India is one of the most rapidly developing nations and one of the biggest concerns is the risk of how easily large public health disasters like the COVID-19 pandemic can thwart it. As climate change intensifies and new diseases emerge the intensity and frequency of these threats will only increase in India. Such challenges emerging from climate change worsen existing vulnerabilities and create new obstacles. One of the main roadblocks is the ripple effect of climate change impacts across various sectors, including public health and development. Climate-related disasters, such as extreme weather events and rising temperatures, directly impact public health by increasing the prevalence of vector-borne diseases, heat-related illnesses, and malnutrition. Additionally, we all know climate change also disrupts ecosystems, leading to food and water insecurity, displacement of populations, and loss of livelihoods, particularly among marginalised communities. The World Bank group report on Managing the Impacts of Climate Change on Poverty clearly stated that without constant efforts to reduce the impact of climate change it ‘could force more than 100 million people into extreme poverty by 2030.’
Dr Angela Chaudhuri, public health specialist and Chief Catalyst of Swasti, says, “Basically, the impact of climate change on public health and development is multifaceted, affecting access to healthcare, infrastructure, and socio-economic stability. Vulnerable populations, including low-income communities, indigenous peoples, women and pregnant people, and rural populations, bear most of the brunt of these impacts due to limited resources and inadequate infrastructure. In fact, numerous factors, such as intense heat, poor air quality, and extreme weather events significantly impact women’s health outcomes. Women are more susceptible to diseases linked to climate change because of their unique health needs, particularly during pregnancy. Studies have indicated a connection between climate-related risks, such as intense heat waves, flooding, and wildfires, and unfavorable health consequences for expectant mothers, such as low birth weight, eclampsia, and unplanned childbirth. This relationship has been supported by recent research, which has shown links between heat stress and unfavorable pregnancy outcomes such as miscarriages, early births, and low birth weights. Further, recent studies also show a direct correlation between the mounting stressors of climate change and sterilisation rates.”
Addressing these challenges requires holistic approaches integrating climate adaptation and mitigation strategies into public health and development policies. Investments in resilient infrastructure, community-based adaptation measures, and capacity building for climate-resilient health systems are essential to mitigate the adverse effects of climate change on public health and promote sustainable development. We talk to Dr Chaudhuri to understand the impact of climate change on health and well being:
What are the primary health problems that climate change is making worse, particularly for marginalised populations, and what can be done to strategically address them?
Climate change exacerbates various health problems, particularly for marginalised populations, including increased heat-related illnesses that includes everything from heat cramps to strokes and worsening of existing chronic diseases such as diabetes, anemia and hypertension, vector-borne diseases such as dengue, malaria and chikungunya, and waterborne and foodborne infections such as cholera, typhoid and even cases of diarrhoea. Marginalised communities are disproportionately affected due to limited access to healthcare, inadequate sanitation, and socio-economic disparities, making every day wellbeing a tough thing to achieve. Outdoor workers such as street vendors, construction farmers, fishers and other daily wage workers are especially prone to these health risks due to prolonged exposure to heat and lack of access to clean water and sanitation facilities.
To strategically address these health problems, a multi-faceted approach focusing on prevention, adaptation, and resilience-building is needed. This includes enhancing access to healthcare services, improving sanitation infrastructure, and implementing climate-resilient public health interventions. Community-based initiatives, such as training community health workers and promoting health education, will definitely play a crucial role in raising awareness and building resilience among vulnerable populations. Additionally, collaboration between government agencies, NGOs, and local communities is essential to develop and implement targeted interventions that address the specific health needs of marginalised populations in the context of climate change.
Given the intensity and impact of climate-related disasters on public health efforts tools like environmental surveillance can become both strategic and critical in identifying and responding to these threats before they impact both lives and livelihoods allowing the decision makers to manage such challenges more effectively by providing timely, useful evidence.
From a sustainability standpoint, how can wastewater management and monitoring support public health and climate resilience, particularly during the recent episodes of heatwaves and the upcoming monsoon season?
Ans – Wastewater management and monitoring is one of the simplest and cost-effective environmental surveillance solutions – it is comprehensive yet non-intrusive and does not disturb the community equilibrium. This particular tool has played an important role in supporting public health globally and in India, especially for Polio and COVID-19 surveillance. We were able to utilize the insights generated from wastewater surveillance in 5 cities of our operations to keep the city stakeholders informed with real-time updates for early action. The tool was recommended by the Ministry of Health urging the states to use this public health preparedness system for COVID monitoring.
