Climate Resilience Is a Human Capability
Integrating science, ethics, and training for a healthcare system that endures
Prof. Bhuputra Panda (Professor of Public Health), Kalinga Institute of Industrial Technology (KIIT), Bhubaneswar
Climate change is no longer a slow-moving variable. It is an accelerating force that is simultaneously reshaping ecosystems, livelihoods, and human health. From recurring heat waves across the Indo-Gangetic plains and coastal flooding in Odisha to erratic rainfall patterns triggering vector-borne outbreaks, the manifestations are no longer sporadic, they are systemic. Yet, paradoxically, the healthcare workforce, the very cadre entrusted with safeguarding population health, remains undertrained, under-informed, and underprepared to manage the health impacts of this rapidly changing climate- an uncomfortable truth that we may be getting comfortable with.
The discourse on climate-resilient healthcare has rightly focused on structural and systemic reforms: infrastructure retrofits, contingency planning, risk-based financing, and energy-efficient service delivery. But there is an equally critical, and often overlooked, domain of resilience: the cognitive and operational readiness of health professionals. In other words, climate resilience must be embedded not just in concrete and code, but in curriculum and clinical practice.
Climate-resilient healthcare systems are, by definition, those that can anticipate, absorb, adapt to, and recover from climate-related shocks while maintaining core functions. The World Health Organization (WHO) outlines six building blocks of a resilient health system: governance, financing, health workforce, medical products and technologies, health information systems, and service delivery. Of these, the health workforce is perhaps the most foundational. Without a trained and responsive cadre of providers and managers, even the best-laid infrastructural and institutional reforms will fail to deliver during climate-induced disruptions.
Despite this, medical and public health curricula in most low- and middle-income countries, including India, continue to treat climate change as a peripheral issue. There is minimal formal exposure to environmental epidemiology, risk communication, early warning systems, or disaster health response as it relates to climate hazards. Training programs for frontline workers such as Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), and Community Health Officers (CHOs) lack modules on climate-sensitive diseases or environmental health determinants. This is a significant gap, given that these cadres often constitute the first line of response during floods, heat waves, or vector-borne outbreaks.
Globally, expert bodies are already advancing integrated approaches. The WHO’s Operational Framework for Building Climate-Resilient Health Systems identifies education and workforce training as a core domain, urging the incorporation of climate-health knowledge into pre-service and in-service training. The The Global Consortium on Climate and Health Education (GCCHE) led by Columbia University has developed core competencies for climate-health literacy among health professionals, including understanding of climate science, the health impacts of extreme weather events, clinical adaptations, and sustainable care practices. Similarly, the One Health approach, endorsed by WHO, FAO, UNEP, and the World Organisation for Animal Health, promotes a multi-sectoral understanding of the interconnectedness of human, animal, and environmental health. This framework is especially relevant in the context of climate-sensitive zoonotic disease outbreaks, antimicrobial resistance, and ecosystem health.
India has the opportunity (and imperative) to localize these frameworks. The National Medical Commission can serve as a catalyst by mandating the inclusion of climate-health modules in MBBS and postgraduate medical curricula. Similarly, national training institutions like the National Institute of Health and Family Welfare (NIHFW) and the Public Health Foundation of India (PHFI) can co-develop certificate programs for district health officers, programme managers, and nursing supervisors. Under the Ayushman Bharat Health and Wellness Centres platform, frontline workers can be capacitated through quarterly workshops and e-learning modules on climate-informed care, risk identification, and community-based adaptation practices. Crucially, these interventions must be embedded within broader national and state-level climate-health strategies, with alignment to India’s National Action Plan on Climate Change (NAPCC) and the National Health Mission.
From a systems perspective, this workforce transformation is not just an academic or technical exercise. It has significant implications for service delivery continuity, risk mitigation, and health security. A climate-literate workforce is more likely to detect early warning signs of disease outbreaks linked to environmental changes, communicate risks effectively to communities, and respond with contextually relevant clinical and public health measures. For instance, during heat waves, a trained PHC team can pre-position ORS, activate community cooling protocols, and identify at-risk elderly populations for proactive outreach. During floods, trained personnel can protect cold chains, monitor for waterborne disease spikes, and provide psychosocial support.
Furthermore, workforce development must include competencies in sustainable health service delivery; equipping health professionals to manage resources efficiently, reduce waste, and adopt low-carbon practices. Hospitals and primary care centres are significant contributors to greenhouse gas emissions and medical waste. Training clinical staff and facility managers in green procurement, waste segregation, energy-efficient operations, and sustainable prescribing can directly reduce the health sector’s environmental footprint. Climate resilience, after all, is as much about mitigation as it is about adaptation.
Importantly, equity must be a guiding principle. Climate impacts are not uniformly distributed. Women, children, the elderly, persons with disabilities, and communities living in coastal, tribal, and low-income urban settlements are disproportionately affected. Therefore, climate-health training must incorporate a rights-based and equity-focused lens, ensuring that the most vulnerable are neither excluded from services nor rendered invisible in program design.
India’s health system is undergoing a digital, structural, and financial transformation. This is an opportune moment to embed climate intelligence into institutional intelligence. The intersection of environmental change and human health must become a core focus of how we train, deploy, and support our health workforce. Only then can we ensure that our systems are not just built to endure shocks, but to evolve through them, safeguarding health outcomes, protecting lives, and building a more equitable and climate-secure future.
At its core, this is not a standalone policy conversation; it is a reckoning with scale. The scale of planetary change. The scale of institutional inertia. And the scale of transformation required in how we conceive of human health in relation to environmental systems. Science has spoken with clarity: climate change is the greatest threat to global health in the 21st century. The question now is whether we are listening- and more importantly, whether we are acting. To build truly climate-resilient health systems, we must move beyond infrastructure and financing to invest in the epistemic and ethical infrastructure of the people who animate these systems. This means embedding climate science into clinical knowledge, ecological awareness into medical education, and systems thinking into everyday practice. It means preparing not just for the next emergency, but for a new era of health where climate is a permanent determinant. Anything less is abdication.
References
WHO Operational Framework for Building Climate-Resilient Health Systems: https://www.who.int/publications/i/item/9789241565073
Global Consortium on Climate and Health Education (Columbia University): https://www.publichealth.columbia.edu/research/global-consortium-climate-and-health-education
WHO-FAO-OIE-UNEP One Health Joint Plan of Action (2022–2026): https://www.who.int/publications/i/item/9789240065406
Climate Change and Health in India – The Lancet Countdown Country Profile (2021): https://www.lancetcountdown.org/data-platform/india
Medical Education Curriculum Review – National Medical Commission, India: https://www.nmc.org.in
India’s National Action Plan on Climate Change (MoEFCC): https://moef.gov.in/en/division/environment-divisions/cc/
WHO Special Report on Climate Change and Health (COP26): https://www.who.int/publications/i/item/cop26-special-report