Limiting the health impact of earthquakes: a call to action.

Earthquakes are the deadliest natural hazards. While stronger building codes are essential for reducing their health impacts, achieving full compliance is a costly, long-term effort, particularly for low- and middle-income countries. We highlight low-cost, high-impact interventions across three areas that can complement building code implementation and significantly reduce risks. First, strengthening health emergency governance to ensure that lines of command and accountability are clear when a disaster strikes. Governments need response plans that outline actions, roles, and responsibilities, and enable coordinated action through emergency operations centres and incident command systems. Second, enhancing risk communication and community engagement is critical. Communities are often the first responders to seismic events. Training them in first aid and search and rescue, involving them in preparedness planning, and co-developing communication approaches ensure more tailored and actionable responses. Finally, improving international coordination can enhance the predictability and effectiveness of external support by establishing aid agreements, harmonising border-entry procedures, and ensuring staff are trained to work with and coordinate international Emergency Medical Teams. Governments and the international community should increase investments to limit the health impact of earthquakes, including through the outlined low-cost interventions.