The ‘climate bill’ we are paying

Extreme shifts taking place in the weather should be treated as an economic and health emergency

When I looked back at the weather in Karnataka 10 years ago, the changes seemed almost invisible at first. In November 2015, Bengaluru was cool, rain-kissed and mild, its air scrubbed clean by an evening shower. This November, a decade later, the city feels different - warmer, stickier, more unpredictable.

The days hover around the high twenties, the nights no longer offer relief, and rain arrives in short, violent bursts rather than soft, soaking spells. The data confirms what our bodies already know.

The India Meteorological Department’s long-term records show that India’s mean temperature has risen steadily for more than a century, by about 0.6 to 0.7 degrees Celsius. The past fifteen years have been the hottest in recorded history, with Karnataka’s once-gentle post-monsoon season now wobbling between swelter and flood.

What appears to be a small shift, a few degrees on a thermometer, a few hours of extra humidity, has enormous consequences. The climate signal is unmistakable: warmer days, hotter nights, and more erratic rain.

IMD analysis shows a significant increase in both mean and maximum temperatures, while rainfall patterns have grown more uneven. Across the peninsula, the balance between warmth and rainfall has fractured, and with it, a sense of normalcy.

So where did we go wrong? The answer lies in a mix of short-term thinking and long-term neglect. As a nation, we built our growth story on the back of fossil fuels and cheap energy, burning coal and petrol long after science warned us of their cost.

Our cities expanded without green buffers or proper drainage. We paved wetlands and cut trees in the name of progress, then wondered why every cloudburst brings chaos. Worse, we treated climate change as an environmental issue rather than a human one. Health, livelihoods and social protection were afterthoughts in climate planning. The result is a warming world that punishes those who did the least to cause it - the poor and the struggling middle class.

For them, climate change is not an abstract future threat; it is a daily tax on survival. Outdoor workers, such as farmers, masons, vendors, gig workers, lose hours of labour to unbearable heat. The Lancet Countdown on Health and Climate Change estimates that India lost hundreds of billions of potential labour hours to extreme heat in recent years, translating into tens of billions of dollars in lost income.

For a daily-wage worker, that means meals skipped, medicines postponed, children pulled from school. For middle-class families, it means soaring electricity bills, damaged homes, disrupted commutes and health expenses that quietly erode savings.

Erratic rainfall and rising temperatures are also reshaping food and water security.

Climate change, in short, has deepened India’s inequality.

Heat that harms

The health toll is harder to ignore with each passing year. Karnataka now reports more cases of heat exhaustion, dehydration and vector-borne diseases, such as dengue and chikungunya. Rising temperatures worsen air pollution by boosting ozone formation, aggravating respiratory and cardiac diseases.

The Lancet and other medical studies have already linked hundreds of thousands of premature deaths in India to fossil-fuel pollution each year. Add the psychological stress of displacement, crop loss and uncertainty, and the mental-health burden begins to mount as well.

Economists and public health experts are now attempting to quantify what all this costs. While it is difficult to isolate the exact rise in healthcare spending caused by climate change, the direction of the trend is obvious.

Families are paying more for doctor visits, medicines and hospitalisations after heat waves and floods. Out-of-pocket medical expenses, already one of the biggest causes of debt in India, climb further when climate disasters strike.

At the national level, the loss of productivity, crop income and disease burden translates into tens to hundreds of billions of dollars in economic damage each year. The poorest households, which lack insurance or savings, absorb these shocks directly. Climate change is thus not only an ecological crisis but also an economic and health emergency.

Karnataka illustrates both the problem and the possibility of change. We have the data, the talent and the tools to adapt, but we have not yet matched them with scale or urgency. The state’s weather stations and rain gauges - the very instruments that warn us of danger - have often fallen into disrepair. Heat-action plans exist on paper but remain under-funded. Urban development continues to privilege concrete over canopy. Meanwhile, public-health systems remain overstretched and underprepared for climate-linked disease.

The first step is to treat climate as a health issue, not just an environmental one. Investing in stronger primary care, resilient hospitals, early-warning systems and green urban infrastructure can save both lives and money. Cutting fossil-fuel use brings double benefits: cooler cities and cleaner lungs. Social-protection measures such as climate-indexed insurance, cooling shelters for outdoor workers, and targeted cash relief after floods can protect the vulnerable from falling deeper into poverty.

Ten Novembers ago, Karnataka’s skies were gentler. Today, they reflect our collective neglect and the urgency of repair. Climate change is not creeping toward us; it is already here, in the form of higher cost of vegetables, in the extra pill for a heat-stricken parent, in the sleepless nights of a worker who cannot afford both a fan and dinner. The question is no longer whether the weather has changed. It has. The question is whether we will.

(The writer is an advisor on Antimicrobial Resistance, Government of Karnataka, and a Professor of Practice at St Joseph’s University, Bengaluru)

Disclaimer: The views expressed above are the author's own. They do not necessarily reflect the views of DH.