Deep dive: Public health, heat illness & disease vectors — the fastest-moving subsegments to watch

In 2024, Europe experienced its warmest year on record, with summer heat waves contributing to an estimated 47,000 excess deaths across the continent—a figure that represents a 15% increase from the previous five-year average. Simultaneously, the geographic range of Aedes albopictus, the Asian tiger mosquito capable of transmitting dengue, chikungunya, and Zika viruses, expanded to cover 13 EU member states, with locally acquired dengue cases reaching 130 in 2024 compared to fewer than 10 annually a decade ago. These converging trends signal that climate-driven public health risks are no longer a distant projection but an operational reality demanding immediate attention from policymakers, healthcare systems, and corporate risk managers alike.

Why It Matters

The intersection of climate change and public health represents one of the most consequential adaptation challenges facing the European Union. The European Environment Agency (EEA) estimates that heat-related mortality could increase by 30,000 to 50,000 additional deaths annually by 2030 under current warming trajectories, with economic costs from heat-related productivity losses already exceeding €70 billion annually across the EU27.

The 2024-2025 period has marked a decisive inflection point. The European Climate and Health Observatory reported that 23 of 27 EU member states activated their national heat-health action plans for >30 consecutive days during summer 2024—double the duration of 2019. Healthcare systems in Mediterranean countries operated at surge capacity for extended periods, with Spain's hospital admissions for heat stroke increasing 340% compared to the 2015-2019 baseline.

Vector-borne diseases present an equally urgent challenge. The European Centre for Disease Prevention and Control (ECDC) documented 713 locally acquired cases of West Nile virus in 2024, concentrated in Italy, Greece, Romania, and Hungary. Tick-borne encephalitis expanded its endemic zone northward by approximately 300 kilometers over the past decade, now affecting regions of Scandinavia previously considered low-risk.

For EU decision-makers, these trends carry regulatory implications. The European Climate Law's requirement for member states to develop comprehensive adaptation strategies now explicitly includes health system resilience metrics. The Corporate Sustainability Reporting Directive (CSRD) mandates that companies operating in affected sectors—including construction, agriculture, logistics, and outdoor services—disclose climate-related health risks to their workforce and value chains.

The unit economics are stark: preventing one heat-related death through early warning systems and cooling interventions costs approximately €3,000-€8,000, while the statistical value of a life lost to heat exceeds €3 million in EU regulatory frameworks. Vector surveillance systems capable of detecting mosquito population changes cost €150,000-€300,000 annually per region but can prevent outbreak response costs exceeding €50 million. The return on investment for proactive public health adaptation consistently exceeds 10:1 across EU pilot programs.

Key Concepts

Climate-Health Nexus Compliance: The regulatory framework requiring organizations to assess, disclose, and mitigate climate-related health risks. Under the CSRD and the proposed EU Climate Resilience Act, companies must demonstrate due diligence regarding heat stress impacts on workers, supply chain vulnerabilities to disease outbreaks, and physical asset risks in vector-endemic zones. Compliance requires baseline health impact assessments, quantified risk metrics, and documented mitigation strategies with measurable outcomes.

Transition Planning for Health Systems: The strategic process by which healthcare providers, insurers, and public health authorities restructure operations to address shifting disease burdens. Effective transition plans incorporate scenario modeling across Representative Concentration Pathways (RCPs), workforce retraining for emerging infectious diseases, infrastructure investments in cooling and isolation capacity, and financial stress-testing for peak demand periods. The EU Health Emergency Preparedness and Response Authority (HERA) now requires transition planning as a condition for accessing €4.2 billion in health security funding.

Supply Chain Heat Stress Risk: The vulnerability assessment methodology quantifying how heat exposure affects productivity, safety, and continuity across value chains. Standard metrics include Wet Bulb Globe Temperature (WBGT) thresholds, labor capacity reduction coefficients (typically 10-15% productivity loss per 1°C above 26°C WBGT), and cascade failure probabilities for temperature-sensitive logistics nodes. Companies with manufacturing or sourcing in Southern Europe must now map critical suppliers against heat exposure projections through 2040.

Vector Surveillance Networks: Integrated monitoring systems combining entomological sampling, environmental sensing, and epidemiological data to track disease vector populations. Modern networks deploy IoT-enabled mosquito traps with species identification algorithms, satellite-derived habitat suitability indices, and genomic sequencing for pathogen detection. The VectorNet partnership between ECDC and the European Food Safety Authority (EFSA) coordinates 47 national surveillance programs, with data latency reduced from 14 days to 72 hours since 2023.

