Journal
LANCET PLANETARY HEALTH
Volume 6, Issue 11, Pages E870-E879Publisher
ELSEVIER SCI LTD
Keywords
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Funding
- Stanford Institute for Innovation in Developing Economies Global Development and Poverty Initiative
- Bill & Melinda Gates Foundation [OPP1114050]
- National Institutes of Health (NIH) [1R01TW010286]
- National Science Foundation (NSF) [BCS-1414102]
- National Institute for Mathematical and Biological Synthesis through the Working Group
- NSF Graduate Research Fellowship [1656518]
- National Center for Ecological Analysis and Synthesis through the Science for Nature and People Partnership programme
- USGS Emerging Disease research programme
- Stanford James and Nancy Kelso Fellowship
- Stanford Interdisciplinary Graduate Fellowship programme
- NSF Postdoctoral Research Fellowship in Biology [1611767]
- Stanford Bing Fellowship in Honor of Paul Ehrlich
- NSF [DEB-2011147]
- Fogarty International Center
- National Institute of General Medical Sciences [D18AC00031]
- Stanford Terman Award
- Stanford King Center for Global Development Woods Institute for the Environment, and Center for Innovation in Global Health
- Sloan Research Fellowship from the Alfred P. Sloan Foundation
- UW Innovation Award from the UW President's Innovation Imperative
- Michigan Society of Fellows at the University of Michigan
- Queensland Government Accelerate Postdoctoral Research Fellowship
- DARPA PREEMPT programme [DEB-1518681]
- [R35GM133439]
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Environmentally mediated infectious diseases pose a significant global health problem, particularly in tropical and impoverished countries. The burden of these diseases is closely linked to rural poverty, political stability, and wealth. Innovative social and ecological interventions are needed to address this issue and achieve global health and sustainability goals.
Background:Billions of people living in poverty are at risk of environmentally mediated infectious diseases-that is, pathogens with environmental reservoirs that affect disease persistence and control and where environmental control of pathogens can reduce human risk. The complex ecology of these diseases creates a global health problem not easily solved with medical treatment alone. Methods:We quantified the current global disease burden caused by environmentally mediated infectious diseases and used a structural equation model to explore environmental and socioeconomic factors associated with the human burden of environmentally mediated pathogens across all countries. Findings:We found that around 80% (455 of 560) of WHO-tracked pathogen species known to infect humans are environmentally mediated, causing about 40% (129 488 of 359 341 disability-adjusted life years) of contemporary infectious disease burden (global loss of 130 million years of healthy life annually). The majority of this environmentally mediated disease burden occurs in tropical countries, and the poorest countries carry the highest burdens across all latitudes. We found weak associations between disease burden and biodiversity or agricultural land use at the global scale. In contrast, the proportion of people with rural poor livelihoods in a country was a strong proximate indicator of environmentally mediated infectious disease burden. Political stability and wealth were associated with improved sanitation, better health care, and lower proportions of rural poverty, indirectly resulting in lower burdens of environmentally mediated infections. Rarely, environmentally mediated pathogens can evolve into global pandemics (eg, HIV, COVID-19) affecting even the wealthiest communities. Interpretation:The high and uneven burden of environmentally mediated infections highlights the need for innovative social and ecological interventions to complement biomedical advances in the pursuit of global health and sustainability goals. Funding:Bill & Melinda Gates Foundation, National Institutes of Health, National Science Foundation, Alfred P. Sloan Foundation, National Institute for Mathematical and Biological Synthesis, Stanford University, and the US Defense Advanced Research Projects Agency. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd.
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