Ahmedabad Heat Action Plan — South Asia's First City Heat Plan, With a Modelled but Statistically Uncertain Mortality Benefit

Ahmedabad's Heat Action Plan (HAP) was developed after the 2010 heatwave and put into full operation in 2014. It combines three components: community outreach to build awareness, a probabilistic forecast and tiered early-warning system (yellow 41–42.9°C, orange 43–44.9°C, red ≥45°C), and health-care capacity building, coordinated through a nodal officer in the city health department.
A pilot evaluation by Hess et al. (Journal of Environmental and Public Health, 2018) compared all-cause mortality in 2014–2015 with a 2007–2010 baseline using distributed lag nonlinear models. The peak relative risk of death at 47°C fell from 2.34 (95% CI 1.98–2.76) to 1.25 (95% CI 1.02–1.53). The authors estimated 2,380 deaths avoided in the post-HAP period (95% CI 324–4,435), or 1,190 per year (95% CI 162–2,218).
Caution is essential: the design is ecological, with no control for air pollution, heatwave timing, air-conditioning uptake or demographic change; there were few very hot days; and none of the incidence-rate-ratio differences between periods was statistically significant (e.g. any-alert days 0.95, 95% CI 0.73–1.22). The result is a plausible, well-documented signal, not proof of causal impact.
The plan is an inexpensive, low-technology model (forecast, alerts, outreach, clinical preparedness) that other Indian cities have adapted, which makes it highly transferable, although its long-term effect and funding model beyond the original partners remain less documented.

Read the full analysis: https://heathealth.info/wp-content/uploads/ahmedabad-heat-action-plan-2018.pdf