**3. Climate and Other Environmental Changes, and Infectious Disease Risk**

There are many historic examples of changing weather patterns and their impacts on the health of the humans and ecosystems of historic civilisations [28]. All sorts of drivers can affect infectious diseases [29], and most known and emerging infectious disease outbreaks are not directly attributable to changes in weather/climate. From the perspective of responding to emergencies, there are recent international examples of unexpected events that have initiated outbreaks including post-disaster outbreaks of cholera, and emerging infectious diseases such as Ebola and Zika. In these examples, a change in climate was not an important factor directly contributing to the increased cases, but they do illustrate the difficulties of predicting and managing such events. However, because some historic events have been associated with sudden changes in the burden of infectious diseases, it seems reasonable to be prepared for what might change in the coming years to better understand the weather and other drivers, and how these can influence the behaviour of individual pathogens. Globally, the historic overview suggests those most likely to be affected will be the poor rather than the rich, and those in low-income, rather than high-income countries.
