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Climate change is increasingly recognised as a public health threat, with rising temperatures, worsening air pollution and extreme weather events putting millions of people at risk. However, a country's climate action plan must do more than promise lower emissions. It must also explain how its policies will protect people from climate-related illnesses, strengthen healthcare systems and reduce the health risks associated with environmental change.
India has scored just 2 out of 32 points in the 2026 Healthy NDC Scorecard, a global assessment examining how countries incorporate health into their climate commitments. Japan received the same score, placing both among the lowest-performing countries assessed. The findings come ahead of the 31st United Nations Climate Change Conference (COP31), scheduled for November 2026.
The assessment by the Global Climate and Health Alliance (GCHA) evaluated 117 national climate plans covering 132 countries. It found that India's latest climate commitment does not adequately address the health impacts of climate change, the health benefits of climate action or air pollution.
The findings are particularly significant for India, where millions face exposure to polluted air, dangerous heat and climate-sensitive infectious diseases. They raise an important question: are national climate action commitments sufficiently focused on protecting people's health, alongside reducing greenhouse gas emissions?
India Scores Low On Health Integration In Climate Action Plans
The 2026 Healthy NDC Scorecard evaluates national climate commitments across eight categories, including health impacts, air pollution, action within the healthcare sector and climate finance.
According to the assessment, Colombia topped the rankings with 29 out of 32 points, followed by Nigeria with 25 and Cambodia with 24. Nineteen of the 20 highest scores belonged to low- and middle-income countries.
India's score reflects a gap between acknowledging health as a vulnerable sector and translating that recognition into meaningful climate policy. The assessment noted that India's Nationally Determined Contribution (NDC) does not sufficiently explain how climate action will address health risks or deliver health-related benefits. It also does not mention air pollutants, despite the country's substantial burden of air-pollution-related deaths.
NDCs are national climate action plans submitted under the Paris Agreement. They outline countries' commitments to reducing greenhouse gas emissions and addressing climate change.
India's latest NDC, covering 2031-2035, was approved by the Union Cabinet in March 2026. Its commitments include reducing the emissions intensity of gross domestic product by 47% from 2005 levels by 2035, achieving a 60% share of non-fossil fuel sources in cumulative installed electricity capacity, and creating an additional carbon sink of 3.5-4 billion tonnes of carbon dioxide equivalent through forest and tree cover.
These targets address important aspects of climate mitigation. However, the scorecard highlights why emissions-reduction commitments must also be assessed for their implications for public health.
Why Climate Change Is A Public Health Concern In India
The health consequences of climate change extend beyond environmental damage. Extreme heat can cause dehydration, heat exhaustion and heatstroke, while also placing additional strain on the cardiovascular and renal systems. People working outdoors, older adults, young children and those with existing illnesses may be particularly vulnerable.
Air pollution presents another major concern. Exposure to polluted air is associated with respiratory and cardiovascular diseases, including asthma, chronic obstructive pulmonary disease, heart disease and stroke. Policies that reduce harmful emissions can therefore deliver health benefits alongside climate benefits.
India's climate and geographical diversity also creates different health challenges across regions. Heatwaves can threaten outdoor workers and people without access to cooling. Flooding can disrupt sanitation and safe drinking water, while changing temperature and rainfall patterns can influence the distribution of mosquitoes and other disease vectors.
These risks require coordinated planning across healthcare, urban development, transport, energy, housing, water and sanitation. A climate policy that reduces emissions but fails to account for the people most exposed to environmental hazards may not adequately address the country's public health needs.
The World Health Organization (WHO), in its guidance on integrating health into NDCs, recommends identifying climate-related health vulnerabilities, strengthening climate-resilient healthcare systems and maximising the health benefits of policies across sectors.
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What India Needs To Strengthen In Its Climate Plans
The scorecard's findings point to the importance of making health a measurable component of climate policy rather than treating it as a secondary consideration.
First, climate commitments should explicitly address air pollution alongside greenhouse gas emissions. Measures that encourage cleaner energy, improve public transport and reduce pollution from transport, industry and household fuels can contribute to better air quality and lower health risks.
Second, climate adaptation plans need stronger links with public health preparedness. Heat-health action plans, early-warning systems, disease surveillance and emergency response arrangements can help communities and healthcare facilities prepare for extreme weather.
Third, hospitals and other healthcare facilities need to remain operational during heatwaves, floods and other climate-related emergencies. This includes reliable electricity, safe water, resilient infrastructure and preparedness for sudden increases in patient numbers.
Health inequalities must also be considered. People living in poorly ventilated housing, informal settlements and areas with limited access to healthcare may face greater exposure to climate hazards and have fewer resources to cope with them. National policies should therefore identify vulnerable populations and set out practical measures to protect them.
Finally, adequate funding and coordination between government departments are essential to translate climate commitments into action. The GCHA assessment emphasised that major current and historical emitters need to reduce emissions more rapidly to maximise domestic health benefits and limit worsening health impacts worldwide. It also called for developed countries to provide climate finance to help developing nations implement their national plans.
Black Carbon Remains A Global Concern
The assessment also highlighted limited international action on black carbon, a short-lived climate pollutant that contributes to both global warming and air pollution.
Only five countries--Cambodia, Chile, Colombia, Costa Rica and Paraguay--had established targets to reduce black carbon, according to the report.
Black carbon is produced by the incomplete combustion of fuels, including diesel and biomass. Reducing emissions can support cleaner air while also delivering climate benefits, making it an important consideration for countries dealing with substantial pollution exposure.
For India, stronger integration of air-quality goals and health protection into climate planning could help connect environmental policy more directly with the everyday risks faced by communities.
India's score of 2 out of 32 in the 2026 Healthy NDC Scorecard highlights a critical gap in the integration of health into national climate commitments. Although the country has established emissions-reduction and clean-energy targets, the assessment indicates that the health consequences and co-benefits of climate action need greater attention.
As climate-related risks grow, protecting public health must become a more explicit objective of climate policy. Better coordination between health and environment authorities, stronger air-pollution measures, resilient healthcare infrastructure and targeted protection for vulnerable populations could help ensure that climate action delivers tangible benefits for India's people.
The challenge is not simply to reduce emissions, but to ensure that the transition towards a more climate-resilient future also protects lives and improves health.
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