3 Keys to Outbreak Preparedness in the Climate Change Era

The laboratory extraction room of the Institute of Lassa Fever Research and Control in Irrua Specialist Teaching Hospital. Nigeria, March 6, 2018.
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The laboratory extraction room of the Institute of Lassa Fever Research and Control in Irrua Specialist Teaching Hospital. Nigeria, March 6, 2018. Image: Pius Utomi Ekpei/AFP/Getty

At the start of the UN General Assembly this week in New York, UN Deputy Secretary-General Amina Mohammed and the WHO Director-General Tedros Adhanom Ghebreyesus stepped into an “air pollution pod” and visibly struggled to breathe.  

This is often our first thought of climate change—the impact we can feel. However, it is also driving changes that are harder to notice, including small drifts in wildlife population and habitats that are altering infectious disease transmission. 

As temperatures change, many species are on the move. I worry about the impact of vectors, such as mosquitoes and ticks, that are extending their reach into new areas. While the links between climate change and infectious diseases are complex and not yet fully understood, we have already begun to record an increased transmission of zoonotic diseases. We have seen this with Lassa fever and monkeypox in West Africa, Ebola virus disease in the Democratic Republic of Congo and others. 

I was heartened to see my President, Muhammadu Buhari, speak at an UNGA event where he announced initiatives to reverse the negative effects of climate change in Nigeria. Until now, many have appeared to be paralyzed by the enormity of the challenge. To wake up from our paralysis and prepare for the impact of climate change on infectious disease outbreak preparedness and response, there are 3 critical steps I believe we must all take. 

First, we have to acknowledge the problem and recognize that no nation will be spared. Climate change’s impact may be worse in many African countries that have limited capacity to respond to disease outbreaks and public health emergencies. Governments must invest more in understanding the science, in disease prevention, and in emergency preparedness. We must develop functioning surveillance systems and ensure that the people on the frontlines have the resources and capacity they need. Planning and vulnerability assessments must be done, and preparations for the future must be made. The best place to host the experts to do this is within national public health institutes. 

Next, we have to ensure that NPHIs not only can do great surveillance, but great science. While they have a unique ability to quickly mobilize resources in response to outbreaks, action is only useful when the science is clear on what the appropriate response should be. To respond to climate change, we must think about what is needed to grow our NPHIs so they have the competencies to do research as well as respond to increasing outbreaks caused by climate change. These resources cannot come from government alone; the private sector needs to be more involved in health security.  

Finally, we must develop capacities for outbreak response from the grassroots to the global level. When a large outbreak does occur, people in rural areas often do not have resources to seek special care outside of their towns. This we have seen in DRC where people are losing loved ones to a disease they do not really understand. We also have seen a similar situation in Nigeria where monkeypox cases have been recorded across the country since 2017. Global health security is really about national and local health security. 

Clearly, it is time we invest in research to better understand climate change and infectious disease and develop responsible policies. We cannot sit and wait to be saved. 

Efforts have begun in Western countries, but we must stand up for ourselves in Africa. Our population density, climatic conditions, economic and political conditions leave us at a higher risk than countries in the Americas and Europe. I do not believe that these are easy solutions to implement, but we have no choice but to increase our understanding of climate change’s effects on infectious disease outbreaks and prepare for them. This, in turn, depends on strong political leadership that will enable national public health institutes to thrive. 


Chikwe Ihekweazu (@Chikwe_I; @NCDCgov) is Director-General of the Nigeria Centre for Disease Control.

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