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South Asia Climate Services Forum for Health

26-28 April 2016
Colombo, Sri Lanka

South Asia Climate Services Forum for Health




In 2015, multiple countries across South Asia experienced the devastating effects of a heat wave which took thousands of lives and stressed critical social systems. In response, the first Climate Services Forum for Health (CSF-Health) in Colombo, Sri Lanka brought together health and meteorological partners to focus on how to improve the management of extreme heat events in South Asia.

The two-day meeting held from 26–28 April 2016 focused on current experiences and capacities to address extreme heat risks across the region, and discussed in depth the experience of a successful approach to city-scale heat action plans in India. Key issues discussed included:

Climate related health risks are varied and significant in South Asia, and extreme heat events are only one of many challenges. The health sector in the South Asia region faces diverse climate-related challenges related to each country’s geographic location and health profile ranging from Glacial Lake Outburst Floods in Bhutan to sea-level rise consequences on drinking water in the Maldives. Common health priorities in South Asia include dengue fever’s widespread resurgence, water scarcity related risks and extreme weather events.

Extreme heat events are an emerging health priority everywhere, particularly in India, Bangladesh, Sri Lanka and Pakistan.

The health sector faces common challenges in climate risk management. Despite diverse contexts and health risks, there are common needs for improving climate-risk management: for enhanced coordination across relevant actors to manage the multi-sectoral nature of climate-related health risks; for improved health information and interoperable data management systems to facilitate vulnerability and impacts research integrating climate information, which is also necessary for establishing climate services for monitoring risks and providing early warnings; for broad investment in translating evidence to practical action; and for capacity building of both health and meteorological professionals in the access and use of climate information for health.

Heat Health Action Plans (HHAP) allow for coordinated, evidence-based and effective local action. HHAPs have proven to be a successful approach across Europe, North America, Australia and China to save lives and reduce the stress placed on communities and health systems during extreme heat events. Experience has also shown that timely and accurate weather forecasts and warnings are often not useful unless pre-established preparedness and response plans are in place and can indicate when and where lifesaving actions are needed. New experiences in Ahmedabad, India demonstrated in 2014 and 2015 that developing an HHAP triggering locally feasible actions saves lives. This model approach provides an excellent example for other partners in the region to adapt and build on.

Effective advocacy and appropriate action is based upon an empirical evidence-base of heat-exposure and vulnerability. Evidence-based decision making is fundamental to public health action. In the case of extreme heat conditions it is essential to conduct vulnerability analyses to identify at risk populations such as workers, children and the elderly, and geographic regions such as mega-cities or drought-prone areas. Understanding the current and future heat exposure of local populations requires interoperable historical data to model and predict health risks, and to identify where interventions will be most needed and effective at saving lives. Health professionals noted that actual heat exposure levels may be much higher than ambient temperature alone as a result of additive heat exposure generated from equipment and machinery in certain occupational settings, radiative heat from the ground in urban heat islands, and metabolic heat generated by the body. Evidence-based research on local vulnerability, exposure variability and institutional responses can help advocate the need for action with local leaders, and inform local policy and practice to protect vulnerable populations from heat stress and extreme heat exposures. Efforts are needed to improve the systematic collection of information and use of observational weather data to build robust local evidence base and enable standardized comparisons across locations.

Heat health warning systems (HHWSs) can extend preparedness lead time and orient interventions to high impact prone areas. Most cities across South Asia do not have advanced notice of extreme heat events that can allow local hospitals and communities to take protective action. Since 2015, the Indian Meteorology Department has provided a five-day forecast of extreme heat events in India that is now being used by cities such as Ahmedabad to inform their local heat health action plans. However, the farther in advance health professionals know about hazardous conditions, the wider the range of interventions that can be put in place to prevent avoidable illness and death. The South Asia Heat Outlook produced by the Indian Institute of Tropical Meteorology and the International Research Institute for Climate and Society at Columbia University, USA for the 2016 heat season is a step in the right direction for improved HHWS in the South Asia region.

Feasible national opportunities exist to improve evidence, awareness, coordination, and preparedness. There are many feasible and often low-cost local actions which can help reduce the impacts of Excessive Heat Events (EHEs) on communities and better prepare health systems for an upcoming heat season and for imminent extreme heat events. At the forum, country teams began to map out opportunities to help enhance national heat health action.

