Delaying Coal Phase-Out Could Cost South Africa $38 Billion in Health Losses

A report released on Earth Day, April 22, 2026 by the Centre for Research on Energy and Clean Air, Greenpeace Africa and GroundWork estimates that postponing the retirement of coal-fired power plants under South Africa's 2025 Integrated Resource Plan could cost the economy around ZAR 721 billion, or $38.3 billion, in healthcare expenses, productivity losses and lost working days. Researchers project that the delay could result in approximately 32,000 additional premature deaths between 2026 and 2050.

South Africa's coal power capacity is concentrated in Mpumalanga at nearly 31.3 gigawatts, followed by Limpopo at 8.8 gigawatts and Free State at 3.7 gigawatts. Extending coal use by up to a decade could result in between 23 and 31 million sick days. Children bear a disproportionate burden: the report estimates 41,000 additional preterm births, 17,000 new cases of childhood asthma and more than 370 deaths among children under five from delayed phase-out. These impacts stem largely from exposure to fine particulate matter and other pollutants impairing lung development.

Pollution's distribution is not limited to coal-hosting provinces. Gauteng, which has no coal-fired power plants, is projected to suffer the highest number of fatalities from the delay — approximately 15,200 additional deaths — due to pollution transported from other regions, while Mpumalanga is projected to see an additional 4,800 deaths. The 2025 IRP, issued by the Department for Mineral Resources and Energy, formalises plans to extend the operating lifetimes of ten Eskom-operated coal-fired power plants, a shift the report says directly conflicts with South Africa's updated Nationally Determined Contributions committing to emissions of 350 to 420 million metric tonnes of CO2 equivalent by 2030.

The report compares two scenarios: coal retirements on the IRP 2019 timeline versus extensions under IRP 2025. It concludes that delaying coal phase-out is not merely an energy decision but a public health and economic one. South Africa's Climate Change Act establishes a legal framework for a just transition to a low-carbon economy, and extending coal makes those targets harder to achieve while locking in higher emissions from one of the country's largest sources. The authors argue that long-term savings from avoided health damage and improved productivity could far outweigh the upfront investment required to accelerate the clean energy transition.

Key figure — ZAR 721 billion ($38.3 billion)