Changing World: Vectors, Climate and Society.

A critical review of the impact of climate change on vector-borne diseases (VBDs) was carried out. The systems Chagas-Triatominae as hemimetabolous insect and leishmaniasis-Phlebotominae as holometabolous with terrestrial larval stages were taken as examples and both were considered for their diversity of vector species, reservoirs and socio-environmental settings of transmission. Results from the literature were discussed in relation to: a) the multiplicity of causes, targets and consequences from the perspective of multilevel eco-epidemiology; b) assumptions of linearity of predictive models rather than chaos and complexity of the systems involved; c) the assumption of species with fixed biological characteristics, rather than species that, under external pressure, can adapt and change their natural nidality, and pathogens that can change host species (Stockholm paradigm); d) consistency between stated objectives and conclusions. Most of the reviewed articles refer to the medium- and long-term impacts of climate change on the transmission of VBDs, and advocate for emission reductions. However, based on the conceptual and operational arguments discussed, recommendations are proposed to develop a strategy for preventive monitoring of VBDs, in line with public health needs in the short term and at the local level, transferable to programmes for timely decision-making.