Discussion and epilogue

Global change is likely to affect human and animal health, as shown by the preceding chapters. Malaria was chosen as the principle example to demonstrate the complex interactions that may affect a vector-borne disease: the mosquito vector, the parasite, human host, climate, topography, vegetation, aquatic habitat, demography, health care, socio-economic status, to name several aspects that all affect the epidemiology of the disease and, hence, the incidence of morbidity and mortality. Had we chosen to focus this workshop on dengue, or leishmaniasis or human African trypanosomiasis, the overall conclusions would not have been much different. There is no doubt that environmental change caused by anthropogenic activities will impact vector-borne diseases severely. The uncertainty of these effects is the level of change we shall witness, and over what time scale we might expect these changes to occur.