The Federal Democratic Republic of Nepal is a landlocked and geographically varied country located in South Asia, situated between India and Tibet. Within a span of less than 200km the country features the high Himalayan Mountains in the north and the low-lying Gangetic Plains in the south. As such, it experiences a range of different climates and climatic extreme events, both of which are being influenced by climate change. The already dry winters will be drier, and the wet summer monsoon season will be wetter by a staggering threefold increase (likely). Temperatures have been increasing and will continue to increase (certain), especially in the dry months (December–May) and warming is most pronounced in the mountains where snow is increasingly falling as rain. This will continue to lead to changes in water runoff from the mountains and hills, with numerous impacts downstream, including on livelihoods. Strong glacial melt will trigger landslides, mudflows and flash floods with increased runoff initially, before there sets in a steady decline in the flow (Ramasamy and Regmi 2014). Nepal faces a range of extreme weather-related events like floods, droughts, landslides, avalanches, high and low temperature, and glacier lake outburst floods (GLOFs). Over 80 per cent of its population is exposed to at least one of these hazards (UNDRR 2019). The impacts these changes will have on livelihoods and health, without substantial global action and national adaptation, are significant.
Nepal ranks among the world’s 30 poorest nations (World Population Review 2021) with one-third of its people experiencing multidimensional poverty (GON and UNDP 2020). Multidimensional poverty differs significantly based on ethnic background and gender, rural or urban areas, ecological region and province (GON and UNDP 2020). A Least Developed Country (LDC), Nepal falls in the medium Human Development category, ranking 147 out of 189 countries (GON and UNDP 2020). Essentially a rural economy, 70 per cent of the people are employed in largely subsistence agriculture, with tourism and wage remittances being the other economic drivers (MoFe et al. 2018; ADB 2019). Climate change has the potential to trigger a negative feedback loop between livelihoods and health. As agriculture and tourism are disrupted from changing rainfall patterns, river system disruptions, and more intense monsoon rains, families may have less income, impacting their ability to afford healthcare.
Impacts on health, in turn, reduce people’s ability to work and earn a livelihood. The main climate-change health risks include direct mortality from natural hazards (especially landslides and floods); increased expansion of vector-borne disease into highland areas (as temperatures increase), which were previously devoid of these diseases; and increasing food and water insecurity, which affects water contamination, waterborne disease transmission and the risk of malnutrition. Women are likely to shoulder a high proportion of the burden as they are typically the caregivers of the family, responsible for subsistence farming and feeding the family; and, therefore, cannot migrate to find alternative employment. There are some links between how climate change will impact mental health as well as sexual and reproductive health, but there remain considerable gaps in the research and evidence.