Fortunate Machingura heads CeSHHAR Zimbabwe’s Climate, Environment, and Health Department and is also a lecturer at the Liverpool School of Tropical Medicine. She describes her pivot from HIV research to another crucial challenge facing Africa: climate change.
In 2023, the world faced extreme heat, which marked a critical point in the world’s climate challenges, especially in sub-Saharan Africa. Zimbabwe’s struggle with high temperatures mirrors the region’s vulnerability and the pressing need for adaptation measures within health systems to shield at-risk populations from the impacts of climate change. In the oppressive heat, I faced a career-defining crossroad, not because of the elevated temperatures but due to an acute realization that the world was in the midst of a yet another crisis, and our decision-makers were navigating blindly, starved of context-specific empirical data. Such data are essential for informed decisions, strategic planning and effective resource distribution.
Since the 1980s, Zimbabwe has faced a persistent human immunodeficiency virus (HIV) crisis, combined with an onslaught of escalating challenges, including non-communicable diseases, mental health issues, brain drain, economic struggles and now the exacerbating effects of climate change. Climate change acts as an inequality multiplier, threatening the most vulnerable populations, and deepening existing socioeconomic and gender disparities — especially for rural pregnant and postpartum women, newborns and children, who are at the crossroads of these increasing hardships.
The decision to pivot my career direction was anything but simple; it was a labyrinthine challenge. Over a 6-month period, I transitioned away from my previous work in HIV research and began focusing on the intersection of climate and health in Zimbabwe.
This shift in focus led to a collaboration with Stanley Luchters, who was himself pivoting from HIV to set up the Climate, Environment and Health Department (CEHD) in 2023, at the Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) in Zimbabwe. Luchters’ European Union-funded multi-country HIGH Horizons project, with a focus on pregnant and postpartum women, infants and health workers, aims to understand the health impacts of heat using a precision health approach that includes biomarker assessments, data science and integrated adaptation–mitigation interventions in Kenya, Zimbabwe, South Africa and several European countries. My role was to lead the local implementation in Zimbabwe.
I joined Luchters on yet another project, funded by Wellcome Trust, on co-producing complex adaptation interventions to reduce the effects of heat on pregnant women and newborn infants in southern Africa, further strengthening our rural-based demonstration laboratories in Zimbabwe. With Luchters, I joined Matthew Chersich in a study at the Heat and Health African Transdisciplinary Centre (HE2AT Center), funded by the US National Institutes of Health, developing data science solutions across the continent. Despite this growing body of research, health workers continue to be unprepared for climate-induced health challenges.
Seizing the initiative, I joined Joanna Raven and Euphemia Sibanda at the Liverpool School of Tropical Medicine and submitted a funding application to the National Institute for Health and Care Research to assess health workforce readiness and to craft interventions to bolster climate-resilient health systems, starting in 2024.
Our growing research relies on extensive partnerships; however, there is a glaring void where there should be a shared space for knowledge exchange, curated by people from the Global South. Instead, discussions are fragmented, with piecemeal efforts falling short of generating the momentum needed for evidence-based policy. This realization catalyzed my decision to organize the first-ever Climate and Health Africa Conference (CHAC) in 2024. The mission felt impossible but, together with Luchters and Wellcome Trust funding, we set out to convene a dynamic assembly of policymakers, emerging and established researchers and communities from over 30 countries in sub-Saharan Africa. My ambition for CHAC was clear: to forge a platform that transcends mere discourse; one that leverages robust context-relevant climate and health research to inform equitable policy strategies for the continent and embrace capacity-building for action on climate and health issues.
This conference is planned for 29–31 October 2024 and is envisioned as a beacon, guiding sub-Saharan Africa toward harnessing its unique vulnerabilities and strengths in crafting a resilient and informed response to the climate-health challenges ahead, drawing on the region’s research evidence and best practices. This event will convene policy leaders from over 30 countries in sub-Saharan Africa, along with academic scholars, early-career researchers, community advocates and representatives of populations most vulnerable to the impacts of climate change. A 'whole of society' strategy is needed for climate-health resilience, and to open the event are Zimbabwe Ministers Douglas Mombeshora and Nqobizitha Mangaliso Ndlovu and Permanent Secretary Prosper Matondi.
My turning point in 2023 from HIV–AIDS research to the critical nexus of climate and health laid the groundwork to establish what we hope will be a vital platform for sharing research and practices. As I prepare to chair the first CHAC conference in 2024, this role marks a major milestone in my journey, not just professionally but also for the impact it promises for Africa. In parallel, my growth as the CeSHHAR CEHD director and at the start of my career-track with Liverpool School of Tropical Medicine reflects my belief that medical research should have actionable health solutions. This opportunity to influence change at the highest levels fuels my passion and commitment. Every morning, this potential for meaningful impact propels me to advance this crucial agenda further, not just for women and Zimbabwe but for ‘my Africa’.
