The Effects of Climate Change on Health: A Systematic Review from a One Health Perspective

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript titled “The effects of climate change on health: a systematic review from a One Health perspective” was an attempt to conduct a systematic review of the literature as it related to climate change and one-health. The authors reviewed an impressive amount of literature, and the article is well written for the most part.

However, I would not classify this study as a “systematic review” but rather just as a review of the literature. The authors do not summarize the study findings or methodology or assess any bias that may be present in these studies. All they do is present relationships between thematic points. This does not qualify as a systematic review in my mind. I would therefore urge the authors to consider changing their study title to more accurately reflect what they did.

I also would also like to say that the One Health approach did not clearly stand out to me. The authors do clearly articulate how their findings are related to a one-health approach. The authors seem to have a list of pathogens that are often studied in the context of one-health and looked for studies that related these to climate change. It is not clear how their findings can the looked at from a one-health perspective, given that all that was conducted as a thematic review. I would urge the authors to re-think their approach.

Finally, the inclusion of a mental health outcomes is confusing. I would urge the authors to stick to only considering infectious diseases in the context of their study.

I also have several minor comments that need to be addressed:

Comment 1: This is minor, but the graphical abstract is not self-explanatory. Some more clarity would be great if possible.

Comment 2: The sentence starting on Line 173 to Line 175 is not clear and seems to either be a run on sentence or is missing something. Please correct it.

Comment 3: Section 3.3 on Vector-borne disease and climate change needs to be re-written. More than half the paragraph deals with issues that have no pairing on vector-borne disease and as a result is rather hard to parse.

Comment 4: The sentence beginning on Line 265 seems out of place. It is not clear what is being “included”.

Comment 5: The discussion is heavily weighted towards arboviruses. This is a dis-service given the amount of literature that was reviewed for this study. I would urge the authors to consider better balancing their discussion section.

Comments on the Quality of English Language

The paper is well written for the most part. However, some sentences require more clarity. 

Author Response

Comments:

The manuscript titled “The effects of climate change on health: a systematic review from a One Health perspective” was an attempt to conduct a systematic review of the literature as it related to climate change and one-health. The authors reviewed an impressive amount of literature, and the article is well written for the most part.

However, I would not classify this study as a “systematic review” but rather just as a review of the literature. The authors do not summarize the study findings or methodology or assess any bias that may be present in these studies. All they do is present relationships between thematic points. This does not qualify as a systematic review in my mind. I would therefore urge the authors to consider changing their study title to more accurately reflect what they did.

Response:

We thank the reviewer for this important observation. We acknowledge that our review does not perform a meta-analysis or a quantitative risk of bias assessment, which are common in certain systematic reviews. However, we followed a systematic protocol (SODIP methodology and PRISMA guidelines) to identify, screen, and analyze the literature. Our approach involved both quantitative (e.g., bibliometric) and qualitative assessments of the studies, which go beyond a narrative review, indicates in Supplementary A.1. We had as examples some systematic review articles published in the journal, such as "An AI-Enhanced Systematic Review of Climate Adaptation Costs: Approaches and Advancements, 2010–2021" and "Climate-Induced Migration in India and Bangladesh: A Systematic Review of Drivers, Impacts, and Adaptation Mechanisms". To avoid confusion, we have clarified in the Methods section the steps taken to ensure systematicity, and we now explicitly state the limitations of our approach regarding bias assessment. We respectfully maintained the term “systematic review” but added further justification and clarification in the text in line 88 "This systematic review is a general approach to research on climate change and health."

Comments:

I also would also like to say that the One Health approach did not clearly stand out to me. The authors do clearly articulate how their findings are related to a one-health approach. The authors seem to have a list of pathogens that are often studied in the context of one-health and looked for studies that related these to climate change. It is not clear how their findings can the looked at from a one-health perspective, given that all that was conducted as a thematic review. I would urge the authors to re-think their approach.

Response:
We greatly appreciate this feedback. We revised the manuscript to strengthen the articulation of how the One Health framework underpins our findings, mainly focusing on the knowledge gaps in studies that clearly relate both themes, as most studies only mention the word One Health and do not carry out in-depth studies of the topic as indicated in the first paragraph of the conclusion.

Comments:

Finally, the inclusion of a mental health outcomes is confusing. I would urge the authors to stick to only considering infectious diseases in the context of their study.

