financing, digitalisation, science, technology and robust partnerships is essential. This approach must foster Africa's reliance on local resources and home-grown solutions. Africa Centres for Disease Control and Prevention (CDC) has a “One Health” approach that emphasises collaboration across sectors and stakeholders. It addresses vector-borne diseases by controlling disease-carrying vectors, improves access to safe water and sanitation to reduce waterborne diseases, promotes sustainable agriculture to enhance food security, and strengthens disaster response to mitigate climate-related emergencies. This "One Health" policy acknowledges the interconnectedness of human, animal, and environmental health and seeks to create resilient and adaptive systems that can withstand the challenges posed by a changing climate. Africa CDC's priorities in addressing climate change as a public health issue involve building resilience and adaptation, advocating for awareness, supporting research and innovation, and fostering partnerships and collaboration. These efforts aim to equip individuals, communities and nations with the capacity to respond effectively to climate change's health impacts, raise awareness among stakeholders, generate evidence-based solutions and mobilise resources for co-ordinated action. The World Health Organisation's alarming statistics highlight the urgency of this crisis. One in four deaths can be attributed to preventable environmental causes. An estimated 250,000 additional people die each year due to climate change. The health consequences carry significant economic ramifications, with the World Bank predicting that climate change will push an additional 132 million people into poverty by 2030. This is not just a health crisis but a crisis of sustainable development. The displacement of populations due to climate change, projected to reach 1.2 billion people by 2050, compounds the problem. At Cop28, Africa seeks to be a decision-maker, not just an observer, in the global climate agenda. The African Union is guiding the continent’s journey, with organisations like the African Risk Capacity ready to lend their expertise. This support is crucial for operationalising climate actions and maximising the impact of initiatives like the loss and damages fund. Cop28 presents a unique opportunity for decisive action and innovative thinking. As we participate in the ground-breaking Health Day at the summit, it's clear that the global climate crisis calls for global solidarity. The African continent, soon to comprise 25 per cent of the world’s population, is not only fighting for its survival; it's fighting for the future of humanity. Therefore, it’s imperative that Cop28 goes beyond rhetoric, ensuring concrete actions and substantial investments in health systems that can withstand the impacts of climate change. Cop28 must be a turning point, marking a shift from discussion to action. Africa's role is crucial, and the continent is prepared to lead in crafting solutions for a sustainable and healthy future. With concerted global effort and solidarity, we can address the challenges posed by climate change and forge a path toward a resilient, equitable future.