Our health is our wealth, or so the saying goes, but increasingly global health is facing growing challenges due to environmental, and in particular, climate change.
According to the IPCC, ‘Africa is one of the most vulnerable continents to climate change and climate variability’. Water-related and vector-borne diseases (VBDs) are especially sensitive to the effects of such change, and Africa is once again greatly impacted as malaria, schistosomiasis and Rift Valley fever (RVF) are all highly prevalent, particularly in sub-Saharan Africa. For example, the World Health Organization states that in 2010 81% of all clinical cases of malaria, and 91% of the estimated 655,000 worldwide deaths from malaria occurred in sub-Saharan Africa, mostly among children below the age of five. Similarly, sub-Saharan Africa currently carries the heaviest burden of schistosomiasis, accounting for 85% of global cases, while major epidemics of Rift Valley fever occur every five to fifteen years.
In the context of current concerns about the likely negative outcomes of anthropogenically-induced environmental and climate change, the changing distribution and epidemic potential of VBDs have been highlighted. For example, the increasing incidence of malaria in the highland areas of eastern Africa has been attributed to warming global temperatures. However, many other (often interrelated) determinants also play important roles in the spread and transmission of VBDs, including socioeconomic dynamics and processes such as urbanisation and migration; the effectiveness of disease control; prevention and treatment programs; and levels of immunity. Thus debates continue as to the relative importance of environmental versus non-environmental factors on VBDs and global health.
Evidently, the challenge facing researchers examining the possible future effects of global change drivers on water-related VBDs is to ensure that such research is highly integrated and interdisciplinary. Through its collaborative research consortium of environment, climate, socioeconomic and health experts, as well as eastern African health departments, the EU FP7-funded HEALTHY FUTURES project tackles this challenge. This project on ‘Health, environmental change and adaptive capacity: mapping, examining and anticipating future risks of water-related vector borne diseases in eastern Africa’ is coordinated by Trinity College Dublin and aims to build a disease risk mapping system for three water-related high-impact VBDs (malaria, RVF and schistosomiasis), accounting for environmental/climatic and socioeconomic trends to predict future risk. The project is deploying a bottom-up, end-user/stakeholder-oriented approach to achieve its aims, and its focus on eastern Africa addresses the concern that the health effects of environmental change are likely to be carried unevenly around the world.