“Cape Town’s water supplies will be reduced through a decrease in mean annual rainfall, an increase in temperatures and increase in demand caused by population growth (including inmigration). Likewise, the City’s Health Services will be placed under further pressures from climate change related in-migration and urbanisation, as well as a potentially increased burden of disease. Strengthening resilience will work towards alleviating increased stress on social welfare services. The current national energy crisis impacts on economic activities and growth, against the backdrop of significant unemployment and a national drive for job creation. Approximately 33 000 people move to Cape Town each year in search of better opportunities43. This in-migration is likely to increase in the future, partially due to climate change impacts on the sustainability of rural livelihoods. This in-migration results in increased pressure for delivery of basic services and a potentially increased burden of disease on the poorest of the poor. Joblessness forces people to adopt survivalist approaches, which can have negative social, environmental, and health impacts on communities.