Climate Change, Malaria, and NTDs: Research priorities for a warming world

Ahead of our World Neglected Tropical Disease Day webinar on Climate Change, Malaria, and NTDs, which focuses on a major scoping review published in RSTMH Journal Transactions of the Royal Society of Tropical Medicine and Hygiene, Professor Deirdre Hollingsworth, one of the paper’s authors and speaker at the webinar, looks at potential ways to advance research on the impact of climate change on malaria and NTDs. 

Climate change is a defining challenge of our time, causing global temperatures to increase, sea levels to rise, and weather patterns to become more extreme and unpredictable. These shifts are not just environmental — they have far-reaching impacts on ecosystems, including by affecting plant, animal and human health, and directly impact livelihoods. 

While everyone will experience changes, the impacts from climate change already disproportionately affect some of the most vulnerable communities worldwide, including those living in deprived regions that are endemic for infectious diseases like malaria and neglected tropical diseases (NTDs). 

However, we still have a limited understanding of how climate change may shape the future spread of these diseases, which impairs our ability to design and implement optimized control interventions that safeguard previous global health gains in the fight against these diseases. 

In this blog, we discuss potential ways to advance research that elucidates how climate change may impact the future dynamics of malaria and NTDs, which is critical to addressing the growing impact of these diseases on vulnerable communities worldwide.

Several studies have begun to explore the potential impacts of climate change on malaria and NTDs. We recently contributed to a scoping review of recent publications in this area, which appeared in RSTMH journal Transactions of the Royal Society of Tropical Medicine and Hygiene, which highlighted that while there were studies investigating the impact of climate change on malaria, dengue and chikungunya, and the leishmaniases, most other NTDs remain largely unexplored. 

Nonetheless, it seems clear that climate change is likely to have profound impacts on malaria and several NTDs, although the amplitude and direction of these effects remains uncertain and will probably differ by disease, location and over time. Importantly, our analysis also revealed a gap in studies that focus on the countries most vulnerable to climate change and with less resilient health systems. Therefore, while it is clear that climate change will likely impact the dynamics of malaria and NTDs, current long-term projections of future transmission of these diseases is insufficient for effective planning of mitigation and adaptation strategies.

While our findings paint a bleak picture of our current understanding on how climate change will likely influence the future spread of these diseases, they also highlight several avenues by which research could fill existing knowledge gaps to better inform future planning. Here, we focus on three recommendations that can start to be implemented now:

1. Deepen Our Understanding of Disease Dynamics. 

To understand more about the impact of climate change on malaria and NTDs, we first need to know more about the transmission dynamics of these infections. 

Malaria and several NTDs have complex life cycles that depend on environmental variables, vectors, and animal reservoirs. For example, rising temperatures or altered rainfall patterns can change the habitats of mosquitoes or other vectors, influencing disease transmission. 

However, our understanding of these dynamic processes is incomplete, especially for many NTDs such as visceral leishmaniasis and schistosomiasis. Basic research into the ecological and biological underpinnings of these diseases is essential. Without this foundation, projections of how climate change will alter disease dynamics remain uncertain. This will require investments in studying disease biology, transmission pathways, and environmental dependencies.

2. Go Beyond Vector Suitability Studies. 

Addressing the impact of climate change on infectious diseases requires going beyond models that focus solely on how weather affects presence of vector populations. For instance, improved models should try to account for the human side of the risk, including population movement resulting from climate change, such as displacement. Rising sea levels, droughts, and conflicts drive migration, which can alter disease transmission patterns. 

Similarly, future studies should account for the impacts of climate change on infrastructure and programs. Extreme weather events like floods, droughts, and wildfires disrupt water and sanitation systems, increase food insecurity, and strain disease control programs, all of which impact disease dynamics. Similarly, few studies currently consider how interventions like vector control, vaccination, or infrastructure resilience might modify future outcomes. 

Therefore, future research should use robust climate scenarios aligned with IPCC categories and incorporate population density, migration trends, and socioeconomic factors. Modeling should also explore the effects of mitigation efforts under varying climate scenarios. 

Such approaches will yield actionable insights, like guiding investments in disease surveillance systems or designing flood-resistant water infrastructure in high-risk areas. For example, studies on the spread of dengue to new regions could focus on developing cost-effective surveillance systems targeted at high-risk areas, and flood-prone regions would benefit from studies examining the resilience of water and sanitation infrastructure to prevent disease outbreaks.

Crucially, investments in research and innovation must prioritize filling knowledge gaps while ensuring that findings are translated into practical strategies for protecting global health.

3. Start Now. 

While long-term projections remain challenging, we can already study how increased extreme weather events are affecting disease dynamics. For example, floods and droughts, which are increasingly common, impact waterborne diseases and disrupt public health interventions. 

Similarly, wildfires and conflicts impact disease control programs, curtailing progress and potentially leading to resurgence in previously controlled regions. By focusing on immediate impacts, researchers can provide policymakers and health systems with tools to prepare for the inevitable challenges of a warming planet. Integrated surveillance systems, particularly in regions with high disease burdens and vulnerability to climate change, are essential for generating data to improve forecasts and responses.

Importantly, these efforts should prioritize local leadership and involve communities to ensure research addresses their specific needs and realities.

The health challenges posed by climate change are vast and interconnected, requiring urgent action across disciplines. By addressing the gaps in our understanding of NTDs and broader health impacts, we can better anticipate and mitigate the risks of a warming world. With a coordinated and inclusive research agenda, we have the opportunity to safeguard not only the gains of past global health efforts but also the health and wellbeing of future generations. 

The choices we make today will determine whether we meet this challenge with resilience and innovation or allow it to overwhelm our capacity to respond.

Professor Deirdre Hollingsworth, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK and Nuffield Department of Medicine, NDM Centre for Global Health Research, University of Oxford, Oxford, UK.