A new report released on Earth Day, April 22, 2026, warns that delaying the phase-out of coal-fired power in South Africa will carry serious health and economic consequences.
The assessment, conducted by the Centre for Research on Energy and Clean Air (CREA), Greenpeace Africa, and the climate non-profit GroundWork, examines the air quality impacts of the government’s plan to extend the life of coal power plants under the 2025 Integrated Resource Plan (IRP).
The report “Unmasked: The Health and Economic Cost of Delaying Coal Phase-Out in South Africa” estimates that postponing coal retirement could cost the economy around ZAR 721 billion (US$38.3 billion). These losses would stem from rising healthcare expenses, reduced productivity, and millions of lost working days. The analysis suggests that extending coal use by up to a decade could result in between 23 and 31 million sick days, placing additional strain on households and the public healthcare system.
The majority of the coal power capacity in South Africa is located in Mpumalanga (almost 31.3 GW), followed by Limpopo (8.8 GW), and Free State (3.7 GW). In these provinces, the extension of coal power in the government’s new IRP is projected to have a dramatic impact on public health.
The health impacts are particularly alarming. Researchers project that delaying the phase-out could lead to approximately 32,000 additional premature deaths between 2026 and 2050. The burden is not evenly distributed. Gauteng, despite having no coal-fired power plants, is expected to suffer the highest number of fatalities, around 15,200 additional deaths due to pollution transported from other regions.
Mpumalanga, which hosts most coal capacity (31.3 GW), is projected to see an additional 4,800 deaths, showing the transboundary nature of pollution and that harm falls both where coal is burned and where pollution travels.
Children are among the most vulnerable. The report estimates that delayed coal phase-out would result in 41,000 additional preterm births, 17,000 new cases of childhood asthma, and more than 370 deaths among children under five.
These impacts stem largely from exposure to fine particulate matter and other pollutants known to impair lung development and increase the risk of chronic illness.
The findings also underscore how the 2025 IRP conflicts with South Africa’s climate commitments.
In 2025, the South African Department for Mineral Resources and Energy (DMRE) released a new IRP that continues and formalises plans to extend the operating lifetimes of ten Eskom-operated coal-fired power plants.
This shift delays coal phase-out and is in direct opposition to South Africa’s climate commitments. The country’s updated Nationally Determined Contributions (NDCs) commit to limiting greenhouse gas emissions to 350-420 Million Metric Tonnes of Carbon Dioxide Equivalent (MtCO2e) by 2030, while the Climate Change Act establishes a legal framework for a just transition to a low-carbon, climate-resilient economy. Extending coal makes these targets harder to achieve and locks in higher emissions from one of the country’s largest sources.
In this briefing, the researchers quantify the air quality impacts of extending coal power under the IRP 2025 by comparing two scenarios:
Base scenario — coal plant retirements proceed on the IRP 2019 timeline and
Delayed scenario — coal plant lifetimes are extended in line with IRP 2025.
This comparison isolates the impact of the policy decision to delay coal phase-out.
Under the government’s plan to extend coal power by an additional 10 years in the most recent IRP, air pollution from these plants is projected to cause 27 million individual work absences (sick days).
The report concludes that delaying coal phase-out is not merely an energy decision, but a public health and economic one. While transitioning to cleaner energy requires upfront investment, the long-term savings from avoided health damage and improved productivity could far outweigh the costs.