In late July, a University of Sydney delegation travelled to Delhi to deepen collaborations across India and Australia on the converging challenges of climate change and public health. Over an intense week of meetings with researchers, policy actors, and civil society leaders, one message was clear: there can be no climate resilience without health resilience, and no health equity without climate justice.

Our itinerary was arranged to engage a range of important partners, new and old from universities and think tanks to local NGOs. We stressed the importance of reflecting on the urgency of developing solutions that are at the top of local national and state priorities.

Shared challenges, complementary strengths

India and Australia face very different climate-health realities, yet both are on the frontline of overlapping crises. In India, over 17,000 excess deaths are recorded annually due to extreme heat, while in Australia, rising mosquito-borne diseases and worsening bushfire seasons are intensifying respiratory and mental health burdens, especially among Indigenous Australian communities.

What stood out during our discussions at the co-hosted roundtable with Observer Research Foundation (ORF) was the recognition of complementary strengths between our countries. India’s vast public health infrastructure, including over a million ASHA workers embedded in communities, offers unparalleled reach, while Australia’s surveillance and early warning systems provide strong technical frameworks for anticipating disease outbreaks and environmental hazards. Further, with Australia and India both having such diverse people and landscapes, and being such large players in the Asia Pacific region, our collaborations could serve as ideal testing grounds to scale up initiatives across the rest of the region.

Bringing these strengths together opens pathways for joint solutions. At the Centre for Communicable Disease Control (CCDC), our exchanges explored how digital health systems can integrate climate and infectious disease surveillance. At the Public Health Foundation of India, conversations centred on scaling “One Health” approaches that bridge environmental, veterinary, and human health responses. And at the Observer Research Foundation roundtable, experts from across the Asia-Pacific stressed the importance of innovation hubs that combine community engagement, technology, and financing to build resilience across the region.

A vulnerability-first approach

A recurring theme was the need to place vulnerabilities rather than impacts at the centre of adaptation planning. Current heat action plans, for example, tend to address risks to formal sector workers while leaving informal labourers, women, and children unprotected.

Partners repeatedly highlighted that resilience will not come from a one-size-fits-all approach but from horizontal governance models that also enable citizens to claim protections and resources in the face of escalating risks. The Kerala Resilience Initiative, which links One Health surveillance with disaster risk financing, was frequently cited as a promising model for scaling up.

Financing and innovation

Another core insight was that financing for climate-health initiatives remains insufficient and often siloed. Too often, health is treated as a co-benefit of climate finance rather than a central pillar. Development agencies such as AFD are beginning to reposition health as a vertical within climate portfolios, but further momentum is required.

In this regard, the private sector was identified as having an essential bridging role: from designing climate-proofed health supply chains to providing return-on-investment models for low-carbon healthcare facilities. India’s rapid advances in diagnostic technologies, combined with Australia’s regulatory strengths, point to practical avenues for bilateral innovation hubs that could serve as incubators for Southeast Asia and the Pacific.

Looking forward: regional collaboration

The inaugural co-hosted ORF/USyd roundtable concluded with a call for India and Australia to jointly spearhead a regional Climate-Health Equity Tracker, akin to the ViewHub platform used in vaccine monitoring. Such a mechanism would not only generate much-needed evidence but also build accountability for action across Asia-Pacific states.

For our USyd delegates, these dialogues reaffirmed the importance of embedding our work within regional partnerships. They also reiterated how academic research can influence diplomacy and financing when grounded in community realities and communicated through trusted partnerships.

As climate change accelerates, health systems will be tested not only by rising health burdens but also by social fractures. Building resilience means that we need to engage with both. From Delhi to Sydney, the message is clear: health equity is climate justice and vice versa, and advancing one without the other will leave our region dangerously unprepared.

This work is funded by a 2025 SEI Collaborative Grant.

Caillin is also a member of the Sustainability, Climate and Health Collaboration (SCHC) at the Sydney School of Public Health.

Header image: Attendees of the inaugural ORF/USYD roundtable outside the ORF building in New Delhi, India. All images supplied by Caillin Dunsford.