The intersection of health and climate change reveals deep inequalities, particularly in the Global South, where countries like India face growing challenges. These challenges arise from both the historical legacy of colonialism and current global governance structures that continue to favor the industrialized North. The global climate crisis is not just an environmental or economic problem; This has profound implications for public health, particularly in countries already struggling with poverty, inequality and inadequate health infrastructure. India’s struggle within this North-South divide highlights the urgent need for more equitable approaches to addressing both health and climate impacts.
Climate change has direct and indirect effects on public health, particularly in countries like India, where the vulnerability of populations is increased by socio-economic disparities. Rising temperatures, shifting monsoons and extreme weather events are worsening food insecurity, exacerbating malnutrition and increasing the prevalence of vector-borne diseases such as malaria and dengue. A 2023 systematic review published in Current nutritional reports points out that 200 million people in India suffer from malnutrition. Additionally, dengue and malaria constitute major health threats in India, accounting for 74.37% of the country’s vector-borne disease burden, particularly affecting tropical and subtropical regions.
Climate change in India is exacerbating health risks, increasing mortality and morbidity, particularly among poorer communities. Environmental changes and rapid urbanization are intensifying air pollution, causing respiratory illnesses and premature deaths. The Global Air Quality Report 2024 ranked India as the third most polluted country, with an average particle concentration of 54.4 micrograms per cubic meter, 10.9 times higher than the recommended limit by the WHO. From 2001 to 2019, India experienced 37.6 million premature deaths from four major non-communicable diseases (NCDs). The poorest and most marginalized are disproportionately affected by these challenges.
Heat waves are already claiming lives in India. In 2024 alone, more than 700 deaths have been attributed to heat-related illnesses and more than 40,000 cases of heatstroke have been recorded according to the nonprofit organization HeatWatch. The country’s growing population, coupled with inadequate health facilities and a lack of climate-resilient infrastructure, leaves millions vulnerable to extreme weather events. A study carried out in 2023 by Shrikhande et al. highlights the urgent need for research focused on the health impacts of climate change, highlighting barriers such as limited funding, lack of interdisciplinary collaboration, and minimal government support.
Even though climate change affects both the North and the South of the planet, the nature and intensity of these impacts differ. The North, which has historically benefited from industrialization and extractive capitalism, is better equipped to mitigate and adapt to the consequences of climate change. Conversely, countries in the Global South, such as India, bear a disproportionate burden of climate-related health impacts, despite contributing far less to global emissions. This disparity has its roots in colonial resource extraction, which continues to shape global economic systems today. Amitav Ghosh, in The curse of nutmegargues that the extractive practices of colonialism laid the foundation for modern capitalism, which prioritizes profits over people and the environment. This system continued to deplete the South’s natural resources while enriching the North. Ghosh draws attention to the historical and ongoing exploitation of land, labor and resources, which leaves countries like India with limited capacity to address climate-related challenges, both in terms of health and environmental protection.
An analysis of extractive capitalism in India further highlights the ongoing struggles of indigenous and caste communities, who are often at the forefront of both land dispossession and environmental degradation. These marginalized groups, who depend on natural resources for their livelihoods, face increased vulnerability to climate change. The combination of extractive practices, environmental degradation and exclusion from governance structures amplifies the health risks they face, from malnutrition to exposure to environmental toxins.
Health and climate inequalities in India are a direct result of the country’s colonial past and current global governance frameworks that perpetuate inequalities. Furthermore, neoliberal policies have exacerbated vulnerabilities by promoting rapid industrialization without adequate environmental safeguards. India’s prioritization of economic growth over environmental protection has contributed to widespread deforestation, pollution and displacement of marginalized communities. India lost 668,400 hectares of forest in five years between 2015 and 2020, making it the second country in the world in terms of forest loss. The effects of these policies are most visible in urban centers, where poor air quality has led to significant health problems.
India also grapples with an asymmetric global system that places the burden of climate action on developing countries, while the North continues to shirk responsibility for historic emissions. The Paris Agreement, while a step forward, reflects this imbalance, as developing countries like India are expected to limit their emissions and implement climate change mitigation strategies despite their emissions per capita are relatively low. India’s Nationally Determined Contribution (NDC) aims to reduce the emissions intensity of its GDP by 45% by 2030 compared to 2005 levels. India’s contribution to global gas emissions to greenhouse effect, although significant, is much lower than that of industrialized countries. Yet the burden of climate change mitigation falls disproportionately on India. This neglects the historical responsibility of the North, which built its wealth on centuries of fossil fuel use and environmental exploitation.
Global governance structures, particularly those related to climate and health, continue to favor the Global North, disadvantaging countries like India. International financial institutions and multinational corporations wield disproportionate power in setting the global agenda, often prioritizing profit over environmental and public health concerns. This imbalance is evident in the global trade regime, which encourages the extraction of natural resources from the South to meet consumption demands from the North. For example, international trade agreements often prioritize intellectual property rights over access to affordable medicines, affecting India’s ability to provide healthcare to its citizens. This is particularly concerning in the context of climate change, as rising temperatures and evolving diseases require more robust health systems and access to new medical technologies. Prioritizing profit over public health perpetuates inequalities, as poorer countries are unable to afford the treatments and technologies needed to address the health impacts of climate change .
India faces significant challenges in addressing the twin crises of health and climate change, but there are also opportunities for innovation and leadership. The country has made some progress in renewable energy, notably through initiatives such as the International Solar Alliance, which aims to promote solar energy and reduce dependence on fossil fuels. However, these efforts are often undermined by the broader economic system, which continues to prioritize extractive industries and industrial growth over environmental sustainability. One promising area is India’s leadership in health diplomacy, particularly during the COVID-19 pandemic. The Vaccine Maitri initiative, which provided vaccines to neighboring countries, demonstrated India’s potential to become a leader in global health. This leadership could be extended to tackling climate-related health impacts, with India playing a greater role in advocating for climate justice and equitable access to health technologies.
To effectively overcome the global North-South divide, India must continue to promote more equitable global governance structures that prioritize public health and environmental sustainability over profit. This will require not only domestic political reforms, but also concerted efforts at the international level to challenge the North’s dominance in setting the global agenda. The historical legacy of colonialism, extractive capitalism and current global governance structures has left India vulnerable to the impacts of climate change, particularly in terms of public health. Although India has made some progress in renewable energy and health diplomacy, these efforts are often constrained by the economic system as a whole. To address these challenges, India must advocate for more equitable global governance that prioritizes climate justice and public health, ensuring that countries in the Global South do not bear the brunt of a crisis that they did not create.
Further reading on international electronic relations