The WHO European Region has experienced an unprecedented rate of warming in recent decades. Heat-waves are projected to increase due to climate change, but their health effects are largely preventable.

WHO/Europe recommends countries, regions and cities in the Region to develop and implement heat–health action plans (HHAP), to prevent, respond to and contain heat-related risks to health.

HHAPs support a systematic and comprehensive public health response that consists of a portfolio of actions at different levels. The process of heat–health action planning brings together actors from multiple sectors with the aim of better managing heat risks.

WHO guidance on heat–health action planning is based on 8 core elements that have been identified for successful implementation:

• agreement on a lead body
• accurate and timely alert systems
• a heat-related health information plan
• a reduction in indoor heat exposure
• particular care for vulnerable population groups
• preparedness of the health and social care system
• long-term urban planning
• real-time surveillance and evaluation.

Implementation of the HHAP and its elements can be organized according to a disaster planning cycle:

• longer-term development and planning
• preparation before the summer (pre-summer)
• prevention during the summer (summer)
• specific responses to heat-waves
• monitoring and evaluation.

In 2021, WHO/Europe issued a comprehensive update of the evidence related to effective heat prevention. Findings are organized around the core elements of the 2008 WHO guidance on heat–health action planning, and are based on recent epidemiological and environmental research and lessons learned from implementation in practice. Despite the existing gaps in knowledge, the evidence clearly points to a need to expand the number, coverage and reach of HHAPs in the Region.