Managing the freshwater impacts of climate change in Africa is as much a political and development challenge as a technical climate change challenge. Even without climate change, many of Africa’s water resources are facing overuse, pollution, and degradation. Poor land-use practices are contributed to this process. Large numbers of people living in poverty in rural and informal urban areas are already vulnerable to water-related risks, whether floods, droughts, poor water quality, or increasing water scarcity. The status of water resources in Africa has been changing for many decades, whether through decreasing water quality, lowered groundwater, more or less rainfall, and changed timing of rainfall. Change is not new. Climate change, however, will profoundly accelerate the rate of change, affecting the ability of people and societies to respond timeously. The rate of change is compounded by uncertainty of the impacts of climate change. While there are a number of models that attempt to predict the impacts of climate change, many of these are at a very coarse scale and do not predict localised impacts, which may differ from the generalised picture. At the same time, different models predict different climate change trends in the same areas, some, for example, predicting an increase in rainfall, while others predict a decrease in rainfall. Managing for high rates of change in a context of uncertainty is thus what is demanded of African governments.