The health sector should play a crucial role in action and advocacy on climate change in India, as indicated by the largest ever survey on climate change conducted among over 3000 healthcare professionals in India.

Over 85% respondents believed that the healthcare sector has a responsibility to address climate change and reduce their own carbon footprint. 3062 healthcare professionals including doctors, nurses, paramedical staff, hospital administrators, Accredited Social Health Activist (ASHA) workers, non-governmental organisations health staff and healthcare students were surveyed in this study conducted between August and December 2020.The respondents belonged to six states in the country representing various zones: Uttar Pradesh, Bihar, Meghalaya, Chhattisgarh, Maharashtra, and Karnataka.

This first-of-a-kind study was conducted to understand the knowledge, attitude, perception and practice of the healthcare sector towards climate change by Healthy Energy Initiative – India in collaboration with data agency, Morsel India.

Findings of the survey were released during an online webinar. Overall awareness of climate change among all sections of health workers was as high as 93%. Of the seven groups of health workers interviewed, doctors were the most aware category at 97.5%, followed by healthcare students at 94.8% and hospital administration staff at 94.3%. ASHA workers with 92.5% awareness ranked fourth, with nurses at 89.6% who are the least aware of climate change, its causes impacts and links to human health among all the healthcare workers.

More than 81% of the respondents agreed that deforestation, burning fossil fuels, waste generation, emissions from industries and population growth are the main reasons for greenhouse gas emissions, which are resulting in rampant climate change. Almost 74% of the respondents also believed that the public health community is now faced with an increased burden of climate-sensitive diseases that directly and indirectly impacts both the healthcare professionals and infrastructure.

The survey, conducted during the second half of 2020 when the country and the world was dealing with the effects of the COVID-19 pandemic, revealed that the majority did not believe that there were adequate preparations to deal with the pandemic and that the healthcare infrastructure is still not prepared to deal with a mass future epidemic.

One of the major findings of the survey on priorities in the post COVID-19 recovery plan was that 83.4% of the respondents indicated that activities that prioritize health of the citizens must be high on the post COVID-19 recovery plan, whereas 82.8% of the respondents said activities focusing on conserving and protecting the environment in a strict manner is important.

The survey also revealed that not many of the respondents were currently actively raising the issue of climate change and its impacts among the public. The respondents felt that a lot of work was needed to make the healthcare systems climate resilient and that the healthcare professionals should be equipped with adequate information for them to raise awareness among the public. 72.8% of those who participated in the survey agreed that it was the need of the hour and climate change and its health impacts must be included in the medical curriculum in India.

Air pollution is often perceived as a Delhi related problem, but interestingly the survey clearly shows that the health impacts of toxic air are understood by healthcare workers across the country. 88.7% of respondents believe that air pollution related illnesses will have a direct impact on the health sector, ranking it as the highest threat among heat and cold related illnesses, vector and water borne diseases, communicable diseases, mental illnesses and malnutrition. 68.9% of the healthcare workers believe that climate change has a direct impact on the health sector, while 74% believe that there has been an increase in climate-sensitive disease burden on the populations.

The study provides recommendations to effectively build capacity among the healthcare professionals and advocates the need to provide nuanced information of the multiple ways (direct, indirect and through economic and social disruption) in which health could be adversely impacted due to climate change.

It further recommends that climate change and health impacts should be a subject in the medical curriculum for education of healthcare professionals from all streams and specialisations; Healthcare professionals should be provided with information and training on the international negotiations on climate treaties, especially the Paris Agreement; and detailed information regarding state and national action plans on climate change and human health, in an easy to understand format must be provided to the healthcare workers.