Climate-health burden hits $20.7 billion a year: Report

Climate-sensitive health risks cost Bangladesh an estimated $20.7 billion a year, equivalent to 4.6% of its gross domestic product in 2024, as rising temperatures, disease outbreaks and climate-related disasters threaten public health and livelihoods, according to a new study by the Knowledge Hub Institute (KHI).

The study estimates that Bangladesh lost 29.3 billion potential working hours to heat exposure in 2024, with the economic value of the lost working capacity estimated at $15.8 billion. Farmers and agricultural workers accounted for nearly two-thirds of the lost hours, highlighting the risks facing people whose livelihoods depend on outdoor and physically demanding work.

The findings are contained in a report titled “Multi-Dimensional Health Impacts of Climate Change in Bangladesh: Pathways, Costs and Policy Implications”, released at BRAC Centre in Dhaka on Thursday. State Minister for Health and Family Welfare Professor Dr MA Muhit attended the event as chief guest, while KHI President Dr Khondaker Golam Moazzem presented the findings.

The report says the estimated annual burden covers heat, vector-borne and waterborne diseases, disasters and selected health-related economic costs. It is a conservative estimate that excludes air pollution and non-fatal illness. Within the broader burden, researchers estimate that $1 billion to $3.3 billion a year can be linked specifically to observed warming.

Analysis of weather data from eight divisional headquarters found that the number of days with temperatures reaching at least 36°C roughly doubled between the 2000s and the 2020s. Higher humidity can intensify heat stress by reducing the body's ability to cool itself through sweating, while warmer conditions may also favour dengue transmission.

“Bangladesh has developed several climate policies, but the health impacts of climate change remain inadequately addressed,” Dr Moazzem said.

He called for sector-specific heat protection guidelines, district-level heat and health action plans and better use of health budgets. He also urged the government to prioritise financing for the Health National Adaptation Plan in national planning and international climate negotiations, including COP31.

Heat threatens health and livelihoods

Heat is the largest contributor to the estimated economic burden, according to the report. Exposure can make physical work unsafe, reduce productivity and increase the risk of illness. Construction workers and others engaged in strenuous outdoor activities also face significant risks.

The health effects extend beyond heatstroke. Modelled estimates cited in the report link high temperatures to approximately 16,000 deaths in 2023, including deaths associated with cardiovascular, kidney, respiratory and other conditions.

The study also cites research linking very hot days to increased cases of diarrhoea and heat exhaustion, as well as higher levels of depression and anxiety during summer than in winter.

Despite the risks, Bangladesh lacks a dedicated national heat-health action plan and systematic reporting of heat-related illnesses and deaths, the report says.

The state minister said rising heat and humidity were becoming major public health concerns and called for coordinated action by the health ministry, meteorological authorities and other relevant agencies.

He also stressed stronger inter-ministerial cooperation, more research and targeted measures to protect vulnerable groups, particularly women, children and persons with disabilities.

Dengue, disasters add to health costs

The study found an association between warmer conditions and higher dengue hospital admissions two to three weeks later. A district that was 1°C warmer over the preceding four weeks recorded about 21% more dengue admissions two weeks later, according to the analysis.

Dengue has also spread beyond the capital. About two-thirds of admissions since 2023 occurred outside Dhaka City, although 57% to 64% of deaths occurred in hospitals in the capital, which receive patients referred with severe cases.

Among admitted patients, women were 1.8 times as likely to die as men, while patients aged 61 and above were 4.5 times as likely to die as children, the report says. Researchers estimate that hospital treatment for dengue cost about $154 million in 2023, excluding outpatient care.

Floods and other disasters create additional health risks by contaminating drinking water, disrupting sanitation and restricting access to medical services. The report also cites research linking saline drinking water in coastal areas to pregnancy-related hypertension and pre-eclampsia.

Disasters caused an average of about 416 deaths a year between 2019 and 2024. Floods and cyclones damaged 824 health facilities in 2024 alone, making it harder for affected communities to obtain treatment.

Pollution and funding gaps

Air pollution adds to the country's health burden. Modelled estimates cited in the study associate particulate pollution with approximately 263,000 deaths in Bangladesh in 2023. A separate estimate links fossil-fuel pollution to 30,600 deaths in 2022.

The report argues that the findings strengthen the case for renewable energy, energy efficiency and clean cooking. Reliable electricity is also essential for health facilities to maintain cooling systems, store vaccines and provide treatment during heatwaves and power disruptions.

Households remain heavily exposed to healthcare costs. They paid approximately 79% of current health expenditure in 2023, according to the report.

Public spending and implementation also fall short of the identified needs. The study found no clear evidence that real health spending increased after severe disaster years, while the Health Services Division spent only 24% of its climate-relevant allocation in the 2024–25 fiscal year.

KHI calls for urgent action

The report recommends introducing a national heat-health action plan before the 2027 hot season, linking Bangladesh Meteorological Department alerts to specific responses by hospitals and upazila health complexes. Measures should include emergency preparedness, cooling, access to fluids and outreach to older people and outdoor workers.

It also calls for workplace heat-protection guidelines covering rest breaks, drinking water, shade and working hours, alongside agricultural advisories. Initial action should focus on 16 districts where health burdens and climate vulnerability are both high.

To improve preparedness for dengue, the report proposes weekly district risk bulletins combining temperature, humidity and recent hospital admissions. Such alerts could help health authorities begin vector control and prepare hospitals two to three weeks before admissions rise.

On financing, KHI recommends costing the Health National Adaptation Plan and introducing identifiable budget lines from the FY2027–28 budget process. It also proposes a contingency fund for heatwaves and disease outbreaks, free dengue tests and inpatient care in public hospitals during declared outbreaks, and a pipeline of costed health projects for international climate funds.

The report further calls for quarterly publication of actual climate-related health spending, stronger protection of health facilities against disasters and a shared climate-health data system linking daily weather records with disease data.

KHI says the measures would help policymakers align spending with the health burden and use evidence on illness, deaths and lost livelihoods to guide investment in climate adaptation, public health protection and cleaner energy.