Shifting times and paradigms: Climate change and public health
by
Paul R. Epstein
Center for Health and the Global Environment, Harvard Medical School

Since the mid-1970s 30 infectious diseases new to medicine have emerged, while old diseases have resurged and others have undergone redistribution. Grouping the multiple causal factors into a framework involving social (human), ecological and global systems can elucidate how changing conditions act synergistically to influence microorganisms, vectors and disease hosts in terrestrial and marine environments.

Climate restricts the range of infectious diseases, while weather affects the timing and intensity of outbreaks. The ranges of several key diseases or their vectors are already changing in montane regions, along with upward shifts in plant communities and the retreat of alpine glaciers. Moreover, extreme weather events are creating conditions conducive to "clusters" of outbreaks. Sequential extremes - eg, droughts punctuated by heavy rains -- can destabilize predator/prey interactions, leading to population explosions of opportunistic, disease-carrying organisms.

Increasing rates of change, variability, anomalies and gradients, and alterations in multiple systemic components all inform us about systemic instability and sensitivity to sudden change. Explosions of nuisance and weedy species -- rodents, mosquitoes and plankton -- and diseases emerging across a wide taxonomic range of species are symptoms of multiple disturbances and mounting instabilities.

Reading the biological signs and symptoms of instability can provide important guides for managing and nurturing ecosystem integrity and the global climate system. An integrative framework of driving factors is also applicable to designing the rules, incentives and governance structures needed to restabilize global environmental and economic systems.

Date received: April 11, 2002

Copyright © 2002 by the author(s). The author(s) of this document and the organizers of the conference have granted their consent to include this abstract in Atlas Conferences Inc. Document # caiq-97.