From Silos to Systems: How South Africa and the Netherlands Are Rewriting the Playbook on Water, Energy, Food, and Health (NRF–NWO Midterm Symposium)

On 5 March 2026, the National Research Foundation (NRF) in Pretoria hosted the Midterm Symposium on Integrating Health Approaches and the Water–Energy–Food (WEF) Nexus, a half-day convening that brought together researchers, policymakers, and practitioners from two continents. The event marked the halfway point of four flagship research projects jointly funded by the NRF and the Dutch Research Council (NWO), each designed to illuminate the hidden connections between resource insecurity and public health in Southern Africa.

What emerged over the course of the afternoon was more than a progress report. It was a provocation: the systems that govern water, energy, food, and health in South Africa were never designed to talk to each other. But the communities who depend on them have no choice but to live at their intersection.

A Partnership Built for Complexity

Dr Makobetsa Khati, Executive Manager at the NRF, opened proceedings by framing the initiative as a “quadruple helix” of partnership an intentional fusion of academia, industry, civil society, and the public sector. The four research projects, running from 2023 to 2027, are not conceived as academic exercises. They are designed to produce tangible societal outcomes, grounded in the understanding that the interconnectedness of resources is inseparable from the interconnectedness of human wellbeing.

The collaborative architecture itself is significant. Each project pairs South African and Dutch research institutions, creating a pipeline for knowledge exchange that runs in both directions from the modelling expertise of Utrecht and Delft to the lived-experience research of Stellenbosch, Johannesburg, and KwaZulu-Natal.

Climate Change as a Health System Stress Test

Professor Monika dos Santos of the University of South Africa delivered a keynote that reframed climate change not as an environmental crisis with health side effects, but as a direct and systemic assault on healthcare infrastructure across Sub-Saharan Africa.

Her core argument was stark: while Africa contributes the least to global CO₂ emissions, the continent is projected to experience warming at double the global average potentially reaching 4°C if the rest of the world hits 2°C. Between 2001 and 2021, more than half of all public health events on the continent were already climate-related, dominated by waterborne and vector-borne diseases.

Dos Santos also spotlighted a dimension of the crisis that rarely makes it into policy discussions: mental health. She pointed to rising suicide rates among farmers who lose their livelihoods to drought, the emergence of eco-anxiety across age groups, and the absence of any specific diagnostic framework for climate-related psychological disorders. Current clinical manuals, she noted, default to generic labels like “adjustment disorders,” failing to capture the unique pathology of climate distress.

Perhaps her most compelling insight concerned what she called “transport poverty” the structural reality that even where clinics exist in rural South Africa, the absence of roads and affordable transit means the most vulnerable populations simply cannot reach them. With 70% of the country’s doctors concentrated in the private sector, this infrastructural gap becomes a de facto barrier to healthcare access.

Yet Dos Santos did not end on despair. She highlighted the strategic advantage of Ubuntu the collective, community-centred philosophy that characterises much of Sub-Saharan African society. Drawing on the Connecting Climate Minds project, she argued that this communal orientation positions African communities to build resilience in ways that individualistic Western models cannot replicate.

From Mapping Insecurity to Understanding Lived Experience

The symposium’s two-part seminar showcased the work of PhD students and postdoctoral researchers across the four projects. What was striking was the deliberate research architecture: each presentation built on the last, moving from macro-level data to micro-level human experience.

Quantifying Vulnerability at Scale

Inge Ossentjuk of Utrecht University presented a sophisticated framework for measuring household water, energy, and food security across 12 domains mapping availability, accessibility, affordability, and acceptability at the municipal level. The resulting “hotspot” maps are not abstract academic outputs; they are intended as practical tools for government agencies to prioritise resource allocation in the areas of greatest need.

Eli Dearden, also from Utrecht, layered a public health dimension onto this spatial analysis. His framework revealed that water insecurity is predominantly linked to communicable diseases, while food insecurity correlates more strongly with non-communicable diseases and injuries a distinction that has significant implications for how interventions are designed and targeted.

Learning from Resilience on the Ground

A’ishah Ebrahim of Stellenbosch University brought the research closer to the ground through her concept of “positive deviance” the deliberate study of communities that thrive despite extreme resource scarcity. Working in partnership with the Do More Foundation, Ebrahim’s research asks a fundamentally different question: instead of diagnosing failure, what can we learn from success? Her approach seeks to identify indigenous resource management strategies that could serve as leverage points for scalable intervention.

Technical Innovation Meets Community Reality

The second seminar session demonstrated that innovation in this space is not about laboratory breakthroughs alone it is about designing tools that speak to the realities of the people they are meant to serve.

