(C) PLOS One This story was originally published by PLOS One and is unaltered. . . . . . . . . . . Lethal heatwaves are challenging India’s sustainable development [1] ['Ramit Debnath', 'Cambridge Zero', 'University Of Cambridge', 'Cambridge', 'United Kingdom', 'Division Of Humanities', 'Social Science', 'California Institute Of Technology', 'Pasadena', 'Ca'] Date: 2023-04 Due to the unprecedented burdens on public health, agriculture, and other socio-economic and cultural systems, climate change-induced heatwaves in India can hinder or reverse the country’s progress in fulfilling the sustainable development goals (SDGs). Moreover, the Indian government’s reliance on its Climate Vulnerability Index (CVI), which may underestimate the impact of heatwaves on the country’s developmental efforts. An analytical evaluation of heat index (HI) with CVI shows that more than 90% of the country is at extremely cautious or dangerous levels of adversely impacting adaptive livelihood capacity, food grains yield, vector-borne disease spread and urban sustainability. The results also show by examining Delhi’s urban heat risk that heatwaves will critically hamper SDG progress at the urban scale. Linking HI with CVI identifies more of India’s vulnerability and provides an opportunity to rethink India’s climate adaptation policies through international cooperation in designing holistic vulnerability assessment methodologies. The conclusion emphasizes the urgent need to improve extreme weather impact assessment by combining multiple layers of information within the existing climate vulnerability measurement frameworks that can account for the co-occurrence and collision of climate change events and non-climate structural SDG interventions. Funding: This work was supported by the Bill and Melinda Gates Foundation (OPP1144 to RD), Laudes Foundation (G111269 to RD), the Quadrature Climate Foundation (01-21-000149 to RD), Keynes Fund, Faculty of Economics (JHVH to RD and RB), and the Africa Albarado Grant (G115009 to RB). RD received salary from the Quadrature Climate Foundation, the Laudes Foundation, and the Keynes Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2023 Debnath et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction April 2022 in India was the hottest in 122 years and followed the hottest March on record, reportedly killing at least 25 people [1, 2]. The cumulative heatwave-related mortality in India is over 24,000 deaths since 1992 [3]. Moreover, the heatwave in the Indian subcontinent has had critical impacts on a broad range of interconnected systems of the built environment, health, etc., including frequent and more extended power outages, an increase in dust and ozone levels leading to spikes in air pollution and accelerated melting of glacier snow in the northern regions. At the same time, economic recovery from the Covid-19 pandemic is further hampering the response to the ongoing lethal heatwave [2, 4]. Thus, such heatwaves’ public health and economic burdens are incredibly high. Long-term projections indicate that Indian heatwaves could cross the survivability limit for a healthy human resting in the shade by 2050 [5, 6]. Moreover, they will impact the labour productivity, economic growth, and quality of life of around 310–480 million people [6]. Estimates show a 15% decrease in outdoor working capacity (i.e., working outdoors in high temperatures, e.g., construction worker) during daylight hours due to extreme heat by 2050 [5]. Furthermore, a Lancet Report projected heatwaves will intensify from these 2050 baseline estimates, affecting around 600 million Indians by 2100 [7]. The increased heat is expected to cost India 2.8%, and 8.7% of its Gross Domestic Product (GDP) and depressed living standards by 2050 and 2100, respectively [5, 8]. Furthermore, a recent report by the World Meteorological Organization demonstrated the interconnections between lethal heatwaves and the Sustainable Development Goals (SDGs), implying that global mean surface temperature rise will affect all the 17 SDGs [9]. The impact of heatwaves on sustainability transition is especially concerning for India as the country is yet to achieve its developmental goals, despite recent strides in its self-reported SDG India Index (2020–21) [10]. India is currently facing a collision of multiple cumulative climate hazards co-occurring due to its size, urbanisation rate, and biophysical characteristics, significantly influencing the hydrological cycle and consequently affecting the behaviour of climate extremes [11]. In 2022 from January to October, India recorded 242 of 273 days of extreme weather events, making it nearly one extreme event daily. These include co-occurrence of extreme heatwaves and coldwaves in the north and western parts, drought in central India [12], and high flooding in the coastal plains along with landslides in north-eastern region [12, 13]. By 2100 India will have more frequent precipitation and consequent floods, cyclonic storms, warming, heatwaves, and sea-level rise concurrently. To comprehensively understand India’s climate vulnerability, a cumulative representative index is imperative that accounts for the co-occurrence and collision of climate events. At present, India assesses its climate vulnerability through a national Climate Vulnerability Index (CVI), designed by the federal government’s Department