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Climate exerts both direct and indirect effects onthe appearance and spread of human and animalinfectious diseases. The impact of climate changeon the transmission and geographical distribution ofvector-borne diseases, including zoonoses (infectionstransmissible between vertebrate animals andhumans), has been associated with changes in thereplication rate and dissemination of pathogen,vector and animal host populations, which aresensitive to changing temperature and rainfall. Theavailable evidence indicates the potential for anincreasing challenge to European public health fromarboviral (arthropod-transmitted) diseases such astick-borne encephalitis (TBE), West Nile fever(WNF), chikungunya, diseases caused byrodent-borne hantaviruses, and parasitic diseases suchas dirofi lariasis and leishmaniasis. Climate changeis also increasing the threat of infections, such asbluetongue virus (BTV), in domesticated animals.
Although the evidence base is fragmented and it isalso important to take account of the other variousdeterminants of changes in ecosystems and in human,animal and microbial behaviour, the fundamentalinfl uence of climate change on infectious diseases inEurope is beginning to be discerned. And althoughthe World Health Organization (WHO), the WorldOrganisation for Animal Health (OIE) and the EuropeanCommission and its agencies are already active inmonitoring and evaluating some infections, there ismuch more to be done to fi ll gaps in the evidence base,prepare public health authorities and raise the politicalprofi le of the issue, without being alarmist—to alert tothe possible emergence of new threats as well as theexpansion of diseases already present in Europe.
Our assessment of the available evidence,predominantly for vector-borne diseases, leads usto make several recommendations directed to EUand national decision-makers, with the objectives ofidentifying and supporting the necessary adaptationresponses to what is unavoidable in climate change:
- It is vital to modernise surveillance, based ontrans-European early warning systems that havethe capability to integrate epidemiological andenvironmental data.
- This also requires integration of data collection andanalysis for human and veterinary health, to includesurveillance of wildlife populations andnew molecular techniques to assess vectorialcompetence—the ability to transmit the infection.
- The health and environment research agendasshould be co-ordinated to develop a broadunderstanding of key determinants of the spreadof vector-borne disease. It is also important tointegrate research in social and biological sciencesto understand and quantify the human responseto climate change. Research-funding agenciesneed to consult with the scientifi c community todevelop a more strategic and sustained approach todefi ne priorities and to train the next generation ofresearchers in the face of impending skills shortagesin critical disciplines.
- Attending to the research gaps is only a fi rst stepin addressing the health risks of climate change. Inaddition, the growing evidence base must be usedto inform the preparedness and responsivenessof public health systems and to develop betterpredictive modelling to allow more robustprojections for future climate impact. It is equallyessential to use the scientifi c outputs as a resourceto sustain the search for new and better diagnostics,vaccines and therapeutics, and to ensure thatscience-based policy facilitates the best use of theseinnovative products and services for the benefi t ofhuman and animal health.
- The goals for the EU cannot be considered in isolationfrom the rest of the world. EU policy-makers musttake account of the issues relating to climate changeand infectious disease when progressing regionalinitiatives, for example for European NeighbourhoodPolicy and for the Euro-Mediterranean Union. EUactions in surveillance, research and innovation mustalso be appropriately integrated with global needs,priorities and strategies.
- Climate change is likely to affect human migrationas well as the mobility of animal hosts, vectors andpathogens. The potential future impact of climatechange on human migration to the EU requiresfurther study within the context of improvingprocedures to identify and quantify the currentimpact of migration on the infectious disease burdenin Europe. In addition to fi lling these knowledgegaps, it is important to improve co-ordination ofpublic health screening and follow-up practices forhigh-risk groups across Europe.
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