Introduction

The moderator introduces the panelists and sets the stage for a discussion on climate and infectious diseases.

• Sarah Fortune introduces the panelists, including Ari Bernstein, Caroline Buckee, and Marcia Castro.

• The panel will discuss climate and infectious diseases in three parts: the problem, solutions, and questions from the audience.

• A video animation from NASA is shown to illustrate the impact of climate change on our planet.

The Problem

Ari Bernstein discusses how climate change affects infectious diseases.

• Infectious disease was one of the first health issues linked to climate change.

• Climate change impacts many aspects of health, including infectious diseases.

• It is difficult to determine how much human influence is responsible for changes in vector-borne diseases like Lyme disease.

• Evidence shows that avian malaria has caused bird populations to become endangered or extinct in Hawaii due to its spread up mountainsides.

Acknowledgments

Ari Bernstein thanks those involved with organizing this event.

• Ari Bernstein thanks Dean Williams for organizing this event during Climate Week at Harvard Chan School.

• He expresses his delight at the turnout and praises the speakers.

Climate Change and Infectious Diseases

In this section, the speakers discuss how climate change affects infectious diseases. They talk about waterborne diseases, indirect pathways, and the impact of carbon dioxide on vitamin A sufficiency.

Waterborne Diseases

• Many people in the world get water from wells, which can lead to outbreaks of waterborne disease during heavy rain or drought.

• Young children are heavily affected by diarrheal disease caused by waterborne diseases.

• Climate change may increase the risk of infectious disease outbreaks in places like refugee camps due to population migrations.

Indirect Pathways

• Nutritional status is often lacking in young children who die from preventable diarrheal outbreaks.

• Carbon dioxide reduces vitamin A production in plants that feed us, leading to nutritional deficiencies that increase susceptibility to infectious diseases.

• Deforestation increases transmission of malaria and raises the possibility of new zoonoses emerging from viruses found in animal species living near humans.

Livelihoods and Migration

• Extreme weather events and shifts in seasonality can force farmers living on the edge of poverty to leave their land, leading to climate migration.

• Climate migration not only creates climate refugees but also disrupts seasonal labor migrants and pushes people into urban environments with high population density.

The Intersection of Climate Change and Pandemics

In this section, the speakers discuss how climate change is setting us up for increasing and worse pandemics due to the diversity of potentially zoonotic emergence events.

The Importance of Multi-Solving

• Deforestation contributes to both climate change and emerging infectious diseases.

• Protecting forests can provide huge benefits to potentially infectious disease risk and also to climate.

• We need to think about intersectionality in the environmental movement.

Regulation and Enforcement

• Indigenous territories in the Amazon are the most preserved areas that contribute by absorbing PM 2.5 in the forest.

• Legislation is not enough, we need measures of accountability and enforcement so people who violate those laws can be held accountable.

• Measures of accountability and enforcement are necessary at all levels.

Conclusion

• Brazil had several measures in protecting land during President Lula's first term which helped control deforestation.

Deforestation and Data

In this section, the speaker discusses deforestation and how data can be used to hold governments accountable. Caroline Buckee also talks about the importance of collecting environmental data as a matter of course.

Drastic Decline in Deforestation

• There was a drastic decline in deforestation due to effective legislation that held people accountable.

• However, in the past four years, there has been a reversal of progress due to relaxed legislation.

• It will take some time to bring back the progress made in terms of holding people accountable through legislation.

Importance of Data

• Caroline Buckee emphasizes the importance of data in infectious disease surveillance and control programs.

• She notes that there are massive data gaps when it comes to environmental data and health system data being integrated into one place.

• The types of available data may not reflect local and regional priorities, and there is a major problem with mechanistic data.

• Collecting environmental data as a matter of course within health systems is necessary, as well as building up mechanistic relationships in the context of social realities.

Learnings from COVID Response

• Ari Bernstein praises the scholarly community's response to COVID and their ability to pivot quickly.

• He highlights Francesca Dominici's work on air quality improvements and its effects on mortality during pandemics.

• Environmental justice is an important aspect when considering rules set by organizations like EPA.

Environmental Justice and Climate Equity

In this section, the speakers discuss the intersection of climate change and health equity. They touch on issues such as global inequality, vaccine distribution, and forced migration.

Climate Change and Health Intersection

• The intersection of climate change and health exacerbates existing vulnerabilities.

• Millions of people in South Asia are already affected by extreme weather events.

• Mobility data shows that migration issues have been getting worse over time.