Response:
We understand the reviewer’s concern. Our rationale for including mental health stems from the fact that One Health approaches increasingly recognizing the interdependence between human well-being, environmental disruption, and animal health. In this sense, mental health was included as a search term within the second group, as indicated in Section 2.1 and Supplementary A.1 Protocol. Climate change affects mental health directly (e.g., eco-anxiety, PTSD after extreme events) and indirectly (e.g., loss of livelihoods for communities dependent on ecosystems), which are consistent with a One Health and Planetary Health perspective. An example of this approach was the article found in the search "Epidemiology of floods in sub-Saharan Africa: a systematic review of health outcomes".

I also have several minor comments that need to be addressed:

Comment 1: This is minor, but the graphical abstract is not self-explanatory. Some more clarity would be great if possible.

Response 1:
We appreciate the reviewer’s observation. The graphical abstract has been revised to include clearer labels, a more detailed legend, and improved visualization of the links between climate change, human, animal, and environmental health. These adjustments were made to make the figure more self-explanatory and aligned with this article.

Comment 2: The sentence starting on Line 173 to Line 175 is not clear and seems to either be a run on sentence or is missing something. Please correct it.

Response 2:
Thank you for pointing this out. We carefully revised the sentence (Lines 173–175) to correct the structure and improve clarity. The revised version now reads in line 188: “In the zoonotic diseases group, countries such as Sub-Saharan, Iran, China, Spain, Uganda, India, and the continents of Europe and Africa are mentioned most frequently.”

Comment 3: Section 3.3 on Vector-borne disease and climate change needs to be re-written. More than half the paragraph deals with issues that have no pairing on vector-borne disease and as a result is rather hard to parse.

Response 3:
The paragraph was revised and rewritten according to the comment.

Comment 4: The sentence beginning on Line 265 seems out of place. It is not clear what is being “included”.

Response 4:
We thank the reviewer for highlighting this issue. The sentence at Line 265 has been revised for clarity and now explicitly states what is being included in the discussion. The corrected sentence reads now in line 269:

The climate migration of vulnerable populations is related to mental health. For example, such as women [77], indigenous people, young people, farmers, and children, has also been recorded due to the level of concern that these groups have about the effects of the climate [78].

Comment 5: The discussion is heavily weighted towards arboviruses. This is a dis-service given the amount of literature that was reviewed for this study. I would urge the authors to consider better balancing their discussion section.

Response 5:
We appreciate this constructive feedback. The discussion section has been revised to achieve a better balance. While arboviruses remain an important focus due to the abundance of studies, we expanded the discussion of other relevant topics identified in the review, including zoonotic diseases, vector-borne diseases beyond arboviruses, and mental health. This ensures a more comprehensive representation of the literature reviewed and also highlights that the number of articles found was grouped into four categories, highlighting the gaps in information regarding other relevant topics and also related to climate change.

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

A very good and precise introduction however, it is unclear what is meant by the research question "What is the state of the art in studies on climate change and One Health?" You may not have to change it but you can just consider a synonym for the term state of the art. 

 

In line 177-178, fix the sentence. Sub Saharan is a region within Africa and not a country as you state in the rest of the sentence.

In lines 179-187, the mentioned continents and regions are countries; however, they do not read off correctly.

in line 259-260, such as, for example, use either one not both.

In line 262-263, "Likewise, extreme events [68,69], sleep disorders, and anxiety caused by air pollution [70]." a bit of a confusing sentence, how does this relate to the previous sentence 

line 288, fix sentence "Arboviruses are infections caused by arboviruses"

327-330, sentence too long

In general, the work is interesting, but to a certain extent, it can be difficult to follow because of all the subheadings that encapsulate the one health approach. But I think this will only be an issue for those that are not too familiar with the concept. but the manuscript suffers from more grammatical issues. I would highly advise that the manuscript go through a language editor to improve this issue. 

Author Response

Comment:

A very good and precise introduction however, it is unclear what is meant by the research question "What is the state of the art in studies on climate change and One Health?" You may not have to change it but you can just consider a synonym for the term state of the art.

Response:

We thank the reviewer for this valuable suggestion. We revised the research question to improve clarity. Instead of “What is the state of the art…”, we now use the expression “What is the current knowledge and main research trends in studies on climate change and One Health?” in line 23 and in line 78 to better reflect our intent.

Comment:

In line 177-178, fix the sentence. Sub Saharan is a region within Africa and not a country as you state in the rest of the sentence.

In lines 179-187, the mentioned continents and regions are countries; however, they do not read off correctly.

Response:

We appreciate the correction. The sentence has been revised to correctly refer to “Sub-Saharan Africa” as a region rather than as a country.

