Dengue, climate change, and vector-borne diseases: Strategic considerations for healthcare leaders

• Vector-borne diseases like dengue are seeing unprecedented outbreaks and expanding into new territories due to climate change
• A surge in dengue cases can quickly overwhelm emergency rooms, leading to a high demand for accurate and rapid diagnostics
• Supporting research and development for climate-sensitive diagnostics is a strategic imperative for healthcare leaders

The escalating impacts of climate change are no longer a distant threat but a present and accelerating reality, profoundly reshaping the global health landscape.¹ Vector-borne diseases like dengue are seeing unprecedented outbreaks and expanding into new territories as rising temperatures create conditions that exacerbate the spread of disease. For healthcare leaders, understanding the relationship between climate change and vector-borne diseases is a critical strategic imperative. However, understanding is not enough. It must be matched by a focus on the tangible tools —diagnostics, treatments and prevention — that will form the frontline of response, and an unwavering commitment to ensuring the right tools reach the most vulnerable populations.

Scientific consensus, reinforced by numerous high-ranking publications, unequivocally links climate change with vector-borne diseases and altered patterns of infectious disease transmission.² Rising global temperatures, erratic precipitation, and extreme weather events create fertile ground for the expansion and intensification of vector-borne, waterborne, and zoonotic diseases by allowing habitat expansion and longer transmission seasons.³ Journals like The Lancet Planetary Health and reports from the World Health Organization (WHO) consistently map the expansion of vector-borne diseases in particular to previously unaffected regions, underscoring the urgency for adaptive health solutions.⁴ In the case of dengue, warmer climates allow the Aedes mosquitoes to survive in higher altitudes and latitudes, while increased rainfall can create more breeding sites. This ecological shift is directly responsible for putting billions more people at risk.⁵

The direct and indirect costs associated with expanding disease burden are staggering. Healthcare systems face:

• Increased patient volume and resource strain: More frequent and widespread outbreaks necessitate increased hospital admissions, emergency room visits, and demand for specialized treatments, straining already stretched resources. A surge in dengue cases, for example, can quickly overwhelm emergency rooms, especially as its early symptoms can be mistaken for other febrile illnesses, leading to a high demand for accurate and rapid diagnostic capabilities to ensure proper patient management.
• Disrupted supply chains: Extreme weather events can cripple logistics, affecting the delivery of essential medicines, vaccines, and medical supplies, creating critical shortages.
• Infrastructure vulnerability: Hospitals and clinics, particularly in coastal or flood-prone areas, are increasingly susceptible to damage from extreme weather, disrupting services when they are needed most.
• Workforce impact: Healthcare professionals themselves can be affected by climate-related health issues, or face challenges in reaching facilities, impacting staffing levels.

Proactive adaptation and mitigation strategies are no longer optional but essential for building resilient and future-proof healthcare systems.

1. Integrate climate health into strategic planning
   • Risk assessment: Conduct comprehensive vulnerability assessments to identify specific climate-related health risks and their potential impact on local patient populations and infrastructure.
   • Scenario planning: Develop contingency plans for extreme weather events, infectious disease outbreaks, and resource disruptions.
   • Investment in resilience: Prioritize investments in climate-resilient infrastructure, including sustainable building designs and renewable energy sources for healthcare facilities.
2. Leverage digital health and data analytics
   • Enhanced surveillance: Implement advanced digital surveillance systems that integrate climate data with epidemiological information to predict and monitor outbreaks in real-time. Artificial intelligence and machine learning can play a pivotal role in early warning systems.
   • Data sharing and collaboration: Foster robust data-sharing agreements between health systems, public health agencies, and environmental monitoring bodies to create a holistic picture of disease risk.
3. Invest in research, innovation, and workforce development
   • Climate-sensitive diagnostics and surveillance: A cornerstone of any effective response to climate-driven disease spread is innovation in diagnostics. For vector-borne illnesses, early and accurate diagnosis is critical not only for patient outcomes but also for public health surveillance and outbreak control. Specifically for dengue, the challenge is that initial symptoms are often non-specific, making it difficult to distinguish from other infections. This requires a multi-faceted diagnostic approach: detecting the virus directly (via its RNA or antigens) in the acute phase of infection, as well as identifying the body’s subsequent antibody response. This allows healthcare professionals to provide appropriate care, monitor for severe complications, and allocate resources effectively.^6,7
   • Public health education: Educate healthcare professionals and the public about the health impacts of climate change and preventative measures.
   • Community engagement: Engage with local communities to understand their unique vulnerabilities and co-create tailored solutions.
4. Advocate for policy and cross-sector collaboration
   • Influence policy: Healthcare leaders must become vocal advocates for climate action and policies that protect public health.
   • Multi-sector partnerships: Forge strong partnerships with government agencies, urban planners, environmental organizations, and the private sector to develop comprehensive, multi-faceted approaches to climate adaptation and mitigation.

The convergence of climate change and infectious disease spread represents one of the most significant healthcare challenges of our era. Healthcare systems need access to highly sensitive and specific tools that can detect pathogens early. This is where supporting research and development for climate-sensitive diagnostics becomes a strategic imperative. Beyond making an impact for patients at the individual level, insights from antibodies detection, genotyping and serotyping can be fed into advanced surveillance systems, allowing public health bodies to track an outbreak and predict its spread.⁸

For leaders at the helm of healthcare organizations, inaction is not an option. By embracing innovation, investing in resilience, leveraging data, and fostering collaboration, we can transform our healthcare systems to not only withstand emerging threats like dengue, but also to lead the charge in building a healthier, more sustainable future.