Climate change is one of several drivers of recurrent outbreaks and geographical range expansion of zoonotic infectious diseases in Europe. Policy and decision-makers need tailored monitoring of climate-induced disease risk, and decision-support tools for timely early warning and impact assessment for proactive preparedness and timely responses. The abundance of open data in Europe allows the establishment of more effective, accessible, and cost-beneficial prevention and control responses. IDAlert will co-create novel policy-relevant pan-European indicators that track past, present, and future climate-induced disease risk across hazard, exposure, and vulnerability domains at the animal, human and environment interface. Indicators will be sub-national, and disaggregated through an inequality lens. We will generate tools to assess cost-benefit of climate change adaptation and mitigation measures across sectors and scales, to reveal novel policy entry points and opportunities. Surveillance, early warning and response systems will be co-created and prototyped to increase health system resilience at regional and local levels, and explicitly reduce socio-economic inequality. Indicators and tools will be co-produced through multilevel engagement, innovative methodologies, existing and new data streams and citizen science, taking advantage of intelligence generated from selected hotspots in Spain, Greece, The Netherlands, Sweden, and Bangladesh that are experiencing rapid urban transformation and heterogeneous climate-induced disease threats. For implementation, IDAlert has assembled European authorities in climate modelling, infectious disease epidemiology, social sciences, environmental economics, One Health and EcoHealth. Further, by engaging critical stakeholders from the start, IDAlert will ensure long-lasting impacts on EU climate policy, and provide new evidence and tools for the European Green Deal to strengthen population health resilience to climate change.

Mosquito-borne diseases place a heavy burden on society, causing widespread suffering and driving poverty. They are increasing in prevalence, geographical distribution and severity, representing a growing threat worldwide. Hence, there is a need for better disease intelligence, capable of anticipating and identifying eco-epidemiological risks leading to explosive epidemics and emergence in previously unaffected areas. The basis of such intelligence stems from a deep understanding of the factors that drive disease circulation, emergence and spread. This requires insights into the complex interplay between humans, pathogen-carrying mosquitoes, pathogen reservoirs (e.g. birds), and a changing environment. The E4Warning consortium brings together interdisciplinary, innovative, and open science to contribute to the One Health paradigm shift that is required to tackle the spread and transmission of zoonotic deadly pathogens, and harness this shift to nowcast and forecast mosquito-borne disease risk in a constantly changing and globally connected environment. Our work aims to disrupt disease transmission pathways connecting humans, mosquitoes, and birds through innovative eco-epidemiological modelling tools and intelligent digital solutions, co-designed and implemented by public health administrations. Open innovation strategies and big data tools are the cornerstone of the next-level One Health Early Warning Systems required in the face of mounting mosquito-borne disease threats.

Exposure to secondhand tobacco smoke (SHS) has been classified as a "Group 1” carcinogen (known human carcinogen) by the International Agency for Research on Cancer and has been shown to have adverse health effects on adults and children, including heart disease and respiratory disorders. Electronic cigarettes (e-cigarettes), the most common “electronic nicotine delivery system”, have irrupted in the past 5 years with sales volumes increasing considerably across the European Union. The TackSHS Project will try to elucidate the comprehensive impact that SHS and e-cigarettes emissions have on the respiratory health of the European population and how health impacts vary according to socio-economic parameters with particular emphasis on specific vulnerable groups (patients suffering from pre-existing chronic lung diseases, heavy smokers, and other disadvantaged groups). By means of an integrated series of work packages, we will investigate the determinants of SHS exposure, assessed at the individual level and in the environment (survey and air quality assessment in 12 countries), the overall burden of disease caused (lung diseases and cardiovascular diseases), including the specific respiratory health changes in patients and healthy people, the economic impact of both mortality and morbidity caused by these exposures, the methods to better characterize these exposures and novel interventions to reduce them. This comprehensive, integrated approach will enable significant step-change beyond the current state-of-the-art in understanding SHS and e- cigarette emission exposure. The participating partners have been at the forefront of cutting edge research in this discipline, with prior collaboration between them in specific projects. The TackSHS Project will put together for the first time all these first-line research teams, and the conjunction of the work packages will result in a step forward to tackle exposure to SHS and e-cigarettes emissions.

PULSE (Participatory Urban Living for Sustainable Environments) will leverage diverse data sources and big data analytics to transform public health from a reactive to a predictive system, and from a system focused on surveillance to an inclusive and collaborative system supporting health equity. Working within five global cities, PULSE will harvest open city data, and data from health systems, urban and remote sensors, personal devices and social media to enable evidence-driven and timely management of public health events and processes. The clinical focus of the project will be respiratory diseases (asthma) and metabolic diseases (Type 2 Diabetes) in adult populations. The project will develop risk stratification models based on modifiable and non-modifiable risk factors in each urban location, taking account of biological, behavioural, social and environmental risk factors. Following the recommendations of WHO Europe (2015), the project will also focus on the development of metrics, and data-driven approaches, to community resilience and well-being in cities. Deploying a Health in All Policies (HiAP) perspective, and a ‘whole-of-city’ model, the project will integrate and analyze data from the health, environment, planning and transport sectors in each city. PULSE will pioneer the development and testing of dynamic spatio-temporal health impact assessments using geolocated population-based data. PULSE will also develop simulation models of potential policy scenarios to allow decision-makers, citizens and businesses to ascertain the impact of proposed policies. The project will culminate in the establishment of Public Health Observatories in each urban location. These observatories will serve as linked hubs that utilize knowledge-driven processes and big data to shape intersectoral public policy and service provision, support citizen health, and encourage entrepreneurship in the fields of data science and mobile health.

The objective of SafetyCube is to develop an innovative road safety Decision Support System (DSS) that will enable policy-makers and stakeholders to select and implement the most appropriate strategies, measures and cost-effective approaches to reduce casualties of all road user types and all severities. At the core of the project will be a novel and comprehensive analysis of accident causation factors combined with newly estimated data on the effectiveness and cost-effectiveness of safety measures, not just in relation to reduction of fatalities but also the number of injured. An operational framework will be established to provide future access to the DSS once the project is completed. The project has four sub-objectives: 1. To develop new analysis methods for (a) Priority setting, (b) Evaluating the effectiveness of measures (c) Monitoring serious injuries and assessing their socio-economic costs (d) Cost-benefit analysis taking account of human and material costs 2. To apply these methods to safety data to identify the key accident causation mechanisms, risk factors and the most cost-effective measures for fatally and seriously injured casualties 3. To develop an operational framework to ensure the project facilities can be accessed and updated beyond the completion of SafetyCube 4. To enhance the European Road Safety Observatory and work with road safety stakeholders to ensure the results of the project can be implemented as widely as possible The project outputs will be framed according to the specific policy and stakeholder areas – infrastructures, vehicles and road users – so that the measures developed in the project can be most readily applied. A systems approach will ensure effective coordination between these areas. The close involvement of road safety stakeholders of all types at national and EU levels and wider will enable the DSS to be focussed on the most appropriate policy-making procedures and ensure the project outputs have global reach.