This HIA examined the Small-Scale Mining and the Milling Operation in Bubi District, Zimbabwe. Artisanal and small-scale mining (ASM) and custom milling in Bubi District expose miners and communities to high risks of accidents, respiratory diseases, and chemical poisoning. An estimated 35% of miners suffer accidents, while 19% develop silicosis and a tuberculosis prevalence of up to 40%. Poor mining practices and management of custom milling effluent of mercury, cyanide, and heavy metals threaten the Mbembesi River, a water source for the downstream community and domestic animals. The projected health impacts raised a number of recommendations, including for: frequent inspection of mining sites and stronger regulatory enforcement; safer technologies; awareness campaigns to mitigate potential health impacts, as reinforced by the Public Health Act, Environmental Management Act, and Mines and Minerals Act; enclosed milling systems and automated controls to minimize dust and noise exposure for workers; and stricter requirements for waste discharge. The authors propose that a policy requiring Environmental Impact Assessments (EIAs) and HIAs should be applied and enforced in all ASM operations as a condition for licensing.
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This Health Impact Assessment (HIA) examined the health impacts of artisanal and small-scale mining (ASM) in the Lualaba province, Democratic Republic of Congo (DRC), to assess the effectiveness and application of Ministry of Mines 2019 Decree N°19/15. The recommendations for improving and implementing the decree included legal revisions to enable voluntary retirement or redeployment of vulnerable workers; to include affected communities and local ASM associations in meetings and decisions impacting their wellbeing and promote improved living and working environments for ASM and adjacent communities. Recommendations to improve the decree’s implementation included encouraging informal artisanal and small-scale miners to join cooperatives; strengthening capacities to enforce the decree, together with training ASM associations on health and safety at work; intensifying the monitoring of the health and environmental impacts of mining activities in communities neighbouring ASM sites and developing remediation plans for environmental or health impacts.
This Health Impact Assessment (HIA) examined Zambia’s Minerals Regulation Commission Act No. 14 of 2024. The Act has been enacted and assented to on 20th December, 2024, but awaits regulations. The HIA examined the Act through the lens of specific health impacts of mining activities on the Copperbelt Province, drawing evidence from Kankoyo Township in Mufurila District. The projected health impacts raised recommendations for the Ministry of Mines and Community development to: Strengthen health and safety conditions in mining by mandating ventilation standards, personal protective equipment (PPE), ergonomic monitoring, and routine health checks.; Prevent mine-related air and water pollution by enforcing emission thresholds with real-time monitoring; and Legally bind developers to replace lost infrastructure and services such as health and education for displaced communities, where mining results in unavoidable displacement. The Ministry of Health was also recommended to ensure that health is embedded in local development plans through its own institutional mechanisms and community engagement.
Tanzania is an emerging critical minerals development frontier. This Health Impact Assessment (HIA) examined the inclusion of health impacts in the Tanzania draft Critical and Strategic Minerals Strategy. . This included the health impact of air and water pollution and hazardous work; of social changes in mining sites and the mental ill health impact of lack of engagement in mining plans. The projected health impacts led to recommendations, including for: monitoring, and managing health risks and outcomes for the various population groups and along different phases of the extractive process; legislating for mandatory HIA in all critical minerals projects; building key agency and community capacities to protect health; ensuring a mechanism for communities to monitor and report on mining compliance with environmental, social and governance (ESG) standards and requiring periodic reporting by state and mining companies on their engagement and awareness campaigns in affected communities.
EQUINET through TARSC in association with colleagues from the Global Climate and Health Alliance and Federal University of Rio Grande do Sul held an online meeting on Tuesday 30th September on 'Strategies for engaging with the public health impacts of climate change and fossil fuels". The meeting was attended by 42 participants from different countries and heard from two international presenters: Shweta Narayan, Global Climate and Health Alliance on a Public health strategy to challenge health and climate impacts of the fossil fuel industry, and Carlos Dora, Federal University of Rio Grande do Sul, Brazil, on Health impact assessment to respond to commercial determinants of climate change. The presentations were followed by discussion.
