Annals of Global Health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles dedicated to all aspects of global health. The journal's mission is to advance global health, promote research, and foster the prevention and treatment of disease worldwide. Its goals are to improve the health and well-being of all people, advance health equity, and promote wise stewardship of the earth's environment. The latest journal impact factor is 2.90. Annals of Global Health is supported by the Program for Global Public Health and the Common Good at Boston College. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health. From time to time, Annals of Global Health publishes Special Collections, a series of articles organized around a common theme in global health. Recent Special Collections have included "Local evidence and strategies in addressing NCDs Non-Communicable Diseases in Tanzania", "Universal Health Coverage through Integrated Care", and "The Minderoo-Monaco Commission on Plastics and Human Health". Global health workers interested in developing a Special Collection are strongly encouraged to contact the Managing Editor in advance to discuss the project.

Africa is grappling with severe food security challenges driven by population growth, climate change, land degradation, water scarcity, and socio-economic factors such as poverty and inequality. Climate variability and extreme weather events, including droughts, floods, and heatwaves, are intensifying food insecurity by reducing agricultural productivity, water availability, and livelihoods. This study examines the projected threats to food security in Africa, focusing on changes in temperature, precipitation patterns, and the frequency of extreme weather events. Using an Exponential Growth Model, we estimated the population from 2020 to 2050 across Africa’s five sub-regions. The analysis assumes a 5% reduction in crop yields for every degree of warming above historical levels, with a minimum requirement of 225 kg of cereals per person per year. Climate change is a critical factor in Africa’s food systems, with an average temperature increase of approximately +0.3 °C per decade. By 2050, the total food required to meet the 2100-kilocalorie per adult equivalent per day will rise to 558.7 million tons annually, up from 438.3 million tons in 2020. We conclude that Africa’s current food systems are unsustainable, lacking resilience to climate shocks and relying heavily on rain-fed agriculture with inadequate infrastructure and technology. We call for a transformation in food systems through policy reform, technological and structural changes, solutions to land degradation, and proven methods of increasing crop yields that take the needs of communities into account.

Introduction: Despite the broad improvement in air quality, air pollution remains a major leading global risk factor for ill health and deaths each year. Air pollution has a significant impact on both health and economic growth in Africa. This paper reviews the health impacts of air pollution and the benefits of air pollution mitigation and prevention on climate change. Methods: We conducted a narrative review and synthesized current literature on the health impact of air pollution in the context of changing climate in Africa. Results: Particulate matter (PM2.5) concentrations in Africa pose significant health risks due to various sources, including household fuels and industrial emissions. Limited air quality monitoring hampers accurate assessment and public health planning. Africa’s rapid urbanization exacerbates air pollution, impacting vulnerable populations disproportionately. Renewable energy adoption and improved monitoring infrastructure are crucial for mitigating air pollution’s economic and health impacts. Recommendations include adopting air quality standards, identifying pollution sources, and prioritizing interventions for vulnerable groups. Integrating renewable energy into development plans is essential for sustainable growth. African leaders must prioritize environmental policies to safeguard public health amid ongoing industrialization. Conclusions: Air pollution prevention remains a vital concern that requires leaders to engage stakeholders, and other opinion leaders in society. African leaders should proactively explore new avenues to integrate non‑polluting renewable energy sources such as solar power, wind and hydropower into their national development plans.

Despite being underreported, orofacial cleft lip/palate (CLP) remains in the top five of South Africa's most common congenital disorders. Maternal air pollution exposure has been associated with CLP in neonates. South Africa has high air pollution levels due to domestic burning practices, coal-fired power plants, mining, industry, and traffic pollution, among other sources. We investigated air pollutant levels in geographic locations of CLP cases. In a retrospective case series study (2006-2020) from a combined dataset by a Gauteng surgeon and South African Operation Smile, the maternal address at pregnancy was obtained for 2,515 CLP cases. Data from the South African Air Quality Information System was used to calculate annual averages of particulate matter (PM) concentrations of particles < 10 µm (PM₁₀) and < 2.5 µm (PM_2.5). Correlation analysis determined the relationship between average PM_2.5/PM₁₀ concentrations and CLP birth prevalence. Hotspot analysis was done using the Average Nearest Neighbor tool in ArcGIS. Correlation analysis showed an increasing trend of CLP birth prevalence to PM₁₀ (CC = 0.61, 95% CI = 0.38-0.77, p < 0.001) and PM_2.5 (CC = 0.63, 95% CI = 0.42-0.77, p < 0.001). Hot spot analysis revealed that areas with higher concentrations of PM₁₀ and PM_2.5 had a higher proclivity for maternal residence (z-score = -68.2, p < 0.001). CLP birth prevalence hotspot clusters were identified in district municipalities in the provinces of Gauteng, Limpopo, North-West, Mpumalanga, and Free State. KwaZulu-Natal and Eastern Cape had lower PM₁₀ and PM_2.5 concentrations and were cold spot clusters. Maternal exposure to air pollution is known to impact the fetal environment and increase CLP risk. We discovered enough evidence of an effect to warrant further investigation. We advocate for a concerted effort by the government, physicians, researchers, non-government organizations working with CLP patients, and others to collect quality data on all maternal information and pollutant levels in all provinces of South Africa. Collaboration and data sharing for additional research will help us better understand the impact of air pollution on CLP in South Africa.

Prolonged exposure to high temperatures can cause heat-related illnesses and accelerate death, especially in the elderly. We developed a locally-appropriate Healthy Environment Assessment Tool, or ‘HEAT’ tool, to assess heat-health risks among communities. HEAT was co-developed with stakeholders and practitioners/professionals from the Rustenburg Local Municipality (RLM), a setting in which heat was identified as a risk in an earlier study. Feedback was used to identify vulnerable groups and settings in RLM, consider opportunities and barriers for interventions, and conceptualize a heat-health vulnerability assessment tool for a heat-resilient town. Using information provided by the RLM Integrated Development Plan, the HEAT tool was applied in the form of eight indicators relating to heat-health vulnerability and resilience and areas were evaluated at the ward level. Indicators included population, poverty, education, access to medical facilities, sanitation and basic services, public transport, recreation/community centres, and green spaces. Out of 45 wards situated in the municipality, three were identified as critical risk (red), twenty-eight as medium-high risk (yellow), and six as low risk (green) in relation to heat-health vulnerability. Short-term actions to improve heat health resilience in the community were proposed and partnerships between local government and the community to build heat health resilience were identified.

Background: Water and sanitation are vital to human health and well-being. While these factors have been studied in relation to heath, very little has been done to consider such environmental risk factors with child development. Here, we investigated possible relations between household water access/storage and early childhood development in four low-income settlements in the City of Cape Town, Western Cape province of South Africa. Our objectives were 1) to determine water access/storage practices in dwellings of children; 2) to assess early childhood development; and 3) and to understand the relationship between water access/storage practices in relation to early childhood development. Methods: We used a questionnaire to assess household water risk factors and the International Development and Early Learning Assessment (IDELA) tool to assess child early learning / cognitive, socio-emotional and motor development. Results: Mean age of the children (N=192) was 4 years and 55% were female. The mean IDELA score was 48% (range: 36% - 54%) where the higher the score, the better the child’s development. Around 70% of households had a tap inside their dwelling and half said that they stored water with the largest percentage of storage containers (21%) being plastic/no lid. Child IDELA scores were lower for children living in households that did not have an indoor tap and for households who stored water. Conclusions: Given the risks associated with climate change and the already poor conditions many children face regarding water and sanitation, research is needed to further investigate these relations to provide evidence to support appropriate interventions and ensure healthy child development.