Supporting Policy Regulations and Interventions to Negate aggravated Global diarrheal disease due to future climate Shocks

Project Information

SPRINGS

Grant agreement ID: 101137255

DOI

10.3030/101137255

EC signature date 7 December 2023

Start date 1 January 2024

End date 31 December 2028

Funded under

• Health

Total cost

€ 5 920 338,88

EU contribution

€ 5 920 338,88

Coordinated by

STICHTING AMSTERDAM UMC
Netherlands

Periodic Reporting for period 1 - SPRINGS (Supporting Policy Regulations and Interventions to Negate aggravated Global diarrheal disease due to future climate Shocks)

Reporting period: 2024-01-01 to 2025-06-30

Summary of the context and overall objectives of the project

SPRINGS is a transdisciplinary project that will inform climate, environmental and public-health adaptation policies by quantifying how future climate shocks affect the burden of water-borne diarrhoeal diseases. Diarrhoeal disease—largely waterborne—is the second leading cause of death in children under five; given this high burden, even modest climate-driven risk changes will affect millions. Risks emerge from interactions among climate hazards, environmental quality, water systems and population vulnerabilities, yet climate, environmental and health surveillance are often siloed. SPRINGS convenes climate, environmental, health and social scientists with communities, industry, authorities and policy makers to produce actionable evidence.
Objectives
1. Improve projections of climate change impacts on microbial water quality and quantity.
2. Improve projections of climate-sensitive diarrhoeal disease to inform adaptation and policy.
3. Through case studies in Italy, Romania, Tanzania and Ghana, measure current links among climate, behaviour and microbial water quality to improve water-safety management.
4. Integrate and translate evidence on climate, disease and costs to guide policy choices and identify robust interventions under climate uncertainty.
5. Promote uptake of recommendations by engaging citizens and stakeholders at local, national, regional and global levels.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

• Climate & water-quality projections: Downscaled global/regional climate datasets to the four case-study areas. Adapted a water-quality model to simulate climate impacts on pathogen dynamics; initial applications in Romania and Ghana focus on Cryptosporidium and Campylobacter. Identified flood-risk hotspots in Ghana using global flood databases, remote sensing and field reconnaissance in the Lower Volta basin.
• Disease projections: Developed statistical models linking hydrometeorological variables (temperature, humidity, rainfall) to diarrhoeal risk and built an online visualisation platform (PLAN-EO). Initiated a spatial agent-based disease model for Ghana.
• Case studies & surveillance: Completed literature reviews and produced harmonised protocols for data collection across sites. Microbial water-quality testing has begun in Italy, Tanzania and Ghana, with Romania in set-up. Diarrhoeal disease surveillance started in Tanzania and Italy; ethics approval for Ghana is pending.
• Policy translation: Began designing a decision-making framework—building on Health Technology Assessment (HTA) methods—that considers environmental and health outcomes. A scoping review mapped adaptation options across sectors to reduce climate-related diarrhoeal morbidity and mortality; prioritisation with stakeholders is under way.
• Engagement & uptake: Completed stakeholder mapping at global, EU and local levels and designed citizen-engagement activities. Replicable workshops and training materials raise awareness of climate–health links; pilots were held in Ghana (teachers in Akuse; University of Ghana) and with local policy makers, community leaders and water managers. Communication via the SPRINGS LinkedIn account is active.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

• Integrated, transdisciplinary approach: SPRINGS links behavioural, hydrometeorological, microbial water-quality and health data within a common framework across high-, middle- and low-income settings to identify shared versus context-specific risks and adaptation needs.
• Pathogen-specific focus: Target pathogens are Campylobacter, rotavirus, Cryptosporidium and Giardia, which are expected to respond differently to climate pressures. Prospective environmental testing and disease surveillance are under way in Tanzania and Italy, with Ghana and Romania following.
• Climate downscaling for health: Applying large ensembles of downscaled climate models and tailoring outputs for health-relevant decision making in each case-study context.
• Water-quality modelling under climate change: An extended model predicts microbiological water quality under changing climate in Ghana, with Romania in development; the approach captures peak contamination during climate shocks. Flooding hotspots are mapped using hydrological/hydraulic modelling adapted to data-poor catchments, combined with remote sensing and field data.
• Diarrhoeal-disease modelling: Two complementary approaches advance the field. A top-down statistical model quantifies historical burdens, identifies climate-sensitive indicators and projects future prevalence. A bottom-up agent-based model simulates disease emergence from behaviour and human–animal–environment interactions, enabling identification of intervention thresholds. Together these forecasts can strengthen surveillance, target vulnerable populations, improve outbreak preparedness and provide quantitative inputs for prioritising behavioural, environmental and public-health interventions.
• Integrated surveillance & QMRA: Implementing prospective, pathogen-specific environmental and disease surveillance at each site. In parallel, developing quantitative microbial risk-assessment (QMRA) tools for catchments, surface waters and wells to guide water-safety planning, surveillance and intervention prioritisation.
• Climate-resilient water-safety plans: Through stakeholder engagement, participatory mapping and downscaled climate information (including flood-risk hotspots), identifying climate-sensitive hazards and system vulnerabilities. Ongoing microbial monitoring across climatic conditions will strengthen hazard assessment and surveillance design.
• Prioritising adaptation across sectors: Developing an HTA-based framework to compare adaptation and mitigation options for diarrhoeal disease under climate change. A scoping review of interventions is complete, and workshops have elicited preferences and values from health-sector stakeholders—an under-explored area.