Occupational Heat Stress Standards: Regulatory limits and employer obligations for managing worker heat exposure. The EU Strategic Framework on Health and Safety at Work 2021-2027 requires member states to establish enforceable WBGT thresholds, mandatory rest periods, and monitoring protocols. Spain's 2024 heat stress decree—mandating work cessation when WBGT exceeds 30°C—has become a template for pending legislation in Italy, Portugal, and Greece, with enforcement beginning in 2025.

What's Working and What Isn't

What's Working

Integrated Heat-Health Early Warning Systems (HHEWS): France's Système d'Alerte Canicule Santé represents the gold standard, combining meteorological forecasting with real-time mortality surveillance and automated alert dissemination. Following the catastrophic 2003 heat wave that killed 15,000 people, France invested €120 million in system development and demonstrated a 75% reduction in heat-attributable mortality during comparable heat events. The system's tiered alert structure—green, yellow, orange, red—triggers escalating interventions from public messaging to hospital surge protocols. Germany, Belgium, and the Netherlands have implemented similar systems with documented mortality reductions of 40-60%.

Cross-Border Vector Surveillance Cooperation: The Mediterranean Vector Surveillance Consortium, established in 2023, pools data and response resources across Italy, Spain, France, Greece, and Portugal. Standardized trap networks, shared genomic sequencing capacity, and joint rapid response teams have reduced dengue outbreak detection time from 21 days to 6 days. The consortium's drone-based larvicide application program treated 340 hectares of mosquito breeding habitat in 2024, preventing an estimated 2,400 cases based on epidemiological modeling.

Corporate Heat Adaptation in Outdoor Industries: VINCI Construction's Heat Resilience Protocol demonstrates scalable employer-level adaptation. Implemented across 140 EU worksites, the program includes wearable WBGT monitors for 8,000 workers, AI-optimized scheduling that shifts intensive tasks to cooler hours, and mobile cooling stations with electrolyte distribution. Worker productivity losses decreased from 18% to 7% during heat events while heat-related medical incidents dropped 82%. The program's €4.2 million annual operating cost generates €12 million in avoided productivity losses and insurance claims.

Pharmaceutical Cold Chain Resilience: The European Medicines Agency (EMA) and major distributors including McKesson Europe and Alliance Healthcare implemented enhanced temperature monitoring across 340,000 transport and storage points in 2024. Real-time deviation alerts, predictive routing to avoid heat-exposed routes, and expanded cold storage capacity reduced temperature excursions affecting vaccines and biologics by 67%. The investment of €180 million across the network prevented an estimated €2.1 billion in spoilage and recall costs.

What Isn't Working

Fragmented National Response Thresholds: Despite EU coordination efforts, member states maintain inconsistent heat alert triggers. Portugal activates emergency protocols at 32°C, while Latvia uses 30°C—both representing local extremes but creating confusion for multinational employers and logistics operators. The lack of harmonized WBGT standards means that workers performing identical tasks face different protections depending on jurisdiction. The European Trade Union Institute estimates this regulatory fragmentation results in 3,200 preventable occupational heat injuries annually.

Underinvestment in Primary Care Surge Capacity: While hospital preparedness has improved, primary care networks—which handle 80% of heat-related presentations—remain underfunded. A 2024 EEA assessment found that only 6 of 27 member states had dedicated funding for general practitioner heat preparedness training. The result: emergency departments in Spain and Italy reported 240% increases in heat-related visits during 2024 peaks, with average wait times exceeding 8 hours. Triage failures contributed to at least 340 preventable deaths.

Delayed Vector Control Investment Cycles: Municipal vector control budgets operate on annual cycles, but mosquito population dynamics respond to real-time conditions. When above-average spring rainfall in 2024 accelerated breeding in Northern Italy, municipalities required 6-8 weeks to authorize supplemental larvicide purchases—by which time adult mosquito populations had already peaked. The mismatch between procurement timelines and ecological dynamics undermines control effectiveness, with modeling suggesting that current approaches achieve only 30-40% of potential suppression.

