African countries that are the least responsible for the climate crisis will have to spend up to five times more on adapting to global heating than they do on healthcare. Analysis of 11 nations with a total population of more than 350 million lays bare the huge financial toll of taking action to avert the severe environmental consequences of global heating. The international NGO Tearfund compared the plans drawn up by Cameroon, Cape Verde, Chad, the Republic of the Congo, the Democratic Republic of the Congo, Eritrea, Ethiopia, Madagascar, Mali, Mauritania and Sudan against their health budgets. Each nation is already suffering the effects of the climate crisis. The expected climate adaptation costs for Eritrea amount to 22.7% of GDP, compared with 4.46% for healthcare costs. Mauritania will need to spend more than four times as much on climate adaptation as it does on healthcare – 13.4% compared with 3.3%. The analysis shows the 11 nations are among the least to blame for the greenhouse gas emissions that are heating the planet. On average, they emit 27 times less per person than the global average. A measurement of global liability found the US has inflicted more than $1.9tn (£1.6tn) in damage to other countries from the effects of its greenhouse gas emissions. Adapting to climate change involves building higher sea walls, capturing rainwater for irrigation and moving to drought-tolerant crops. Sub-Saharan Africa already experiences one-third of the world’s droughts and is extremely vulnerable to temperatures and extreme weather, because of its dependence on rain-fed agriculture, according to the International Monetary Fund. East Africa is currently suffering its worst drought in a generation, with 20 million people at risk of severe hunger. Elizabeth Myendo, Tearfund’s disaster management lead for southern and east Africa, said: “The hunger crisis in East Africa has shown the terrible power of the climate emergency. Acute malnutrition and lack of clean water is putting intolerable strain on hospitals and clinics. “Entire communities have been forced to leave their homes in search of food, leaving them more vulnerable to disease outbreaks and unable to access local health services … The climate crisis will only worsen and governments will have to find the money somewhere to help people adapt. I fear that crucial services like healthcare will suffer unless rich countries deliver the climate finance they promised.” Adapting to climate change was a key feature of the Paris agreement in 2015. But a pledge made in 2009 by wealthy nations to deliver $100bn a year from 2020 to 2025 to help low-income countries with mitigation has still not been fully met, says the report. At the Cop26 climate summit in Glasgow last year, countries agreed only to launch a two-year effort to define a “global goal on adaptation”, leaving further details vague. Wealthy nations came up with new pledges of about $960m a year, but the amounts promised are well below the $70bn a year developing countries are estimated to need now. The amount required is likely to rise to $300bn a year by 2030, the UN has said. Tearfund called on the UK government, which still holds the Cop presidency, to ensure the promised $100bn a year is delivered, with 50% allocated for adaptation. The UK government says addressing climate challenges is a top priority and that adaptation funding for many developing countries is insufficient. But recent comments by Kwasi Kwarteng, the business secretary, suggest the government is diverting money previously earmarked for helping avert the effects of global heating towards defence spending. The report says: “It is a huge injustice that the impacts and the costs of the crisis are being borne by communities that have the fewest resources to respond to it – and who did the least to cause it.” Low-income countries are receiving as little as one-tenth of what they need for adaptation from international climate finance. In many of the countries, communities are coming up with innovative solutions to reduce the impact of climate change, but they do not have the money to generate wider positive consequences. The report highlights action being taken in southern Ethiopia, where more than 10,000 farmers are practising conservation agriculture to enable them to grow crops even in dry seasons, thus helping them adapt to the more frequent and prolonged droughts. Climate finance would enable the scaling-up of these practices in other areas, increasing resilience to a crisis that is causing hunger and malnutrition, as well as the loss of livestock and livelihoods, the report states.