The 2025 Lancet Countdown on Health and Climate Change presents a stark warning for India: climate inaction is no longer a distant environmental concern but an immediate public health emergency with measurable human and economic costs. The data reveal an escalating convergence of heat stress, air pollution, infectious disease expansion, coastal vulnerability, and ecological degradation collectively threatening lives, livelihoods, and long-term development.
Heat as a Structural Health Risk
In 2024, Indians were exposed to an average of 19.8 heatwave days, of which 6.6 days were directly attributable to climate change. Compared to the 1990s, people experienced 366 additional hours of heat stress exposure, marking a record high.
The economic consequences are equally severe. Extreme heat resulted in 247 billion lost labour hours in 2024, amounting to approximately 419 hours per person, a 124% increase compared to 1990–1999. Agriculture bore 66% of these losses, followed by construction at 20%, with an estimated US$194 billion in income losses.
This indicates that climate change is not merely increasing discomfort—it is structurally undermining India’s productivity, food systems, and informal workforce resilience.
Air Pollution: A Persistent and Expensive Killer
Air pollution remains one of India’s gravest health crises. In 2022, over 1.7 million deaths were attributable to anthropogenic PM₂.₅ pollution, a 38% increase since 2010. Fossil fuels accounted for 44% of these deaths, with coal alone responsible for nearly 394,000 deaths, largely from power generation. The economic valuation of premature mortality from outdoor air pollution stood at US$339.4 billion in 2022—equivalent to 9.5% of India’s GDP. Household air pollution continues to disproportionately affect rural India, with mortality rates higher in rural areas than urban ones.
The data reinforce a critical insight: fossil fuel dependence is simultaneously a climate liability and a public health catastrophe.
Expanding Disease Frontiers
Climate change is reshaping infectious disease geography. The transmission potential (R₀) for dengue via Aedes albopictus has increased from 0.86 (1951–1960) to 1.60 (2015–2024), crossing the epidemic threshold. Coastal suitability for Vibrio transmission is now 46% greater than the historical baseline.
These trends suggest that India’s public health systems must prepare not only for higher case loads, but for structurally shifting epidemiological patterns driven by warming and changing rainfall.
Coastal and Urban Vulnerability
Over 18 million people in India now live less than one metre above sea level, placing them at heightened risk from sea-level rise. Simultaneously, urban ecological resilience is declining. Between 2015 and 2024, average urban greenness decreased by 3.6%, and only one of 189 major cities was classified as having high urban greenness.
Additionally, India lost 2.33 million hectares of tree cover between 2001 and 2023, with significant losses continuing in 2023. Reduced tree cover diminishes natural cooling capacity and exacerbates both heat stress and air pollution exposure.
A Governance and Policy Imperative
The Lancet data demonstrate that climate change in India is no longer an environmental silo issue—it is a cross-sectoral governance challenge implicating labour law, urban planning, coastal regulation, public health infrastructure, energy transition, and disaster management.
The scale of health and economic loss suggests that mitigation (rapid fossil fuel phase-down, clean energy expansion) and adaptation (heat action plans, urban greening, disease surveillance strengthening, coastal resilience) must proceed simultaneously. The “all hands on deck” framing is not rhetorical, it reflects the magnitude of systemic risk.
For India, climate action is not merely about emissions targets; it is about safeguarding constitutional commitments to life, health, livelihood, and intergenerational equity. The 2025 Lancet Countdown makes clear that delayed action is already costing lives and that decisive intervention could function as a public health lifeline.
Planetary Objectives 