South Africa: Use of Go.Data in response to COVID-19 - November 2021. © WHO / Lehlohonolo Koekoe
South Africa
South Africa plays a pivotal role in Southern Africa’s health security ecosystem. As the region’s most economically advanced nation, it is well-positioned to drive innovation, coordination and cross-border collaboration, Yet, it too is increasingly vulnerable to the impacts of climate change. Ranked 24th on the Climate Risk Index, South Africa faces intensifying climate-related hazards including droughts, floods and heatwaves. These events are reshaping the country’s health landscape, exacerbating the spread of vector-borne and waterborne diseases, straining public health systems, and increasing the burden on vulnerable communities, particularly in informal settlements and rural provinces. Although South Africa benefits from stronger infrastructure and institutional capacity compared to many neighbouring countries, overlapping health burdens such as HIV, tuberculosis, food insecurity and climate-induced migration continue to challenge its adaptive capacity.
ALLOCATION
US$ 5.4 M
PARTNERS
National Institute for Communicable Diseases (NICD)
NATIONAL STEERING COMMITTEE
Co-Chairs: Dr. Anban Pillay, Deputy Director General, National Department of Health and Shenaaz El-Halabi (WHO Representative, South Africa). First convened 11 April 2025.
Climate-related health challenges
South Africa’s diverse geography exposes it to a range of climate-related health risks that are increasing in frequency and severity:
- Heatwaves and prolonged droughts are placing enormous pressure on water security, agriculture and food systems, driving malnutrition and undernutrition, particularly among rural and peri-urban communities. These impacts are especially pronounced in Limpopo, North West and the Eastern Cape provinces.
- Flooding and flash floods, often following periods of drought, result in displacement, contamination of water sources, and outbreaks of waterborne diseases such as cholera and diarrhoea. Informal settlements are disproportionately affected due to inadequate drainage, sanitation and health care infrastructure.
- Climate-driven shifts in vector-borne diseases are expanding the geographic range of malaria into new areas, including parts of Mpumalanga, Limpopo and KwaZulu-Natal, challenging traditional malaria control efforts.
- Rising food safety risks linked to climate-induced changes in food production, storage and distribution systems are increasing the likelihood of food-borne illnesses.
- Degraded air and water quality due to climate change and environmental degradation are heightening respiratory illnesses and increasing risks of water-borne pathogen transmission.
- Cross-border migration influenced by climate shocks in neighbouring countries is contributing to disease spread, particularly along busy points of entry.
Early warning and disease surveillance systems
South Africa will enhance its climate-health surveillance infrastructure by:
- Conducting all-hazards emergency risk assessments using the STAR tool across six provinces.
- Updating the national risk profile and contingency plans for high-risk climate-related health threats, including food safety.
- Integrating meteorological and hydrological early warning data into electronic health information systems and event-based surveillance (EBS) dashboards.
- Expanding wastewater-based surveillance for priority pathogens such as mpox, cholera and antimicrobial resistance (AMR).
- Strengthening event detection and verification through the Epidemic Intelligence from Open Sources (EIOS) platform.
- Conducting joint cross-border risk profiling and simulation exercises at high-risk points of entry to harmonize preparedness.
A national integrated surveillance strategy, supported by real-time data platforms, simulation exercises and multisectoral collaboration, will underpin these efforts.
Laboratory systems
To strengthen laboratory readiness and coordination, South Africa will:
- Expand wastewater testing sites and train sub-regional experts in environmental surveillance methodologies.
- Develop a comprehensive Environmental Health Strategy, linking air and water quality surveillance with burden-of-disease monitoring.
- Build biosafety and biosecurity capacity across laboratories through procurement, training, and accreditation initiatives.
- Conduct data quality audits to enhance surveillance reliability, and integrate foodborne illness outbreak detection protocols.
- Strengthen malaria diagnostics and information systems, including the development of district-level contingency plans for endemic and epidemic-prone areas.
These efforts will contribute to more robust laboratory systems capable of detecting and responding to complex, climate-sensitive health threats.
Strengthening human resources and public health workforce
South Africa will invest in a multidisciplinary health workforce through:
- Localizing and rolling out AVoHC SURGE trainings focused on climate, foodborne and zoonotic threats.
- Conducting comprehensive surge capacity assessments at subnational levels to map workforce, stockpiles and infrastructure readiness.
- Establishing and training Emergency Medical Teams for subnational deployment in emerging health threats.
- Rolling out Health Emergency Leadership Manuals for district-level and subnational responders through cascaded Training of Trainers models.
- Building national and provincial rapid response team rosters, supported by cross-sectoral capacity-building for human, animal and environmental health experts.
- Upgrading capacity at points of entry through Field Epidemiology Training Programmes, infrastructure support and contingency planning exercises.
South Africa’s strengthened emergency workforce will be critical to ensuring rapid, coordinated and climate-resilient health emergency responses, both nationally and regionally.