Four nations join forces to tackle rising El Nino heat

As El Nino packs more power and extreme heat emerges as a growing public health and livelihood challenge across South Asia, India, Nepal, Bangladesh and Bhutan are seeking to strengthen regional cooperation, with four new country assessments identifying gaps in heat preparedness. The assessments, released at the Global Heat Forum on Thursday by the South Asia Hub of the Global Heat Health Information Network (GHHIN), caution that heat action plans and weather alerts must translate into effective protection on the ground, particularly for outdoor workers, vulnerable communities and people with limited access to healthcare and cooling.

The reports have been prepared by the Hub, hosted by the Council on Energy, Environment and Water (CEEW) in New Delhi with partners including the Sustainable Futures Collaborative (SFC), Natural Resources Defense Council (NRDC), BRAC James P Grant School of Public Health and the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP).

The assessments come as an El Niño event strengthens across the Pacific, raising the risk of another severe heat season in the region. The reports point that while governments have made progress in heat planning and forecasting, health surveillance, dedicated financing and coordination across departments remain uneven.

“Extreme heat is now a year-round, regional risk in South Asia, and these assessments show the region is not starting from zero,” said Dr Vishwas Chitale, fellow at CEEW and chair of the GHHIN South Asia Hub. The priority, he said, is to connect forecasts with health systems, local budgets and labour rules so that warnings reliably lead to protection.

India has advanced furthest in institutionalising heat preparedness but the scale of the challenge remains substantial. A district-level assessment cited in the report found that 57 per cent of the country’s 734 districts, home to nearly three-quarters of the population, face high to very high heat risk.

The country has moved from reactive relief towards risk reduction, with more than 250 city and district heat action plans in place. Heatwaves have also been recognised as a notified natural disaster under India’s disaster risk management framework, enabling access to disaster-related funding. India has expanded surveillance of heat-related illnesses and trained more than 18,000 medical officers. The India assessment calls for heat preparedness to extend beyond disaster management. It recommends dedicated and sustained financing, stronger coordination between departments and the integration of health outcomes into heat action plans to determine whether interventions actually reduce illness and deaths.

The report says average temperatures rose by about 0.89 degree Celsius during 2015–2024 compared with the 1901-1930. It identified 2024 as the warmest year on record since 1901. Warm days have increased by five to 15 days per decade across most parts of the country, while warm nights are also becoming more frequent.

The report says heat-related deaths rose by 63 per cent from the 1990s to 2012–2021, reaching an estimated 546,000 annually worldwide. In India, about 25,958 heat-related deaths were reported between 1992 and 2019, according to figures cited in the report. Between 2021 and 2024, 71,880 suspected heatstroke cases and 381 deaths were reported under the National Heat-Related Illness and Death Surveillance system. From March 1 to July 26, the figures stood at 4,853 cases and 20 deaths.

The report also highlights the impact of heat on workers. Heat exposure in India resulted in the loss of 247 billion potential labour hours in 2024, equivalent to 419 hours per person, with agriculture accounting for 66 per cent of the losses and construction for 20 per cent. The potential income loss was estimated at $194 billion.

The reports look at a changing heat-risk landscape in Nepal and Bhutan where rising temperatures are exposing populations that have historically faced less extreme heat than the plains. In Nepal, the southern Terai plains recorded 50 days with temperature above 40 degree Celsius in 2024, according to the country’s meteorological department. The country has issued its first federal heat plan and operates tiered heat alerts, but heat-related illness is not yet systematically captured in health data.

In Bhutan, warming in the southern lowlands is pushing temperature higher in valleys where extreme heat has not traditionally been a major planning concern. Existing mandates assigning heat-related responsibilities to the health ministry and regulations requiring worker protection provide a foundation, while established flood and glacial-lake early-warning systems could be adapted to heat. The report recommends bringing these arrangements together under a single heat action plan.

Similarly, Bangladesh faces a different but equally pressing challenge with rising humidity intensifying the health risks of hot weather. According to the World Bank figures cited in the assessment, the feel-like temperature has risen by around 4.5 degree Celsius since 1980, while dangerous humid heat now affects the country for close to a third of the year.

UNESCAP’s Kiyoung Ko said countries could share forecasts, align warning thresholds and integrate heat into existing disaster management systems rather than developing separate arrangements independently.

The initiative proposes that the next phase must focus on implementation, health-system readiness and sustained funding rather than simply expanding the number of plans.

Dr Farzana Misha of BRAC James P Grant School of Public Health said heat remained an under-recognised health risk, with consequences for work and food security. She called for health systems to be equipped and funded to anticipate heat and act before it causes harm.

Prima Madan, director of cooling and climate resilience at NRDC, said preparedness needed to be accompanied by stronger health systems, local financing and the sharing of solutions across the region. Dr Purvi Patel of SFC stressed that heat adaptation should be evaluated by its effect on population health and supported by long-term reforms and climate mitigation.

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