 many potential human health effects have been hypothesized to result either directly or indirectly from global climate change . 
 changes in the prevalence and spread of infectious diseases are some of the most widely cited potential effects of climate change , and could have significant consequences for human health as well as economic and societal impacts . 
 these changes in disease incidence would be mediated through biologic , ecologic , sociologic , and epidemiologic processes that interact with each other and which may themselves be influenced by climate change . 
 although hypothesized infectious disease effects have been widely discussed , there have not yet been thorough quantitative studies addressing the many processes at work . in part 
 this is because of the complexity of the many indirect and feedback interactions or mechanisms that bear on all aspects of the climate issue . 
 it also results from the difficulty of including the multitude of always - changing determinants of these diseases . 
 this paper proposes a framework for an integrated assessment of the impacts of climate change on infectious diseases . 
 the framework allows identification of potentially important indirect interactions or mechanisms , identification of important research gaps , and a means of integrating targeted research from a variety of disciplines into an enhanced understanding of the whole system.imagesfigure 1figure 2 
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