Handling Climate Driven Health Risks in Indian Cities
The lack of resources is no longer an excuse not to act. The idea that action should only be taken after all answers and resources have been found is a sure recipe for paralysis. The planning of a city is a process that allows for correction; it is supremely arrogant to believe that planning can only be done after every possible variable has been controlled. – Jaime Lerner, former Mayor of Curitiba, Brazil
The World Health Organization (WHO) estimates that extreme heat kills nearly five lakh people every year. Extreme heat, accompanied by increased rainfall and temperatures, have led to the rampant spread of malaria, cholera, and dengue. Urban areas experience these effects more acutely because concrete absorbs and re-emits heat, while crowded spaces allow pathogens to spread more easily.
How can Indian cities prepare for climate-driven health risks?
1. Develop Early Warning Systems:
Rio de Janeiro created an early warning system for dengue fever, a mosquito-borne viral disease, by integrating health and meteorological data. In 2022, the city established an Epidemiological Intelligence Centre, which directs mosquito control efforts and healthcare using weather forecasts, infection numbers, and mosquito-population data from over 2,500 traps.
Dengue cases typically drop during the cooler, drier winters and surge during wet summer months. In 2023, the Centre warned of a prolonged wet season, predicting dengue would persist through winter. This forecast gave Rio authorities two extra months to monitor areas where cases were growing. Although they could not prevent the outbreak, they reduced the death rate to its lowest recorded level.
2. Unite Climate and Health Data:
In 2022, the Bangladesh Red Crescent Society (BDRCS) collaborated with other organizations and government agencies to implement a data-driven early action protocol for heatwaves. The protocol defines clear trigger points based on temperature thresholds. Last year, Dhaka endured its longest recorded heatwave. Forecasting allowed authorities to act early by distributing 3,500 umbrellas, supplying water to 30,000 people, and providing relief to 15,000 people through three dedicated cooling stations.
3. Develop “Always-On” Communication Strategies:
Lusaka, the capital of Zambia, used effective communication to manage a cholera outbreak. When cholera cases surged last year, the mortality rate hit 4%, four times the limit set by WHO. The Collective Service - a partnership between IFRC, UNICEF, and WHO - interviewed survivors, families of the deceased, and residents from the most affected areas. They shared their findings with Zambia’s health ministry, which used the insights to deliver clear, life-saving information. As a result, vaccine uptake increased by 100%.
India has an advantage with 100 ready-made command-and-control centres (3C). These centres can take proactive measures by collecting data from multiple departments, using sensors and cameras. They can analyze this data in real time, guide field workers on necessary actions, assess outcomes, and make mid-course corrections. Authorities can also share relevant information with city residents. Consider how these centres could help control mosquito populations:
Sensors can detect mosquito tadpoles in stagnant water and monitor mosquito density in the air. In the absence of sensors, traditional methods can serve as temporary solutions. Hospitals can also report the incidence of dengue and malaria.
Combining these data sources will identify neighborhoods (mohallas) with high breeding levels and mosquito activity.
Field workers must carry out mosquito control and tadpole eradication measures in these areas.
Authorities should monitor reductions in breeding sites and mosquito density daily and adjust strategies if needed.
Information about mosquito populations and breeding sites should be shared with residents to raise awareness.
This approach extends beyond the 100 cities with command-and-control centres. Most Indian cities have explored some level of digitalization and deployed single-purpose applications to address specific issues. Some have experimented with multiple applications without a long-term strategy. To improve efficiency, cities need to integrate data from various sources, generate actionable insights for field workers, monitor progress in real time, and make adjustments on the go.
