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Southern Africa is highly vulnerable to drought because of its dependence on climate-sensitive sectors of agriculture, hydro-energy and fisheries. Recurring droughts continue to impact rural livelihoods and degrade the environment. Drought severity in southern Africa is exacerbated by poor levels of preparedness and low adaptive capacity. Whilst weather extremes and hazards are inevitable, the preparedness to manage such hazards determines their impact and whether they become disasters. Southern Africa is often caught unprepared by drought as existing early warning systems lack the drought forecasting component, which often results in reactionary interventions as opposed to well-planned and proactive response mechanisms. This study assesses the spatio-temporal changes of rainfall and aridity in southern Africa through an analysis of long-term precipitation and evaporation trends from 1960 to 2007. Stakeholder consultation was conducted in Madagascar, Malawi, Zambia and Zimbabwe during the peak of the 2015/16 drought, focusing on overall drought impacts, current water resource availability, existing early warning systems, adaptation mechanisms and institutional capacity to mitigate and manage droughts as part of overall disaster risk reduction strategies. Average rainfall has decreased by 26% in the region between 1960 and 2007, and aridity has increased by 11% between 1980 and 2007. The absence of drought forecasting and lack of institutional capacity to mitigate drought impede regional drought risk reduction initiatives. Existing multi-hazard early warning systems in the region focus on flooding and drought monitoring and assessment. Drought forecasting is often not given due consideration, yet it is a key component of early warning and resilience building. We propose a regional drought early warning framework, emphasising the importance of both monitoring and forecasting as being integral to a drought early warning system and building resilience to drought.