changes have multiple and profound effects upon the epidemiology,
and hence on attempts to control, communicable diseases. Some of the
most important are:
- Climate change, and the shorter periodicity El Nino Southern
Oscillation (ENSO) have effects on vector-borne disease as the
rates of parasite and virus development in insect vectors and
molluscan intermediate hosts is temperature-dependent. Breeding
sites for the mosquitoes, other insect vectors and snails are
greatly affected by the pattern of rainfall, since most such vectors
are aquatic in the larval stages and often inhabit ephemeral water
bodies liable to flood and drought effects.
- Local but globally pervasive processes such as urbanization,
land and water resource development, and habitat fragmentation,
affect many communicable diseases: urbanization increases population
density and facilitates epidemic contagious disease transmission;
water resource development and deforestation affect vector breeding
and human contact with water and forests, so increasing vector-borne
diseases such as malaria and schistosomiasis; habitat fragmentation
brings people and wild mammals and birds into overlapping areas
and fosters both zoonoses and the emergence of new diseases in
- The process of change is associated with transient periods of
complex high disturbance levels between two states of the ecosystem.
These periods, or chronotones, are times of great communicable
(and other) disease hazards and of opportunities for disease control.
- The great increases in frequency, scale and rapidity of migration
have large effects on the spread and transmission of communicable
diseases and on the spread of genetic resistance to chemotherapeutic
- Globalisation and the increase of market forces have an adverse
effect on public health measures for infectious disease control,
which are pre-eminently global public goods, and as such need
to be provided for, both globally, and at national and regional
- Effects of settlement of pastoralists upon vector-borne disease
- Conceptualisation of charge processes in relation to global
change and disease consequences' ecotones and chronotones.
- Migratory processes and the epidemiology of communicable diseases.
Conceptual and practical aspects, the latter in China, Brazil,
- Policy transfer of the DOTS strategy for TB control in four
countries (Zambia, Malawi, Brazil and Mexico), in collaboration
with the International Union Against Tuberculosis and Lung Disease
(IUATLD), and with funding from DFID
- Bradley DJ (2004) An exploration of Chronotones:
a cocept for understanding the health processes of changing ecosystems.
Ecohealth 1 (2) 165-171.
- Saker L, Lee K, Cannito B, Gilmore A, Campbell-Lendrum
D (2004) Globalization
and infectious diseases. Special Topics in Social,
Economic and Behavioural Research. UNDP/World Bank/WHO/UNICEF
Special Programme on Tropical Diseases Research. Geneva, WHO.
- Lee K (2005) Bovine spongiform encephalopathy.
In Robertson R. and Scholte J.A. eds. (in press), Encyclopaedia
of Globalization. New York, Moschovitis Group.
- Lee K and Fidler D (2007) Avian and pandemic influenza:
Progress and Problems with global health governance. Global
Public Health, July, 2(3): 215-234.