Now line 181: In this group of words, regions such as Sub-Saharan, countries such as Iran, China, Spain, Uganda, India, and the continents of Europe and Africa are mentioned most frequently.

Comment:

in line 259-260, such as, for example, use either one not both.

Response:

We have corrected the redundancy. The phrase now uses only one example to ensure conciseness. Now in line 261

Comment:

In line 262-263, "Likewise, extreme events [68,69], sleep disorders, and anxiety caused by air pollution [70]." a bit of a confusing sentence, how does this relate to the previous sentence

Response:

This sentence has been rewritten to provide a clearer link with the preceding idea, explicitly connecting extreme events and air pollution to mental health outcomes.

Now in line 262: "Likewise, extreme events [67,68] that caused sleep disorders, and anxiety caused by air pollution [69]."

Comment:

line 288, fix sentence "Arboviruses are infections caused by arboviruses"

Response:

We corrected this sentence for precision and clarity. It now reads in line 288: “Arboviruses are infections caused by viruses that are transmitted to humans and ..."

Comment:

327-330, sentence too long

Response:

We have revised the sentence to break it into two shorter sentences, improving readability and flow. Now in line 327: "It is essential to invest in research focused on One Health to strengthen the health system [85,102] to implement surveillance systems, based on citizen science and other innovative approaches. This can be directed to prevent potential outbreaks of arbo-viruses, zoonotic diseases, or even effects on mental health. These actions are valuable and relevant tools to promote climate adaptation [103]"

Comment:

In general, the work is interesting, but to a certain extent, it can be difficult to follow because of all the subheadings that encapsulate the one health approach. But I think this will only be an issue for those that are not too familiar with the concept. but the manuscript suffers from more grammatical issues. I would highly advise that the manuscript go through a language editor to improve this issue.

Response:

We thank the reviewer for the positive feedback and the constructive recommendation. We maintained the subheadings to reflect the structured thematic review under the One Health framework, but we improved transitions between sections to enhance readability. Additionally, the manuscript has been carefully revised and professionally proofread to address grammatical and language issues.

Author Response File: Author Response.docx

Reviewer 3 Report

Comments and Suggestions for Authors

This study presents a systematic review of the effects of climate change on health from a One Health perspective. While the review appears to be comprehensive within its defined bounds and well documented, I believe there are several opportunities for improvement prior to publication.

First and most importantly, the manuscript would be much improved with further explanation as to its own utility. What are the benefits of the One Health perspective, and why is it important to understand how the literature frames climate and health? This strikes me as the greatest limitation, as it is largely the purpose of the paper. I certainly don’t disagree that it is a helpful framework, but it must be very clear in the text why this is the focus of the paper, and how using the One Health framework could improve the state of the literature or even health outcomes in the context of climate change.

Second, it is great to see that there are clearly stated research questions, and it is helpful to clearly state that you limit your search from a global to national scale. However, this scale will miss many studies on climate and health, as most are narrower in scale, limited to a smaller jurisdiction such as a county, state (or geographical equivalent) or city, or even a specific population of interest. While it is very helpful to explicitly state your scale of interest, I would recommend briefly explaining why you are focused on these scales, the benefits of doing so, and possible limitations regarding excluded studies on a finer scale. If this is a misinterpretation of the studies included, then it may be helpful to revise your methods to improve clarity for the reader.

Third, the paper could use some reorganization for more readability. Namely, I point out the potentially overlapping sections regarding vector-borne disease and arboviruses, but this could potentially be streamlined throughout to better delineate complicated concepts. Indeed, many of these concepts are interrelated and overlapping, but it will be important for the authors to clearly present these ideas, if only by using headers and sub headers to better organize the information.

Fourth, I do not see any discussion of possible limitations. Please document anything that may be a limitation in your study, such as the example I give above about study scale, anything that may be missing from your search, or anything that could be improved in future research.

Finally, many of the figures are not fully legible even in the supplementary materials. Please see the detailed comments below for more information.

Given these limitations, I recommend minor, but thorough revision. The study will not need to be re-conducted, but it must be clearly presented and explained. Please see the detailed comments below for additional notes.

Detailed comments:

Graphical abstract – This may need more explanation with simple labels for a complete understanding of the symbology. The green web figure on the left is also very difficult to read and may not even be interpreted as a literature search without some revision or labeling.

