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Designed by Adrian Cousins
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London School of Hygiene & Tropical Medicine
Communicable Disease

Global 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 people.

  • 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 agents.

  • 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 levels.

  • Effects of settlement of pastoralists upon vector-borne disease in Uganda.

  • 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, Uganda, UK.

  • 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.

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