Climate change and tuberculosis: an analytical framework.

Climate change is likely to exacerbate a range of determinants which drive tuberculosis, the world's leading infectious disease killer. However, tuberculosis is often neglected in wider climate health discussions. Commissioned by the World Health Organization, we developed an analytical framework outlining potential causal relationships between climate change and tuberculosis. We drew on existing knowledge of tuberculosis determinants, identified which are likely to be sensitive to the effects of climate change, and conceptualised the mechanistic pathways through which this might occur. We collated evidence for these pathways through literature reviews. Our reviews found no studies directly linking climate change and tuberculosis, warranting research to build evidence for action. The available evidence supports the existence of plausible links between climate change and tuberculosis, and highlights the need to include tuberculosis in climate risk adaptation and mitigation programmes, and climate-resilient funding and response mechanisms. Further evidence is urgently needed to quantify the effects of climate change on tuberculosis.