Profiling health for equitable benefit-sharing in the global critical mineral value-chain: a lens from East and Southern Africa.

Critical minerals used in low-carbon technologies are vital for the global energy transition, but with disproportionate benefit for wealthy countries and risks from their extraction in the Global South. Globally, African countries, particularly in East and Southern Africa, are reported to hold high shares of global reserves of critical minerals such as cobalt, manganese, graphite, copper, nickel and lithium. Large- and small-scale extraction of these critical minerals has thus escalated due to global demand. Despite regional policies to protect health, in practice limited attention is given to health in the sector. The paper outlines the under-reporting of health risks and impacts, particularly in artisanal and small-scale mining (ASM), in vulnerable workers, and in adjacent and displaced communities, women and children in both small and large-scale mining. This leaves a significant information gap in implementing the 2025 South Africa-led G20 Summit call for more equitable benefit-sharing with local communities in the global critical mineral value-chain. Evidence presented in this paper on efforts to assess and manage the health risks in East and Southern Africa points to the role that Health Impact Assessment (HIA) can play as an internationally recognised tool to lever recognition of the distribution of health risks, and to link this to options and duties to plan for, regulate and embed prevention and control of these risks in sector activities, including through inclusive decision-making on the findings. Evidence indicates that Environmental Impact Assessments do not meet this need. The authors thus argue for HIA to be institutionalised as a duty in sites of critical mineral extraction and processing. In East and Southern Africa this calls for strengthened capacities, legal mandates and duties for, and widened implementation and reporting of HIAs, responsive also to ASM contexts, to embed this process as a key early step for equitable benefit-sharing in the global value chain, and as one lever for a more just green transition.