Navigating Health and Climate Inequities in India: Bridging the Divide

India's climate and public health challenges present a paradox. On one hand, the country is a global economic powerhouse, pioneering technological and renewable energy advancements. On the other, it struggles with climate change, systemic inequities, and poverty that disproportionately burden its vulnerable populations. This dual reality, shaped by colonial legacies and global governance, underscores some of the world’s most pressing health and environmental crises.

New Delhi, India Source: Saakshi Yadav

A Crisis of Inequity

For millions, climate change is not a future threat but a lived reality. Rising temperatures, erratic monsoons, and extreme weather events like heatwaves and floods devastate communities already marginalized by poverty and inequity. Rural farmers lose livelihoods to droughts, urban slum dwellers endure sweltering tin-roofed homes, and women in arid regions walk miles to fetch scarce water.

Although historically a minor contributor to global greenhouse gas emissions, India is among the most climate-vulnerable nations. Centuries of colonial extraction left its ecosystems fragile, and current global governance systems perpetuate inequities. Agreements like the Paris Accord, while advocating collective action, fail to adequately address the historical emissions of the Global North, leaving countries like India bearing an outsized burden.

When Heatwaves Turn Deadly

India faces an alarming rise in heatwaves, which have grown increasingly lethal. The summer of 2024 saw record-breaking temperatures, resulting in over 700 deaths and more than 40,000 cases of heatstroke. Low-income communities living in overcrowded, poorly ventilated homes are especially vulnerable.

Families without air conditioning suffer in furnace-like shanties, farmers collapse under scorching suns, and urban workers faint on congested buses. Informal settlements made of heat-retaining materials like tin and plastic exacerbate these conditions. Despite the growing need for cooling solutions, marginalized groups have limited access to infrastructure like reflective roofing and urban green spaces.

Barriers to mitigating heatwave impacts include insufficient funding, lack of early-warning systems, and systemic neglect of at-risk populations. Without targeted interventions, these challenges will continue to claim lives.

The Air We Breathe

Air pollution is another silent killer in India, with urban centers like Delhi, Mumbai, and Kolkata surpassing the World Health Organization's (WHO) safe PM2.5 levels by tenfold. This pollution contributes to 2.1 million premature deaths annually, with rising rates of asthma, strokes, and cardiovascular diseases.

Paradoxically, India’s drive for modernization—factories, vehicles, and construction—fuels the very pollutants poisoning its air. The burden of this pollution disproportionately affects poorer communities near industrial zones, while wealthier neighborhoods enjoy cleaner air and better healthcare access.

Efforts to combat air pollution, such as stricter emissions standards and investments in clean energy, are critical but often face resistance from powerful industries and insufficient political will.

District Wise Heat Threshold Determination for Uttar Pradesh. Uttar Pradesh State Disaster Management Authority, Government of Uttar Pradesh. Imdad, K., Sahana, M., Krishnan, A., Das, U., & Mall, B. (2024).

Water Scarcity: A Looming Crisis

Erratic rainfall and over-extraction have pushed India’s water resources to critical levels. Rivers have dwindled, and groundwater has become scarce. Rural communities, particularly women and children, walk hours to fetch water, often resorting to contaminated sources. This has led to outbreaks of waterborne diseases like cholera and typhoid.

Diarrheal diseases alone claim 2.2 million lives annually, predominantly among children under five. Beyond health, water scarcity threatens food security as farmers struggle to irrigate crops. Urban areas, too, face strained municipal supplies, fueling tensions between communities and authorities.

Immediate action is needed to prevent the intensification of these challenges.

Colonial Legacies and Exploitation

India’s vulnerabilities to climate and health crises are deeply rooted in its colonial history. British exploitation stripped forests, disrupted agricultural systems, and extracted resources to fuel industrial growth abroad, leaving behind weakened ecosystems and economic fragility.

This extractive mindset persists today in modern capitalism. Industrial expansion, deforestation, and displacement of indigenous communities for mining projects continue to prioritize profit over people. Neoliberal policies, while driving economic growth, exacerbate environmental degradation and deepen social inequities.

Global Governance: An Unequal System

Global governance frameworks like the Paris Agreement often place undue pressure on developing nations to reduce emissions while ignoring the historical responsibilities of the Global North. India, with its relatively low per capita emissions, must balance ambitious climate targets with its development goals.

Additionally, global trade regimes often prioritize intellectual property rights over public health. Stringent patent protections hinder India’s ability to produce affordable medicines, leaving vulnerable populations exposed to climate-related health risks. Equitable access to treatments is critical as new diseases emerge under shifting climate conditions.

Pathways to Progress

Despite these challenges, there are glimmers of hope. Community-led initiatives in regions like the Sundarbans showcase resilience. Projects such as mangrove restoration and the development of saline-resistant crops demonstrate how local solutions can mitigate climate impacts.

Urban cooling projects, clean energy investments, and public transport initiatives also offer pathways to healthier cities. India’s leadership in the International Solar Alliance exemplifies its potential to drive renewable energy transitions. However, such efforts must be coupled with policies protecting marginalized groups to ensure economic growth does not perpetuate inequities.

Reimagining global governance is equally essential. Holding industrialized nations accountable for historical emissions, funding adaptation efforts in the Global South, and prioritizing health equity in international agreements are critical steps forward.

India’s struggle with climate change and health inequities is a microcosm of global challenges. It highlights the urgent need to address historical injustices, rethink economic priorities, and foster global solidarity.

The stakes are high—not just for India but for the world. The country’s choices will shape the futures of its 1.4 billion citizens and set an example for other nations navigating similar crises. By blending resilience, innovation, and justice, India can offer a roadmap for a more equitable and sustainable future.

In this fight for survival and equity, India’s efforts remind us that addressing the twin crises of climate and health requires collaboration, accountability, and hope. The time to act is now.