/ 3 December 2020

No country, rich or poor, is immune from the health effects of climate change

Without action by 2030
Climate change poses a health risk to our society.

South Africans have experienced some of the world’s highest exposures to wildfire risk, and recorded significant heatwave exposure. And large swathes of the country have seen a substantial reduction in the maize crop growing season, aggravating food insecurity.

These are among the findings of the 2020 Lancet Countdown on Health and Climate Change report, an international collaboration by 120 leading health and climate change academics and clinicians, dedicated to tracking the emerging health profile of the changing climate.

Dr Alice McGushin, the programme manager of the Lancet Countdown report, says the findings show that South Africa experienced an 85% increase in the number of days its population was exposed to very-high-to-extreme-fire-risk days between 2001 and 2016. This equates to each person being exposed to an extra 33 days of high-to-extremely-high wildfire risk. 

“Considering exposure to actual wildfires, South Africa experienced an increase in annual daily population exposure to wildfires of 151 067 days (13.6%) from 2001-04 to 2016-19,” she McGushin says. South Africa, together with Lebanon and Kenya, was singled out among 114 countries for an increase in the risk of wildfires.

The report also found that:

  • Last year, South Africa experienced a reduction in crop growth, meaning that the crops mature too quickly, which leads to lower than average yields; 
  • South Africa experienced 1 360 heat-related deaths in 2018, which is a 90.3% increase from the 2000-2004 average; and
  • There were an estimated 10 050 premature deaths attributable to air pollution in 2018, a similar figure to the 10 140 deaths estimated in 2015. More than half of these premature deaths were a result of coal combustion in power plants.

James Irlam, the chairperson of the climate, energy and health special interest group of the Public Health Association of South Africa, says the Lancet report’s findings are sobering. 

“They confirm many of the predictions that have been made about the severe impact of climate change and the fact that South Africa is particularly vulnerable to the environmental and health impacts by virtue of our existing climate, deep inequalities and pre-existing burden of poverty and disease,” Irlam says. 

“It underscores the need for urgent and meaningful action to mitigate greenhouse gas emissions and adapt to the growing climate-health impacts.”

Muted response to climate change

In 2015, countries committed to limit global warming to “well below 2°C” as part of the landmark Paris Agreement on Climate Change, says the Lancet report, which was published on Wednesday, the fifth anniversary of the agreement.

“But five years on, global carbon dioxide emissions continue to rise steadily, with no convincing or sustained abatement, resulting in a rise in the global average temperature of 1.2°C. Indeed, the five hottest years on record have occurred since 2015,” says the report.

That the planet has already warmed by more than 1.2°C compared with pre-industrial levels (1850-1900), has triggered profound, immediate and rapidly worsening health effects, says the report. The health effects are seen on every continent. There is an ongoing spread of dengue virus across South America; cardiovascular and respiratory effects caused by record heatwaves and wildfires in Australia, western North America and western Europe; and undernutrition and mental health effects from floods and droughts in China, Bangladesh, Ethiopia and South Africa.

With the loss of life from the Covid-19 pandemic and climate change measured in the hundreds of thousands, the potential economic costs estimated in the trillions — and the broader consequences expected to continue for years to come — “measures taken to address both of these public health crises must be carefully examined and closely linked”.

2020 on track to be one of three warmest years on record

Also on Wednesday, the World Meteorological Organisation (WMO), unveiled its provisional State of the Global Climate 2020 report.

It revealed that climate change “continued its relentless march this year”, with 2020 on track to be one of the three warmest years on record.

The period of 2011-20, will be the warmest decade on record with the warmest six years all since 2015, it found.

Ocean heat is at record levels with more than 80% of the global ocean experiencing a marine heatwave at some point in 2020.

The secretary-general of WMO, professor Petteri Talaas, said that record warm years have usually coincided with an extreme El Niño event, as was the case in 2016. 

“We are now experiencing a La Niña, which has a cooling effect on global temperatures, but has not been sufficient to put a brake on this year’s heat … 2020 has, unfortunately, been yet another extraordinary year for our climate. We saw new extreme temperatures on land, sea and especially in the Arctic. 

“Wildfires consumed vast areas in Australia, Siberia, the United States West Coast and South America, sending plumes of smoke circumnavigating the globe. We saw a record number of hurricanes in the Atlantic, including unprecedented back-to-back category four hurricanes in Central America in November. Flooding in parts of Africa and Southeast Asia led to massive population displacement and undermined food security for millions,” Taalas stated.

‘The fingerprints of climate change’

Studies from 2015 to 2020 have shown the fingerprints of climate change in 76 floods, droughts, storms and temperature anomalies, the Lancet report finds.

Correspondingly, 67% of global cities surveyed expected climate change to compromise their public health assets and infrastructure seriously.

Based on current populations, between 145-million people and 565-million people face potential inundation from rising sea levels.


Vulnerable populations were exposed to an additional 475-million heatwave events globally in 2019, which was, in turn, reflected in excess morbidity and mortality.

“During the past 20 years, there has been a 53.7% increase in heat-related mortality in people older than 65 years, reaching a total of 296 000 deaths in 2018.”

Last year, Africa’s over-65s experienced more than 123-million above-baseline days of heatwave exposure, with seven out of the 10 highest-ranking years for heatwaves having occurred since 2010. Record heat cost 30-billion hours of potential labour capacity lost in 2019, with Indian and Indonesia among the worst-affected countries.


Heat and drought are also driving sharp increases in exposure to wildfires, resulting in burns, heart and lung damage from smoke, and the displacement of communities.

Africa has seen a 67% increase in daily population exposures to wildfires since the early 2000s. 

What must be done

Tackling climate change, by implementing plans to deliver commitments of limiting global temperature increases to well below 2°C, will mitigate shocks and achieve health and economic benefits. 

This will also reduce the risk of future pandemics, because the drivers of climate change can also drive zoonotic pandemic risk, the authors of the Lancet report say.