Climate change impacts are felt in many sectors and across all Nepalese population. The Nepal National Adaptation Programme of Action (NAPA) to climate change has identified public health as one of the most vulnerable sectors to the negative effects of climate change. There are increasing evidences on the impacts of climate variability and change on health outcomes in Nepal. The health impacts of climate change are water-borne diseases, vector-borne diseases, air-borne diseases, food-borne diseases and nutrition related diseases such as malnutrition, injuries and mental illnesses . Though the effects of climate change on health are noticeable, there are limited etiological studies on the health impacts of climate change in Nepal. Several challenges for conducting climate change and health research in developing mountainous countries have been reported which include lack of trained human resources, financial resources, long-term data and information, and suitable methods that are applicable to the local context . Entomological and epidemiological studies carried out in Nepal show early effects of climate change on vector-borne diseases with clear shifting of vector-borne diseases and their vectors in the highlands of Nepal . The impacts of climate change could be seen or observed through the changes in average temperature, precipitation and extreme weather conditions over the past three decades. These changes bring about direct impacts on human health or indirectly on disease transmitting agents and thereby affecting human health.

Based on global evidences and scientific consensus, if climate change continues as projected across the RCPs scenarios, the major increase of ill-health will occur in Nepal compared to no climate change scenario through: 

1. the greater risk of injury, disease, and death due to more intense heat waves, cold waves and fires; 

2. the increased risk of under-nutrition resulting from diminished food production in resource poor regions; 

3. consequences on health of lost work capacity and reduced labour productivity in vulnerable populations; 

4. the increased risks of food- and water-borne diseases and vector-borne diseases especially in previously considered non-endemic mountain areas; 

5. modest reductions in cold-related mortality and morbidity in the highlands due to fewer cold extremes, 

6. increased morbidity and mortality related to cold waves in southern Terai; and 

7. the reduced capacity of disease-carrying vectors due to exceeding thermal thresholds especially in the lowland Terai regions. 

Management of these health effects of climate change will require inputs from all sectors of government and civil society, collaboration between many academic disciplines, and new ways of international cooperation. Involvement of local communities in discussing, advocating, assisting and monitoring of the process of adaptation will be crucial.