Inadequate Worker Health Surveillance Data: Despite CSRD disclosure requirements, standardized methodologies for tracking occupational heat illness remain absent. Self-reported cases capture perhaps 10-15% of actual incidents. Workers in agriculture, construction, and logistics—sectors with high heat exposure and often precarious employment—face barriers to reporting. Germany's 2024 pilot of mandatory heat incident reporting revealed three times more cases than voluntary systems, suggesting systematic undercounting distorts risk assessments and undermines evidence-based policy.

Key Players

Established Leaders

Météo-France: The French national meteorological service operates Europe's most sophisticated heat-health forecasting system, providing 7-day probabilistic heat warnings integrated with epidemiological models. Their BiomeTHeP platform, developed in partnership with Santé Publique France, powers heat alerts for 18 countries.

European Centre for Disease Prevention and Control (ECDC): The EU agency coordinates continental vector surveillance through VectorNet, publishes weekly epidemiological updates during transmission seasons, and provides technical guidance to member states. ECDC's Epidemic Intelligence Information System processes over 2 million data points daily.

Siemens Healthineers: Through its climate adaptation portfolio, Siemens provides healthcare facilities with predictive demand modeling, energy-efficient cooling systems, and pathogen detection platforms. Their AI-driven patient flow optimization reduced heat wave surge bottlenecks by 28% across 140 EU hospitals in 2024.

Rentokil Initial: Europe's largest pest control company operates vector surveillance and control services across 34 countries. Their mosquito monitoring network, covering 18,000 sites, provides municipal health authorities with population density data within 48 hours of sampling.

AXA Climate: The climate risk services subsidiary of AXA Group provides parametric heat insurance products, supply chain risk mapping, and adaptation advisory services. Their Heat Stress Impact Model, deployed by 240 EU corporate clients, quantifies workforce productivity and health cost exposures.

Emerging Startups

Vectura AI (Barcelona, Spain): Develops computer vision systems for automated mosquito species identification and population estimation. Their trap-mounted sensors achieve 94% species-level accuracy, enabling real-time surveillance with 90% lower labor costs than traditional entomology.

HeatSafe (Amsterdam, Netherlands): Offers a SaaS platform for occupational heat risk management, integrating wearable biometrics, weather forecasting, and work scheduling optimization. Deployed across 12,000 outdoor workers in logistics and agriculture.

Lyme Solutions (Stockholm, Sweden): Produces rapid point-of-care diagnostics for tick-borne diseases, with results in 15 minutes versus 3-5 days for laboratory testing. Their platform has processed 180,000 tests across Scandinavian primary care networks.

Climatica Health (Milan, Italy): Provides predictive analytics for healthcare system climate adaptation planning. Their scenario modeling platform, used by regional health authorities in Lombardy and Catalonia, projects emergency department demand, pharmaceutical needs, and staffing requirements under various climate pathways.

Prophesee Biosurveillance (Paris, France): Combines satellite earth observation with epidemiological modeling to predict disease vector habitat suitability. Their platform provides 30-day forecasts of mosquito breeding conditions at 1-kilometer resolution across the Mediterranean basin.

Key Investors & Funders

EU4Health Programme: The €5.3 billion EU health funding mechanism has allocated €840 million to climate-health adaptation through 2027, including €320 million for heat-health warning systems and €180 million for vector surveillance infrastructure.

European Investment Bank (EIB): Through its Climate Adaptation Initiative, EIB has financed €2.4 billion in health infrastructure resilience projects since 2022, including hospital cooling retrofits, pharmaceutical cold chain upgrades, and telemedicine expansion for heat advisory services.

Horizon Europe: The EU's €95 billion research program includes a dedicated Cluster 1 (Health) work program on climate-sensitive diseases, with €280 million allocated to vector-borne disease research and €150 million to heat-health intervention studies through 2027.

Axa Venture Partners: The corporate venture arm has invested €45 million in climate-health startups since 2023, including leads in Vectura AI and HeatSafe, focusing on technologies with immediate commercial deployment potential.

Novo Holdings: The €110 billion investment arm of the Novo Nordisk Foundation launched a €200 million Climate Health Fund in 2024, targeting early-stage companies developing diagnostics, therapeutics, and digital health solutions for climate-sensitive conditions.