The same approach can be replicated for climate resilience, particularly during episodes of heatwaves and the upcoming monsoon season as it can provide valuable insights into disease trends and environmental health indicators, enabling early detection and timely response to public health threats. During heatwaves, for example, wastewater monitoring can identify hotspots of heat-related illnesses and prioritise interventions to protect vulnerable populations. Similarly, during the monsoon season, monitoring sewage for pathogens helps prevent outbreaks of waterborne diseases, such as cholera and diarrheal infections.
Precision Health Platform, for instance, utilises a public health preparedness system with various disease surveillance tools to monitor climate-mediated health risks impacting the lives of marginalised communities. These tools help detect pathogens, pollutants, and health risks within communities, aiding in larger epidemic and pandemic detection and public health decision-making. In combating climate-related health issues, these tools enable early detection of climate-sensitive diseases such as vector-borne illnesses or waterborne infections that are particularly relevant during the monsoons as these diseases increase with humidity, scarcity of clean water, and the subsequent rise in stagnant, polluted water.
But this is not it as there are several other tools of disease surveillance that can be easily deployed during monsoons such as event-based surveillance, an AI-powered web scraping tool that looks for the most relevant reports on disease outbreaks online. It allowed us to report early on mumps and cholera outbreaks in several regions of India this year alone. Participatory surveillance is another complementary tool that can be utilized, this tool allowed us in the past to detect symptoms such as cluster cases of diarrhoea and vomiting in the community.
And most of all triangulation of intelligence received from such tools allows disease risk identification that could get mixed with reliance on just one solution. Triangulating insights and intelligence allowed us to share alerts on time so that everyone, and especially the most vulnerable, are constantly equipped and empowered to make the most of any season.
In areas with scarce resources, how can public health systems more effectively anticipate and address the health effects of climate-related disasters?
In resource-scarce settings, public health systems face unique challenges in anticipating and addressing the health effects of climate-related disasters especially since resource availability is even dire due to climate disasters. Limited resources, inadequate infrastructure, and weak healthcare systems exacerbate the vulnerability of populations to climate impacts, such as extreme weather events, heat waves, and infectious diseases.
To effectively address these challenges, a proactive approach is needed that integrates climate adaptation measures into public health planning and emergency response strategies. This includes strengthening early warning systems, enhancing public health preparedness and monitoring of climate-sensitive diseases, and building capacity for rapid response and recovery. In times like this, the integration of climate and health data is even more significant to identify high-risk areas and vulnerable populations. This data-driven planning allows for more optimal resource allocation.
Collaborative partnerships between government agencies, NGOs, academic institutions, and local communities are essential to mobilise resources, share knowledge, and implement effective interventions. By leveraging local knowledge and resources, public health systems can better anticipate and address the health effects of climate-related disasters, ensuring the health and well-being of vulnerable populations.
What new ideas or partnerships are needed to make public health efforts more resilient to climate change, and how can these efforts help communities in India?
With climate change posing new challenges some of which we can predict as well, what we need is blend of new and old ideas and partnerships for there is no one solution or one organization that can work towards climate change resilience for communities.
These new ideas and partnerships could be innovative approaches to disease surveillance, monitoring, and response that integrate climate data, health indicators, or community-based observations to anticipate and mitigate health risks. Leveraging emerging technologies, such as remote sensing, artificial intelligence, and mobile health applications, can enhance the effectiveness of public health interventions and improve resilience to climate impacts. One of the key solutions is the implementation of real-time health and climate risk monitoring systems that can quickly detect and respond to climate-related health issues, such as disease outbreaks or heat-related illnesses. To have real-time insights and early warnings a one-time surveillance approach does not work, it should be continuously monitored.
We are taking a continuous monitoring approach to our overall work around public health, focusing on long term, comprehensive health and wellbeing rather than a parceled approach focusing on disease instances. This is why our key goal that contributes to our vision is achieving 100 million “healthy” days for vulnerable people by 2026. We are also keenly aware that to achieve this goal, we cannot simply work as a solo entity without engaging several partners in the larger ecosystem to orchestrate better outcomes for the communities we serve. These partners include policymakers, civil society organisations, and private sector actors, who are crucial to mobilise resources, foster innovation, and drive transformative change in public health systems.