CLIMATE change in Bangladesh is no longer a distant environmental threat; it is unfolding as a public health crisis. The signs are unmistakable. Rising temperatures, erratic rainfall, recurrent floods, saltwater intrusion and worsening air pollution are already placing considerable strain on an overburdened healthcare system. These environmental pressures are not only altering the physical landscape but are also aggravating existing health challenges, disproportionately affecting the poor and the vulnerable.
While sea-level rise and cyclones dominate the climate discourse, the most immediate costs of climate change are increasingly evident in public health outcomes. Diseases once considered seasonal or contained are becoming more persistent and widespread. Vector-borne illnesses like dengue and chikungunya are thriving in warmer temperatures and extended monsoon seasons. Waterborne diseases 鈥� cholera, diarrhoea, typhoid 鈥� surge after every flood or cyclone, particularly in low-income and displaced communities. Respiratory ailments such as asthma and bronchitis are on the rise, driven by dust and air pollution during prolonged dry periods. Mental health impacts, though less visible, are also growing, exacerbated by displacement, livelihood loss and repeated exposure to environmental shocks.
Coastal districts, notably Satkhira, Khulna and Bagerhat, are on the frontlines. Here, saltwater intrusion has contaminated drinking water sources, leading to hypertension, skin conditions and pregnancy complications. Pregnant women and children are especially vulnerable. Local health workers report an increase in such cases, yet healthcare responses remain reactive, fragmented, and under-resourced. Clinics lack sufficient equipment, trained personnel and continuity in care, making it difficult to cope with the scale of the problem.
In urban centres, particularly Dhaka, the crisis is no less severe. As one of the world鈥檚 most polluted cities, Dhaka is experiencing a growing burden of respiratory and cardiovascular diseases. The urban poor, living in densely packed settlements with poor ventilation, minimal sanitation and limited access to healthcare, are especially exposed. The city鈥檚 heat island effect 鈥� amplified by concrete sprawl and lack of greenery 鈥� raises the risks of heatstroke and dehydration during heatwaves, especially among older adults and children.
The health infrastructure across the country is ill-prepared to meet the demands of climate-linked illnesses. Many rural clinics operate without refrigeration, reliable electricity, or clean water. Emergency responses during floods or cyclones are often delayed or inaccessible due to damaged roads or inundated health centres. Moreover, frontline health workers are rarely trained to recognise or respond to climate-sensitive health risks, which compromises early detection and preventive care.
Despite Bangladesh鈥檚 recognised progress in disaster preparedness 鈥� cyclone shelters, early warning systems and community-based resilience 鈥攖 he integration of health into climate policy has lagged. The Ministry of Health and the Ministry of Environment continue to work in silos, while public health remains peripheral in climate adaptation strategies. What is needed now is a coordinated, integrated framework that acknowledges health as a central component of climate resilience.
The economic implications are also significant. Climate-sensitive health issues contribute to rising out-of-pocket medical expenses, lost productivity and increased household poverty. In a country where millions are informally employed and lack health insurance, even minor illnesses can have devastating financial consequences. A proactive investment in climate-resilient health systems could reduce long-term costs, avoid avoidable mortality and protect the country鈥檚 human capital.
The burden of this crisis is not shared equally. Women and children are among the hardest hit. During climate-related disasters, pregnant women face disrupted access to prenatal care, unsafe birthing conditions and higher rates of miscarriage or complications. Children suffer from malnutrition, stunting and poor cognitive development, particularly in flood-prone or drought-affected regions. These developmental setbacks have long-term consequences for education, income and overall productivity.
Public awareness remains an underutilised tool in this context. Many communities are still unaware of how climate change is linked to health, or what preventive steps to take during extreme weather. Awareness campaigns need to be localised, simple and sustained 鈥� not limited to disaster alerts. Schools, local governments, NGOs and religious leaders must be mobilised to disseminate accurate, actionable information on health risks and resilience strategies.
A meaningful response to this crisis requires several strategic shifts. First, public health planning must be informed by climate data and risk projections. Surveillance systems should be updated to monitor and respond to climate-sensitive disease outbreaks in real time. Second, health infrastructure 鈥� hospitals, clinics and mobile units 鈥� must be made resilient to flooding, power failures and extreme heat. Third, medical education must be updated. Doctors, nurses and community health workers should receive training on emerging climate-related health risks and appropriate responses.
Policy integration is critical. Climate change does not fall neatly under the jurisdiction of a single ministry. Ministries responsible for health, environment, water, agriculture, disaster management and local government must coordinate through joint task forces or working groups to ensure policy coherence. Local governments should also be empowered and adequately resourced to implement health-climate interventions tailored to regional vulnerabilities.
Bangladesh would benefit from regional collaboration and global partnerships. Many countries in South Asia and beyond face similar climate-health risks. Shared research, joint early warning systems and knowledge exchanges could improve collective response capacity. Furthermore, international climate finance must begin treating health adaptation as a priority, rather than a secondary or overlooked sector. The global climate agenda must reflect the reality that public health is among the most immediate and life-threatening aspects of climate change.
Crucially, climate change must be understood not only as an environmental or infrastructural challenge but also as a human one. It intersects with poverty, inequality and access to essential services. Bangladesh鈥檚 Vision 2041 and other development strategies must mainstream health resilience into every sector. Without a healthy population, no development goal is sustainable. Without integrating health into climate planning, existing gains will be at risk of reversal.
Bangladesh has repeatedly demonstrated global leadership in disaster management. It is now time to extend that leadership to the intersection of climate and health. The evidence is already here: in swelling hospital queues, in salt-tainted water, in air too thick to breathe. The challenge is not whether the country can afford to act, but whether it can afford to wait.
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Md Mehedi Hasan works with a United Nations organisation.
