For cities in sub-Saharan Africa a 1.5 °C increase in global temperature will bring forward the urgency of meeting basic needs in sanitation, drinking water and land-tenure, and underlying governance weaknesses. The challenges of climate sensitive management are exacerbated by rapid population growth, deep and persistent poverty, a trend for resolving risk through relocation (often forced), and emerging new risks, often multi-hazard, for example heat stroke made worse by air pollution. Orienting risk management towards a developmental agenda can help. Transition is constrained by fragmented governance, donor priorities and inadequate monitoring of hazards, vulnerability and impacts. Opportunities arise where data and forecasting is present and through multi-level governance where civil society collaborates with city government.