Given its associated burden of disease, climate change in South Africa could be reframed as
predominately a health issue, one necessitating an urgent health-sector response. The growing impact
of climate change has major implications for South Africa, especially for the numerous vulnerable
groups in the country. We systematically reviewed the literature by searching PubMed and Web
of Science. Of the 820 papers screened, 34 were identified that assessed the impacts of climate
change on health in the country. Most papers covered effects of heat on health or on infectious
diseases (20/34; 59%). We found that extreme weather events are the most noticeable effects to date,
especially droughts in theWestern Cape, but rises in vector-borne diseases are gaining prominence.
Climate aberration is also linked in myriad ways with outbreaks of food and waterborne diseases,
and possibly with the recent Listeria epidemic. The potential impacts of climate change on mental
health may compound the multiple social stressors that already beset the populace. Climate change
heightens the pre-existing vulnerabilities of women, fishing communities, rural subsistence farmers
and those living in informal settlements. Further gender disparities, eco-migration and social
disruptions may undermine the prevention—but also treatment—of HIV. Our findings suggest that
focused research and effective use of surveillance data are required to monitor climate change’s
impacts; traditional strengths of the country’s health sector. The health sector, hitherto a fringe
player, should assume a greater leadership role in promoting policies that protect the public’s health,
address inequities and advance the country’s commitments to climate change accords.
Supplementary Materials: File S1, Protocol for systematic review of Climate Change research in South Africa.