Yuxiao He of Deltares presented an integrated modelling system for Mpumalanga province that couples traditional WEF models with disease transmission models for malaria and schistosomiasis. The resulting interactive dashboard, co-developed with local resource managers, allows users to test “what-if” scenarios such as the health consequences of building a new dam or removing invasive species before decisions are made. His reflection was candid: “Reality is not shaped by models, but by people. The value of these models lies in creating a space for dialogue.”

Hluphi Mpangane of the Mpumalanga Department of Health brought attention to the “double burden” of malnutrition in farmworker communities where children suffer from stunting and wasting while their mothers may simultaneously face overweight or obesity. Her four-phase research framework is co-developed with farmworker mothers themselves, ensuring the resulting support tools reflect actual household dynamics rather than externally imposed assumptions.

Mgcini Ncube of the University of Twente offered perhaps the symposium’s most vivid case study from Lake Chivero in Zimbabwe, where fishermen deliberately seek out hyacinth-infested waters because these polluted zones harbour the largest fish populations. The health trade-off is severe: these same areas are cholera hotspots. Ncube’s team is developing a satellite-based early warning system that uses hyacinth and algal bloom patterns as proxies for disease risk, enabling health responders to target interventions before outbreaks occur.

Jing Zha of Delft University of Technology presented a waste-to-energy system that converts household bio-waste into biogas, which is then fed into a high-efficiency fuel cell to generate electricity. Testing with 16 households in Cape Town’s Centre Ground community, her research demonstrated that a single household’s organic waste can produce enough power to treat its own drinking water a genuinely circular solution that simultaneously addresses waste management, energy poverty, and water safety.

From Nexus Thinking to Nexus Doing

The stakeholder panel, moderated by Dr Palesa Skhejane, was where the symposium shifted from research to strategy. The panellists represented a cross-section of the institutions that will ultimately determine whether these research insights translate into policy and practice.

Dr Maneshree Jugmohan-Naidu of the Department of Science, Technology and Innovation offered a clear signal to the research community: government listens when innovation is presented collectively and with a unified voice, not as isolated pilot projects. She pointed to the One Food Risk Tool as a model for science-based decision-making and noted its expansion toward a holistic One Health approach.

Mr Hassani of the Inkomati-Usuthu Catchment Management Agency called for a fundamental rethink of water governance. South Africa’s water management, he argued, has historically been siloed between resource management and service provision. Upstream failures acid mine drainage, collapsing municipal wastewater infrastructure are directly driving downstream health crises. Systems thinking is no longer optional; it is an operational necessity.

Dr Nwabisa Masekwana of the Agricultural Research Council delivered a necessary reality check: the most vulnerable populations live far from roads and markets, and research must be intentionally designed to reach them. She also challenged the body of work to move beyond its water-centric focus and give equal weight to energy security and the immediate drivers of malnutrition.

Berto Bosscha of the Dutch Embassy framed these nexus innovations as preventive measures that could help governments manage spiralling healthcare costs. His most pointed observation was a call to decouple research timelines from election cycles, advocating instead for 10–20-year visions that allow scientific innovations to survive political transitions.

Nicole Du Plessis of SAEON, joining online, brought the marine dimension into focus. Ocean health, she argued, is human health particularly for coastal communities where degraded marine ecosystems translate directly into nutritional deficiencies, disease, and lost livelihoods.

Impact by Design, Not by Accident

The symposium closed with a challenge that resonated well beyond the room. Impact, the closing speaker argued, must be "by design, not by accident." She questioned whether the incentive structures of academia where publications sit at the top of deliverable lists and community engagement at the bottom are fit for purpose when the stakes are this high.

"Do we fund research for universities, or do we fund research for society?" she asked. The answer was unequivocal: the end goal of research is not publications. It is people.

The afternoon's discussions crystallised around three calls to action. First, institutional innovation: creating cross-sectoral task teams at the local level to dismantle government silos. Second, community co-production: embedding a co-design phase into funding frameworks so that research begins with a community's lived experience, not a researcher's hypothesis. Third, sustainable financing: ensuring continuity beyond pilot funding so that hard-won data and community trust do not simply evaporate when grants expire.

The NRF–NWO partnership represents something increasingly rare in the research landscape: a programme that refuses to treat complexity as a problem to be simplified and instead embraces it as the very terrain on which meaningful solutions must be built. As these four projects enter their second half, the question is no longer whether water, energy, food, and health are connected. That much is settled. The question now is whether the institutions that govern these domains can learn to work as seamlessly as the communities who have no choice but to navigate them every day.