The intersection of health and climate change is revealing deep inequalities, particularly in the Global South, where countries like India face shared challenges. These challenges come from both the legacy of colonialism and current global governance structures that continue to favor the industrialized Global North. The global climate crisis is not just an environmental or economic issue; it has a significant impact on public health, especially in countries that already face poverty, inequality and inadequate health care infrastructure. India’s struggle between this North-South divide highlights the urgent need for equitable approaches to addressing health and climate impacts.
Climate change has direct and indirect effects on public health, especially in countries like India, where the vulnerability of the population is magnified by social and economic disparities. Rising temperatures, climate change and extreme weather are increasing food insecurity, worsening malnutrition, and increasing the spread of vector-borne diseases such as malaria and dengue. A 2023 systematic review published in Current Nutrition Reports shows that 200 million people in India are malnourished. In addition, dengue and malaria are major health threats in India, accounting for 74.37% of the country’s zoonotic diseases, which mainly affect tropical and subtropical regions.
Climate change in India is increasing health risks, increasing mortality and morbidity, especially among the poorest communities. Climate change and rapid urban growth are intensifying air pollution, which causes respiratory diseases and premature death. The World Air Quality Report 2024 ranks India as the third most polluted country, with an average PM concentration of 54.4 micrograms per cubic meter—10.9 times higher than the WHO recommended limit. From 2001 to 2019, India saw 37.6 million premature deaths due to the four major non-communicable diseases (NCDs). The poorest and most disadvantaged are equally affected by these challenges.
Heatwaves are already killing people in India. In 2024 alone, more than 700 people will die from heat-related illnesses and more than 40,000 cases of heatstroke will be recorded, according to the non-profit HeatWatch. The country’s growing population, coupled with inadequate health care facilities and a lack of climate-resilient infrastructure, leaves millions vulnerable to extreme weather events. A 2023 study by Shrikhande et al. highlights the urgent need for research focusing on the health effects of climate change, noting barriers such as limited funding, lack of interdisciplinary cooperation and limited government support.
Although climate change affects the Global North and South, the nature and intensity of these impacts differ. The Global North, which has benefited from industrialization and extractive capitalism, is better equipped to mitigate and adapt to the effects of climate change. In contrast, countries in the Global South, such as India, bear a disproportionate burden of climate-related health impacts, despite contributing much less to global pollution. These differences can be traced back to colonial resource extraction, which continues to shape global economic systems today. Amitav Ghosh, at The Nutmeg Curseargues that the processes of decolonization laid the foundation for modern capitalism, which prioritizes profit over people and the environment. This system has continued to deplete the natural resources of the Global South while enriching the Global North. Ghosh draws attention to the historic and ongoing exploitation of land, labor and resources, which leaves countries like India with limited ability to address climate-related challenges, both in terms of health and environmental protection.
Analysis of extractive capitalism in India further emphasizes 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 rely on natural resources for their livelihoods, face the greatest risk of climate change. The combination of extraction processes, environmental degradation, and exclusion from administrative structures increases the health risks they face, from malnutrition to exposure to environmental toxins.
India’s health and climate inequalities are a direct result of the country’s colonial past and current global governance structures that perpetuate inequality. In addition, neoliberal policies have increased risks by encouraging rapid industrialization without adequate environmental protection. India’s prioritization of economic growth over environmental protection has contributed to deforestation, pollution and displacement of marginalized communities. India lost 668,400 hectares of forest in the five years between 2015 and 2020, making it the second highest country in the world in terms of forest loss. The effects of these policies are most visible in urban areas, where poor air quality has led to significant health challenges.
India also faces a twisted global system that places the burden of climate action on developing countries, while the Global North continues to shirk responsibility for historical emissions. The Paris Agreement, although a step forward, reflects this imbalance, as developing countries like India are expected to limit emissions and implement climate mitigation strategies despite their low per capita emissions. India’s Nationally Determined Contribution (NDC) aims to reduce its GDP emissions by 45% by 2030 compared to 2005 levels. India’s contribution to global greenhouse gas emissions, though significant, is much smaller than that of industrialized countries. However, the burden of mitigating climate change falls squarely on India. This ignores the historical responsibility of the Global North, which built its wealth on centuries of fossil fuel use and exploitation of the environment.
Global governance structures, particularly those related to climate and health, continue to favor the Global North, leaving countries like India in the lurch. International financial institutions and multinational corporations wield disproportionate power in setting the global agenda, often prioritizing profits over environmental concerns and public health. This imbalance is reflected in the global trade system, which encourages the extraction of natural resources in the Global South to meet the consumption needs of the Global North. For example, international trade agreements often prioritize intellectual property rights over access to affordable medicine, affecting India’s ability to provide healthcare to its citizens. This is particularly relevant in the context of climate change, as rising temperatures and changing disease patterns require stronger health care systems and access to new medical technologies. The prioritization of profit over public health perpetuates inequality, as poor countries cannot afford the necessary treatment and technology to address the health impacts of climate change.
India faces significant challenges in addressing the twin challenges of health and climate change, but there are also opportunities for innovation and leadership. The country has taken some steps towards renewable energy, particularly through initiatives such as the International Solar Alliance, which aims to promote solar energy and reduce reliance on fossil fuels. However, these efforts often undermine the broader economic system, which continues to prioritize manufacturing and industrial growth over environmental sustainability. One promising area is India’s leadership in healthcare, especially during the COVID-19 crisis. The Vaccine Maitri program, which provides vaccines to neighboring countries, has demonstrated India’s ability to lead in global health. This leadership can be extended to addressing climate-related health impacts, where India has played a prominent role in promoting climate justice and equitable access to health care technology.
To successfully navigate the global North-South divide, India must continue to push for equitable global governance structures that prioritize public health and environmental sustainability over profit. This will require not only domestic policy changes but also concerted efforts at the international level to challenge the dominance of the Global North in setting the global agenda. The historical legacies of colonialism, extractive capitalism and current global governance structures have left India vulnerable to the impacts of climate change, particularly in terms of public health. While India has made some progress in renewable energy and health communications, these efforts are often hindered by the broader economic system. To address these challenges, India must promote equitable global governance that prioritizes climate justice and public health, ensuring that the Global South is not left to bear the brunt of hardships it did not create.
Further Studies in E-International Relations
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