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Paper short abstract

Climate change worsens health disparities in Lesotho, impacting vulnerable groups. Extreme weather events challenge health access, while current interventions fail to address specific needs. The study advocates for political reforms and tailored health policies to enhance equity and meet SDG 3.

Paper long abstract

Climate change serves as a threat multiplier in the global South, where the impacts of extreme weather are inextricably linked to asymmetric power structures and systemic marginalisation. Due to increasing frequency of droughts, floods, snowfall and extreme temperatures, vulnerable populations in Lesotho are disproportionately burdened by these factors, whose resilience is often undermined by top-down governance models. While state and non-state actors have initiated climate-smart interventions, these frameworks frequently operate within rigid institutional bureaucracy that prioritise generalised aid over the intersectional health needs of chronically ill groups, including the elderly, women, youth, and persons with disabilities. This study argues that the "one-size-fits-all" approach to health provision in Lesotho reflects a technocratic bias that neglects the political economy of health access. Drawing on a case study of the Mafeteng District, the research examines how centralised decision-making and asymmetric resource allocation shape the health-seeking behavior of the chronically ill during climate-induced disruptions. It investigates how extreme weather events exacerbate existing socio-political barriers for individuals managing conditions such as HIV, diabetes, and hypertension. Moreover, the study assesses the adequacy of current policy frameworks, questioning whether current power configurations and institutional protocols actively facilitate or obstruct equitable health access. By situating health-seeking behavior within the context of governance and structural authority, the research provides critical insights into the political reforms necessary to achieve Sustainable Development Goal (SDG) 3.