L64: you may want to name the author of this study (e.g. The US Global Change Research Project’s report…”

Figure 1: I would recommend further differentiating the grayscale symbology of your pie chart. Perhaps make the darkest fully black, the lightest fully white with a black outline, and the middle two light and dark gray to ensure they are quickly and distinctly readable. I would also recommend not using icon symbology for the diseases, as there is little convention to guide the symbology. I would recommend simply writing them out as there is space to do so, or using abbreviations explained in the key below (i.e. D for Dengue, M for Malaria, MH for Mental Health, etc.). It would also be helpful to expand the caption to explain the diseases – for example: “Disease labels indicate the first year a study on climate change and the listed disease was published” or similar.

Figure 2: Similarly, please include further explanations for your scales in the caption. Is this total number of studies per country? Please also be very explicit with the labels when the scale is different, such as “Total kt of C02eq emissions (1970-2018)”

L141: Here you can also be more explicit – “The total number of studies identified on arboviruses…”

L164: How do you define “attention-grabbing?” I would recommend a more precise term as I don’t see much of a theme among those listed.

Figure 3: None of these clouds are easily readable. I would recommend either increasing the font size or making these images available as supplementary figures and explicitly referencing the supplementary material in the text for quick reference.

L216-219: I don’t see how this sentence connects to vector-borne disease. Similarly, around 222-223. I would recommend revising this paragraph to ensure it is only related to vector-borne disease.

3.4: I have often seen arboviruses as a type of vector-borne disease. Given the recommended re-scoping of section 3.3, I might recommend combining these sections to focus on arboviruses and other vector-borne disease. Alternatively, you could consider making section 3.4 a subsection of 3.3.

Figure 4: This figure is also very difficult to read. I would recommend adding a larger image to supplementary and referencing the supplementary materials in the caption similar to Table 1.

Table 1: Do heat waves lead to more arboviruses like dengue and Lyme or is it more long-term warming expanding mosquito/tick populations? I usually think of heat waves as short-term events. I see “hotter temperature” is used lower down the table, perhaps this is a better term to use here. I might also recommend revising “Extreme climate” and “Climate change” wherever they appear in the table to be more specific, if possible, as these capture quite a few individual effects. Including cell outlines for the table may also help with readability, as I’m not entirely sure which rows the far-left column labels refer to (e.g. One Health vs. Mental health). Finally, I would recommend including the citations in this table here as you do in the supplementary table A.4, as I could see it being a useful resource for those who want to quickly identify and then read the source publications.

L273: How do you measure “improved” in this sense? Could be helpful to use more precise language here.

L287: redundant language here, recommend revision (e.g. “Arboviruses are infections transmitted to humans…” This also seems late to define, this definition should be in the introduction.

L319: Is this statement still true? The referenced study is from 2010. I would imagine there is much more evidence on the relationship between zoonotic diseases and climate change now.

L316: Do you mean “systematically reviewed” rather than “systematized” here?

L326: This warrants more explanation. Why is it essential to use the One Health framework? What are the specific benefits?

L334: Are these pillars recommended in the context of One Health or in general? How do the concepts interrelate? The following paragraph is helpful but making that connection as explicit in the text as possible will be very helpful for the reader.

Supplementary A.2 – These figures are still not of sufficient resolution to be read clearly without zooming in substantially (about 400% in my case). Please include higher resolution images as supplementary.

Author Response

Comment:

This study presents a systematic review of the effects of climate change on health from a One Health perspective. While the review appears to be comprehensive within its defined bounds and well documented, I believe there are several opportunities for improvement prior to publication.

First and most importantly, the manuscript would be much improved with further explanation as to its own utility. What are the benefits of the One Health perspective, and why is it important to understand how the literature frames climate and health? This strikes me as the greatest limitation, as it is largely the purpose of the paper. I certainly don’t disagree that it is a helpful framework, but it must be very clear in the text why this is the focus of the paper, and how using the One Health framework could improve the state of the literature or even health outcomes in the context of climate change.

Response:

We thank the reviewer for this insightful suggestion. We revised the Introduction to explicitly highlight the benefits of applying the One Health framework. Now in line 77 to 88.

Comment:

Second, it is great to see that there are clearly stated research questions, and it is helpful to clearly state that you limit your search from a global to national scale. However, this scale will miss many studies on climate and health, as most are narrower in scale, limited to a smaller jurisdiction such as a county, state (or geographical equivalent) or city, or even a specific population of interest. While it is very helpful to explicitly state your scale of interest, I would recommend briefly explaining why you are focused on these scales, the benefits of doing so, and possible limitations regarding excluded studies on a finer scale. If this is a misinterpretation of the studies included, then it may be helpful to revise your methods to improve clarity for the reader.

