Deadly Heat, Broken Systems, Forgotten Lives

In 2024, the pre monsoon season became the hottest ever since 1901, with India recoding 54 days of heatwaves. States like Delhi, Rajasthan, Uttar Pradesh and Bihar bore the brunt of these deadly temperatures. Delhi was the worst hit among them all, with its toll touching 275 deaths by June. Though the hospitals have reported over 40,000 suspected heatstroke cases, experts warn that the real numbers are higher due to underreporting  and misdiagnosis.

The deadly consequences of systematic unpreparedness were evident in the Ballia crisis in Ballia district in UP where power outrages during brutal heat lead to 54 deaths in just 3 days. Authorities kept downplaying the role of heat while families watched their loved ones gasping for breath in suffocating wardsThe catastrophe was so deeply ignored at an institutional level that the chief medical officer was dismissed from his position simply for acknowledging the heat.

A Public Health System That Cannot Take the Heat

Despite repeated warnings from the Intergovernmental Panel on Climate Change (IPCC) and the WHO, India’s health infrastructure remains acutely vulnerable to climate-induced heat stress. Although early warning systems technically exist, primarily in the form of IMD’s Heatwave Forecasts, Colour-Coded Alerts (Yellow, Orange, Red), and collaborative Heat Action Plans (HAPs) involving NDMA and local governments, they often act too late or fail to trigger timely interventions. These systems rely heavily on centralised temperature monitoring and forecasts issued by the Indian Meteorological Department (IMD), which are then expected to be relayed to state and district-level disaster management units and public health departments. However, bureaucratic bottlenecks, poor inter-agency coordination, and a lack of defined responsibilities often delay the communication chain. Alerts may be issued only after several days of rising temperatures or when thresholds for “extreme heat” are already breached, by which time damage control becomes harder than damage prevention. Additionally, language barriers, lack of localised data, and ineffective dissemination channels (especially in vernacular media or rural outreach systems) mean that many local authorities receive either insufficient or non-actionable information. In such cases, even when a Red Alert is issued, it rarely translates into advance hospital preparedness, opening of cooling shelters, or community outreach in time. (Reuters, 2024).

A second major insufficiency exists due to a lack of capacity in hospitals. Most of the hospitals in India do not have backup cooling systems, IV rehydration stocks, or staff trained to identify and respond to heat illnesses. In many tier 3 cities in Uttar Pradesh, the hospital’s corridors were found to be “smelling like urine”, and patients were left unattended in 40°C+ heat.

Thirdly, the problem remains that surveillance/recording systems are inefficient. In 2022, the National Crime Records Bureau reported 730 heatstroke deaths while the health ministry reported just 33. Such discrepancies are not mere statistical errors but institutional attempts to undermine targeted health interventions, mislead funding decisions, and conceal the true scale of climate vulnerability

Additionally, a major flaw lies in the implementation of Heat Action Plans (HAPs) which remain largely on paper. Though in 2019 the NDMA had issued a national guideline which urged all states and cities to adopt HAPs but the fact remains that many have not. Other states have plans with funding and execution mechanisms. According to Rajasthan High Court in its suo motu proceedings, the state’s HAP had not been updated since 2021 despite record-breaking temperatures in 2023 and 2024. These systemic shortcomings in public health infrastructure during heatwaves have resulted in a chaotic and an uncoordinated national response. Many damage control bandages have been slapped on systematic wounds rather than an actual cure such as, in June 2024 the Union Health Ministry issued orders to free up hospital beds and treat heatstroke patients with “immediate attention”.

Heatwaves as a Constitutional Injustice

Extreme heat constitutes a violation of fundamental rights protected under Article 21 of the Indian Constitution. In Ranjitsinh v. Union of India (2024), the Supreme Court explicitly recognised the right to be free from the adverse effects of climate change as a component of the right to life and dignity under Article 21, and as an essential part of the equality guarantee under Article 14. The judgment affirmed that climate inaction by the state, whether through policy delays or failure to implement existing mechanisms, amounts to a breach of constitutional obligations.

Within this constitutional framework, extreme heat, as an increasingly frequent and deadly manifestation of climate change, directly infringes upon the right to life, health, and safe living conditions. In a Public Interest Litigation filed in 2025 by activist Vikrant Tongad, the Supreme Court observed that state inaction on heatwaves violates Article 21 protections and issued notice to the Centre, stressing the obligation to ensure "living conditions free from deadly heat stress".

