The protection of human health and the environment are two major goals of international environmental law. However, there has been little coherent scrutiny of their scope or implementation at international and domestic levels in developing countries and Africa in particular. This thesis shows that international environmental law regimes with a health protection objective have not maximized opportunities to reinforce the promotion and protection of public health in Africa. Through inter alia a study of sustainable management of shared freshwaters, trans-boundary movement of hazardous wastes and their disposal and international climate law, the thesis shows that a range of legal frameworks comprised of substantive, institutional and procedural law mandates States to advance the health objective in international environmental law. However, the thesis demonstrates the limits of these regimes and suggests options to enhance their potential in promoting and protecting public health. An enhanced framework of adaptive governance is proposed to improve environmental health governance. The thesis illustrates how the discourse on health in international environmental law can strengthen international environmental health governance to improve environmental and public health outcomes. It contains seven publications that analyse the strengths and weaknesses and options for reform of the international environmental law regime for health. The implications of these findings for theory, practice and public policy are discussed.