In 2023, the world grappled with unprecedented heat induced by climate challenges, marking the year as the hottest one on record. This precipitated severe droughts, deadly heat waves, catastrophic forest fires, storms, and floods and took a heavy toll on human health, with India being one of the worst impacted, according to The Lancet’s Countdown on Health and Climate Change. Each Indian was exposed to more than 100 days of such high heat that even light outdoor activity like walking posed at least a moderate risk to their health. The changing weather and rising mercury have also substantially altered the transmission dynamics of climate-sensitive infectious diseases in India. Malaria, which was earlier confined to lowlands, has spread to the Himalayas while dengue has expanded throughout the country, including coastal regions. The double burden of morbidity that India faces from communicable and non-communicable diseases will be worsened by climate change. Worryingly, it could also facilitate the growth of vectors such as mosquitoes, sandflies, ticks and as yet unknown ones and alter the seasonality of infection through changes in their life cycle. Furthermore, reduced availability of food and water and the decrease in the nutritional value of food due to heat waves and so on increase vulnerability to diseases. Less well-recognised is the impact of climate change on non-communicable diseases and mental health — heat, physical exertion, and dehydration can lead to kidney ailments, chronic obstructive pulmonary disease, depression, anxiety and many other diseases.

If India aspires to be in the league of developed nations, it must remember that health impacts due to rising climatic factors will slow economic growth by pulling down the gross domestic product. There is thus a case to urgently reconsider India’s health budget and infrastructure. India’s expenditure outlay for healthcare is 3.83% of its GDP. But the devil is in the details: this share includes the budget for not only ‘health and family welfare’ and ‘medical and public health departments’ but also ‘water and sanitation’. Thus, the actual expenditure on health is lower than 3.83%. According to a NITI Aayog report, about 10 crore people are pushed into poverty each year due to the money they spend on healthcare, a figure that will rise as climate change intensifies. But merely focusing on healthcare expansion will be akin to addressing the symptoms. India and the world must first cure the sickness of climate inaction.