South Africa’s just transition must also be a health transition

South Africa stands at an important crossroads. The country faces the challenge of managing a coal-dependent energy system while confronting high unemployment and growing climate vulnerability. These pressures are often discussed as separate policy challenges, yet in reality they are closely interconnected.

The debate around South Africa’s Just Energy Transition has rightly focused on economic justice, energy security and the livelihoods of workers and communities that depend on the coal economy. However, another dimension deserves far greater attention. The transition away from fossil fuels is also fundamentally a public health strategy.

Air pollution associated with coal combustion remains one of South Africa’s most significant environmental health challenges. Communities located near coal-fired power stations, mines and heavy industry experience elevated exposure to fine particulate pollution. A substantial body of medical research links this pollution to respiratory disease, cardiovascular illness and increased premature mortality. These impacts place a direct burden on households while also increasing pressure on national health systems and reducing economic productivity.

Climate policy, therefore, cannot be understood purely through the lens of emissions reductions. It must also be seen as a tool for protecting populations from the health and economic risks created by pollution and climate change.

A new report from the Climate Crisis Advisory Group, Protecting People: Health-Centred NDCs for the Overshoot Era, argues that climate strategies should increasingly be designed around protecting human wellbeing in a world that has already entered a period of climate overshoot.

The health dimension

Reducing greenhouse gas emissions remains essential, but governments must also focus on reducing the immediate harms that climate change and environmental degradation are already imposing on communities.

For South Africa, this perspective is particularly relevant. The country faces a combination of environmental and socioeconomic pressures that make the health dimension of climate policy especially significant.

Coal-based energy systems contribute not only to global greenhouse gas emissions but also to local air pollution with substantial health consequences. Reducing reliance on coal, therefore, has the potential to deliver immediate improvements in air quality and public health, while simultaneously supporting long-term climate objectives.

Climate-related risks

At the same time, South Africa is increasingly exposed to climate-related risks that threaten water systems, infrastructure and economic stability. The water crisis that brought Cape Town close to Day Zero in 2018 demonstrated how climate variability can rapidly become a national economic concern. Drought, heat and water stress will place growing pressure on communities and public services in the years ahead.

The Just Energy Transition should therefore be viewed as an opportunity to address multiple risks simultaneously. If implemented effectively, it can reduce pollution, improve public health, strengthen economic resilience and create new employment opportunities.

The health dimension of the transition is particularly important because it connects climate policy directly to the everyday wellbeing of citizens. Cleaner air reduces respiratory illness and improves quality of life in communities that have long been exposed to industrial pollution. Warmer and more energy-efficient housing reduces health risks during extreme weather. Reliable and affordable energy systems improve living standards while supporting economic activity.

Employment challenge

The transition also intersects with South Africa’s urgent employment challenge. Youth unemployment remains one of the most pressing social and economic concerns facing the country. Investments in renewable energy generation, electricity grid infrastructure, housing retrofits and climate-resilient infrastructure can create employment while supporting long-term economic development.

Several policy priorities could help strengthen the link between climate action, health and economic opportunity.

An accelerated but carefully managed phase-down of coal power is essential, but it must be accompanied by strong support for workers and communities whose livelihoods depend on the coal economy. Job guarantees, retraining programmes and targeted regional investment can help ensure that the transition remains socially just.

Investments in housing and urban infrastructure can also play an important role. Improving energy efficiency in buildings and expanding access to cleaner electricity reduce household costs while improving health outcomes in vulnerable communities.

Reducing methane emissions from coal mines and waste systems represents another important opportunity. Methane is a highly potent greenhouse gas and also contributes to safety and environmental risks. Addressing these emissions can provide relatively rapid climate benefits.

Finally, governments should incorporate the health costs of pollution into economic decision-making. When the full economic burden of pollution-related illness is properly accounted for, the case for cleaner energy systems becomes considerably stronger.

South Africa’s Just Energy Transition is often framed as a difficult balance between climate ambition and economic development. In reality, protecting public health may be one of the most compelling reasons to accelerate the transition.

Cleaner air, healthier communities and new economic opportunities are not secondary benefits of climate policy. They are central outcomes of a transition designed to protect people and the economy.

A just transition that ignores the health dimension risks overlooking its strongest political and economic argument. DM

Sir David King is the former UK chief scientific adviser and chair of the Climate Crisis Advisory Group.