Emissions of carbon have recently been found to pose potential public health risks since they affect air quality, transmission of climate-sensitive diseases and the environment in which infectious disease agents thrive. Nonetheless, there is little known about the relationship between carbon emissions and infectious diseases in HIPCs. This paper investigates the aggregate and individual country effect of carbon emissions on infectious disease burden in 28 HIPCs in Africa between 1990 and 2023. Infectious diseases include adult HIV prevalence rate, incidence rate of tuberculosis per 100,000 inhabitants and incidence rate of malaria per 1,000 population at risk. The dependent variables used include carbon emissions measured in metric tons per capita while other control variables used are the percentage of urban population, GDP per capita, current health expenditure and percentage access to basic sanitation facilities. For the statistical analysis, second-generation panel procedures have been employed which include cross-sectional dependence tests and slope heterogeneity test followed by the Augmented Mean Group estimator. The findings show that carbon emissions have a positive and significant effect on all three infectious-disease indicators. In aggregate terms, 1% change in carbon emissions is associated with a 0.025% change in adult HIV prevalence rate, 0.201% in tuberculosis incidence rate and 0.049% in malaria incidence rate. The effect of carbon emissions on the above three indicators shows large heterogeneities across countries such as Senegal, Burkina Faso, Cameroon, Niger, GuineaBissau, Gambia and Zambia depending on disease outcomes. Thus, climate and pollution sensitive public health risks need to be incorporated in debt-sensitive development, urbanization and health system financing policies in African HIPCs. It has contributed to environmental health and development literature in that carbon emissions have not only environmental-growth consequences but also disease-burden consequences in fiscally constrained African economies.