Climate Change, Health, and Interconnected Systems: A Call for Change

South African urban communities are highly vulnerable to climate change with data reflecting significant growth in extreme weather events including droughts and flooding, increases in temperatures, and other changes in weather patterns. Yet, dependency on extractive sectors such as the reliance on coal for electricity generation and the industrial sectors on which the economy relies also make our country a major carbon emitter. The interconnectedness of climate change, the degradation of our ecologies, and the resulting complexities can be directly linked to diminishing human health. These challenges are growing, and responses befitting holistic solutions need to be more considerate of these factors. We must consider how we innovate differently in consideration of the systemic nature of climate change. This innovation must consider policy shifts and how we direct our advocacy by applying a systems lens. Systems change is an approach to solving complexity to transform communities and the systems surrounding them.

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The ways we consider planetary health and the linked systems require a focus on the symptoms we experience as we navigate the systemic complexity related to planetary health. South Africa faces several climate challenges that have systemic impacts leading to adverse effects on human health. The country’s energy dependence on coal, increasing drought conditions, biodiversity loss, and land degradation, alongside inequality and exposure to climate vulnerability, result in various systemic impacts. These include the long-term use of fossil fuel infrastructure, ageing water infrastructure and unequal access to water services, land policies that favor deforestation and mining over agriculture or food security, and urban planning that inadequately addresses socioeconomic needs or climate adaptation best practices. Consequently, there is limited progress towards a Just Energy Transition, which affects air quality, and inequality in access to resources limits healthcare options, contributing to the proliferation of respiratory and non-communicable diseases.

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In response to some of these issues, there are proven interventions already taking place, such as the Renewable Energy Independent Power Producer Programme (REIPPP). However, more systemic shifts are needed specifically to focus on stronger community ownership. Additionally, the greater effect of climate change on human health is linked to food security, with land accessibility highlighting economic inequalities. The degradation of land is leading to lower crop yields, and economic pressures are leading the agricultural sector to focus on exports, which affects the local availability of food. However, the challenges in the agricultural sector are also systematically complex. The connected issues around food security exacerbate the growing health challenges such as growing rates of diabetes as access to fresh foods is difficult for many households. Food insecurity also increases many instances of non-communicable diseases; these all create pressure on the healthcare system that is already greatly strained. Additionally, the production of coal and other mining and industrial activities exacerbate air pollution and result in more respiratory diseases. Lastly, the systemic and historical challenges of suitable urban housing linked to urban planning create growing inequalities and climate vulnerability becomes skewed towards poorer populations. Many of these issues also affect mental health as sudden and extreme change also creates strain on people as they also deal with compounding cyclical challenges linked to poverty and inequality. These challenges also point to systemic failures in policy, governance, and implementation and point to a greater need for holistic interventions to improve the capacity for sustainable change across the system.

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Demonstrating the systemic nature of these challenges also demonstrates how planetary health solutions advocate systems-level thinking in driving solutions through local actions and advocacy interventions. Stronger climate governance and policy must have a systems lens applied to them, and advocacy groups should collaborate more to ensure that we think and create solutions that consider the system as a whole and not just one aspect of it. Across the continent, there are practices that focus on nature-based solutions to reduce the impact of extreme weather events on communities. These practices need more organized action driven from a government level. Water resilience programs are also focusing on the need to restore wetlands, and growing focuses are also shifting towards regenerative farming as it becomes a necessity for sustainable food production. The healthcare system is also being engaged more actively to understand climate change and shift practice as communities need to adapt in a variety of ways. Linked to this, healthcare policies, budgets, and planning need to also shift to focus on current and expected future health challenges as the complexities continue to overlap. Municipalities are also implementing locally relevant sustainability initiatives and can strengthen a focus on grassroots-level actions to drive systemic change.

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As the Local Conference of Youth (LCOY) 2025 gains momentum, we should all explore how to integrate planetary health and systems change into policy interventions. The LCOY's focus on just transition, local governance, and urban South Africa already indicates a systems-based approach. Leveraging this systems-thinking in our collaborative work, including G20 engagements and LCOY's emphasis on intentional youth engagement, can embed sustainable development practices in local communities, fostering future-oriented empowerment and capacity building. This approach is crucial for our survival and planetary regeneration.

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Nontuthuzelo Nikiwe is an alumnus of the Global Shapers Tshwane Hub where she served as an impact officer and, later, a curator. She continues to support the Hub’s work related to annual LCOY activities. She is a social impact practitioner working to strengthen social and impact investing across a variety of sectors in Southern Africa.

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