Published in Nature Scientific Reports the research determined insight from 3,752 health professionals and researchers across 151 countries and is one of the largest Global studies of its kind, with 86.9% of participants based in low- and middle-income countries. Participants reported that climate change, poverty, and drug resistance are combining to create an escalating health crisis that could become a 'creeping catastrophe' if left unaddressed.
Data gathered in countries across Africa, Asia and Latin America identified that experts throughout the world consider vector-borne diseases such as malaria and dengue as the most rapidly escalating threats, followed by tuberculosis and HIV/AIDS. The research confirmed they find the three main drivers are:
- Climate change, especially rising temperatures and shifting precipitation patterns, emerged across all regions as a primary driver of disease escalation as it expands mosquito and other vector ranges, increases breeding sites, and accelerates human mobility and displacement.
- Socioeconomic inequality, affecting living conditions and access to healthcare
- Antimicrobial resistance, undermining treatments for a wide range of infections worldwide
Professor Trudie Lang , Director of The Global Health Network at Oxford's Nuffield Department of Medicine and senior author of the study said: "This study provides unparalleled evidence from communities experiencing these threats from Climate Change right now across the Global South, where disease burdens are highest.
"Typically these regions are under-represented and not collectively voiced but these data and insights are grounded in lived experience and global diversity. Our research clearly demonstrates that the next major health emergency may not be a sudden new outbreak, but the steady worsening of the quiet diseases that shorten lives every day."
The study's authors contend that this risk will not present as a dramatic outbreak, but as a slow-unfolding humanitarian disaster where endemic diseases spread into new geographies - impacting health systems and economies.
The authors argue that tackling these cross-cutting drivers of disease could strengthen preparedness for both existing and future threats. They call for sustained investment in diagnostics, surveillance, and equitable research partnerships that empower local leadership and build lasting research capacity.
Dr. Aliya Naheed. Country Director NIHR GHR Centre for NCDs and Environmental Change, Bangladesh said: "This phenomenal study echoes the core disparity in the top health priorities between the low to middle income countries (LMICS) and the high-income countries, recognizing the role of climate change on future health emergencies. The message of the future threat of the known disease burdens emphasizes the need of equitable global investment in the prevention and control of common infectious diseases in LMICs."
The project was commissioned by Wellcome to inform its global infectious disease strategy and ensure research priorities reflect the realities faced by those working in health systems around the world.
Josie Golding, Head of Epidemics and Epidemiology, Infectious Disease, at Wellcome, said: "Climate change is driving the spread of infectious diseases, and it's hitting hardest in communities least able to adapt. Rising temperatures, floods, and droughts create ideal conditions for mosquitoes, ticks, and harmful bacteria to thrive, while extreme weather adds strain to already fragile health systems.
"We need urgent global climate action, paired with investment in innovative solutions to prevent and treat infectious diseases. Acting on both fronts is essential - without it, diseases like malaria, dengue, and chikungunya will continue to surge, deepening inequalities and putting millions of lives at risk.
"We know that climate and health are inseparable, and by tackling common drivers of disease - from climate change to antimicrobial resistance - we can strengthen health systems to cope with current and emerging issues."
The study, Global perspectives on infectious diseases at risk of escalation and their drivers, is published in Nature Scientific Reports (DOI: 10.1038/s41598-025-22573-3 ).
