An integrated assessment framework for climate change and infectious diseases

Many potential human health effects have been hypothesized to result either directly or indirectly from global climate change. Changes in the prevalen ce and spread of infectious diseases are some of the most widely cited pote ntial effects of climate change, and could have significant consequences fo r human health as well as economic and societal impacts. These changes in d isease incidence would be mediated through biologic, ecologic, sociologic, and epidemiologic processes that interact with each other and which may the mselves be influenced by climate change. Although hypothesized infectious d isease effects have been widely discussed, there have not yet been thorough quantitative studies addressing the many processes at work. In part this i s because of the complexity of the many indirect and feedback interactions or mechanisms that bear on all aspects of the climate issue. It also result s from the difficulty of including the multitude of always-changing determi nants of these diseases. This paper proposes a framework for an integrated assessment of the impacts of climate change an infectious diseases. The fra mework allows identification of potentially important indirect interactions or mechanisms, identification of important research gaps, and a means of i ntegrating targeted research from a variety of disciplines into an enhanced understanding of the whole system.