아프리카ㆍ중동

The health effects of future climate and other environmental changes have been projected to be substantial, often negative and to vary geographically (Semenza, 2014). The impacts will be felt most acutely among the most vulnerable members of society, for instance the poor, who already carry a disproportionately high share of the burden of environmentally sensitive diseases, with sub-Saharan Africa a focus of adverse health impacts (Tosam and Mbih, 2015). No region is completely immune (Watts et al., 2015): populations in the developed world are also at risk, as changes in environment drive the emergence of new diseases, and alter the distribution and epidemic potential of existing infectious diseases. Environmental change will impact health in a multitude of ways, with impacts mediated through other factors (Papworth et al., 2015), such as poverty, access to health facilities and nutritional security. The impacts may be direct, in terms of outbreaks of disease among human populations, or indirect, in the form of out-breaks of diseases that affect domesticated animals or plants, and therefore jeopardise food security, agriculture-based economic activities and trade. Concern has, however, tended to focus on the future distribution and spread of infectious diseases, in the context of increasing population mobility (Tatem, 2014), and in particular the negative health impacts of changes in transmission and outbreaks of vector-borne diseases (VBDs) as a result of anthropogenic climate change (Campbell-Lendrum et al., 2015).