Solutions for Climate Equity

• Meaningful academic partnerships with researchers on the ground can help prioritize and come up with innovative solutions.

• Global health partnerships need to be reimagined in the context of the climate emergency.

• Listening, understanding, and working together is key to addressing equity issues.

Indigenous Communities' Solutions

• Predatory models of development based on exploitation of resources ignore local people's culture, knowledge, and needs.

• Listening, understanding, and working together is key to addressing equity issues.

Indigenous Peoples and Environmental Justice

In this section, the speakers discuss how to address equity by bringing people to the table and sharing their knowledge. They also highlight the importance of giving voice to Indigenous Peoples and using drones for environmental justice.

Addressing Equity

• Bringing people to the table and sharing their knowledge is key to addressing equity.

• The pandemic has shown us in a painful way what we need to fix in the world.

Environmental Justice

• Drones can be used for environmental justice.

Preventing Emerging Infectious Diseases

In this section, the speakers discuss strategies for preventing emerging infectious diseases, including primary prevention strategies that involve conservation of nature.

Primary Prevention Strategies

• Our foundational approach to dealing with infectious disease is reactionary.

• Most major emerging infectious diseases come from other animals, sometimes livestock or wild animals.

• There are enormous opportunities to prevent the movement of those diseases into people through primary prevention strategies that involve conservation of nature potentially.

Benefits of Prevention

• Preventing emerging infectious diseases at the source creates benefits to health equity.

• When you stop these events from happening in low-income countries, the benefits accrue greatest in these communities.

Interplay Between Infectious Disease Burden and Economic Development

In this section, the speakers discuss how infectious disease burdens create poverty traps and how ecological substrate plays a role in community health.

Poverty Traps

• Infectious disease burdens create poverty traps.

Ecological Substrate

• The ecological substrate of the community plays a role in infectious disease burden and economic development.

Equity, Climate Change, and Community Protection

In this section, the speakers discuss how to achieve a win for equity and climate while protecting communities where diseases tend to erupt.

Achieving a Win for Equity and Climate

• The speakers suggest that it is possible to achieve a win for equity, climate change, and community protection.

• Protecting communities where diseases tend to erupt is crucial in achieving these goals.

Climate Change and Violence in Latin America

In this section, the speaker discusses the link between climate change and violence in Latin America.

Prevention in Low-Income Countries

• The speaker emphasizes the need for hope when dealing with climate change.

• She expresses concern about her country's struggle with narco traffic and drug dealers.

• The speaker quotes an Uruguayan journalist who highlights the problem of narco trafficking and warlords in Latin America.

• Illegal economies often linked to drug trafficking have representatives across all parties from extreme right to leftists.

Impact on Indigenous Communities

• The Amazon regions of Peru and Bolivia are major producers of gold.

• There is an intermingled situation between narco traffic warlords, mining, illegal mining, extractivism leading to territories devastated by violence.

• Indigenous communities are already impacted by violence caused by narco warlords.

Challenges Faced in Addressing Violence Caused by Narco Warlords

In this section, the speakers discuss challenges faced when addressing violence caused by narco warlords.

Challenges Faced

• The region is armed due to easy access to guns facilitated by previous governments' policies.

• It's difficult to reverse these policies as people are just killing each other.

• Fixing this issue will take time.

Personal Experience with Health System Failures

In this section, the speaker shares her personal experience with health system failures.

Health System Failures

• The speaker feels failed by the health system and health professionals.

• She attended a panel on climate change being personal.

• Infectious disease and Lyme disease are also personal issues that need to be addressed.

The System Failed Me

A parent shares her experience of navigating the healthcare system for her children's health issues and how she feels let down by the system.

Feeling Let Down

• As a parent, she had to navigate on her own without guidance from medical professionals.

• Her son was diagnosed with Lyme meningitis after three weeks of debilitating neurological symptoms.

• Her younger son has severe allergies and asthma, but no one helps her plan for these expanded allergy seasons.

• She feels failed as a parent because she doesn't have the partners that she needs to help manage her children's health.

Providers Need to Do Better

Dr. Bernstein responds to the parent's concerns and discusses how providers need to be accountable for climate change.

Providers Need to Be Accountable

• Dr. Bernstein acknowledges that many parents feel disappointed with medical providers who aren't aware of what's going on with their children's health issues.

• He believes that the profession of medicine needs to be accountable for climate change.

• Harvard Medical School curriculum now includes confronting climate change in every graduate program.

