Case study

Health and climate change research through two multidisciplinary research initiatives has supported decision-makers to create policies for healthy and sustainable diets and household air pollution and informed implementation in Africa and India.

Climate change impacts pose a significant risk to health and food security. Climate change’s greatest impacts on health will be in the way it increases or exacerbates existing health problems, particularly on already vulnerable communities, exacerbating impacts of: poverty and inequality, inadequate housing and water and sanitation services, poor nutrition, natural disasters, weak governance, and emotional/mental stress. It is therefore vital to understand how the two different elements intersect and their trade-offs.

PART 1: Sustainable and Healthy Food Systems (SHEFS)

UK Funders:


Funding programme

Our Planet, Our Health

UK Investment:

£5.7 million

Total Investment:

£5.7 million

Project dates:

2017 – 2022

Lead Institution:

London School of Hygiene and Tropical Medicine (LSHTM)

Partner Institutions

University of KwaZulu Natal, Centre for Chronic Disease Control (CCDC), New Delhi, and Ashoka Trust for Research in Ecology and the Environment (ATREE), Bangalore.

Countries of focus:

South Africa, India, UK


Food systems are changing rapidly and influencing what we eat, our health and the environment. Climate change and variability challenges countries ability to deliver a sustainable and healthy food system under environmental change. SHEFS (Sustainable and Healthy Food Systems) is a global research programme funded through Wellcome’s Our Planet Our Health programme (OPOH) to help decision-makers create policies that deliver nutritious, healthy, affordable and sustainable diets.

Underpinning Research

SHEFS is working on the transformation of existing agricultural systems so they are resilient to changing climates and can provide food and nutrition security. Part of this includes use of neglected and underutilised species (NUS) – a transformative adaptation to climate change and food and nutrition security. SHEFS is contributing to knowledge on: how understanding socio-political, food, and environmental systems, and the urban, urban-rural and rural environments they produce supports an understanding of how climate change, which undermines or enhances these systems, impacts on health. Research in SHEFS spans across agriculture, livestock, environment, human development (poverty and community), economics, policy, nutrition and health.

Towards Impact


  • In South Africa, SHEFS research on indigenous crops contributed to a new national research strategy, a commitment to add indigenous crops to the Climate Smart Agricultural Strategy.
  • An interdisciplinary project on the water-energy-food (WEF) nexus contributed to the adoption of the nexus as a framework to achieve national goals aligned with the National Development Plan. This work has led to the development of an integrated analytics tool for assessing the WEF nexus, which has now been adopted by the Water Research Commission of South Africa as a planning tool.
  • In India, SHEFS research has supported the National Institute of Nutrition and engaged the government on inclusion of food in smart cities initiatives.


  • SHEFS research contributed to knowledge and social learning that supported the establishment of the Transformative Riverine Management Programme (TRMP) in Durban, South Africa, which aims to adapt 7,400km of streams and rivers in the city to flooding, drought and higher temperatures. The TRMP now forms part of the Durban Climate Change Strategy and its Climate Action Plan as a C40 city.
  • SHEFS research on river rehabilitation in Durban led to a partnership between environmental and engineering departments in the eThekwini Municipality and research institutions and civil society groups. The partnership is implementing participatory river rehabilitation projects in Durban, which are supporting climate adaptation responses including built infrastructure, social learning and improved ecosystem services to urban residents.

PART 2: CLEAN-Air (Africa)


Globally 3 billion people rely on polluting solid fuels for cooking and heating their homes. Exposure to smoke from burning these fuels has significant health implications, causing more premature deaths and illness in Africa than malaria. Indoor air pollution can also release carbon-based fuels which contribute to greenhouse gas (GHG) emissions. Clean Household Energy for the Prevention of Non-communicable Disease in Africa [CLEAN-Air (Africa)] aims to help communities in Africa transition to clean modern energy, informing national policies and programs.

Underpinning Research

Led by research experts, physicians and academics, CLEAN-Air(Africa) aims to address the burden of disease from household air pollution through a program of policy relevant implementation research and health systems capacity building. Its mixed-methods participatory research in Cameroon, Ghana and Kenya supports communities to adopt clean household energy alongside national government policies to scale household use of liquified petroleum gas (LPG) to reduce the negative impacts on health, deforestation and climate of reliance on solid fuels for cooking and heating. CLEAN-Air(Africa) has demonstrated that the major health gains achieved from scaling LPG for household energy include climate co-benefits from reduced deforestation and reduced emissions of climate forcing pollutants from solid fuels. In collaboration with the World Health Organization, CLEAN-Air(Africa) has implemented programs of national health professional training in household air pollution, health and prevention working with the ministries of health in its focus countries.

Towards Impact


  • 5,000 households switched to clean cooking in Cameroon as result of pioneering microfinance programme.
  • 130,000 community health workers in Kenya, reaching households across all 47 Kenyan counties, will be trained in household air pollution, health and prevention through new training adopted by the Ministry of Health as part of 2021 Universal Health Coverage.
  • Informed international recognition of the need to scale adoption of LPG for clean cooking across sub-Saharan Africa, as opposed to technologies for burning solid fuels more cleanly (“improved cookstoves”). This aligns with WHO Air Quality Guidelines and many sub-Saharan African governments’ targets to expand LPG to meet SDG7.