In recent years, extreme climate events have negatively impacted many parts of the globe, but due to its already high vulnerability, Sub Saharan Africa has been the theatre for some of the early and more dramatic climate impacts. This has affected most significantly the livelihoods and health of the most deprived people. As observed in the countries concerned by this case study (Malawi, South Africa, Kenya and Zimbabwe), droughts, floods, extreme temperatures have caused successive crop failures, the drying up of water sources and the spread of malaria to locations where it was not endemic (Koelle et al 2010; Wakhungu et al 2010; Zvigadza et al 2010).