Can South Africa’s health system keep pace with climate change?

Climate change is no longer a distant concern but a public health emergency that presents a growing threat globally, including in South Africa. The country is already experiencing climate-related health effects, including rising temperatures, floods and droughts, shifting vector-borne disease patterns, and water scarcity that compromises sanitation infrastructure. These impacts increase the risk of diarrhoeal, waterborne, heat-related, and other climate-sensitive illnesses, particularly among vulnerable communities.

South Africa has developed several policy frameworks to address the climate crisis, including the National Climate Change Response Policy, the National Climate Change Adaptation Strategy, and the Climate Change Act (2024). While these provide an important foundation for climate action, health remains insufficiently integrated, and implementation is often fragmented, under-resourced, and poorly coordinated across sectors.

This policy brief examines the current climate-health policy landscape in South Africa and highlights opportunities to strengthen public health preparedness and resilience.

Gaps and challenges

Despite these policy advances, important implementation gaps continue to limit South Africa’s public health response to climate change.

• Fragmented policy implementation: Multiple national frameworks address climate and health, but without a unified operational plan, clear accountability, or coordinated implementation across national, provincial, and municipal levels.
• Limited health system preparedness: Climate-related health risks are not consistently incorporated into clinical guidelines, disease surveillance, or service delivery, reducing the health system’s ability to anticipate and respond to emerging threats.
• Workforce capacity: Training on climate and health remains limited across South Africa’s health workforce, with few opportunities for healthcare workers to develop competencies in climate-informed risk assessment, preparedness, and response.

Opportunities and recommendations

Building a climate-resilient health system will require coordinated action to strengthen governance, surveillance, workforce capacity, and community engagement.

Integrated climate and health adaptation plan

Develop a coordinated national climate and health plan with measurable health goals, dedicated funding, clear institutional responsibilities, and risk-based prioritisation of vulnerable populations.

Strengthen surveillance and early warning systems

Improve integration of meteorological, environmental, and health data to strengthen surveillance, predictive analytics, and early detection of climate-sensitive health threats.

Workforce capacity building

Integrate climate and health into medical, nursing, and public health education, while expanding in-service training to strengthen preparedness across all levels of the health system.

Community engagement

Promote locally driven adaptation planning and accessible public health communication to support communities most vulnerable to climate-related health impacts.

Conclusion

South Africa is at a critical juncture. The health impacts of climate change are no longer hypothetical; they are accelerating. By embedding health into national climate strategies, integrating climate into health strategies, investing in adaptive capacity, and prioritising equity, South Africa can build a health system resilient to future climate shocks.

For a more in-depth look into this policy brief download the full PDF below