Barometers of the Biosphere
What’s Driving the Crisis?
From my perspective, four main forces are accelerating East Africa’s health crisis:
Westernised diets: As local food systems are replaced by ultra-processed imports high in sugar, seed oils and refined flours, we see growing rates of obesity, diabetes and metabolic inflammation. In contrast, African heritage diets—think fermented porridge, leafy greens, beans, goat—support gut health and immune balance.
Pollution: Fossil fuels (from tuktuks and boda bodas), poor waste management and unregulated agrochemical use expose communities to toxins that overwhelm detox pathways and increase the risk of autoimmune conditions and cancers.
Biodiversity loss: Deforestation, fertiliser-heavy monocultures and urban sprawl reduce the microbial and plant diversity that humans co-evolved with. Without these, the immune system can’t regulate itself properly—what some call the “extinction of biological experience.”
Stress and inequality: Climate shocks, food insecurity, economic pressures and systemic inequality act as chronic stressors. And chronic stress, we know, weakens immune defences and worsens inflammation.
Growing Health in the Anthropocene: East Africa’s Path from Crisis to Healing - Listening to the Land and Our Bodies.
Across East Africa today, more and more people are facing a new kind of health crisis: the rise of non-communicable diseases (NCDs) like diabetes, heart disease, allergies, autoimmune conditions and chronic inflammation. As a nurse practitioner and public health specialist, I’ve seen these illnesses increase steadily over the years. They're showing up alongside climate extremes—floods, droughts, food shortages—and they point to something bigger: a breakdown in the delicate balance between people and planet.
These shifts are now recognised as part of a broader pattern—what some call Anthropocene epidemiology. This field explores how human-caused environmental change—climate disruption, pollution, biodiversity loss—is reshaping disease patterns across the globe. From chronic conditions to mental distress, these impacts touch every aspect of well-being.
We’re living in a world our bodies didn’t evolve for. Toxins in air and soil, ultra-processed foods, loss of traditional diets, and daily stress from social and ecological upheaval are straining our health in ways that no pharmaceutical system alone can solve.
The East African Reality
East Africa is especially vulnerable.
Temperatures here are rising faster than the global average. Droughts are longer, rains less predictable. In Tanzania and Kenya, recent back-to-back droughts followed by catastrophic floods have devastated harvests and introduced a new kind of chronic stress—eroding immune health and fuelling inflammation.
At the same time, people are losing connection with nature. Healthy soils and diverse ecosystems play an essential role in regulating our immune systems. Contact with natural environments helps calibrate immunity, protecting against allergies and inflammatory disorders. But rapid urbanisation, deforestation, monoculture farming, and Western-style diets are eroding that protective buffer.
Health surveys confirm the rise: asthma, eczema, diabetes and cardiovascular disease—once rare in the region—are becoming common. When I began practising in the mid-90s, we hardly saw these issues. Now, they are front and centre.
A recent randomised controlled trial in Kilimanjaro, published in Nature Medicine, provides strong evidence for what we are seeing. Researchers compared the metabolic and immune effects of a traditional Kilimanjaro heritage-style diet to a Western-style one, as well as the impact of consuming a fermented banana beverage known as mbege.
Within just two weeks, those who switched to a Western diet developed pro-inflammatory immune profiles and disrupted metabolic markers. In contrast, switching to a traditional diet—or simply drinking mbege—led to anti-inflammatory effects, some of which persisted even after the intervention. This research affirms what traditional knowledge has long held: food is medicine, and the loss of traditional diets is fuelling disease.
Reconnecting with Land and Tradition
The good news is that the land holds the remedies and so does our traditional knowledge.
It’s time to re-centre health around ancestral wisdom, grounded ecological practice, and food systems and ceremonies that nourish both people and soil.
Some key solutions:
Heritage diets & food as medicine: Local foods rich in fibre and micronutrients help modulate the immune system and reduce inflammation. Supporting community seed banks, indigenous food festivals and local nutrition programmes can restore this connection. Even traditional beverages like mbege—as shown in the Kilimanjaro study—can help in the repair of gut health and immune function.
Agroecology & soil health: Healthy soil grows more nutrient-dense food and retains more water. Practices like composting, agroforestry, and diverse seed systems restore soil biodiversity and buffer communities against climate stress. Investing in agroecological farming and staying clear of synthetic fertilizers is a true public health strategy.
Biodiverse lifestyles: Exposure to nature strengthens immune regulation. Breastfeeding, spending time in forests, tending gardens, walking barefoot—all these reintroduce beneficial microbes. Simple public health interventions like school gardens, green spaces and forest days could have far-reaching immune benefits.
7th-generation thinking: Many African traditions valued future generations. This mindset—aligned with the “seventh-generation principle”—urges us to make decisions today that benefit people seven generations from now. In practice, it means protecting land, empowering women, and building local systems of care, trade and governance that restore ecosystems rather than extract from them.
A Final Word
The science is clear, and so is the wisdom of our elders: our bodies are barometers of the biosphere. When ecosystems are unwell, we are too.
East Africa’s rising tide of NCDs is not an individual problem—it’s a systemic one. But by drawing on both traditional knowledge and new evidence, we can chart a different course.
Reclaiming local diets, restoring soil health, and reconnecting with nature aren’t just cultural ideals. They are essential acts of public health, resilience and healing.
Let’s reimagine health together
If this reflection resonates with your work or your questions, I’d love to connect.
I support organisations and communities exploring the links between food, soil and chronic disease—drawing on both evidence and traditional wisdom. Whether you’re developing programmes, shaping curricula or looking for grounded, systems-based strategies for the NCD crisis, I may be able to help.
Feel free to reach out for a conversation.
References
Whitmee, S. et al. (2015). "Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health." The Lancet, 386(10007), 1973-2028.
Haahtela, T., von Hertzen, L., Holgate, S. et al. (2013). "The biodiversity hypothesis and allergic disease: World Allergy Organization position statement." World Allergy Organization Journal, 6(3), 1–18.
Katato, P., Byamungu, L, Brand, A. et al (2019). "Ambient air pollution and health in Sub-Saharan Africa: Current evidence, perspectives and a call to action.” Environmental Research Volume 173: 174-188
Akdis, C.A. (2021). “Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions?” Nature Reviews Immunology, 21, 739–751.
Prescott, S. & Logan, A.C. (2016). The Secret Life of Your Microbiome: Why Nature and Biodiversity are Essential to Health and Happiness. New Society Publishers.
Schnorr, S.L. et al. (2014). “Gut microbiome of the Hadza hunter-gatherers,” Nature Communications, 5, 3654.
Altieri, M.A. (2012). “Agroecology, small farms, and food sovereignty,” Monthly Review, 61(3).
Temba, G.S., Pecht, T., Kullaya, V.I. et al. (2025) “Immune and metabolic effects of African heritage diets versus Western diets in men: a randomized controlled trial.” Nat Med