From Trade Routes to Transmission Routes: Climate, Mobility, and Risk Assessment of Japanese Encephalitis Outbreak in Pakistan under the China-Pakistan Economic Corridor: A One Health Approach

The China-Pakistan Economic Corridor (CPEC), a cornerstone of China’s Belt and Road Initiative (BRI), has significantly enhanced economic connectivity, infrastructure, and mobility between China and Pakistan, with investments exceeding $60 billion. However, this rapid transformation raises critical questions about the intersection of climate, trade mobility, and public health. Increased connectivity under CPEC may amplify the risk of Japanese Encephalitis (JE), a zoonotic, mosquito-borne disease endemic to several Asian countries, including China. JE transmission is influenced by complex ecological and climatic factors, including temperature, precipitation, and land-use changes, which impact mosquito vectors (Culex tritaeniorhynchus) and their habitats.

This study evaluates the risk of JE outbreaks in Pakistan through a One Health framework, highlighting the interplay of climate, mobility, and health. Specifically, it focuses on cross-sectoral collaboration across public health, veterinary, and environmental agencies to mitigate emerging threats. Objectives include assessing JE transmission risks along CPEC and proposing climate-sensitive, One Health interventions for prevention and control.

The risk assessment integrates data from human health, veterinary, and environmental sectors using interdisciplinary methodologies:

• Climate and environmental mapping of Culex breeding sites along CPEC using satellite imagery and meteorological data, identifying that over 50% of CPEC-associated regions, particularly in Sindh and Punjab, have optimal conditions for mosquito breeding due to rice paddies, irrigation systems, and seasonal climatic variability.
• Analysis of trade and mobility data, showing a 240% increase in human and animal movement along CPEC, intensifying vector and amplifying host exposure.
• Stakeholder interviews, revealing critical gaps in JE surveillance, real-time communication, and coordinated climate-informed response strategies.

Findings highlight that approximately 60% of identified high-risk areas are vulnerable to JE outbreaks, driven by favorable climatic and environmental conditions for vector proliferation. This underscores the urgent need for integrated strategies that account for climate variability and its impacts on vector dynamics.

Key recommendations include:

• Developing GIS-based vector surveillance systems to monitor climate-driven changes in mosquito breeding habitats.
• Establishing real-time data-sharing platforms for JE surveillance between China and Pakistan, incorporating climate and environmental data.
• Promoting JE vaccination programs for vulnerable populations in high-risk, climate-sensitive areas.
• Enhancing diagnostic and response capacity across public health and veterinary laboratories through climate-informed training initiatives.
• Raising community awareness through public health campaigns on vector control, emphasizing climate adaptation strategies.
• Formulating a joint JE outbreak preparedness and response framework, integrating climate projections, vector control, and rapid response teams.

This study demonstrates the critical need for interdisciplinary approaches to address health risks at the nexus of climate, trade mobility, and emerging infectious diseases. By integrating climate science into One Health strategies, the research underscores how transdisciplinary collaboration can build resilience against the multifaceted challenges of climate change and global connectivity.