Introduction: Nepal is vulnerable to climate change and extreme weather events, resulting in the expansion of vector-borne diseases such as dengue throughout the country. Due to rising temperatures, dengue cases have been significantly increasing, underscoring the urgent need for a climate-smart approach to public health resilience. This case study assesses how the health system in Nepal has coped with the increase in dengue cases in relation to climate change over the last decade. Methodology: We conducted a desk review concerning the impact of climate change on dengue in Nepal using WHO’s six-building blocks framework (leadership and governance, health workforce, health service delivery, health information system, and access to essential medicines). To complement the review, we also held two multi?stakeholder consultative workshops on dengue outbreak management convening academics, government (federal, provincial, municipal), the World Health Organization, private sector, and NGOs . One was conducted before the desk review and the other after the draft report was prepared to validate findings. Findings: Our findings reveal that, despite comprehensive federal dengue policies and guidelines, implementation is undermined by limited local capacity, poor multisectoral collaboration, weak information transmission, and inadequate workforce and diagnostic resources. Strengthening health-worker and volunteer training, laboratory and surveillance systems (including collaborative, data-driven climate-smart public health platforms), meaningful community engagement, and sufficient resource allocation are essential to enable timely, locally tailored dengue prevention and control in Nepal. Conclusion: Although national policies for dengue control are well established, local implementation suffers from limited capacity, poor coordination, and inadequate surveillance and diagnostics. Investing in workforce training, laboratory and data-driven surveillance enhancements, and community-centered engagement—backed by consistent resource allocation—is critical for timely, locally tailored dengue prevention and control in Nepal.

The authors have declared no competing interest.

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The seed funding for this case study was provided by Norwegian Agency for International Development (NORAD). This research study is also linked to the research project entitled “Health Policy and System Research Responding to Climate Crisis: a Lesson from Nepal” funded by the Alliance for Health Policy and System Research, World Health Organization and “Big Data Climate-Health Analyses Across Infectious and Non-Communicable Diseases and Nutritional Disorders in Nepal” funded from Harvard T. Chan School of Public Health. There is no role of funding body on research design and interpretation of findings. The views expressed in this case study are solely those of the authors and do not reflect the views of any affiliated institutions.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This study is primarily a desk review and conducted as a part of research study approved from the Ethical Review Board (ERB) of Nepal Health Research Council (Reg. No. 1977). In order to validate findings of desk review, stakeholder consultation workshop was carried out and feedbacks and suggestions are summarized without identifying individual level information. Before conduct of the workshop, oral consent of all workshop participants was taken which was approved by the ERB of Nepal as per national ethical guidelines for health research in Nepal.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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This article does not report any primary data. All findings are based on a desk review of published literature and stakeholder consultations, during which no individual level or sensitive data were collected.