In recognition of the critical mass of people with health impact assessment (HIA) capacities in Zimbabwe and inclusion of HIA in Zimbabwe's Public Health Act (Chapter 15:09, 2018) the Ministry of Health and Child Care (MoHCC) in co-operation with the Training and Research Support Centre (TARSC) and EQUINET invited key stakeholders to a meeting on Friday 22nd August 2025 to discuss practical steps for advancing regulatory guidance, capacities and implementation of health impact assessments in Zimbabwe. The meeting included an overview on HIA, presentation of HIA work already implemented in Zimbabwe, followed by discussion on proposals for priority sectors for HIA implementation, and the provisions in the Public Health Act and other laws related to HIA. This document reports the proceedings of the meeting.
The global race for critical minerals (lithium, cobalt, rare earth) to enable green energy transition has sparked mining expansion across East and Southern Africa, yet extraction operations contaminate air, water, and soil, causing respiratory diseases, kidney problems, miscarriages, and elevated heavy metal exposure in workers and communities (including pregnant women and children), with chronic illnesses extending into future generations while environmental impact assessments fail to prevent these harms and export profits bypass local communities. The video advocates for mandatory health impact assessments, citizen monitoring by mining associations and unions, stricter pollution and occupational safety standards, mine-funded cleanup and health services, community rights to refuse harmful projects, and establishment of sovereign wealth funds from mineral exports to finance regional technology development and healthcare infrastructure, reframing the green transition around health equity to ensure corporate accountability, patent-free green technology access, and fair trade that values people and planet equally.
Across East and Southern Africa, accelerating climate change through droughts, heat waves, floods, and storms threatens farming-dependent communities with harvest losses, food insecurity, and displacement, while creating health crises including malaria, diarrhoea, and malnutrition that disproportionately impact poor households, women, and youth who lack resources to adapt or relocate, even as transnational agribusiness corporations clearing smallholder land for export-oriented production profit amid widespread poverty. This video documents community-led adaptation strategies including seed saving, rainwater harvesting, agroecology, tree food processing for income generation, health impact assessments for new investments, and demands for agribusiness taxation to support local services, emphasizing that climate change deepens existing inequalities while transnational corporations externalize costs onto vulnerable populations, but collective action at local, national, regional, and global levels linking health equity and climate justice offers pathways to protect communities, share knowledge, develop local solutions, strengthen solidarity, and ensure well-being for all.
EQUINET’s recommendations on integrated urban health in 2024 in Eastern and Southern Africa include measures to BUILD health promoting integrated improvements for urban health, including supporting the locally produced technologies for this. This case study exemplifies the ‘BUILD’ agenda in its domestic investment in technology R&D, and in a supportive technology ecosystem for locally appropriate, climate-sensitive technologies and infrastructures that build links between food, waste and energy systems. This case study illustrates a promising practice in the construction of a biodigester at the Ecole Nationale des Sous-Officiers d’Active (ENSOA) in Antsirabe Madagascar.It is based on key informant interviews after consent and review of published documents collected in May 2025. Despite the initial challenges, the biodigester at ENSOA has yielded notable results. The use of firewood has decreased by 30%, reducing pressure on forest resources and lowering greenhouse gas emissions. Organic waste now has effective value, strengthening the environmental sustainability of ENSOA. The biogas produced enables the school to partially meet its energy needs, providing around eight hours of cooking time per day for approximately 700 people.
The final thematic webinar in EQUINET's climate and health equity webinar series was held in March 2025, It brought together 52 participants from east and southern Africa and internationally, focusing on the interplay for health equity between climate and migration in and beyond the region. Organised and moderated by TARSC, three panellists gave presentations: Mr Francis Pawandiwa, Coordinator, Nyahunure Community Trust, Mutoko district, Zimbabwe, from a community lens; Dr Moeketsi Modisenyane, School of Health Systems and Public Health, Faculty of Health, University of Pretoria, from a national and regional lens and Hannah Marcus, Environmental Health Working Group, World Federation of Public Health Associations, covering the international lens. People migrate to exploit new resources and opportunities, or are forced to migrate due to conflict, land expropriations, economic, food and water insecurity, emergencies and loss of livelihoods. When climate changes intensify these drivers, it also increases migration. The webinar interrogated the relationships between climate, migration and health equity at the local, national and global levels, and suggested actions to be taken to mitigate the impacts. This brief summarises the key issues raised on the role of climate change as a risk multiplier of drivers in sending communities leading to migration, for affected migrants along the route, and in the receiving communities. It highlights their health equity impacts in these three groups, the responses to these impacts and areas for further research.