<p>School science education needs to change its aims, content and pedagogies if it is to prepare students for the challenges of the Anthropocene. Climate change is the single biggest health threat facing people and other organisms. We argue for embedding EcoHealth as a curriculum aim within school science, as well as other subjects. Findings from a study undertaken in Egypt are presented, where a critical realist approach was employed, in part because of critical realism’s distinction between reality and our knowledge of reality, and in part because of its treatment of absence. A documentary analysis of the Egyptian school curriculum was conducted to examine how climate change and its health impacts are dealt with and 34 secondary students and seven teachers were interviewed across seven schools to explore their understandings of climate change and its health effects. The analysis shows stark absences in teaching and learning about climate change in Egyptian schools and little understanding or recognition of its health impacts. The findings are used to argue for a Vision III science education for climate change education in the face of environmental decline and future uncertainties. Limitations of the study include a relatively small sample size for the number of interviews undertaken, limited time to collect data due to bureaucratic delays in issuing official permissions to access schools and a paucity of existing research on this topic in Egypt. Future research could determine how the Egyptian curriculum and classroom practices are addressing the worsening climate emergency.</p>