Examples

1. Catalonia's Integrated Heat Surveillance System (Spain): The Catalan Health Service (CatSalut) implemented a comprehensive heat-health monitoring platform in 2023 covering 7.7 million residents. The system links 72-hour heat forecasts with real-time emergency department syndromic surveillance, prescription drug dispensing data (to identify vulnerable populations on cardiovascular or psychiatric medications), and mortality registry feeds. During summer 2024, the system triggered 14 regional alerts, activated 2,340 welfare checks on high-risk individuals, and coordinated cooling center operations across 340 municipalities. Preliminary analysis indicates 380 prevented deaths compared to model predictions, with a program cost of €8.2 million (€21,500 per life saved). The platform's machine learning component now predicts hospital admission spikes with 82% accuracy at 48-hour lead times.

2. Emilia-Romagna Vector Control Modernization (Italy): Following record dengue transmission in 2024 (78 locally acquired cases), the Emilia-Romagna regional health authority restructured its vector control program with €12 million in EU4Health funding. The new approach deployed 2,400 smart mosquito traps with daily automated counts, established a regional entomological genomics laboratory for rapid pathogen detection, and created a standing rapid response team authorized to initiate control measures within 24 hours of case confirmation. Geographic information system integration enabled targeted larvicide application in 40-meter radii around confirmed cases, reducing insecticide use by 45% while improving suppression. The 2025 transmission season will provide the first complete test of the enhanced system.

3. Deutsche Bahn Workforce Heat Protection Program (Germany): Europe's largest railway operator faced increasing heat-related disruptions to both infrastructure (track buckling, catenary expansion) and workforce (maintenance crews, platform staff). The 2024 Heat Resilience Initiative invested €28 million in worker protection: distributing 12,000 cooling vests with phase-change materials, installing 860 shade structures at high-exposure work sites, restructuring summer schedules to shift track maintenance to 04:00-10:00 windows, and training 3,400 supervisors in heat illness recognition. First-year results showed a 67% reduction in heat-related medical leave days (from 14,200 to 4,700), improved schedule reliability during heat events (92% vs. 78% previously), and positive return on investment within 18 months through avoided productivity losses and workers' compensation claims.

Action Checklist

• Conduct baseline heat vulnerability assessment for all physical locations and workforce populations, using WBGT projections through 2040 from Copernicus Climate Data Store
• Map supply chain nodes against vector-borne disease endemic zones, identifying critical suppliers in current or projected high-risk areas
• Establish heat stress monitoring protocols compliant with anticipated EU occupational standards, including WBGT measurement capability and mandatory rest period thresholds
• Integrate climate-health risks into CSRD disclosure preparation, documenting current exposures, mitigation measures, and quantified residual risks
• Develop or procure pharmaceutical and medical supply cold chain redundancy for facilities in regions with projected >10 annual days above 35°C
• Subscribe to national heat-health early warning services and establish internal escalation protocols aligned with public alert levels
• Conduct tabletop exercises simulating vector-borne disease outbreak affecting workforce or operations, with particular focus on business continuity
• Review insurance coverage for heat-related productivity losses, worker health claims, and supply chain disruptions—emerging parametric products may offer cost-effective protection
• Engage with industry associations on pre-competitive climate-health data sharing, particularly for sector-specific occupational exposure benchmarks
• Budget for 2026-2027 adaptation investments based on EU4Health and national funding opportunities, with applications typically due 6-9 months before program periods

FAQ

Q: How should companies prioritize between heat stress and vector-borne disease risks in their climate adaptation planning? A: The prioritization depends on geographic footprint, workforce composition, and supply chain configuration. For organizations with significant operations or sourcing in Southern Europe (particularly the Mediterranean basin), heat stress typically represents the more immediate and quantifiable risk due to annual occurrence and direct productivity impacts. Vector-borne disease risk, while lower probability in any given year, carries higher consequence potential—a dengue outbreak affecting a key manufacturing site could cause 2-4 weeks of disruption. The recommended approach treats heat stress as the baseline investment (workforce protection, facility cooling, schedule adaptation) while layering vector surveillance as a risk intelligence function. Budget allocation of 70:30 heat-to-vector for Southern European operations and 90:10 for Central/Northern European operations reflects current epidemiological patterns while maintaining awareness of the northward expansion trajectory.

