The effects of air pollution and climate change on human health are profound and increasingly palpable. Environmental epidemiologists have highlighted associations between heat and heatstroke, kidney injury, malnutrition and anaemia. Air quality has been linked to lung disease, cardiovascular disease and neonatal mortality.
Extreme rainfall has been associated with mosquito-borne and diarrhoeal illnesses. More than four of every five Indians are exposed to extreme weather events. Other challenges include exposure to unsafe levels of air quality and vulnerability to zoonotic diseases.
Given these challenges, we could be exposed to a silent pandemic, putting our society’s health at stake. As health secretary of Rajasthan in 2020, I witnessed the first reported cases of covid among Italian tourists in Jaipur. To tackle this common challenge, we conducted daily meetings across traditionally siloed government verticals.
Such a multi-stakeholder commitment is again the need of the hour. As the central government and states form their climate action and One Health committees, the issues involved need to be addressed through inter-sectoral collaboration.
We must begin with a thorough assessment of needs. Insights are crucial on which regions face the most pressing climate-related health burden. This cannot be an annual exercise limited to the district level. Decision-makers need a real-time weather map for climate-related health vulnerability.
A vulnerability index should take into account exposure levels, population sensitivity and adaptive capacity. While environmental exposure data has been available in real-time through geospatial sensors and satellites, we need data on sensitivity and adaptive capacity, particularly as it relates to the health of India’s rural residents.
During covid, technology played a crucial role in understanding and responding to the pandemic. As health secretary in Rajasthan, I oversaw the launch of a Community Health Integrated Platform (CHIP) in collaboration with Khushi Baby, an NGO.
This platform was initially used for community-based covid symptom surveillance and later expanded to track comprehensive primary care in each village, reaching 45 million people across the state. This is an example of the multi-stakeholder effort required.
Similarly, the Centre’s CoWin online platform facilitated the world’s largest vaccination drive, showcasing our ability to manage complex health challenges through technology.
Building on these technological foundations, with Khushi Baby leveraging CHIP data, Rajasthan developed a Climate-related Health Vulnerability Index (CHVI) that incorporates multiple data-sets. Tens of thousands of ASHA workers in the state—who played front-line roles during the covid pandemic—are acting as public health researchers in villages and using digital tools to report socio-demographic and health conditions as they change.
The CHVI can be used to empower each block official on the ground with a close understanding of local risks and their driving factors. Additionally, the CHVI’s automated assessment capability allows us to track which interventions are making an impact, providing feedback from those closest to the affected communities. This index could be adopted by the entire country for this purpose.
Beyond putting trackers in place, collaborative efforts must be made by government agencies, NGOs, health professionals and local communities. We must break down silos and foster a culture of shared responsibility. The Bhilwara Model used during covid exemplifies how local on-the-ground collaboration and decentralized decision-making can help contain public health threats. Such models should be adapted and scaled up.
The stakes are high. The increasing frequency and intensity of extreme weather events underscore an urgent need for action. Heatwaves, floods and storms not only disrupt daily life, but also strain our healthcare system. Vulnerable populations bear the brunt. Addressing this requires a proactive and inclusive approach towards public health and resilience.
Investing in climate-resilient healthcare infrastructure is no less crucial. Our health systems must be able to withstand climate shocks so that service levels hold up during a crisis. The effort must include upgrading facilities, training healthcare workers and ensuring adequate supplies of essential medicines and equipment.
Public awareness and education also play a crucial role. Empowering individuals with knowledge about climate-related health risks and preventive measures can lead to community-driven action. Grassroots movements, supported by resources and accurate information, can drive behavioural changes that reduce vulnerability.
As climate change represents the largest emerging public health crisis of our time, it demands immediate attention. To protect communities and safeguard public health, we must leverage technology, foster collaboration and build resilient health systems. This is a collective responsibility and it’s time to act. Together, we must confront this challenge to assure India a healthy future.