The ‘just transition’ and health in South Africa

Abstract

Background South Africa’s long history of dependence on coal-fired power has had severe impacts on climate, environmental health, and public health. Global pressures and local demands for a planned just transition in South Africa have been growing. People are calling for a transition to clean renewable energy that optimises socio-economic and local ecological benefits. The Just Transition Open Agenda is a contribution to the national debate by the Life After Coal civil society campaign. The Open Agenda proposes radical changes leading to a new health system for all. This is needed, especially to address the differential and continual health impacts of unsafe levels of air pollution especially where most of South Africa’s coal-fired power stations are located. Approach This paper reviews South Africa’s climate change response and the role that the healthcare sector (as a significant source of emissions and environmental pollution) can play in reducing global carbon emissions and helping societies to adapt and become more ‘climate resilient’. The chapter considers some of the recommendations for public health within the just transition movement in South Africa, with a particular focus on the heavily polluted Highveld Priority Area in Mpumalanga, and the implications of these recommendations for the healthcare sector. Conclusions A comprehensive public health plan for the Highveld Priority Area, guided by the principles of communication, collaboration, and active participation, would begin to provide some measure of restorative justice for the communities most affected by coal-related pollution. The plan should include effective health surveillance and air pollution early-warning systems, community outreach programmes, and well-resourced and accessible public health facilities prepared to deal with respiratory emergencies. The Global Green and Healthy Hospitals network agenda’s 10 goals towards ‘climate-smart’ health care, which provide practical guidance for achieving sustainable, low-carbon, and climate-resilient health systems must be urgently pursued as part of global and local efforts towards greater climate justice and health equity.