Climate Change Amplifies Health Risks: The Nexus of Air Quality and Vector-Borne Diseases

When I left Jakarta to study full-time in UIII and live part-time at a student dormitory, I hoped to escape the heavy air pollution that has become synonymous with urban life. Jakarta, with its smog-choked skies and constant traffic gridlock, has always felt like a symbol of the modern urban climate crisis. I imagined that moving to Depok, a quieter town with lightly better air quality, would give me a fresh start—a respite from both the stress of the city and its environmental toll. My daily routines quickly adopted a small, simple habit: opening my balcony’s door and windows in the early morning and evening while studying. This was my way of reducing overreliance on air conditioning, thereby cutting personal carbon footprint and contributing a tiny effort toward a better climate. Yet, as I let the cool breeze flow into my study space, I encountered an unexpected challenge. Mosquitos.

The mosquitos were everywhere. Despite my minor efforts to reduce my contribution to air pollution, I found myself exposed to Aedes aegypti, the primary carrier of diseases like dengue fever. Spending a big chunk of time outside of the classrooms, spacious library, and campus hallways to stay in my tiny space with the window wide open, it struck me how my small climate-conscious act had led to a new kind of risk. While I had managed to reduce emissions, climate change, with its multifaceted effects, was not a linear problem. It was complex, interconnected, and deeply rooted in a pattern of threats that amplify each other. Indeed, climate change is a threat multiplier — a factor that exacerbates existing vulnerabilities, making a situation more dangerous or complex.

This interplay of risks is not unique to my isolated experience. Climate change acts as a threat multiplier, intensifying health risks globally. Vector-borne diseases, like those spread by black and white-striped mosquitos, thrive in the warmer, wetter conditions created by rising temperatures and disrupted ecosystems. Urban areas like Jakarta and Depok, with their dense populations and poor waste management systems, provide ideal breeding grounds for mosquitos, exacerbating the spread of dengue and other diseases. At the same time, air pollution, driven by the combustion of fossil fuels in vehicles, factories, and power plants, contributes to respiratory illnesses and cardiovascular conditions. Both issues disproportionately affect vulnerable populations: children, older adults, and those with pre-existing health conditions such as asthma, particularly in low-income urban settlements.

Globally, the primary contributors to climate change include fossil fuel combustion and industrial processes, which release significant amounts of carbon dioxide and other greenhouse gases into the atmosphere. Agriculture and deforestation further exacerbate the problem in rural contexts, while urban areas see high emissions from transportation and building energy use. Surprisingly, even the health sector contributes to climate change, with hospitals, supply chains, and healthcare facilities accounting for a notable share of global emissions. According to a 2014 WHO report, this sector’s reliance on energy-intensive infrastructure and fossil fuels highlights the interconnectedness of our systems and the need for sustainable practices.

While climate change’s health impacts are universal, some groups face heightened vulnerability. People living in small island nations, coastal regions, and mountainous or polar areas experience unique climate pressures. Megacities like Jakarta, with their sprawling urban landscapes, amplify these risks for their inhabitants. Children are particularly susceptible to both air pollution and vector-borne diseases due to their developing immune systems. Senior citizens and individuals with chronic conditions like asthma face compounded risks, as do low-income urban populations who often lack access to healthcare and live in poorly ventilated or overcrowded conditions. These vulnerabilities underscore the urgent need for comprehensive action to mitigate and adapt to climate change’s effects on health.

Mitigating climate change requires reducing or preventing the emission of greenhouse gases. Shifting to clean energy sources, improving urban transportation systems, and implementing energy-efficient practices in buildings are essential steps. Many of these measures offer co-benefits: reducing air pollution, saving energy, and enhancing public health. For example, transitioning to renewable energy not only decreases carbon emissions but also reduces pollutants that contribute to respiratory diseases. Similarly, urban greening projects can lower city temperatures, improve air quality, and provide habitats that reduce mosquito breeding grounds.

Adaptation strategies are equally critical in addressing the health impacts already unfolding due to climate change. Strengthening health systems to cope with climate-sensitive diseases, improving water and sanitation infrastructure, and developing early warning systems for extreme weather events are vital measures. For instance, integrated vector management programs can help control mosquito populations and reduce the transmission of diseases like dengue. Public health campaigns educating communities about protective measures, such as using mosquito nets and eliminating standing water, can also play a significant role in adaptation efforts.

However, these actions cannot succeed without public participation. Climate change and health are everyone’s business, not just the government’s responsibility. Lessons from Jakarta’s air pollution case highlight the importance of promoting procedural rights—access to information and access to justice—in addressing environmental challenges. For years, Jakarta’s residents have endured poor air quality without adequate information about its health risks or meaningful opportunities to engage in solutions. Court-ordered measures, such as publicly reporting vehicle emissions data, increasing air quality monitoring, and involving citizens in air pollution control strategies, demonstrate how empowering the public can drive change.

Vivid in our memory. A landmark ruling handed down on 16 September 2021 by the Central Jakarta District Court found the government liable for the air pollution caused by millions of motor vehicles and coal-fired power plants in neighbouring provinces. Jakarta is routinely ranked among the most polluted major cities in the world, with experts estimating that poor air quality causes 5.5 million cases of disease each year, amounting to 6.8 trillion rupiah ($477 million) in health costs. This case, filed in 2019 by 32 citizen plaintiffs, including our faculty member Dr. Sonny Mumbunan, was hailed as a landmark decision by the Jakarta Legal Aid Institute, marking the first air pollution lawsuit in Indonesia. The court called on the government to take serious measures to improve air quality, including updating the national air quality standard, which had long been laxer than international benchmarks.

Citizen science initiatives offer a promising avenue for public participation in both air quality and vector-borne disease management. By monitoring air quality or mosquito populations, individuals can contribute valuable data to support policy reforms and enforcement. Access to real-time information about environmental conditions enables communities to take proactive measures to protect their health. Moreover, involving the public in co-designing strategies ensures that solutions are equitable and address the needs of those most affected.

Reflecting on my experience, I see how interconnected and multifaceted the challenges of climate change and health truly are. My minuscule attempt to reduce emissions by turning off AC led to an encounter with a broader, more complex issue: the interplay of air quality and vector-borne diseases. Yet, it also reinforced my belief that collective action—from individual choices to systemic reforms—is essential in addressing these challenges.

Climate change affects all of us, and it demands a response that is as interconnected as its impacts. By working together—reducing emissions, building resilience, and empowering public participation—we can create healthier, more sustainable and equitable communities. The journey toward a better future starts with recognizing that we are all part of the problem and solution.