Every time there is an emergency like a flood, and a hospital is affected, it is the “invisible” vulnerable population who are impacted the most, says Dr Angela Chaudhuri, with the public health organisation Swasti.

From air pollution to floods, climate emergencies are frequenting our neighbourhoods, adding to the physical and mental stress on people and increasing the pressure on health systems as well.

On December 3, the ongoing COP28 UN climate conference (Dubai) recognised this overlap of climate and health and hosted its first-ever health day. Governments were urged to put health at the heart of their policies, and fund it.

The rationale was simple. “The year 2023 has witnessed an alarming surge in climate-related disasters, including wildfires, heatwaves and droughts, leading to the displacement of populations, agricultural losses and heightened air pollution. The ongoing climate crisis has significantly increased the risk of life-threatening diseases such as cholera, malaria and dengue,” the World Health Organization (WHO) noted.

Over 40 million health professionals from around the world joined the WHO in urging governments to meet existing commitments to deliver on the Paris Agreement, accelerate the phasing out of fossil fuels and work towards “a healthier, fairer and greener future for humanity”. With health receiving just 0.5 percent of global climate financing, they called for increased spending towards creating climate-resilient health systems.

Climate care champions

Also at COP28’s health day, Swasti and the Global Consortium on Climate and Health Education (Columbia University) launched their ‘ClimateCare Champions’ programme. Their aim was to equip community workers with skills to address health impacts of climate change in countries including India, Cambodia, the Philippines and Bangladesh.

“The messaging needs to be clear, it should be from a trusted source and in a language familiar to the community,” says Chaudhuri, Swasti’s Chief Executive Officer, explaining their outreach efforts that teach communities to stay safe. During monsoons and flooding, for example, she says, people may know that it’s necessary to boil water before drinking it. But its importance needs to be communicated, especially to the vulnerable population, who may not do this due to lack of resources. The risk of cholera or typhoid, for example, need to communicated, along with local solutions on water purification, hand washing and so on, she explains.

An action plan is needed to build climate-smart and resilient health systems to tackle extreme climate events, says Dr Srinath Reddy, Founder and former president, Public Health Foundation of India.

During extreme heat, health systems should be prepared for strokes, heart attacks and renal failures; in rain emergencies, the risk is from water and vector-borne diseases like malaria and dengue, says Reddy, a cardiologist and epidemiologist. As weather patterns change and cold countries witness warmer climes, newer regions begin to report mosquito-linked diseases like chikungunya.

Primary healthcare centres should be strengthened to provide care close to/or at home, to treat diseases early and avoid complications, says Reddy. And governments need to outline “green norms” governing procurement and other systems, as they increase investments in health and co-opt private sector services, he points out.

The climate-health intersection is seen when deforestation depletes animal habitats, resulting in zoonotic diseases (where viruses jump species); heat creates migration where people and farm animals travel, again leading to diseases spreading, explains Reddy. And, climate change and displacement cause mental health issues, including anxiety, depression and fear of impending change, he says.

Nutrition gets impacted, as every one degree celsius rise in temperature results in a 10 percent decrease in cultivation of staple crops in South Asia and Sub Saharan Africa; there is a drop in the quality of crops, impacting its protein, zinc and iron content and leading to these deficiencies in people, says Reddy. Besides focusing on climate-resistant agriculture, water-use will need to be revisited, in products like aerated beverages and ultra processed foods which are already harmful to health, he adds.

Some observers expressed concern on India not participating in the Health Day, as it did not agree to the green-house gases reduction requirements in health and in the reduced timelines. Nevertheless, the day saw 124 countries commit to a Declaration on Climate and Health, developed with the support of countries, including India. So while global discussions continue beyond COP28, local governments will need to build resilient systems to tackle the cascading effects on health that climate change is set to bring, right to our very doorstep.