Context

• The national conference India 2047: Building a Climate-Resilient Future showcased an urgent truth: climate change is not a distant threat; it is a present and intensifying health crisis.
• Bringing together diverse voices, from garment workers to climate modellers, paediatricians to architects, the event highlighted the necessity of interdisciplinary collaboration.
• If India is to safeguard its population from the worsening impacts of extreme heat, the health system must evolve from its current reactive model to one that is proactive, preventive, and rooted in equity.

The Hidden Toll of Heat on Public Health

• Despite the early onset of the monsoon, India has already endured another brutal summer.
• Rising temperatures exert immense strain on public health, exacerbating dehydration, heatstroke, and chronic illnesses.
• The current health response, however, is skewed toward crisis management, hospital admissions, IV fluids, and emergency care, rather than anticipation and prevention.
• This reactive model is both unsustainable and insufficient in the face of recurring heatwaves.

Challenges and Prospective Solutions

• Primary Care as the First Line of Defence
  • To combat heat-related health issues effectively, India's primary health-care system must be fortified and climate-proofed.
  • Community health workers such as ASHAs (Accredited Social Health Activists) are strategically positioned to become champions of heat safety.
  • With the right training and protocols, they can deliver early warnings, educate communities, and provide vital interventions, from hydration advice to checking on vulnerable individuals.
  • The integration of meteorological early warning systems with local health networks can further enable swift, community-level action.
  • For example, a forecast of extreme heat could trigger door-to-door visits, WhatsApp alerts, and distribution of hydration kits, simple yet impactful measures that have already shown success in urban centres like Ahmedabad.
  • Importantly, prevention must also be integrated into chronic disease management.
  • Patients with diabetes, heart disease, or kidney issues are particularly susceptible to heat stress, and their treatment must adapt accordingly during summer months.
• Updating Clinical Protocols for Heat Readiness
  • Despite the rising frequency of heatwaves, clinical awareness remains alarmingly low.
  • Many health-care providers fail to screen for heat exposure, and cases of heatstroke are frequently misdiagnosed or missed entirely.
  • There is an urgent need to establish clear, standardised clinical protocols for identifying and managing heat-related illnesses.
  • Simple measures, such as conducting summer readiness drills in hospitals, creating dedicated ‘heat corners’ in emergency departments, and pre-stocking cooling kits, can greatly enhance the capacity of health facilities to deal with the heat crisis.
  • These steps reflect a shift from treating symptoms to proactively preventing illness.

The Way Forward

• Beyond Medicine: The Role of Interdisciplinary Action
  • Preventing the health impacts of extreme heat requires more than a medical response. It demands systemic, cross-sectoral collaboration.
  • Urban planners must redesign housing and public spaces to reduce heat exposure. Water departments must ensure reliable access during peak summers.
  • Labour regulations must protect outdoor workers with mandated rest periods and shaded spaces. Crucially, climate scientists must work closely with health officials to ensure that interventions are data-driven and targeted.
  • India must move away from isolated ‘centres of excellence’ and towards networks of excellence, interdisciplinary teams that combine public health, urban development, labour rights, and grassroots knowledge to create context-specific, scalable solutions.
  • These might include misting shelters in informal settlements or cool roofing in community centres and Anganwadi facilities.
• Equity at the Core of Climate Resilience
  • Extreme heat is not just an environmental hazard; it is a force multiplier of social injustice.
  • The brunt of rising temperatures is borne by society’s most vulnerable: street vendors, schoolchildren, the elderly in poorly ventilated homes, and daily wage workers under tin roofs.
  • For them, stay indoors is not practical guidance but a stark reminder of systemic neglect.
  • Therefore, equity must be at the heart of climate resilience.
  • Mapping social vulnerabilities, such as occupation, housing, and access to resources, is as critical as tracking temperature trends.
  • Responsive measures such as early morning health checks during heat alerts, mobile hydration stations in low-income areas, and subsidised cool shelters are not just humane but necessary.
  • Protecting the most exposed is both a scientific imperative and a moral duty.

Conclusion

• The window for meaningful action is rapidly closing. As climate extremes become the norm, India must act with vision and urgency.
• Embedding heat resilience into public health is not optional it is essential.
• This requires a decisive shift toward proactive care, cross-sector collaboration, and, most importantly, equity-driven solutions that protect those most at risk.