 A major El Nino may give us a taste of a 1.5 degree Celsius world. Global temperatures are expected to rise, and extreme weather events are more likely. This could have a serious impact on our health, including malnutrition, heat-related deaths, infectious diseases and worsening mental health. We need to take action. Early prediction of the El Nino has given us time. We can limit these catastrophic health effects if we put health at the center of El Nino preparedness and response.