CariEco-Mos - Building Resilient Environments to Mitigate Mosquito-Borne Epidemic Threats in the Caribbean UKOTs

Our goal is to enable small island Caribbean nations to address the threat of emerging mosquito-borne diseases. In recent years, these islands have suffered unprecedented epidemics of mosquito-borne diseases (MBDs), including dengue, Chikungunya, Zika, and malaria [1], [2], [3]. Since tourism is a major source of national income, these epidemics have substantial economic as well as health impact [4]. Anthropogenic changes, such as population growth, urban expansion, and climate change can damage ecosystems, decrease biodiversity, create artificial habitats, and introduce invasive species; these changes make environments more vulnerable to disease outbreaks, such as MBD epidemics [5], [6], [7], [8], and small islands in the Caribbean are especially vulnerable [1]. At present, the response to these threats in most islands is to deploy insecticide spraying and fogging against adult mosquitoes, or larviciding to control breeding. The impacts of such interventions are transitory: insecticide-fogging may mitigate an ongoing epidemic, but does not reduce the risk of future mosquito-borne epidemics. In addition, it can cause further damage to ecosystems by affecting non-target species, including predators of mosquito larvae and adults [9], [10], [11]. Mitigating the effects of anthropogenic change that damage environments and opting for sustainable nature-based alternatives could manage epidemic threats, whilst benefiting ecosystems as a whole [8], [12], [13]. Aside from the peri-domestic risks posed by Aedes aegypti, many other known and potential vector species breed in natural and created wetlands [14]. In particular, we are concerned with native wetland-breeding Culex and Aedes spp., potential vectors of emerging pathogens of epidemic potential (such as West Nile Virus and encephalitides ), and with the malaria vector Anopheles albimanus [3], [15], [16], which has recently been detected for the first time in the Turks and Caicos Islands and the British Virgin Islands [14]. Local officials are especially concerned about the latter. There is plenty of evidence from other parts of the world that increased plant and predator biodiversity keeps wetland mosquito populations in check [17], [18], [19]. Economic development is of course essential, but negative effects on the environment are not inevitable. Experience elsewhere suggests that by understanding the ecological mechanisms through which anthropogenic activities reduce environmental resilience and increase epidemic risk, it is possible to identify 'win-win' solutions - whereby local economies develop, without growing mosquito populations and without sacrificing ecosystems [13]. So far, there has been very little research on environmental drivers of MBD risk in the Caribbean. To understand these interactions requires a One Health perspective [20], [21]. The UK government currently supports public health programmes in the UK Overseas Territories (UKOTs) in the Caribbean, and the Medical Entomology and Zoonoses Ecology (MEZE) team at the UK Health Security Agency (UKHSA) have provided support to local vector control teams over the past decade, particularly in relation to the prevention of Aedes aegypti-transmitted arboviruses. These small islands are home to a diversity of mosquito vectors and have experienced recurring arboviral outbreaks that strain under-resourced health systems, but face barriers to sustainable, nature-based approaches [14]. Our broad aim is to assess these MBD threats, the anthropogenic changes that drive them, and identify possible mitigation strategies that will enable development to proceed without increasing epidemic risk. Our project team combines experience in medical and wetland entomology, practical vector control, plant sciences, epidemiology, policy, ecology, data modelling and One Health principles.