Climate change is known to affect Pacific Island nations in a variety of ways. One of them is by increasing the vulnerability of human health induced by various climate change impacts, which pose an additional burden to the already distressed health systems in the region. This paper explores the associations between climate change and human health on the one hand, and outlines some of the health care challenges posed by a changing climate on the other. In particular, it describes the links between climate variations and the emergence of climate-sensitive infectious diseases, such as the mosquito-borne diseases dengue, chikungunya, and Zika. The paper also presents a summary of the key findings of the research initiatives Climate Change and Prevalence Study of ZIKA Virus Diseases in Fiji and the findings from the World Mosquito Program as two examples of public health action in the Pacific region.

Plastic debris is a worldwide problem. This is particularly acute in the Pacific region, where its scale is a reason for serious concern. There is an obvious need for studies to assess the extent to which plastic debris affects the Pacific. Therefore, this research aims to address this need by undertaking a systematic assessment of the ecological and health impacts of plastic debris on Pacific islands. Using pertinent historical qualitative and quantitative data of the distribution of plastic debris in the region, this study identified pollution and contamination trends and risks to ecosystems, and suggests some measures which may be deployed to address the identified problems. The study illustrates the fact that Pacific Island States are being disproportionately affected by plastic, and reiterates that further studies and integrated strategies are needed, involving public education and empowerment, governmental action, as well as ecologically sustainable industry leadership. It is also clear that more research is needed in respect of developing alternatives to conventional plastic, by the production of bio-plastic, i.e. plastic which is produced from natural (e.g. non-fossil fuel-based sources) materials, and which can be fully biodegradable.

Introduction Dengue fever is the most prevalent arboviral disease in the Brazilian Amazon and places a major health, social and economic burden on the region. Its association with deforestation is largely unknown, yet the clearing of tropical rainforests has been linked to the emergence of several infectious diseases, including yellow fever and malaria. This study aimed to explore potential drivers of dengue emergence in the Brazilian Amazon with a focus on deforestation. Methods An ecological study design using municipality-level secondary data from the Amazonas state between 2007 and 2017 (reported rural dengue cases, incremental deforestation, socioeconomic characteristics, healthcare and climate factors) was employed. Data were transformed according to the year with the most considerable deforestation. Associations were explored using bivariate analysis and a multivariate generalised linear model. Results During the study period 2007–2017, both dengue incidence and deforestation increased. Bivariate analysis revealed increased incidences for some years after deforestation (e.g. mean difference between dengue incidence before and three years after deforestation was 55.47 cases per 100,000, p = 0.002), however, there was no association between the extent of deforestation and dengue incidence. Using a negative binomial regression model adjusted for socioeconomic, climate and healthcare factors, deforestation was not found to be related to dengue incidence. Access to healthcare was found to be the only significant predictor of dengue incidence. Discussion Previous research has shown that deforestation facilitates the emergence of vector-borne diseases. However, no significant dose-response relationships between dengue incidence and deforestation in the Brazilian Amazonas state were found in this study. The finding that access to healthcare was the only significant predictor of dengue incidence suggests that incidence may be more dependent on surveillance than transmission. Further research and public attention are needed to better understand environmental effects on human health and to preserve the world’s largest rainforest.

Objectives: This research aimed to explore the health behaviours of health sciences students over time and across different settings.Methods: A health behaviour surveillance system has been implemented in Hamburg and Manchester among under- and postgraduate health sciences students. Trends among the Hamburg sample were described. In a cross-sectional assessment, health behaviours across both universities were examined using multivariate regression analysis.Results: Between 2014 and 2018, increasing trends in physical activity and cannabis and alcohol consumption were observed in Hamburg (n = 1,366). While fruit and vegetable intake was constantly low, tobacco smoking decreased. No clear trend was observed for stress perception. The comparison (n = 474) revealed that Manchester students had higher odds of smoking, excessive alcohol consumption, and fruit and vegetable consumption; and lower odds of being physically active, and consuming cannabis. No difference in stress perception was observed.Conclusions: Varying trends and potential areas of intervention were identified for health behaviours in Hamburg. The comparison with Manchester students revealed differences in behaviours, which could be further explored to help inform health promotion strategies in both settings.

Despite efforts by the WHO to support local surveillance strategies in developing countries, there is a lack of robust public health surveillance frameworks. As a result, early infectious disease outbreak detection and response remain a significant challenge for local health systems in low-resource settings such as sub-Saharan African countries. In contrast, the growing digital infrastructure, especially in the mobile phone sector, and the global availability of extensive digital data offer promising solutions to enhance and strengthen epidemiological surveillance. Yet, there is little insight into concepts of utilisation and transfer into local public health practice. Using Tanzania as an example, a novel electronic surveillance and early outbreak alert framework is being developed that links signals on emerging diseases with relevant contextual Open Data for rapid outbreak risk assessment. The concept focuses on haemorrhagic fever diseases, specifically dengue virus disease, which is increasingly spreading in sub-Saharan Africa. A data stack framework forms the core of the system, which augments electronic information on the occurrence of acute haemorrhagic fever syndrome, e.g., collected via mobile phone-based surveillance tools, with openly available socio-ecological context data specific to dengue. Preliminary results on the data and information flow within the surveillance framework are presented and strategies for an automated indicator-based risk assessment for dengue outbreaks will be discussed, supplemented by an agent-based simulation framework to model possible short-term outbreak scenarios. In addition, adequate data inputs, identified through an appraisal of various data sources available for Tanzania, are outlined. The framework could serve as a blueprint for designing locally implementable early warning and decision support systems integrated with existing digital surveillance infrastructure. Key messages • Digital health surveillance and Open Data offer great potential for early outbreak detection and supporting health decisions but require tailored solutions to benefit low-resource settings. • Building on existing digital surveillance infrastructure, the framework may serve as a blueprint for designing an enhanced surveillance and decision support system for infectious disease outbreaks.