The issue of how the climate crisis affects health is often sidelined in the discussion on climbing global temperatures. However, for the first time, last year’s Congress of the Parties conference included a day dedicated to highlighting the link between the climate crisis and health. In South Africa, a changing climate can increase the severity of existing diseases in a country with an already stressed healthcare system.  

Climate crisis indicators such as heat stress increase South Africa’s risk of mosquito-borne diseases such as malaria, dengue and yellow fever, communicable diseases such as HIV/Aids, TB and cholera, and non-communicable diseases such as cardiovascular and respiratory diseases.  

Dr Gloria Maimela, the director of climate and health at Wits RHI, told Daily Maverick the climate crisis had direct and indirect health implications, especially for the very young, the elderly and pregnant women. People living in informal settlements were also vulnerable as they lived in areas with low vegetation. 

“Exposure to high ambient temperature can lead to adverse health outcomes including heat stroke. A systematic review of literature conducted by Chersich et al has revealed that there is an association between heat and health affecting pregnant women and newborns. It was discovered through this review that exposure to high ambient temperatures can lead to pregnancy-induced hypertension, low birth weight, premature birth and stillbirth,” Maimela said. 

“Indirect pathways as a result of global warming also include food insecurity, as crops fail, leading to malnutrition. Extreme weather events can also result in infrastructure damage, with public health infrastructure not being barred from these effects, impacting access to healthcare. The World Health Organization has found that over 51% of public health infrastructure damage in 2022 can be attributed to climate change.”

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The COP28 Health Day, which drew more than 50 health ministers to the climate conference, highlighted the relationship between health and climate, as well as the needs of low and middle-income countries, best practices and how to build climate-resilient systems. 

At Health Day, more than 120 countries endorsed the COP28 UAE Declaration on Climate and Health, a pledge acknowledging support for the urgent action needed to address the health challenges stemming from the climate crisis. South Africa is not a signatory of the declaration.

South Africa is a water-stressed country, and higher temperatures carry the risk of outbreaks of waterborne diseases such as cholera — as seen in Hammanskraal in 2023.

Maimela said there were ongoing efforts at a regional and national level, including through global partnerships, to address the health impacts of the climate crisis. 

The WHO’s African region has partnered with African countries including South Africa to support vulnerability assessments across these countries. Identifying the most vulnerable areas can spur urgent action to address challenges. 

Read more in Daily Maverick: The climate crisis is also a healthcare crisis and we must start preparing ourselves now

In October 2023, the Department of Forestry, Fisheries and the Environment and the Department of Health hosted a national climate change adaptation strategy workshop. The session included actions that could be taken by individuals and institutions to address the health impacts of the climate crisis. 

One such action is “cool roofing”, which entails painting roofs with white reflective paint, which reduces temperatures inside the house by up to 60%.  

“Climate change is real,” said Maimela. “We are feeling the impacts like never before. Weather events have become extremely unpredictable. What is important to know and understand is that climate change is problematic to your health; the more extreme heat and air pollution you are exposed to, the higher the risk it is to your health.” DM