South Africa is losing an estimated R721 billion each year to the health and economic impacts of air pollution, with researchers warning that extending the lifespan of ageing coal-fired power stations could significantly increase those costs.
The findings come as the Department of Mineral Resources and Energy (DMRE) moves ahead with plans to keep ten Eskom-operated coal-fired power stations running for at least another decade. While the proposal is intended to strengthen electricity security, environmental and economic researchers argue that it could create long-term financial risks that extend well beyond the energy sector.
According to the Centre for Research on Energy and Clean Air (CREA), the annual cost of air pollution is equivalent to about 14% of South Africa’s gross domestic product. The estimate includes healthcare expenses, lost productivity, absenteeism, and the wider social costs associated with chronic illness.
Rather than being confined to communities near coal plants, the pollution spreads across provincial borders, affecting millions of South Africans far from the original source.
Gauteng bears the largest health and economic burden
Fine particulate matter known as PM2.5 is produced during coal combustion and can remain suspended in the atmosphere for up to two weeks. Regional wind patterns carry these particles hundreds of kilometres, allowing pollution generated in Mpumalanga to reach densely populated areas including Pretoria and Johannesburg.
Although Gauteng has no large Eskom coal-fired power stations, CREA identifies it as the province suffering the greatest health consequences from coal emissions.
Researchers estimate that approximately 15,200 premature deaths linked to coal-related air pollution occur in Gauteng, accounting for nearly half of the national total.
Beyond the human cost, poor air quality reduces labour productivity by increasing sick leave and placing additional strain on businesses that rely on a healthy workforce. Higher healthcare spending and reduced employee availability also create indirect costs that affect economic performance across the province.
CREA said these impacts represent a significant but often overlooked financial burden on South Africa’s largest economic hub.
Coal policy may complicate climate and trade commitments
Researchers also warn that extending the operational life of coal-fired power stations could make it more difficult for South Africa to meet its legally binding climate commitments.
Under the Climate Change Act and the country’s updated Nationally Determined Contributions (NDCs), South Africa has committed to limiting greenhouse gas emissions to between 350 and 420 million tonnes of carbon dioxide equivalent by 2030.
If emissions from electricity generation remain high, other sectors—including manufacturing, mining, agriculture and transport—may need to invest substantially more in emissions reductions to compensate.
Failure to reduce emissions could also expose exporters to international carbon border adjustment measures, potentially increasing the cost of doing business in overseas markets and reducing competitiveness.
CREA argues that electricity generation is generally among the easiest sectors to decarbonise. Delaying the transition, the organisation says, shifts a larger share of the burden onto industries where emissions are harder and more expensive to reduce.
The report also highlights the long-term consequences for children. It estimates that delaying the phase-out of coal could result in around 41,000 additional preterm births, 17,000 new childhood asthma cases and approximately 370 deaths among children under the age of five.
Researchers say these outcomes would increase healthcare costs for families while diverting public resources away from education, infrastructure and other long-term investments that support economic growth.
While government officials continue to emphasise the importance of energy security, the report argues that the financial cost of air pollution should be considered alongside electricity supply when evaluating South Africa’s future energy policy.
Source: Centre for Research on Energy and Clean Air (CREA); Department of Mineral Resources and Energy (DMRE).