The physical and temporal scales of global change processes and of their likely health impacts mean that they cannot be primarily addressed at local level. Rather, there is a need for a regional approach that links environmental and health data collection and research transnationally, taking into account all the research efforts already made. Many informative comparisons can be drawn across the geographic and climatic gradients regionally.
Integrated regional data collection activities are increasingly being carried out in relation to environmental indices and health outcomes. These include remote sensing of environmental data and formal networks collecting standardized health data (such as WHO's European infectious disease monitoring system and multinational networks for certain specific diseases).
A World Health Organization working group has recommended the establishment of a Europe-wide interagency network for monitoring, researching and reviewing the early human health effects of climate change and of stratospheric ozone depletion, developing and advocating prevention, mitigation and adaptation policies, and identifying specific research priorities in that field. The WHO European Centre for Environment and Health should act as a coordinator of this network, as part of the global programmes under the Inter-Agency Committee on the Climate Agenda endorsed in 1998 by the World Health Assembly, and link it to other relevant global programmes such as those arising from the United Nations Framework Convention on Climate Change and the Montreal Protocol on Substances that Deplete the Ozone Layer.
The European region exhibits several characteristics that can enhance the informativeness of regional epidemiological research: (1) a broad variety of environmental conditions, including gradients in geography, climate, culture and socioeconomic conditions; (2) a variety of diseases occurring in diverse environments; studies of infectious diseases in relation to climatic influences could focus, for instance, on leishmaniasis around the Mediterranean, tick-borne encephalitis in Scandinavia and central Europe, and waterborne infectious diseases in countries throughout Europe; (3) the distribution of malaria vectors in Europe and population dynamics in relation to climate; and (4) pre-existing regional networks for the recording of certain diseases. Capitalizing on these research opportunities within the European region will strengthen the information base for policy-making.