The report identifies poorer nations, particularly in the Global South, as the most affected by El Niño-driven heat. Countries in Africa's Sahel region are projected to experience the highest toll, with approximately 66,800 additional deaths. India is also expected to see significant impacts, with 15,800 heat-related fatalities. Vulnerable populations in these regions face heightened risks due to limited access to cooling systems, reliable water supplies, and healthcare infrastructure. The cumulative exposure to elevated temperatures poses severe health risks, especially in areas already experiencing high temperatures and economic challenges.