Director: Romina Rekers

This project is supported by the Oxford-Johns Hopkins Global Infectious Disease Ethics Collaborative (GLIDE). GLIDE is funded by a Wellcome Humanities and Social Science Award.

Changes in climate affect vector pathogen-host relations and the range of infectious disease geography and seasonality. According to the LANCET report 2022 the basic reproduction number "increased by 11·5% for the transmission of dengue by Aedes aegypti and 12·0% for the transmission of dengue by Aedes albopictus; and 12·0% for the transmission of chikungunya by A albopictus, and 12·4% for the transmission of Zika by A aegypti compared with 1951-60, globally. During the same period, the length of the transmission season increased for all arboviruses by approximately 6%" (Romanello et al 2022, p.11). In the region of the Americas, specifically, "the number of suitable months in highland areas (≥1500 m above sea level) increased by 31·3%" (ibídem).

Among the key climate impacts and risks across the South America region, the last IPCC report alerts about the increased rate of epidemics of vector-borne diseases (2022, C.12). It also considers the "severe health effects and damages to health systems in countries with low adaptive capacity and where original endemicity is high and control status poor" (IPCC 2022, C.12:47). The report highlights that one of the main problems is that "higher temperatures increase the geographical range of vectors" (ibídem). Finally, it underlines that the increase in the rate of infections can lead to an increase in the incidence of more severe variants (ibídem).

These climate impacts and risks demand the development and implementation of climate-health adaptation strategies. Adaptation to climate change has the potential to improve the capacity of health systems to manage infectious disease outbreaks and other health emergencies (Romanello et al 2022). One of the main challenges in adapting to the adverse effects of climate change in South America is the lack of policy with climate-health linkages. This is not a problem exclusive to this region but globally. Using the data from the 2021 WHO Health and Climate Change Global Survey, the 2022 report of the Lancet Countdown on health and climate change identifies that until 2021 only "48 (51%) of 95 countries reported having completed a climate change and health vulnerability and adaptation assessment, but these only strongly influenced resource allocation in nine countries" (idem, p.13). In addition, "(o)nly 18 reported that assessments strongly informed the development of health policies and programmes" (idem, p.14). Finally, "(o)nly about half of countries (49/95) reported having a national health and climate change plan in place. Of these countries, 62 (65%) indicated a moderate or lower level of implementation" (ibídem).

The lack of climate-health adaptation policies poses severe challenges in regions particularly affected by climate-driven health impacts and risks. In response to these challenges, for instance, "the Wellcome Trust Africa and Asia programmes (AAP) are embedded in the world's regions most affected by global heating, and most exposed to the impact of further climate disruptions" (Choisy et al. 2022). "The AAPs in Southeast Asia already have extensive research expertise on climate-sensitive infections including vector-borne diseases like malaria and dengue, as well as diarrheal diseases, respiratory and novel emerging infections" (ibídem). South America lacks a robust and regional research agenda like the one developed by the AAPs. In this region, the government and scientific engagement in health and climate change is underdeveloped. The IPCC report 2022 identifies only these climate-health adaptation strategies in place in the region (IPCC 2022, C.12: 92):

1) Epidemic forecast tools.

2) Heat and cold early warning and alert systems.

3) Public dissemination of climate-health warnings.

4) Integrated climate-health surveillance.

5) Vulnerability and risk maps.