• There is a huge trajectory nationally towards an integrated curriculum so that every student will learn about these things.

Changing Tapestry

• The changing tapestry is very real, and sometimes it takes some parents with a little bit of motivation to help people realize that we need to change.

• Medical students organized nationally on this issue, pushing schools like Harvard Medical School and schools of Public Health to embrace the reality of climate change.

The Need for Adaptive Research Funding

In this section, the speakers discuss the need for adaptive research funding to prepare for rare infectious diseases that may become more common in the future.

Shifting Mindset on Rare Diseases

• With emerging pandemics in low- and middle-income countries, we need to shift our mindset about what it means to be rare.

• CEPI is trying to make vaccines against pandemic-prone but now rare infectious diseases, but funding models have to change.

• We need to reflect on pathogens that have pandemic potential and are important already in parts of the Global South.

• We need a much more adaptive system of research funding allocation and focus when it comes to pandemic preparedness.

Interdisciplinary Work

• Some fields are due for a major reckoning, especially in infectious disease research.

• We need interdisciplinary work that goes beyond just collaborating with other fields.

• Truly multidisciplinary research can lead to innovation and extraordinary things happening.

• Universities create silos over time, so we need real ways to come together on some of these issues.

Low-Hanging Fruit and Innovation

• There are basic things we just need to measure well and start doing the work.

• There's a lot of room for innovation, such as new technologies like AI for adaptive medicine practice.

• Paper-based multiplexed assays can tell more than one disease at once and are heat stable.

• Translation is key in making progress.

Data Gaps in Current Systems

In this section, the speakers discuss data gaps in current systems related to environmental factors and human health.

Combining Environmental and Human Health Data

• There's a need for data on the environmental side and the human health side to be combined in a way that can be usable and operationalized.

• It's challenging to have long, deep, thoughtful conversations and read scientific literature across fields and speak each other's languages.

• We need to prioritize truly multidisciplinary research to break down silos.

• There are political challenges in making progress.

Overall Summary

The speakers discuss the need for adaptive research funding to prepare for rare infectious diseases that may become more common in the future. They emphasize interdisciplinary work, truly multidisciplinary research, and innovation as key factors in making progress. The speakers also discuss data gaps in current systems related to environmental factors and human health, highlighting the need for combining these types of data.

Qualitative Research and Data Collection

Caroline Buckee discusses the importance of local prioritization in data collection and how qualitative research can inform the way data systems are collected. She also talks about the challenges of bringing together climate and health data sets due to differences in spatial and temporal scales.

Local Prioritization is Key

• Local prioritization is essential for actionable data collection.

• State-level or even more local collection of data could drive decision making at that scale.

• Collaborative teams from different aspects of the problem are needed to ensure key local context informs methods.

Importance of Qualitative Research

• Human behavior plays a significant role in driving models, which can get it wrong without considering local context.

• There has been an arrogance in academia that places quantitative methods above qualitative methods, but we need to be more systematic about bringing qualitative data into our modeling frameworks.

• We need to readjust our biases and recognize how key local context is to informing some of our methods.

Catalytic Ask: How Can We Do Better?

The speaker asks public health officials, researchers, and practitioners how they can innovate and do better when it comes to addressing issues around climate change, which are centered around planetary health and public health.

Innovating Public Health

• Climate change issues are centered around planetary health and public health.

• In any one child's lifetime now, they will suffer through at least one climate change event.

• No further bullet points available.

Multiplicative Modeling of Multiple Exposures

The speakers discuss the challenges of modeling multiple exposures at once and longitudinally over someone's lifetime. They emphasize the need for innovation in public health research to move forward.

Challenges in Public Health Research

• Heat stress exposure and vitamin A decreases are affecting public health.

• Innovative multiplicative modeling is needed to address these issues.

• Longitudinal studies are necessary to understand the impact of exposures over a person's lifetime.

Moving Forward with Data

• Obtaining data is crucial for effective use in public health research.

• Public health practitioners and researchers should lead the way in using data effectively.

• Collaboration and re-examining priorities can help us achieve this goal.

Mindset Shift Needed

• A mindset shift is necessary for public health research to be successful.

• Academic pressures must not hinder progress towards innovative solutions.

• This event and developments around the school suggest that people are starting to take this issue seriously.

Working with Public Health Officials

• Collaboration with public health officials is essential for success.

• Capacity building, raising awareness, training, listening, and working together are all important steps towards change.

• Developing models that lead to change rather than just publications is crucial.