2025 Lancet Countdown Report: Climate Change Is Now India's Biggest Public Health Threat

 

 

If you wanted to find the pulse of a planet under pressure, you wouldn’t look at the melting poles or the coral reefs gasping for breath, you’d look at India. A country of 1.4 billion, where the next chapter of humanity’s survival story is being written in Celsius, microns, and particulate matter.

The 2025 Lancet Countdown report on health and climate change, a collaboration of 128 experts from around the world, reads like the diagnostics of a feverish Earth... and India’s charts are among the most alarming. The report, the ninth in the series and the most comprehensive yet, makes one thing clear: the planet’s vital systems (the air, water, soil, and climate that sustain human life) are destabilizing faster than our institutions can adapt. The data feels almost algorithmic in its consistency: record heat, record drought, record rainfall, record disease vectors. Everywhere, the graphs spike like a heartbeat in distress.

 

In 2024, the average Indian experienced 19.8 heatwave days. Six and a half of those, scientists say, would not have happened without climate change. The math of discomfort gets crueler: compared to the 1990s, every Indian was exposed to 366 more hours of heat intense enough to cause stress during outdoor work. That’s not just sweat and discomfort, it’s economics. The Lancet report estimates that extreme heat led to a loss of 247 billion potential labour hours in 2024 alone. Agriculture (the oldest profession in the subcontinent) took two-thirds of that hit, while construction, another heat-exposed sector, lost one-fifth.

 

The bill for this heatwave economy? About US$194 billion in potential income gone, disappeared into the haze rising off parched soil and asphalt. For a nation that dreams in GDP targets and productivity metrics, this is a silent crisis... less visible than a flood or cyclone, but more insidious. When labourers collapse in the fields, when schools close early because classrooms turn into ovens, when families skip meals because food spoils faster.

 

India’s air has long been infamous. But the 2025 data adds a grim precision to that notoriety. In 2022, Coal alone, the dirty lifeblood of India’s power plants, claimed 394,000 lives that year. Petrol, used for road transport, contributed to another 269,000. In purely economic terms, the cost of these premature deaths amounted to US$339.4 billion (roughly 9.5% of India’s GDP). To put that in context: the nation’s entire health budget that year was just a fraction of that number.

 

Even homes, the supposed sanctuaries, are part of the problem. More than half of India’s households still rely on solid biofuels (wood, dung, crop residue) for cooking. The smoke from these stoves kills quietly, disproportionately affecting rural women and children. In 2022, household air pollution caused 113 deaths per 100,000 people, with mortality rates 25% higher in villages than cities.

The irony, of course, is that the very fuels subsidized in the name of progress are underwriting the country’s decline. In 2023, India spent US$48.5 billion more on fossil fuel subsidies than it earned from carbon pricing: a net-negative carbon revenue.

 

Wildfires used to be an Australian or Californian problem. Not anymore. Between 2020 and 2024, wildfire smoke claimed an annual average of 10,200 lives in India, up by 28% from the previous decade. Meanwhile, drought has extended its dominion: 35% of India’s land area now faces at least one month of extreme drought each year, a staggering 138% increase since the 1950s.

 

When the rains finally do arrive, they’re often in catastrophic bursts. The country now witnesses both extremes, too little water for months, then too much in a week. In coastal India, where over 18 million people live less than a metre above sea level, another threat rises with the tides. The total coastal area suitable for Vibrio bacteria (responsible for diseases like cholera) has increased by 46% since the 1980s. Inland, the dengue-carrying Aedes albopictus mosquito now thrives further north and higher up the mountains, its reproduction rate (R0) jumping from 0.86 to 1.60 in half a century. Translation: outbreaks that once seemed seasonal or regional are becoming endemic.

 

India’s climate story is not one of ignorance but of constraint. The report underscores a painful reality: fossil fuels still make up 46% of India’s total energy supply, and a staggering 72% of its electricity generation. Renewables, despite political fanfare, contribute only 10% of electricity and 2% of total energy.

Electric vehicles are still rounding the first corner of adoption... electricity powers just 0.3% of India’s road transport. For a nation that prides itself on digital transformation, the energy transition is lagging behind the software revolution. You can build an app for everything, but you can’t code your way out of coal. Between 2016 and 2022, India’s CO2 emissions from fossil fuel combustion rose by 21%. At the same time, its readiness for a low-carbon transition actually fell by 2% between 2023 and 2024. The message is unmistakable: progress is nonlinear, and in India’s case, sometimes regressive.

 

Agriculture, India’s oldest innovation, is also one of its most polluting. In 2022, red meat and dairy accounted for 65% of all agricultural emissions. From 2000 to 2022, the sector’s emissions grew by 13%, while 2.33 million hectares of tree cover vanished—143,000 in 2023 alone.

 

Cities, meanwhile, are turning into concrete microclimates. Of India’s 189 largest urban centres, 110 have very low levels of greenness, and only one—Tamluk—ranks as “high.” Between 2015 and 2024, urban greenness fell by 3.6%. The data reads like a digital heatmap of environmental neglect: less green, more grey, more heat, less life. Yet, the report insists, transitions in food and land use could offer the fastest returns.

Essentially, healthier diets, reforestation, and sustainable agriculture are public health interventions waiting to be scaled.