Building capacities in and implementing Health Impact Assessments to make visible and integrate health and social improvements in Critical Minerals extraction

East and southern African countries have achieved many gains in health, but also face many health challenges, including from commercial activities and the challenges of climate change. Poverty and inequality continues to affect opportunities to lead healthy lives. The mining sector, and particularly the new extraction of Critical Minerals (CM) and ASM mining lack systematic evidence to leverage policies, laws and actions to protect and improve health1. As noted in the AEGT proposal, public health specialists have nevertheless exposed evidence on CMs in other countries, and have called for legal and fiscal strategies to improve public health outcomes and services in mining communities in the region. One of the reasons for this gap in evidence on and planning for health impacts in CM activities is that while environmental impact assessment (EIA) exists in law in most African countries, few countries have institutionalised health impact assessment (HIA) in ways that have been done in Latin America, Asia, Europe and Canada to proactively embed evidence and health-promoting changes in activities and policies that raise health risks. Policy leaders in Africa recognized this in the WHO AFRO Regional multi-sectoral strategy to promote health and well-being, 2023–2030, with a target by 2030 to have institutionalized and integrated HIA. Public health law requires all persons (including institutions and companies as legal persons) to prevent harms to health, and national constitutions assign a duty on states to protect the right to health. However these rights and duties are poorly implemented when health impacts are not exposed, and when those involved see ill health as a necessary consequence of precarious income. Even in countries that provide for HIA in law, such as Zimbabwe’s 2018 Public Health Act, weak HIA capacities in those affected means that legal duties are not being implemented. This weakens resource contributions for health. Overlooking health impacts of CM activities is however unjust to populations affected, generates ill health that is costly for the state and households potentially damaging to industry reputations and litigation over health risks.

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This project provides evidence and capacities to assess the health impacts of areas of new CM extraction in the four AEGT countries, generating knowledge and recommendations for improvements to address these impacts. It addresses a knowledge gap on current and future health impacts of large and small scale CM activities in different settings, and a capacity gap to assess these impacts.

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