Public health impact of heatwave in Africa: an urgent call for action

Abstract

Introduction: Heatwaves are a global phenomenon that disproportionately affects low- and lower-middle-income countries. Africa contributes little to global emissions yet faces rising heatwave risk, with direct impacts such as heat exhaustion, heatstroke, and dehydration, and indirect effects on air quality, infectious disease transmission, and mental health. Limited adaptive measures in many African settings highlight the public health gap. Theory: This review is based on public health and climate adaptation frameworks. It draws on environmental epidemiology, disaster risk reduction, and health system resilience to examine how heatwaves affect vulnerable populations and guide context-specific adaptation strategies. Method: We conducted a narrative review of studies from 2000, identified through PubMed, Google Scholar, and reports from global health organizations. Titles, abstracts, and reference lists were screened, and key articles and reports were included. Results: This review identified the direct health effects of heatwaves, including heatstroke, cardiovascular events, and renal dysfunction, and indirect impacts such as worsened respiratory disease, increased vector-borne transmission, and mental health stress. These outcomes fall most heavily on older adults, children, outdoor workers, and people with pre-existing conditions. Projections indicate an increasing frequency and intensity of heatwaves across Africa. Discussion: Our findings highlight the urgent need for integrated, African-specific adaptations. Priorities include heat health early warning systems, climate-resilient urban planning, targeted public health messaging, and health services. Future research should refine heatwave definitions, apply longitudinal designs, and evaluate adaptation measures to reduce the growing burden on health systems and vulnerable communities.