Regional knowledge exchange and capacity building is essential to accelerate local heat health action. A range of valuable technical resources, research, and decision and information tools have been generated worldwide, and help accelerate the scale up of heat health plans in South Asia. The forum proposed the establishment of a regional network of heat health actors to help connect regional and national experts and at-need communities, and to accelerate sharing of experience and access to available resources.

Dr. Mavalankar and Dr. R.K. Kolli Dr. Partha Ganguly
Dr. Simon Mason and Dr. Joy ShumakeDr. M. Nosheen, Dr. Asma Ibrahim, Dr. Mavalankar, Dr. Azhar Ghouse
Dr. Partha Ganguly, Dr. Chowdhury, Dr. N. DograDr. Shubhayu Saha, Dr. Washeed, Ms. Rada Dukpa

Case Study: Innovative Heat Wave Early Warning System and Action Plan in Ahmedabad, India

More than 7 million people live in the rapidly urbanizing city of Ahmedabad, located in Gujarat state of Western India. Heat waves have already proven to be dangerous in the city, leading to heat stress, heat stroke and heat-related illnesses. With climate change creating higher daily peak temperatures and longer, more frequent and intense heat waves, and following a deadly heat wave in May 2010, the Ahmedabad Municipal Corporation (AMC) realized that coordinated action was needed to protect its residents from extreme heat and to become more climate-ready. Read more

Concept Note
List of Participants

Action Plan
To accelerate heat health action the forum proposed to establish a network of heat health practitioners. The forum recommended that a Regional Heat Health Action network could help advance a common agenda for:

  1. Research
    To better understand extreme heat exposure vulnerability, exposures, impacts and effectiveness of preventive measure.
  2. Data, Information and Product Development
    To improve extreme heat prediction products and warning systems for information dissemination, interoperable data management platforms, and improved measurement of indicators.
  3. Partnerships and Communications
    To identify and provide outreach to a wide range of relevant actors, assist with quality assurance of EHE warnings, and promote opportunities for sharing and communication of research, evidence and action
  4. Capacity Development
    To develop technical guidance, mobilize training opportunities, and enhance networking and exchange with experts
  5. Evaluation


WHO-WMO Guidance and Resources on Heat Health
This guidance developed jointly by WMO and WHO for practitioners in both National Meteorological and Hydrological Service (NMHSs) and National Health Services (NHSs) outlines the issues surrounding the general heat–health problem and presents how an understanding of the biometeorology, epidemiology, public health and risk communication aspects of heat as a hazard can be used to inform the development of an HHWS as part of a wider HHAP.

City Resilience Toolkit
This toolkit was developed by the Indian Institute of Public Health – Gandhinagar based on the Ahmedabad experience, and includes a how-to manual on developing an HHAP. This easy to read guide can help anyone planning to develop and implement an HHAP in their city or region.

Understanding Climate & Health Association in India (UCHAI) Network
UCHAI is a network that brings together national actors in a neutral non-governmental setting to develop technical work, share information, and improve capacity.

National Heat Health Information System (NIHHIS)
NIHHIS is an integrated system that builds understanding of the problem of extreme heat, defines demand for climate services that enhance societal resilience, develops science-based products and services from a sustained climate science research program, and improves capacity, communication and societal understanding of the problem in order to reduce morbidity and mortality due to extreme heat. NIHHIS is jointly developed by the Centers for Disease Control (CDC) and Prevention and the National Oceanic and Atmospheric Administration.

US-Climate Resilience Toolkit
Features tools and resources for health including:

  • Excessive Heat Events Guidebook: for public health officials to estimate of potential local health risks from EHEs
  • Heat Safety Tool: a mobile application lets outdoor workers and supervisors calculate the risk level of extreme heat to outdoor workers and suggested actions for workers to take.
  • Recognizing, Preventing, and Treating Heat-Related Illness: This tailored training course helps understand heat-related illness in student athletes and know how to prevent, as well as treat, it when it occurs.

CDC’s Building Resilience Against Climate Effects (BRACE) Framework
A five-step process that allows health officials to develop strategies and programs to help communities prepare for the health effects of climate change



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