Climate dimension of disease prevention

In India, the southwest monsoon brings the combined concern of droughts and floods. While Vidarbha (Maharashtra), Bundelkhand (Uttar Pradesh and Madhya Pradesh), Purulia (West Bengal), and northern parts of Karnataka often face protracted drought, the regions along the Brahmaputra and Ganga River basins face the onslaught of floods. Both these sudden and slow onset climate anomalies are looked upon as ecological problems, exacerbated by anthropogenic activities. 

The problems may be ecological, but their impact has multiple dimensions. The Leprosy Mission Trust India recently conducted a multi-state study to understand the impact of climate anomalies such as droughts and floods on a population that already experiences multidimensional poverty, high exposure and sensitivity to extreme weather events, and poor socio-economic indicators.

The study reaffirmed that climate anomalies not only cause long-term disruption in traditional livelihood options (agriculture) and worsen existing multidimensional poverty but also reduce people’s access to nutrition, clean water, and sanitation

The study reaffirmed that climate anomalies not only cause long-term disruption in traditional livelihood options (agriculture) and worsen existing multidimensional poverty but also reduce people’s access to nutrition, clean water, and sanitation—prerequisites for the prevention of several neglected tropical diseases (NTDs). 

Correlation between climate extremes and disease prevalence

There is scientific evidence to suggest that nutritional deficiencies, such as protein-energy malnutrition, is linked to reduced immunity and increased susceptibility to leprosy—a bacterial infection that affects more than 100,000 people in India each year. It is also a leading cause of disability among communicable diseases. Similarly, some studies attribute leprosy transmission to the “lack of hygiene and proper sanitation, poor and inadequate supply of water”.

The two southwestern districts of Odisha—Nabarangpur and Nuapada—face the triple challenge of the high rate of multidimensional poverty, extreme climate vulnerability, and high leprosy prevalence. According to the multi-hazard mapping done by the Odisha State Disaster Management Authority, both Nabarangapur and Nuapada have a very high risk of drought. They also have a very high rate of annual new case detection rate (ANCDR) for leprosy. Nabarangapur has an ANCDR of 19.5 per 1,00,000 population and Nuapada has an ANCDR as high as 47/1,00,000—close to 10 times the national average of 5.09/100,000 population (2021-2022). In these districts, a steady rise in prolonged and recurring drought has raised concerns over nutrition security—potentially creating a situation conducive to leprosy transmission in the community.

The two southwestern districts of Odisha—Nabarangpur and Nuapada—face the triple challenge of the high rate of multidimensional poverty, extreme climate vulnerability, and high leprosy prevalence.

Purulia district in West Bengal is no stranger to droughts. However, in the last two decades, rising temperatures and erratic rainfall have made it most susceptible to it, leading to a decline in agricultural production by 65 percent, and malnutrition. Purulia, along with the neighbouring Bankura district, have red soil, which usually supports a single crop a year, which sustains families for about six months. The other six months are uncertain. Drought is now making it difficult to grow even a single crop, which has affected the availability and accessibility of food. All the 20 blocks of Purulia—a district where almost 50 percent of the population is multi-dimensionally poor—have an ANCDR of leprosy of more than 17/100,000, with the highest being 37.83/ 100,000. This is almost 800 percent higher than the national average.  

Maharashtra mirrors this phenomenon. Nandurbar district in northwest Maharashtra has witnessed the highest reduction in rainfall in the recent past. This not only affects farmers, but also has a direct impact on food security of the district, which is already grappling with malnutrition. Nandurbar has the second-highest number of underweight children under five in the country (57.2 percent). It also has a much higher percentage (69.3 percent) of tribal population than the state average (9.3 percent). They are more vulnerable to climate extremes as they are dependent on natural resources for their livelihood. The district also has a high number of cases of leprosy. 

Source: Central Leprosy Division, NITI Aayog MPI, and Climate Vulnerability Assessment for Adaptation Planning in India Using a Common Framework

During the monsoon months of 2022, over 23.32 million farmers in Uttar Pradesh were “swinging between drought and floods”. Residents of the eastern districts of Shravasti and Bahraich know what it means to shuttle between droughts and floods. Their crop yield and cropped areas have been affected, and so are their livestock. These districts have a high prevalence of neglected tropical diseases (NTDs) such as leprosy, kala-azar, filariasis, and chikungunya. They also have an alarmingly high multi-dimensional poverty: 74 percent of the population in Shravasti and 71.8 percent of the population in Bahraich.

Residents of the eastern districts of Shravasti and Bahraich know what it means to shuttle between droughts and floods. Their crop yield and cropped areas have been affected, and so are their livestock.

Under such circumstances, what we need is a greater push on building India’s resilience to climate anomalies. We can achieve that by looking at it not just as an ecological threat but by emphasising the link between climate anomalies and their health threats. Subsequently, we will be able to engage multiple stakeholders, develop more insightful databases and surveillance systems, identify holistic solutions to risks and impacts, and make the community more invested in this process. We need to look at developing climate resilience measures as an opportunity to address gaps in social determinants of health and strengthen disease prevention strategies. 

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Subhojit Goswami is a Senior Program Manager at The Leprosy Mission Trust India.

Nikita Sarah is a Head of Advocacy & Communications at The Leprosy Mission Trust India.

• Climate, Food and Environment
• India
• Neighbourhood
• climate change
• Climate Resilience
• Drought
• Floods
• Multidimensional Poverty
• Neglected Tropical Diseases (NTDs)

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