Vector-borne diseases, respiratory diseases and diarrheal diseases are among those that most affect Colombians. In addition to the difficult social, economic and sanitary conditions, climatic conditions have been decisive in their behaviour, especially the effects of climate variability and extreme events. Precipitation deficits are related to the increase in dengue cases, with the average monthly intensity of precipitation inversely correlated with the monthly number of dengue cases. Therefore, it is necessary to systematically consider the climate component in epidemiological monitoring and prognosis136 in order to improve the preparation of recommendations and the development of preventive actions by the country’s health system.

Since 2016, the National Institute of Health (INS), the Institute of Hydrology, Meteorology and Environmental Studies (IDEAM) and the Ministry of Health and Social Protection have developed actions, within the Climate Variability and Change Board of the Comisión Técnica Nacional Intersectorial para la Salud Ambiental (CONASA), to establish the development of research and products and their dissemination within the national health system. For example, the IDEAM had conducted research into the relationship of rain, rain mean intensities, temperature and humidity with dengue and malaria cases, and incidences per hundred thousand inhabitants. In April 2017, the first Climate and Health Bulletin was prepared and published, containing information on climate conditions and predictions, epidemiological conditions and recommendations. The publication and dissemination are carried out by the Sub-directorate of Environmental Health of the Ministry of Health and Social Protection, which sends the bulletin to departmental and local health bureaus to help inform their prevention and control plans and actions. The INS and IDEAM have developed research on the identification and characterization of the favourability of climatic variables in diseases such as vector-borne diseases, susceptible to climate. A methodology was developed to relate the favourability with the epidemiological behaviour. The result of this work was used to develop the bulletin. In the monthly meeting of the bulletin contributors, the conditions, climatic and favourable predictions, and behaviour of the current and expected number of cases are presented, with their recommendations.

The effort of the three institutions (INS, IDEAM and Ministry of Health and Social Protection) has been reflected in the formal integration in the Climate Variability and Change Board, as an intersectoral workspace, and in the Climate and Health Bulletin, as an information tool for decision-making by territorial entities, including departmental and municipal health secretariats. It has also generated a space for discussion and the development of technical documents for policy formulation. With the research project financed by the Ministry of Science and Technology, and with the support of IDEAM, the INS has identified events of interest in public health and their relationship with climatic variables, designed to determine trends and cyclicality. For example, the organizations have led research into climate conditions and dengue in the Colombian Caribbean region. Delegates of the departmental health secretariats have participated in meetings about the bulletin’s objective and content, which has helped to develop capacities.

In the development of this work, various difficulties have arisen. Changes of government have brought different objectives and conceptions that are reflected in the priorities of its management and in the resources assigned. Also, there is a lack of experience in interdisciplinary and intersectoral work, which has been resolved through the exchange of knowledge, first between INS, IDEAM and the Ministry of Health and Social Protection, and secondly with regional and local health bureaus. It was necessary to define some priorities in the approach to vector-borne diseases, due to the limitations of information and its nature.

56 issues of the Climate and Health Bulletin have been published.