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Earth Day: India urged to fortify its health system

Rising global temperatures have triggered a cascade of impacts on human life, setting in motion a chain of reactions that have disrupted food production cycles, altered weather patterns, and lead to natural disasters and population displacement. This profound shift in climate dynamics exerts a compounding effect on public health, rippling through communities with multi-layered consequences.

India, from its bustling urban centres to remote rural regions, now stands at a pivotal moment, as it confronts the realities of climate change. Heatwaves, droughts, and floods have become increasingly common occurrences, posing significant challenges to the health and well-being of communities. In urban areas, where population density is high and infrastructure strains under the weight of rapid urbanisation, the effects of extreme heat are particularly pronounced. The lack of adequate green spaces, coupled with the heat-retaining properties of concrete jungles, exacerbates the urban heat island effect, further intensifying the heat stress. Meanwhile, rural communities, often marginalised and with limited access to essential services, face their own set of challenges during extreme weather events. Inadequate infrastructure, including poorly constructed housing and limited access to clean water and sanitation facilities, leaves rural populations highly vulnerable to the impacts of climate change.

Climate change sets the stage for the spread of parasitic and infectious diseases, reshaping the distribution of disease vectors and expanding the geographic footprint of illnesses. A study concluded by The Lancet Planetary Health indicated that mosquito-borne diseases earlier concentrated in eastern and southeastern India have found newer breeding grounds in higher altitude regions experiencing shifts in rainfall and temperature patterns. This expansion of disease vectors increases the risk of parasitic and pathogenic transmission, as evidenced by the recent emergence of Kyasanur Forest Disease (KFD) in Karnataka. Such instances underscore the urgent need for proactive measures to safeguard public health amidst changing climatic conditions.

Climate change’s impacts extend beyond the physical realm to affect mental health, an aspect often overlooked. A scientific assessment by the US Global Change Research Program (GCRP) in 2016 suggested events such as floods, droughts, and cyclones can trigger anxiety, depression, and post-traumatic stress disorder. Exposure to extreme heat can exacerbate aggressive behaviour, substance use, and mood disorders. Additionally, researchers have found that climate change indirectly affects mental health through nutrient deficiencies, particularly that of iron and zinc. Higher temperatures accelerate crop maturation, diminishing the absorption of essential nutrients and increasing susceptibility to disorders like depression, psychosis, and bipolar disorder.

As ramifications of climate change have become increasingly apparent in public health, the imperative for proactive measures intensifies. According to Poonam Khetrapal Singh, Regional Director of the World Health Organization for Southeast Asia, healthcare systems must now anticipate, respond to, cope with, recover from, and adapt to climate-related shocks and stress. Developing climate-resilient health systems is crucial in this effort. Thus, India building a climate-resilient health system is not only an overdue necessity to tackle climate change but a key to achieving its broader goals of health equity and inclusivity for all.

Building resilience
Developing a climate-resilient health system demands enhancing primary healthcare services to handle potential surges in demand and fostering adaptable supply chains. Climate-resilient infrastructure and technologies can play a crucial role in achieving these goals. Firstly, by adapting existing processes to anticipate and address current and future climate risks, such as heightened heatwaves and extreme weather events like cyclones and storms. This practice involves aligning the location of health facilities and construction codes accordingly while also evaluating the resilience of essential services like water, sanitation, and electricity supply. Secondly, by advocating for the adoption of new technologies, such as advanced information management systems, to analyse the interplay between environmental factors and health data. Integration of these technologies into disease surveillance systems facilitates vulnerability assessment, adaptation, and early warning capabilities. Furthermore, prioritising medical technologies with lower environmental footprints enhances climate resilience and long-term sustainability.

Additionally, gridded mapping techniques offer a valuable tool for visualising spatial data and identifying vulnerable areas where interventions are most urgently needed. By mapping climate change projections alongside socio-economic indicators and health data, policymakers and public health officials can prioritise interventions and allocate resources more effectively, thereby enhancing the resilience of health systems and communities.

Bolstering the capacity of the healthcare workforce emerges as another fundamental element for creating a climate-resilient health system. To achieve this, interventions are again required on two fronts. First, adequately sensitising these professionals to recognise the various health vulnerabilities posed by climate change. Integrating a module on the health impacts of climate change in the medical and allied professionals’ curriculum could be instrumental in this regard. Second, building the capacity of healthcare workers through training and knowledge management programmes, so that they are better equipped to respond to climate-related risks and diseases.

In light of the escalating impact of climate change on public health, urgent action is paramount. India’s diverse and vulnerable population magnifies the stakes, underscoring the critical need for collaborative efforts among policymakers, healthcare professionals, and communities. It is time to fortify our health system against climate-induced challenges by integrating climate considerations into healthcare planning, bolstering disease surveillance, and enhancing healthcare infrastructure. Through proactive measures, India can ensure the well-being of its citizens and chart a path towards a healthier, more sustainable future. Down To Earth

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