Sentinel Physicians for the Environment: A Chilean Perspective to Address Global Health and Climate Resilience.

Climate change and environmental degradation are intensifying health risks across Latin America, placing increasing pressure on primary health care (PHC) systems. Physicians working at community level are often the first to observe climate- and environment-related health effects, yet operational models that link clinical practice, environmental surveillance and community engagement remain insufficiently defined. This article adopts a policy-oriented narrative synthesis approach, drawing on peer-reviewed literature, policy documents, institutional records, memoranda of understanding, and outputs from professional seminars and stakeholder meetings conducted between 2024 and 2025 to develop an evaluable operational framework. Chile is examined as a case study, while the proposed framework is situated within a broader Latin American perspective. We conceptualise the model of Sentinel Physicians for the Environment (SPEs) as an operational framework embedded within PHC, structured around four core pillars: surveillance, prevention, communication and advocacy. The model clarifies how SPEs can contribute in practical terms to addressing major climate-related health threats, including heatwaves, air pollution, wildfires, vector-borne diseases, migration-related vulnerability, antimicrobial resistance and zoonotic risks. The Chilean experience illustrates feasible implementation pathways, distinguishing actions already undertaken, initiatives under development and proposed future steps. The SPE model offers a pragmatic and scalable approach to strengthening climate-resilient primary health care in Latin America. By leveraging existing PHC structures and community trust, SPEs can enhance early detection, risk communication and preparedness without requiring complex technologies or high financial investment, providing a transferable contribution to public health practice and policy, with clear implications for future evaluation.