Response:

We appreciate this observation. We revised the Methods section to better explain our focus on global and national scales, which was chosen to capture broad trends and cross-country comparisons. We acknowledge in the Limitations section that this decision may have excluded studies at subnational levels, which are also highly relevant. We suggest that future research could focus on finer spatial scales to complement our findings. By adopting a global perspective, our goal was to provide a broad and systematic overview of the state of knowledge on climate change and health from a One Health perspective, identifying key trends and gaps across regions. This scale allows us to highlight general patterns in the literature and to map areas where knowledge is abundant versus lacking. We acknowledge that local and subnational studies are highly relevant for implementation and policy, but we considered them beyond the scope of this general systematic review. We have now made this rationale explicit in the Methods and Limitations sections, noting that future research could specifically address subnational scales to complement our findings. Line 110: “We limited the scope of our search to global and national scales to provide a broad and systematic overview of the literature; including subnational studies would have generated an unmanageable volume of articles and limited the feasibility of the analysis.”

Comment:

Third, the paper could use some reorganization for more readability. Namely, I point out the potentially overlapping sections regarding vector-borne disease and arboviruses, but this could potentially be streamlined throughout to better delineate complicated concepts. Indeed, many of these concepts are interrelated and overlapping, but it will be important for the authors to clearly present these ideas, if only by using headers and sub headers to better organize the information.

Response:

We thank the reviewer for this valuable feedback. We reorganized Sections 3.3 and 3.4, integrating arboviruses more clearly within the broader category of vector-borne diseases. Now in line 227 "3.3. Vector-borne disease, arboviruses, and climate change".

Comment:

Fourth, I do not see any discussion of possible limitations. Please document anything that may be a limitation in your study, such as the example I give above about study scale, anything that may be missing from your search, or anything that could be improved in future research.

Response:

We agree and have now included a dedicated Limitations section, in line 383. This section highlights constraints such as the exclusion of subnational studies, potential publication bias, limitations in database coverage, and challenges in interpreting heterogeneous methodologies. We also identify opportunities for future research to address these gaps.

Comment:

Finally, many of the figures are not fully legible even in the supplementary materials. Please see the detailed comments below for more information.

Given these limitations, I recommend minor, but thorough revision. The study will not need to be re-conducted, but it must be clearly presented and explained. Please see the detailed comments below for additional notes.

Response:

We thank the reviewer for this important point. All figures and supplementary materials have been revised for improved resolution and legibility. We also reformatted captions to provide clearer explanations of the symbols, scales, and content.

Detailed comments:

Graphical abstract – This may need more explanation with simple labels for a complete understanding of the symbology. The green web figure on the left is also very difficult to read and may not even be interpreted as a literature search without some revision or labeling.

Response:

We revised the graphical abstract to include simpler labels and a clearer explanation of the symbology.

Comment:

L64: you may want to name the author of this study (e.g. The US Global Change Research Project’s report…”

Response:

We added the authoring body for clarity: “The Impacts of Climate Change on Human Health” by USGCRP. The author indicates in reference 10.

Comment:

Figure 1: I would recommend further differentiating the grayscale symbology of your pie chart. Perhaps make the darkest fully black, the lightest fully white with a black outline, and the middle two light and dark gray to ensure they are quickly and distinctly readable. I would also recommend not using icon symbology for the diseases, as there is little convention to guide the symbology. I would recommend simply writing them out as there is space to do so, or using abbreviations explained in the key below (i.e. D for Dengue, M for Malaria, MH for Mental Health, etc.). It would also be helpful to expand the caption to explain the diseases – for example: “Disease labels indicate the first year a study on climate change and the listed disease was published” or similar.

Response:

We improved readability by differentiating grayscale tones more distinctly (white, light gray, dark gray, black). We replaced icons with abbreviations and expanded the caption to explain that the disease labels represent the first year a study was published. See figure 1.

Comment:

Figure 2: Similarly, please include further explanations for your scales in the caption. Is this total number of studies per country? Please also be very explicit with the labels when the scale is different, such as “Total kt of C02eq emissions (1970-2018)”

Response:

The caption now specifies that values represent “the total number of studies per country”. For CO₂ emissions, we explicitly note “Total kt of CO₂eq emissions (1970–2018).” The map had an error in the numbering, it was corrected.

