The staggering loss of an estimated 153 billion hours of labour during 2017 due to rising temperatures around the globe is a reminder to governments that they are not doing enough to dramatically curb greenhouse gas emissions. The Lancet countdown on health and climate has reported that India was particularly affected by the rising frequency of heatwave events and lost about 75 billion hours of work, a significant part of it in the agricultural sector. This has worrying implications for rural employment and the well-being of a large section of the population that depends on farming. At stake for all countries in the developing world is the health of millions, many of them already vulnerable to extreme weather events. Coming on the eve of the UN climate conference in Katowice, Poland, the report of the Lancet panel for 2018 brings clarity, placing connected issues in perspective for governmental action. It is vital that India gets more ambitious about cutting back on carbon emissions, even as it presses for the fulfilment of the climate finance obligations of developed countries under the Paris Agreement of the UN Framework Convention on Climate Change. A further reduction in the share of coal in the energy mix through sustained support for renewable energy, particularly solar photovoltaics, must form the cornerstone of national policy. This must be matched by a shift away from use of fossil fuels for transport, and the induction of more electric vehicles. Such a policy would yield the parallel benefit of improving air quality; ambient air pollution led to the premature death of an estimated half a million people in India in 2015. The consensus on climate change is that it has begun to affect the intensity and frequency of extreme weather events. India’s approach to adaptation should, therefore, prepare for catastrophes with a well-considered plan to provide relief and rehabilitation. If the Centre and State governments can arrive at a consensus on the strong climate link to the excessive rain in Kerala and Cyclone Gaja in Tamil Nadu, for instance, a case could be made for climate funds under the Paris Agreement. Such a claim has to be supported by a perspective plan that identifies vulnerable regions and communities, and incorporates transparent systems for funds utilisation. The importance of funds for adaptation is underscored by Lancet ’s finding that 99% of losses from climate-related events in low-income countries were not insured. From a public health perspective, the report sounds a warning that rising temperatures will enable the dengue virus and malaria to spread farther and faster. This is also true of some other infections. The aggravated impact of climate change on health is a serious issue for policymakers to consider when they gather in Katowice for the conference on December 2.