2026 Theses Doctoral

End-to-End Climate Services for Public Health: A Novel Earth-System Forecasting Framework and Operational Toolkit for Vector Borne Disease Prevention in Latin America and the Caribbean

Diaz, Avriel R.

The Earth’s climate system plays a central role in shaping the spatial and temporal dynamics of dengue transmission through its influence on temperature-dependent vector competence, precipitation-driven habitat availability, and large-scale modes of variability. In the Caribbean and Latin America, processes such as the El Niño–Southern Oscillation (ENSO), the Intertropical Convergence Zone (ITCZ), and regional circulation patterns modulate rainfall and temperature on seasonal to interannual timescales, generating a predictable environmental signal that precedes dengue outbreaks by several weeks to months. Despite this predictability, climate information remains underutilized in public health decision-making. This dissertation advances the development of climate-informed early warning systems for dengue by examining how environmental signals can be translated into operational decision-support tools. It presents four interconnected studies across the Caribbean and Latin America.

First, a climate services for health, demand-driven implementation framework is developed through transdisciplinary engagement, identifying how we can move from modeling tool to operational service. Second, a novel climate-driven dengue budget forecasting system (PROA) is developed with Panama, integrating rainfall variability, lagged environmental effects, immunological dynamics, and transmission momentum into a hybrid statistical–mechanistic framework that produces probabilistic projections of disease burden and associated resource needs. Third, the dissertation examines how uncertainty (inherent in seasonal climate prediction) can be structured and communicated to support interpretation and use of climate tools in health decision making. Fourth, a monitoring and evaluation framework is co-developed to assess climate-informed early warning system performance, usability, and sustainability.

The findings demonstrate that the utility of climate information depends not only on predictive skill, but on how environmental signals are structured, interpreted, and embedded within decision-making systems. In the context of climate change, where shifts in temperature and precipitation are altering dengue risk, climate-informed early warning systems represent a critical mechanism for anticipatory public health action and climate adaptation.