By Dr. Rajib Dasgupta

The Indian Meteorological Department (IMD) released its forecast for the ensuing summer season on 31 March 2025. In specific, above-normal temperatures lasting 10-11 days are expected particularly in the central and eastern Indian states of Odisha, Jharkhand, and eastern Uttar Pradesh. Significantly, night temperatures are also likely to be higher than usual in all states except the Himalayan and sub-Himalayan parts. Some areas of Gujarat, Odisha and Vidarbha region of Maharashtra have already experienced above-normal heatwave days (3-5 days) in March.

Earlier, the State of the Global Climate 2024 report released by the World Meteorological Organisation (WMO) considered 2024 as the warmest in the last 175 years for which records are available. The global mean near-surface temperature was 1.55 ± 0.13 °C above the 1850-1900 average, breaking the ‘1.5°C above the pre-industrial era’ barrier. The economic costs of extreme heat due to direct impacts of labour productivity, agriculture, healthcare costs, infrastructure damage and supply chain disruptions. India experienced the most intense heatwave year in 2024, with June in the northwestern region experiencing an all-time high of 181 heatwave days.

The Department of Economic and Policy Research, Reserve Bank of India had warned that climate change, driven by rising temperatures and shifting monsoon patterns, can account for losses up to 2.8 per cent of GDP and 34 million of the projected 80 million global job losses. Rapid urbanisation has led to hotter cities, amplified by the urban heat island effect. It is estimated that cities could warm by 4 degrees Celsius on average by 2100; such sharp increases will mean significant health challenges for India’s dense urban and peri-urban settings. Worryingly, both hot temperatures and heatwaves are associated with excess mortality risks. Not just fatalities, extreme heat implies significant social disruptions include school closures, livelihood loss, water shortages, power outages and food insecurity.

The UN Secretary-General António Guterres had called for an urgent and concerted effort to enhance international cooperation to address extreme heat in July 2024 and underscored four critical areas: caring for the vulnerable; protecting workers; boosting resilience of economies and societies using data and science; and, limiting temperature rise to 1.5°C by phasing out fossil fuels and scaling up investment in renewable energy.

Heat Action Plans (HAPs) are now the dominant planning instrument for heat governance in the Indian urban context. Extreme heat events (EHEs) in 2003 in Europe and North America led to heat-health response plans. India’s earliest city heat health action plan, however, date back to 1999 following a devastating 1998 Odisha statewide heatwave in 1998 that claimed 2000-plus recorded deaths. The World Health Organisation Regional Office for Europe (WHO/Europe) initiated the EURO-HEAT Project (2005-2007) that provides a framework for assessment of HAPs. A recent analysis of 8 Indian city HAPs (that were framed or updated between 2014 and 2018) shared on the Social Science Research Network platform makes some interesting observations. These cities are Ahmedabad, Bhubaneswar, Delhi, Jodhpur, Rajkot, Surat, Thane, and Vadodara. To emphasise again, this is an analysis of the HAP provisions and not performance.

The WHO/Europe’s framework, that this analysis adopts, consists of eight ‘core elements’: agreement on a lead body for coordination, accurate and timely alert systems, heat-related health information plan, reduction in indoor heat exposure, particular care for vulnerable population groups, preparedness of the health and social care system, long-term urban planning, and real-time surveillance and evaluation. It provides insights into how Indian city-level HAPs incorporate components that are considered essential for comprehensive heat-health action planning, identifying gaps and opportunities for HAP planning and implementation.

‘Agreement on a lead body’, ‘health information plans’, ‘accurate and timely alert systems’ and ‘reduction in indoor heat exposure’ show higher coverage in the HAPs than core elements that require long-term institutional or intersectoral planning and implementation such as ‘particular care for vulnerable groups’, ‘preparedness of health/social care system’, ‘long-term urban planning’ and ‘real-time surveillance.’  Amongst the 8 HAPs, Thane has the highest coverage of sub-elements (38 out of 42), followed by Bhubaneswar (37) and Delhi (37). Vadodara has the least number of sub-elements mentioned in the HAP (17 out of 42), followed by a considerable gap with Surat (28). The element ‘health information plan’ has the best coverage amongst all the core elements in the HAPs, followed by ‘agreement on a lead body’ and ‘accurate and timely alert systems. The core elements that require identifying and addressing long-term and/or contextual factors (such as ‘particular care for vulnerable groups,’ ‘real-time surveillance’ and ‘long-term urban planning’) are least represented in the HAPs. The Thane HAP was the only one to include a framework for monitoring and evaluation. ‘Health information plans’ was the best-represented core element; most of the information was geared towards the public and medical professionals though and marked by a noticeable absence of health information tailored for specific populations such as children and other vulnerable populations. 

Long-term measures are the weakest component in these HAPs. It is inappropriate to consider heat as an episodic hazard such as floods or cyclones that are typically marked by immediate destructiveness. An acute disaster framing of heat health compromises the scope of planning for heatwaves and addressing social vulnerability. The four-level Graded Response Action Plan (GRAP) system has a legal mandate to become automatically operational with worsening of air quality in the National Capital Region under the oversight of the Commission for Air Quality Management (CAQM). There is no such notion of risk and mitigation around high heat. Interventions need to be rapid when a heat alert is issued by the India Meteorological Department (IMD) but deaths may occur up to few days after a heat wave. Naming of heatwaves (like the universal standardised system of hurricanes) to increase public awareness and facilitate communication is being experimented with; “Zoe” was the first such in Seville, Spain in 2022. The WHO strongly advocates that the health sector leads the heat-health response by strengthening governance, preparedness, and response to acute impacts to protect high risk populations.

The writer is Professor and Chairperson, Centre of Social Medicine and Community Health, Jawaharlal Nehru University and is a collaborator in the Wellcome Trust supported “Economic and Health Impact Assessment of Heat Adaptation Action: Case studies from India”

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