Roads, deforestation, cattle ranching, mining, power plants: economic development projects in large forests such as the Amazon are vectors of changes that degrade the health of the ecosystem and make way for the spread of viruses and diseases Foto: Felipe Werneck / Ibama

In a conversation with Luciana Julião, environment editor at The Conversation Brasil, during COP30 in Belém, Fiocruz researcher and environmental health specialist Sandra Hacon explained why the integration of climate, environment and health has guided her research for two decades. Hacon has a background in biology and ecology and is a member of the Amazon Scientific Panel (Painel Científico da Amazônia), the Climate Network of the Ministry of Science, Technology and Innovation (Rede Clima), and the National School of Public Health (ENSP). Since 2005, she has been conducting studies on the impacts of climate change on health and the social determinants that amplify these effects, analysing how deforestation, ecological changes and inequalities structure the circulation of viruses, vectors and other biological agents in different territories. Check out an excerpt from the conversation:

“My background is in Biology and Ecology. I am also part of the Scientific Panel for the Amazon, which brings together more than 320 scientists, and I am a member of the Climate Network of the Ministry of Science, Technology and Innovation and am from the National School of Public Health. I have been working at Fiocruz for 25 years and have been working on climate change since 2005, assessing its impacts on health and the social determinants that aggravate them, because we know that inequalities amplify the effects of climate change.

Since the beginning, when I wrote my first scientific article, I have been seeking to integrate environment and health, because there is no human well-being without a healthy environment. What we do at Fiocruz is precisely that: environmental health. I cannot see the planet without this ecological connectivity that involves human beings. In isolation, academic disciplines do not explain the impacts we are experiencing.

Environmental health proposes precisely that: to assess the effects of large projects and also of ongoing environmental transformations. Deforestation in the Amazon, a topic I have always heard about, is now understood as part of a larger process of degradation: alteration of the hydrological cycle, pollution, loss of biodiversity, illegal mining.

As much as climate discussions take centre stage here at COP 30, it is politics that prevails. But we cannot be afraid of politics, and we need to understand what is happening in Brazil and around the world in order to understand the changes underway and their direction. For example, there are parallel debates to the conservation of the Amazon that concern the Congo rainforest, the second largest on the planet.

From an environmental health perspective, we need to discuss the role of these forests in order to formulate health promotion policies and take proactive action. Historically, Brazil has waited for things to happen before taking action — we have seen this in Rio Grande do Sul, São Sebastião, Petrópolis, Rio de Janeiro and so many other places we experienced natural disasters caused by extreme weather and climate events.

Health in the climate change discussions

With each environmental disaster, the question returns: how many more times will we have to see this scenario play out before we change course? Health continues to be a latecomer to this discussion. Until the fourth report of the Intergovernmental Panel on Climate Change(IPCC), a UN scientific body created in 1988, there was almost no mention of health. It was only in 2007 that the panel began to look at the issue differently, revealing how we insist on separating what has never been separate. Health and the environment have always been connected. The forest peoples know this, the riverside communities know this, the quilombolas and indigenous peoples know this. Is it only white men who still do not know this? And yet we pride ourselves on having so much knowledge; I would say that we know very little.

I have been following the UN Climate Change Conferences for many years and have never seen an audience like the one in Belém: sensitive to climate change. This is good, because it indicates greater awareness, but we cannot just stick to theory. The Amazon is home to the greatest indigenous diversity in Latin America and is the biome with the largest number of microorganisms on the planet — and the least known.

We have identified around 48 important viruses, all of them Amazonian, but a vast number remain unknown. The Oropouche virus is an example: endemic to the region, it began to spread after intense deforestation near Manaus and quickly spread throughout Brazil and Latin America.

Viruses respond to environmental pressures — temperature, humidity, ecological changes — and mutate until they find ideal conditions. Dengue fever demonstrates this: when the minimum temperature, previously between 15°C and 18°C, rises to 22 °C, it creates the perfect environment for Aedes aegypti and the virus to multiply more quickly. This is how we reached millions of cases in a single state. Today, dengue fever is found all over the world: Germany, the United States, Italy.

And this applies to other arboviruses, such as chikungunya. On 12th November, Brazil had the highest incidence rate of chikungunya in Latin America, with the highest number of cases in Rio Grande do Sul. This is linked to the imbalance of rainfall, tornadoes, and windstorms that cause viruses, bacteria, and fungi to circulate much faster.

Based on this diagnosis and biotechnological advances, institutions such as Fiocruz are developing new vaccine platforms. If the virus adapts, we seek to identify the critical point for intervention. But we should not act only after the damage is done. Healthcare is not yet prepared to face the climate crisis — not because of a lack of technology or professionals, but because the system works reactively.

Diseases change quickly; healthcare cannot keep up with this speed. There is a lack of installed capacity, integrated surveillance, and coordinated response. Other countries face the same problem. The challenge is to accelerate team building, strengthen early warnings, and bring healthcare closer to climate modelling. When the National Centre for Natural Disaster Monitoring and Alerts (Cemaden) points out a risk, as it did in São Sebastião, the signs were already there.

Anticipating and preventing

Prevention is still weak in Brazil and Latin America. The culture is to act after the fact. But the climate crisis requires behavioural change, immediate action, monitoring and surveillance. There are important experiences, such as the app developed by Márcia Chame, from Fiocruz, which is used by forest peoples to record dead animals. This is how a possible yellow fever epidemic was prevented in Paraná, because non-human primates die first. Other diseases do not have such a clear sign, and monitoring needs to start in the field, in the village.

We also need specific programmes for newly contacted indigenous peoples. Those who have not yet been contacted are difficult to monitor, but those who have recently been contacted can be monitored — and this should be a priority so that ongoing mutations do not reach these populations and, later, the so-called white man. We have the technical conditions. We know how to do it. What is lacking is political decision-making and the allocation of resources — which clearly exist, as shown by the ever-increasing parliamentary expenditures of taxpayers’ money.

Brazil has everything it needs to be a leader in Latin America: excellent institutions, qualified researchers, and countless partnerships. We have the means to be proactive, but we are in a holding pattern. And there is a sign of that here at COP30 itself: people do not make the connection between climate, environment, and health.

Air conditioning is insufficient, the heat and humidity are high, and many arrive tired and dehydrated. High temperature and humidity disrupt homeostasis, especially for those with hypertension, diabetes or cardiovascular disease — it is a trigger that can lead to anything from dehydration to death. I saw people with disabilities and elderly people feeling unwell.

At an event on climate, health was not a central theme, although it should have been. We presented a report on communicable diseases, zoonoses, outbreaks, vectors, viruses and climate, but health remains on the sidelines. The connection between climate, environment and health is here for all to see — and yet it remains unseen. Placing this urgency at the centre of the debate is what environmental health seeks to do.

This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Sandra de Souza Hacon, Fundação Oswaldo Cruz (Fiocruz)

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Sandra de Souza Hacon não presta consultoria, trabalha, possui ações ou recebe financiamento de qualquer empresa ou organização que poderia se beneficiar com a publicação deste artigo e não revelou nenhum vínculo relevante além de seu cargo acadêmico.