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This study aims to explore the impact of environmental sustainability on government health expenditure in Africa for the period 2000–2021.

The study employs the generalized method of moments (GMM) technique and utilizes a sample of 43 African countries.

The study reveals that carbon dioxide (CO2) emissions and renewable energy consumption have a positive relationship with health expenditure. For the control factors, we demonstrate that economic growth, urbanization and industrialization have a significant negative influence on health expenditure, while the impact of education on health expenditure is positive.

The study proposes several policy recommendations, including prioritizing investment in renewable energy sources and promoting the use of cleaner energy sources such as wind, solar and hydroelectric power. These measures would help improve environmental quality and reduce government health expenditure.

The study contributes to the limited research on the relationship between environmental quality and health expenditure in Africa. Moreover, it goes beyond previous studies that only considered CO2 emissions and explores the impact of adopting cleaner energy sources on health expenditure.