This topic aims at supporting activities that are enabling or contributing to one or several expected impacts of destination “Living and working in a health-promoting environment”. To that end, proposals under this topic should aim to deliver results that are directed at, tailored towards and contributing to most of the following expected outcomes:

• Citizens, patients, public authorities, social care services, healthcare practitioners and policymakers have a better understanding of the climatic health risks and determinants of disease and are better equipped to address health outcomes through enhanced and inclusive prevention, resilience, adaptation, preparedness and response, including better diagnosis and treatment.
• Governments, public health authorities, researchers and civil society organisations are supported to tackle societal challenges linked to the health impacts of climatic factors.
• Public authorities, organisations and the research community can rely on data collection and sharing according to FAIR^[1] principles and leveraging of data availability and quality.
• Policymakers and public authorities develop evidence-based climate change and health policies and interventions that are nature positive, inclusive and responsive to diverse population needs.

Scope:

The climate crisis poses an existential challenge to planetary and human health with larger effects on populations, groups and regions in a vulnerable situation. Climate change increases the incidence of non-communicable diseases and the prevalence of mental health conditions and facilitates the emergence and spread of infectious diseases. Climate change can act as a risk multiplier and exacerbates existing health conditions and vulnerabilities.

Applicants should explicitly state in their proposal which of the following broad focus areas is targeted and the proposed work should address only this specific broad focus area:

1. Non-Communicable Diseases (NCDs) and/or individual safety (e.g. injuries or fatalities), excluding mental health aspects: proposals should explore evidence on the complex interactions between climate change (e.g. changes in the frequency and intensity of extreme weather events) and NCDs and individual safety, which often involve multiple climate exposure pathways and compound and cascading climatic events.
2. Mental health, considering interactions with brain health if relevant: in the broad focus area of mental health and psychosocial well-being, proposals should increase the evidence on the acute and long-term impacts of climate change and the understanding of new syndromes related to climate stress.
3. Infectious diseases, including vector-borne and non-vector-borne: proposals should increase the understanding of the factors driving climate-related burden from infectious diseases.

In general, proposals should develop approaches to prevent and reduce the impacts of climate factors in the studied health outcomes and increase population and workforce resilience. A One Health approach should also be applied where relevant.

More specifically, research actions under this topic should include several of the following activities, depending on the relevance of each group of activities to the broad focus area targeted in the proposal:

• Increase the understanding of correlations, causal pathways and mechanistic effects between climate change and disease/health outcomes, developing unified and standard methodologies and metrics to assess short- and long-term positive and negative impacts of climate change with an adequate level of granularity. Consider individual and/or cascading climatic events and exposure patterns, and risks and drivers of vulnerability and inequality.
• Develop longitudinal studies to better ascertain differential effects of climatic stressors on health including multiple scales of impacts, ranging from the molecular level to population health outcomes. Consider variability across populations, generations and life phases, regions and occupations, and collect real-world exposure and health data in living and occupational settings, considering the use of emerging ecosystems such as the European Health Data Space (EHDS)^[2] and the European Open Science Cloud (EOSC)^[3].
• Study differential acute and long-term health impacts of climate (including a wide range of factors and cumulative effects) on vulnerable, sensitive or exposed population groups. Consider also differences in geographical vulnerabilities including, when relevant, geographical settings outside of urban areas, in overseas regions and in low- and middle-income countries (LMICs)^[4]. Understand the role of inequalities and societal vulnerability in determining climate-related health impacts and adaptive capacity.
• Advance the knowledge on the climate, ecological and environmental drivers of pathogen abundance, including mechanisms and determinants of distribution, life-cycle patterns, transmission, virulence and survival. Consider climate change drivers of disease severity. Study host/pathogen and vector/host interactions clarifying the role of secondary reservoir hosts such as sylvatic, wildlife and livestock in the maintenance of pathogen life cycle. Assess the efficacy, cost-effectiveness and impact of control measures.
• Explore the role of climate-driven human and wildlife mobility (e.g. bird migration patterns, human migration) in enhancing the global spread of pathogens and creating opportunities for their local establishment. Collect better field data and develop tools for disease modelling, risk and scenario projections that encourage interoperable data systems and cross border collaboration.
• Increase the availability, accessibility, quality and standardisation of diagnostic testing for early diagnosis of infections and determining immune responses and vaccine efficacy. Increase the capacity for pathogen subtyping, and genomic surveillance for early warning and investigations of climate-related outbreaks. Develop rapid, portable, and affordable standardised diagnostic tools that can withstand climate extremes.
• Increase the understanding of the factors that strengthen health resilience to climate change at the individual, local and societal levels. Investigate the role of individual mechanisms, community resilience and local solutions in mitigating the health impacts of climate change and related environmental degradation.

International cooperation, in particular with LMICs, is strongly encouraged.

In order to maximise synergies and increase the impact of the projects, all proposals selected for funding from this topic will form a cluster and be required to participate in common networking and joint activities. Guidance on the potential activities to be developed can be obtained by consulting the clusters of projects ongoing under the Environment, Climate and Health research portfolio^[5].

Proposals should make sure that relevant activities, outcomes and outputs are shared with the European Climate and Health Observatory^[6] through the cluster that will be formed after the approval of the proposals. Actions’ results should also contribute to future European Climate Risk Assessments. When relevant proposals should build on the outcomes of the projects that are part of the European Climate-Health Cluster^[7].

Proposals are encouraged to consider, where relevant, the data, expertise and services offered by European research infrastructures^[8] in the environment, climate and health domain.

This topic requires the effective contribution of social sciences and humanities (SSH) disciplines and the involvement of SSH experts, institutions as well as the inclusion of relevant SSH expertise, in order to produce meaningful and significant effects enhancing the societal impact of the related research activities.

Applicants envisaging to include clinical studies^[9] should provide details of their clinical studies in the dedicated annex using the template provided in the submission system.

[1] See definition of FAIR data in the introduction to this Work Programme part.

[2] https://health.ec.europa.eu/ehealth-digital-health-and-care/european-health-data-space-regulation-ehds_en

[3] https://research-and-innovation.ec.europa.eu/strategy/strategy-2020-2024/our-digital-future/open-science/european-open-science-cloud-eosc_en

[4] As defined by the World Bank, https://www.worldbank.org

[5] https://research-and-innovation.ec.europa.eu/research-area/health/environment-climate-and-health_en

[6] https://climate-adapt.eea.europa.eu/en/observatory

[7] https://climate-health.eu

[8] The catalogue of European Strategy Forum on Research Infrastructures (ESFRI) research infrastructures portfolio can be browsed on the ESFRI website: https://ri-portfolio.esfri.eu

[9] Please note that the definition of clinical studies (see introduction to this Work Programme part) is broad and it is recommended that you review it thoroughly before submitting your application.