Climate Change And Its Impact On Asthma In South Africa.

South Africa is experiencing climate-related warming 1.5 times faster than the global average, which is driving shifts in meteorological and environmental conditions that exacerbate respiratory health risks. More extreme weather events, including heatwaves, floods and wildfires, combined with increasing aeroallergens, mould growth and poor air quality, are contributing to increased rates of asthma and allergic respiratory diseases, at the same time driving morbidity and mortality. While these risks are real and growing, they also present an opportunity to strengthen climate-health resilience. Existing health and environmental monitoring systems remain fragmented and unevenly distributed. Linking environmental exposure data to respiratory health outcomes is essential if public health planning and adaptation are to be effective. This narrative review highlights and contextualises the current evidence on climate-related respiratory risks in South Africa, with a focus on asthma. It highlights recent national studies, identifies key data and policy gaps and introduces SA-CARES, a sentinel-based early-warning system for respiratory health as a model for pre-emptive integrated surveillance. Coordinated investment in data integration, healthcare preparedness and community engagement will be key to building adaptive capacity and advancing climate-resilient health policy in South Africa and other low- and middle-income countries.