Extreme Weather across Africa

With extreme flooding occurring in Southern Africa only days ago, impacting almost one million people, the climate–health link feels increasingly relevant. A large region of Southern Africa, including Mozambique, Eswatini, Zimbabwe and South Africa, has suffered abnormally heavy rains since December 2025, with more than 200mm falling within a 24-hour period.

Flooding across Africa is projected to increase by 13% in area-days flooded by the 2040s, alongside more intense Category 5 cyclones in the southern Indian Ocean.

Exacerbation of Malaria

A recent study examining the link between climate change and malaria across the African continent estimates that climate-related factors could lead to 123 million additional malaria cases and 532,000 additional deaths between 2024 and 2050. Further analysis suggests that 79% of additional malaria cases and 93% of additional deaths would be driven by increasing extreme weather.

Outbreaks are not expected to expand into new regions. Instead, malaria will intensify in areas already struggling with transmission; only 0.05% of additional cases are projected to occur in areas currently outside malaria suitability.

Driving Factors

Extreme Weather

Patterns of extreme weather across the African continent are increasing in both intensity and frequency. Tropical cyclones and flooding in particular create infrastructural barriers to healthcare. Damage to roads, closure of healthcare facilities, and disruption to medication supply chains can cut off community access to treatment.

Reduced access to effective antimalarial drugs increases the likelihood that infections will progress and become fatal. The study finds that disruption to treatment access alone accounts for approximately 38% of projected additional cases, making it the single largest driver.

Housing Damage

Extreme weather can significantly damage homes. High winds, flooding and prolonged heavy rainfall threaten structural integrity, weakening physical barriers that normally protect residents.

Solid walls, roofs and screened windows do more than provide shelter – they reduce mosquito entry and therefore, infection risk. When these structures are compromised, exposure increases.

Vector Control Disruption

Vector control refers to strategies used to limit disease-carrying insects, including insecticide-treated bednets and indoor spraying campaigns.

Flooding and cyclones can destroy bednets, interrupt spraying programmes and delay prevention campaigns. Even short-term disruptions can lead to spikes in transmission.

Ecological Intensification

Climate shifts also affect mosquito ecology. Warming temperatures increase suitability in some highland and southern regions, while flooding can create additional breeding sites.

However, the study notes that while ecological effects are significant, their impact is considerably smaller than that of extreme weather disruption.

Who is most affected?

The study highlights Southern and central Nigeria; the African Great Lakes region (including Kenya, Uganda, eastern DRC, Rwanda and Burundi); Zambia and Angola; and floodplains in the Sahel as the most affected areas.

This reinforces a broader pattern of climate injustice; climate change worsens conditions and disrupts control systems in regions already burdened by disease, leading to more severe outbreaks and higher mortality rates.

Conclusions

The projections assume that current malaria control efforts stay at today’s levels, with no major improvements in health system resilience and no additional investments in adaptation. However, the authors emphasise that strong, climate-resilient health systems could reduce much of this risk.

Yet resilience is not evenly distributed. The regions where malaria transmission is already entrenched, and where extreme weather is projected to intensify cases, are often those constrained by limited health budgets, fragile supply chains and climate-vulnerable infrastructure. Let us also remember that these same countries have contributed only a very small share of historical global greenhouse gas emissions.

The burden will fall most heavily on those with the least capacity to absorb it, and on populations who have done the least to drive the crisis.