<p>The climate change-driven increase in heat wave frequency, intensity and duration, along with megatrends of urbanization and population ageing are worsening the global heat and health crisis. The speed and scale of implementation of public health and adaptation activities is insufficient and inequitable, and the deployment of solutions is uncoordinated and not systematic. We propose a “people centered” cooling framework to protect the person wherever they may be. It is structured around protection layers spanning the individual, room or dwelling, building, urban level and regional to global levels. In each level, key actors can systematically explore the most suitable combinations of interventions and technologies based on the evidence on their health protection potential, equity and applicability, environmental impact, resource and energy implications, costs and cultural acceptability, as well as co-benefits for other levels. Across levels, different actors and stakeholders hold varying degrees of agency, competency and power to enact and implement strategies, though at all levels the support, facilitation and enabling power of all levels of government is crucial for heat exposure protection to be effective and sustainable.</p>