The real-time cost of climate change and the needed real-time response


By Michelle A. Williams and K. Viswanath

In the past decade, India has entered a positive new era in public health. The country’s infant mortality rate has declined, the
sex ratio has improved, food security and nutrition have improved, and the average life expectancy
increased by five years from 2005 to 2015. But threatening this upward trajectory is the greatest threat to public health the world faces today: climate change.

Look no further than the recent, historic heat wave that enveloped much of the country. Just last week,
more than 180 people were killed in Bihar when temperatures rose past 40 degrees Celsius. In the city of Churu, temperatures rose to over
degrees Celsius in early June, less than one degree shy of

India’s all-time record. Since May, more than 200 people across the country have died due to heat-related illness and complications. Hundreds more have been admitted to hospitals, which are already overburdened and ill-equipped to deal with the increasing incidence of heatstroke.


In response to the deadly heat, the Health Ministry issued an advisory urging large swaths of the Indian subcontinent to cease most aspects of daily life: to remain indoors, stop drinking tea and coffee, and sleep under a slightly damp sheet. Schools and universities closed for days at a time, construction work ground to a halt, and tens of thousands fled their homes and communities in search of cooler temperatures.

Precautions like these are the result of hard-learned lessons. In recent years, heat waves have become the norm in India, resulting in the deaths of more than
6,000 people since 2010. And extreme weather events are expected to worsen in years to come, as global temperatures rise due to human-induced climate change. In fact, experts predict that by the turn of the century, parts of South Asia could become so hot and humid that humans will not be able to survive more than
six hours outdoors.

Climate change is having far-reaching consequences for public health around the world, affecting everything from the nutritional content of our food to our ability to combat the spread of infectious disease. But the cruel irony is that while the world’s wealthiest countries contribute the most to climate change, the world’s poorest and most vulnerable
bear the brunt of its impact.

Across India, tens of millions of people will be affected by sea-level rise and coastal flooding. Changes in agricultural productivity patterns could cost the country’s farmers
an estimated 15 to 18 percent of their incomes. By 2020, demand
on India’s water
will exceed its supply, leading to severe drinking water shortages. Those most imperiled will be India’s rural and urban poor, who already face disproportionately high barriers to
accessing fresh water, nutritious food, and basic health care.

There is no question that the effects of human-caused environmental changes are far-reaching—and devastating. But all hope is not lost. Because as India has itself demonstrated, increased awareness of the human stakes of climate change can spur collective action to address it.

For example, despite an increase in heat waves across India, we have seen a dramatic decline in heat-related fatalities in recent years. In 2015,
more than 2,000 lives were lost. But the following year, the death toll dropped to 375—and to 20 the year after that. These remarkable reductions are due in large part to coordinated efforts by the government to communicate the dangers of extreme heat, urge employers to modify or reduce working hours during heat waves, and improve access to resources such as free drinking water and cooling centers. (Prime Minister Narendra Modi also recently
launched “Piped Water for All by 2024,” an ambitious plan to bring tapped drinking water to the entire country in the next five years.)

Of course, it is not enough to simply mitigate the impacts of extreme heat—we must apply a public health lens to the climate crisis in order to curb its impacts. Limiting global warming to 1.5 degrees Celsius, as outlined by the Paris Climate Agreement, would have dramatic global benefits, from reducing sea level rise and extreme weather events to decreasing the risk of drought, food-shortages, and heat-related deaths. But achieving that goal means dramatically reducing carbon emissions, which are growing at a
faster rate in India than any other energy-consuming nation.

It has been heartening, then, to witness the problem-solving steps taken by the Indian government in recent years. The country has set ambitious decarbonization and renewable energy targets and has made
considerable progress toward its goal of installing 175 gigawatts of renewable energy by 2022. Last September, various city officials and government employees met at the Global Climate Action Summit, where they publicly pledged to scale efforts to reduce greenhouse gas emissions. Perhaps most importantly, the country’s leaders have publicly embraced
a multilateral approach to combatting global warming—even as the U.S.
has retreated from the same plan of attack.

As a global community, we have to stop talking about the climate threat in distant terms and begin connecting the dots between planetary trends and local lives. As the inextricable link between earthly health and human health becomes more apparent, so should our willingness to pursue bold solutions. As Prime Minister Modi himself put it, further inaction on climate change would be an
“immoral and criminal act.”

(Michelle A. Williams is the Dean of Harvard T H Chan School of Public Health and K Viswanath is the Lee Kum Kee Professor of Health Communication at Harvard T. H. Chan School of Public Health. The views expressed are their own.)

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