As COP27 kicks off in Sharm el-Sheikh this week, we asked Stuart Halford, Uniting’s Director of Resource Mobilisation and Advocacy, about the interlinked challenges of climate change and neglected tropical diseases, and what would be a good outcome from COP this year.

What is the link between neglected tropical diseases and climate change?

Climate change will increase the spread of neglected tropical diseases (NTDs) as they are directly influenced by changes in temperature, rainfall, relative humidity, and climate. In many cases, warmer temperatures create more opportunities for vector-borne diseases to thrive. This includes several neglected tropical diseases that are vector-borne such as dengue and chikungunya (viral diseases transmitted by mosquitoes which cause fever and joint pain) and visceral leishmaniasis (a disease caused by the infected bite of sandflies which attacks the immune system and has a high fatality rate).

 The impact of climate change is significant – neglected tropical diseases risk being turbocharged by global warming. For example, it has been estimated that 500 million more people could become exposed to chikungunya and dengue as these diseases spread to new geographies due to warmer climates [1]. By 2080 this figure doubles to one billion more people. Visceral leishmaniasis, an NTD that if left untreated is fatal, is very climate-sensitive, with small fluctuations in temperature increasing transmission and spread. We may see this fatal disease in new areas previously not endemic.

A second dimension is the impact of climate change on safe drinking-water, sanitation and hygiene (WASH). Extreme weather such as floods and hurricanes can negatively affect WASH which is a critical tool in the prevention and management of NTDs. Sanitation plays a key role in preventing exposure to diseases such as soil-transmitted helminth infections, schistosomiasis, and trachoma, while safe water and hygienic conditions in health facilities and in homes are essential for the management and care of many NTDs.

Finally, there is an inequity dimension that must be highlighted; both climate change and NTDs disproportionately affect vulnerable communities. Africa is particularly affected by both challenges. The African continent accounts for about 35% of the global NTD burden and bears the brunt of climate change impacts; home to seven out of the ten countries in the world considered most threatened by climate change. 

Do you think the link between neglected tropical diseases and climate change is well understood?

The interlinkages between health and climate have long been studied in academia, but are increasingly becoming a key part of the debate in policy spaces. This year, we were delighted to see that health and equity are placed at the centre of the climate negotiations at COP27. The World Health Organization and the Wellcome Trust are hosting a Health Pavilion which will convene the global health community to showcase evidence, initiatives and solutions to maximise the health benefits of tackling climate change across regions, sectors and communities.

This is an important step as there is an urgent need for collaboration to grapple with the interlinked challenges of climate change and infectious disease, to mitigate the impact. We must step out of our sector bubbles and push for bold and decisive collective action. Intersectoral dialogue is also important. Climate mitigation must be integrated into broader health and developmental agendas, and health (including infectious diseases) must be a key dimension of the climate debate. 

By taking tough action on climate change, we can protect hundreds of thousands of lives from infectious disease. And by taking action on neglected tropical diseases, we can strengthen national and community health systems and build resilience to ensure health systems have the capacity to respond to shifting disease risk that we will see as a result of climate change.

What would you like to see at COP27 this year?

Governments at COP27 must deliver on past promises – we must see decisive action to prevent the climate crisis from spiralling out of control. 

It is also vital that efforts to mitigate climate change and deliver health-sensitive climate adaptation plans are accompanied by renewed leadership and investment in the fight against neglected tropical diseases. We are calling on Heads of State to endorse the Kigali Declaration on Neglected Tropical Diseases – a high-level, political declaration which is helping mobilise political will and secure commitments against NTDs – and commit to its delivery.

We have seen incredible leadership from Botswana, Djibouti, Ethiopia, Malawi, Nigeria, Papua New Guinea, Rwanda, United Republic of Tanzania, Timor Leste, Uganda, and Vanuatu, along with Belgium, Canada, Germany, Japan, Switzerland, UAE, USA, and the UK, all who have signed the Kigali Declaration and we welcome fellow Heads of State to join them and be 100% Committed to ending NTDs. 46 countries have eliminated an NTD, 600 million people no longer require treatment for NTDs… we have seen incredible progress, but there is still a lot more work to be done before the 1.7 billion people around the world still affected by NTDs are free from these debilitating diseases. Ending NTDs within our lifetime is possible, but it requires concerted action. It is time for real change.

[1] Ryan SJ, Carlson CJ, Mordecai EA, Johnson LR (2019) Global expansion and redistribution of Aedes-borne virus transmission risk with climate change. PLoS Negl Trop Dis 13(3): e0007213. https://doi.org/10.1371/journal.pntd.0007213

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