Changes in temperature and rainfall will have many negative impacts on human health. Temperature increases will extend disease vector habitats. Where sanitary infrastructure is inadequate, droughts and flooding will result in increased frequency of water-borne diseases. Increased rainfall could lead to more frequent outbreaks of Rift Valley fever. Poor sanitation in urban locations and increased temperatures of coastal waters could aggravate cholera epidemics. [10.2.4.1.1, 10.2.4.4]

Although the basic infrastructure for development—transport, housing, and services—is inadequate in many instances, it nevertheless represents substantial investment by governments. An increase in the frequency of damaging floods, heat waves, dust storms, hurricanes, and other extreme events could degrade the integrity of such critical infrastructures at rates the economies may not be able to tolerate, leading to a serious deterioration of social, health, and economic services delivery systems. This condition will greatly compromise general human welfare. [10.2.5.3]

Sea-level rise, coastal erosion, saltwater intrusion, and flooding will have significant impacts for African communities and economies. Most of Africa's largest cities are along coasts and are highly vulnerable to extreme events, sea-level rise, and coastal erosion because of inadequate physical planning and escalating urban drift. Rapid unplanned expansion is likely to predispose large populations to infectious diseases from climate-related factors such as flooding. [10.2.5.2]

Alteration of spatial and temporal patterns in temperature, rainfall, solar radiation, and winds from a changing climate will exacerbate desertification. Desertification is a critical threat to sustainable resource management in arid, semi-arid, and dry subhumid regions of Africa, undermining food and water security. [10.2.6]

Given the diversity of constraints facing many nations, the overall capacity for Africa to adapt to climate change currently is very low. National action plans that incorporate long-term changes and pursue "no regrets" strategies could increase the adaptive capacity of the region. Seasonal forecasting—for example, linking SSTs to outbreaks of major diseases—is a promising adaptive strategy that will help save lives. Current technologies and approaches, especially in agriculture and water, are unlikely to be adequate to meet projected demands, and increased climate variability will be an additional stress. It is unlikely that African countries on their own will have sufficient resources to respond effectively.

Climate change also offers some opportunities. The processes of adapting to global climate change, including technology transfer and carbon sequestration, offer new development pathways that could take advantage of Africa's resources and human potential. Regional cooperation in science, resource management, and development already are increasing, and access to international markets will diversify economies and increase food security.

This assessment of vulnerability to climate change is marked by uncertainty. The diversity of African climates, high rainfall variability, and a very sparse observational network make predictions of future climate change difficult at the subregional and local level. Underlying exposure and vulnerability to climatic changes are well established. Sensitivity to climatic variations is established but incomplete. However, uncertainty over future conditions means that there is low confidence in projected costs of climate change. This assessment can create the framework for individual states to begin to construct methodologies for estimating such costs, based on their individual circumstances.

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