Climate changes may affect human health through a myriad of pathways; of particular interest are pathways affecting the geographic ranges and incidence of vector- and water-borne diseases. As society chooses how to deal with projections of long-term climate change, decisions must be based on scientific knowledge. A 2-day workshop¹ was convened in September 1997 to discuss what is known about the relationship between projected climate changes and the incidence of water-borne diseases (e.g., cholera) and vector-borne diseases, including those typically considered tropical (malaria, dengue fever, yellow fever, and schistosomiasis), plus subtropical or temperate-zone diseases whose vectors are likely to be affected by projected climate changes.

The workshop participants discussed the systems involved in potential climate changes, from the global ocean-atmosphere-landmass system that drives climate to the regional ecologic and human socioeconomic systems where disease dynamics occur. These systems are extremely complex, as are the interactions among them, which underscores the need for more research before accurate projections can be made. Major research gaps were identified, and an agenda was framed for a sound scientific basis for public policy debates and decisions. The proposed agenda included the following items: climate modeling; ecosystem and habitat dynamics; disease surveillance; technologies for disease prevention and mitigation; disease transmission dynamics; data sets for empirical studies; integrated assessments; and detecting, understanding, and responding to unexpected events. Further discussion and implementation of this research agenda is encouraged. A summary of the workshop is available from the Electric Power Research Institute, TR-109516, EPRI Distribution Center, 207 Coggins Drive, P.O. Box 23205, Pleasant Hill, CA 94523; Telephone: 510-934-4212.

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