of Science and Technology [14], based on the Intergovernmental Panel on Climate Change (IPCC)’s SREX framework. The concept of vulnerability used by the Government of India is adopted from the IPCC AR5 [15] where it is conceptualised as an ‘internal property of a system’ that represents the propensity or predisposition of the system to be adversely affected, independent of hazard and exposure [15]. The CVI is a composite index that uses various indicators to account for India’s socio-economic features and livelihood, biophysical, institutional and infrastructural characteristics (see Table 2, pp. 11–12 in [14]). These indicators were further mapped to related SDG indicators [16], as presented in Table 1. The mapping of the CVI indicators with the SDG was performed based on (i) key domain of impact, (ii) keywords that match the SDG, and (iii) based on the Government of India’s SDG indicators. When all these criteria matched for a CVI indicator, it was assigned to the specific SDG. For example indicator–“Percentage of households below the poverty line as of 2011” is related to reducing poverty or SDG1- No Poverty. While there are few methodological and sensitivity analyses for CVI [17–19], it is the only official federal measure available for the country’s climate adaptation planning [14]. Therefore, we use it to analyse how lethal waves can challenge the progress in the nation’s SDGs and the implications of heatwave impacts on India’s climate vulnerability assessments—at the same time, examining the missed opportunity of not having heat-related policy measures in its current CVI-led assessment. There is a knowledge gap in the literature evaluating the appropriateness of CVI as a holistic vulnerability measure [17–19]. Contributing to this measurement gap, Edmonds, Lovell and Lovell [20] proposed a multiple climate vulnerability index to make it a comprehensive measure for empirically estimating the exposure, mitigation and adaptive capacity [20]. However, the authors did not mention how such an index-based measure can be used as an effective decision-making tool to ensure that progress in SDGs is not reversed. This gap is persistent in the current literature as climate vulnerability indices like India’s CVI use socio-economic indicators to measure vulnerability, which links it with SDG indicators. Whereas, in the case of extreme weather events, the measures are primarily based on hazard probabilities (like the Heat Index (HI). Using these measures as overlapping information layers can improve the overall climate vulnerability assessment. This shapes the paper’s motivation, which is not to compare CVI and HI for India, but instead to provide an empirical basis for evaluating and rethinking India’s approach to vulnerability measurement, especially when the impact of an extreme weather event like heatwaves challenges its development goals and climate adaptation policies [3]. This paper uniquely contributes to the above gap by examining the following questions: (1) What does India’s current climate vulnerability assessment miss in terms of identifying the vulnerability caused by the heatwaves? (2) To what extent is SDG progress impacted by the absence of a holistic vulnerability measurement? Furthermore, (3) How to co-design policies for improving climate vulnerability assessment in India? Using the 2022 heatwaves across India as a case study, this paper analyses its vulnerability impact using Heat Index (HI). It discusses this impact assessment with the latest CVI-led SDG ranking across the Indian states and the national capital using publicly available federal data (see Methods section). This study is designed in two stages to demonstrate that a holistic climate measurement is important across different spatial scales for India. Here, we set the scope of study at a state level and an urban scale. Due to a lack of data, we could not evaluate a more granular scale (like at the district level). The first stage analyses CVI in the country using the latest publicly available government data. The next step estimates the HI and temperature anomaly across India for April 2022. It performs a normative heatwave impact assessment on India’s SDG progress. In the second stage, a scaled-down analysis was performed at an urban scale for Delhi to evaluate its HI and assess its impact on the national capital’s urban sustainability. This was done as a case study to show the severity of heatwaves at an urban scale, especially emphasising the need for contextualised heatwave impact studies. The case of Delhi is interesting because it is the largest city and the capital of India, with a population of 32,065,760 [21], which is at high risk from heatwaves [22] and was the first to draft a State Action Plan on Climate Change (SAPCC). The SAPCC was recently updated with 17 climate risks (see Methods), including urban heat islands but without considering heatwaves. This paper argues that such state-level vulnerability assessment methodology can be improved by considering the heatwave impacts and upgrading its climate adaptation policies. Finally, broader implications were drawn from international efforts on heatwave adaptation at the national climate vulnerability scale and shaped the discussion on the urgency of similar policy action for India and its neighbouring nations. 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