Similarly, the Rajasthan High Court in May 2024, in Suo Motu PIL: Earth is Priceless, No Plan(et) B (2025), condemned the failure to enact enforceable heatwave protections. It held that despite rising death tolls, the Union and State responses remained fragmented and underfunded. The Court issued concrete directions: mandating pre-summer hospital inspections, establishing urban cooling centres, broadcasting localised heat alerts, and compensating victims’ families under the State Disaster Response Fund. Together, these interventions mark a judicial shift from passive recognition to enforceable climate-health obligations under constitutional law.

Policy in Slow Motion: The Long Wait for a National Climate-Health Framework

The National Programme on Climate Change and Human Health (NPCCHH), launched in 2019, is India’s first serious attempt to address climate-health issues. It focuses on building resilience to heat stress, creating climate-friendly hospital infrastructure, and integrating weather alerts into health decisions. But implementation remains sluggish.

According to the program’s own 2022 internal review less than 15% of states had submitted usable vulnerability assessments, and training workshops on heat-related illnesses were conducted in only 9 states. Many district health officers lacked knowledge of the program altogether. Worse, NPCCHH lacks legal enforceability, depending entirely on inter-ministerial cooperation without clear accountability or performance metrics.

Even in places where HAPs exist, like in Ahmedabad, Nagpur, and Bhubaneswar, they often rely on civil society partnerships, donor funds, or municipal leadership. Urban HAPs often neglect those who face the brunt of heat stress such as rural populations, street vendors, migrant workers, and children in government schools. The Prevention of Death due to Heat and Cold Waves Bill, 2015, which proposed to define heatwaves as national disasters and mandate advanced public health planning, has still not been passed. Without statutory recognition, most local responses remain ad hoc.

Global Lessons: What France and Australia Get Right

This lag in policy is not accidental but rather, a matter of choice. Other countries have learned to treat heat as a matter of life and death. France’s Plan Canicule was introduced in 2004, after a 2003 heatwave killed 15,000 people. This plan includes a four-tier alert system, targeted public messaging, mandatory response protocols, and designated cooling centres. As a result, there were an astounding 87% fewer heat-related deaths. This was accomplished in just four years, from 2003 to 2006.

Australia also initiated it's state-specific Heatwave Emergency Plans which are detailed, regularly updated, and integrated into broader disaster response frameworks. For instance, New South Wales regulates social servers, school closures and ambulance preparedness using real-time heat-health triggers.

WHO also has taken noteworthy steps to address heatwaves by introducing Heat Health Action Guidelines in 2008. These guidelines emphasize on early warning, inter-agency coordination, social protection for the poor and elderly, and urban design interventions like reflective roofs and green cover. These are well-optimised, evidence-backed strategies but India is yet to adopt them comprehensively. Unlike India, these countries did not wait for heat to become endemic before making it a governance priority.

Conclusion

Heatwave deaths in India are preventable catastrophes rather than acts of nature. Every individual who passes away from heatstroke because of not having access to shelter, water, or medical attention is a victim of policy neglect. It is imperative that heatwaves ought to be considered as a public health emergency and a climate injustice in India. India must legislate heatwaves as national disasters, thereby unlock dedicated funds, and create enforceable legal duties. It is also imperative that a comprehensive Heatwaves Bill be passed to formally safeguard vulnerable groups. Every state and district should need Heat Action Plans, and noncompliance should be severely penalized. Concurrently, climate-resilient infrastructure, such as backup power, skilled staff, medical procedures, and necessary supplies, must be added to the public healthcare system. Social reactions like water distribution, early school and workplace closures, and the opening of cooling shelters should all be automatically triggered. It is necessary to create legal assurances of restitution and compensation for victims and their families. Most importantly, any environmental governance must acknowledge the connection between health and climate as a constitutional issue.

Heat is no longer seasonal, it is structural. With rising temperatures and increasing climate instability, India cannot afford to pass each new summer in silence. In this 1.4-billion-person nation, we cannot afford policies that see human life as expendable in the face of heat. We do not have a Planet B. India cannot continue to respond reactively to heatwaves. It needs to be financed, regulated, and codified. Anything less would be a breach of constitutional obligation as well as climate justice.

[This post has been authored by Ishita Gupta, a second-year law student at JGLS.]