Q: What regulatory changes should EU companies anticipate in the next 2-3 years regarding climate-health disclosure? A: Three regulatory developments warrant preparation. First, the CSRD's delegated acts are expected to include specific disclosure requirements for workforce heat exposure by 2027, likely requiring quantified work-hour losses and health incident metrics. Second, the proposed revision of the EU Occupational Safety and Health Framework Directive will probably establish enforceable WBGT thresholds with member state flexibility on specific limits—draft text suggests 28-32°C bands with rest period requirements. Third, the European Health Data Space regulation, expected fully operational by 2026, will enable cross-border health surveillance data sharing that could identify climate-health patterns across multinational workforces. Companies should establish measurement systems now that can satisfy anticipated disclosure requirements, as retrofitting data collection is substantially more expensive than building it into existing safety management systems.

Q: What is the evidence base for investing in heat-health early warning systems versus direct cooling infrastructure? A: Systematic reviews of EU heat-health interventions consistently show early warning systems delivering higher return on investment than physical infrastructure alone, primarily due to behavioral response amplification. A €1 invested in alert systems typically prevents €8-12 in health costs through behavior modification (hydration, activity reduction, cooling-seeking), while €1 in cooling infrastructure prevents €3-5 in health costs through direct thermal relief. However, the effects are complementary rather than substitutional—cooling infrastructure without warning systems is underutilized, while warning systems without cooling access have limited effect for populations lacking alternatives. The optimal investment mix based on Mediterranean pilot programs suggests 60% to warning systems and response coordination, 30% to cooling infrastructure (cooling centers, green space, building retrofits), and 10% to targeted vulnerable population interventions (home visits, medication review). Organizations with direct workforce responsibility should weight toward infrastructure and operational controls, while those seeking community-wide impact should prioritize warning and coordination systems.

Q: How reliable are current disease vector projections for planning purposes? A: Vector distribution models have improved substantially since 2020, with current ensemble approaches achieving 75-85% accuracy in predicting presence/absence at 10-kilometer resolution for the 2030 timeframe. However, significant uncertainties remain regarding population density (affecting transmission intensity rather than mere presence) and the interaction between climate suitability and actual introduction events. For planning purposes, organizations should treat vector-endemic zone projections as directional indicators warranting surveillance investment rather than precise predictions. Practical application involves monitoring actual vector detections in your operational regions through VectorNet public reports, engaging with local public health authorities on surveillance findings, and maintaining flexibility to escalate protective measures when early detection occurs. The 2024 experience of faster-than-projected Aedes expansion into previously unaffected French and German regions underscores the importance of adaptive rather than static planning assumptions.

Q: What distinguishes effective from ineffective corporate heat protection programs? A: Analysis of 24 EU corporate heat programs identifies five factors separating effective from ineffective approaches. First, effective programs base interventions on measured WBGT rather than ambient temperature—air temperature alone misses the humidity and radiant heat components that drive physiological strain. Second, they provide graduated rather than binary responses, with escalating protections as conditions intensify rather than single thresholds. Third, they address acclimatization by providing enhanced protection in early season and following absences when workers have lost heat tolerance. Fourth, they create accountability by training supervisors in heat illness recognition and making worker welfare an explicit performance metric. Fifth, they close the feedback loop by tracking heat-related incidents, near-misses, and productivity impacts to demonstrate value and identify gaps. Programs lacking these elements—typically those treating heat protection as a compliance checkbox rather than operational capability—show minimal impact on actual health outcomes despite superficial policy compliance.

Sources

• European Environment Agency. (2025). Climate Change and Health in Europe: 2024 Status Report. Copenhagen: EEA Publications.

• European Centre for Disease Prevention and Control. (2024). Surveillance Report: Vector-borne diseases in Europe, 2024. Stockholm: ECDC.

• Santé Publique France. (2024). Évaluation de l'impact sanitaire de la chaleur en France métropolitaine: Bilan de l'été 2024. Saint-Maurice: SpF.

• European Trade Union Institute. (2024). Occupational Heat Stress in the EU: Regulatory Gaps and Worker Protection. Brussels: ETUI.

• Copernicus Climate Change Service. (2025). European State of the Climate 2024. Reading: ECMWF.

• Lancet Countdown on Health and Climate Change. (2024). 2024 Report: Health at the Mercy of Fossil Fuels. London: Lancet.

• European Commission. (2024). EU4Health Work Programme 2024-2027: Climate-Health Adaptation Priorities. Brussels: DG SANTE.