Comment:

L141: Here you can also be more explicit – “The total number of studies identified on arboviruses…”

Response:

Revised to: "Studies on arboviruses are in orange (298 studies)" in line 158.

Comment:

L164: How do you define “attention-grabbing?” I would recommend a more precise term as I don’t see much of a theme among those listed.

Response:

We replaced “attention-grabbing” with “At the same time, topics ” for precision, see in line 182.

Comment:

Figure 3: None of these clouds are easily readable. I would recommend either increasing the font size or making these images available as supplementary figures and explicitly referencing the supplementary material in the text for quick reference.

Response:

The figure was split in two to provide greater visibility of the words within the word cloud. Now Figure 3 and Figure 4.

Comment:

L216-219: I don’t see how this sentence connects to vector-borne disease. Similarly, around 222-223. I would recommend revising this paragraph to ensure it is only related to vector-borne disease.

Response:

These paragraphs were revised to ensure the content strictly relates to vector-borne diseases.

Comment:

3.4: I have often seen arboviruses as a type of vector-borne disease. Given the recommended re-scoping of section 3.3, I might recommend combining these sections to focus on arboviruses and other vector-borne disease. Alternatively, you could consider making section 3.4 a subsection of 3.3.

Response:

As recommended, we streamlined the overlap. Arboviruses are now treated as a subset of vector-borne diseases (3.3), improving structure and clarity.

Comment:

Figure 4: This figure is also very difficult to read. I would recommend adding a larger image to supplementary and referencing the supplementary materials in the caption similar to Table 1.

Response:

We reviewed the figure and decided to leave only the climate impacts and events, as the countries are already indicated on the map, in order to improve the quality of the figure.

Comment:

Table 1: Do heat waves lead to more arboviruses like dengue and Lyme or is it more long-term warming expanding mosquito/tick populations? I usually think of heat waves as short-term events. I see “hotter temperature” is used lower down the table, perhaps this is a better term to use here. I might also recommend revising “Extreme climate” and “Climate change” wherever they appear in the table to be more specific, if possible, as these capture quite a few individual effects. Including cell outlines for the table may also help with readability, as I’m not entirely sure which rows the far-left column labels refer to (e.g. One Health vs. Mental health). Finally, I would recommend including the citations in this table here as you do in the supplementary table A.4, as I could see it being a useful resource for those who want to quickly identify and then read the source publications.

Response:

We decided to insert terms, such as heat waves, according to the articles found. For example, this article, which relates heat waves to dengue population dynamics, "Potential effects of heat waves on the population dynamics of the dengue mosquito Aedes albopictus."

We also decided not to place the references within the table within the article, as it would be too large. Regarding the table format, we followed the journal's formatting guidelines. If it's okay to change the table format according to the guidelines, we can modify it.

Comment:

L273: How do you measure “improved” in this sense? Could be helpful to use more precise language here.

Response:

Response:

We revised this terms. Now in line 293 "Research on the concept of One Health is growing with a holistic approach [11], and this has been evident in the results of this systematic review research, as it fills gaps in information through the systematisation of terms related to this topic."

Comment:

L287: redundant language here, recommend revision (e.g. “Arboviruses are infections transmitted to humans…” This also seems late to define, this definition should be in the introduction.

Response:

Corrected redundant phrasing to: “Arboviruses are infections that are transmitted to humans and other animals ...” This definition was also moved to the Introduction for earlier clarity.

Comment:

L319: Is this statement still true? The referenced study is from 2010. I would imagine there is much more evidence on the relationship between zoonotic diseases and climate change now.

Response:

We updated this statement with more recent references (post-2010) that provide stronger evidence of links between zoonotic diseases and climate change. Now in line 328 "Although there is little reliable data on zoonotic diseases and their relationship with climate change [93,94]".

Comment:

L316: Do you mean “systematically reviewed” rather than “systematized” here?

Response:

We mean the systematization of information, that is, we systematized publications.

Comment:

L326: This warrants more explanation. Why is it essential to use the One Health framework? What are the specific benefits?

Response:

The explanation was explained in the introduction. See line 77.

Comment:

L334: Are these pillars recommended in the context of One Health or in general? How do the concepts interrelate? The following paragraph is helpful but making that connection as explicit in the text as possible will be very helpful for the reader.

Response:

According to the section indicated, there are 6 pillars to combat arboviruses as indicated in the reference.

Comment:

Supplementary A.2 – These figures are still not of sufficient resolution to be read clearly without zooming in substantially (about 400% in my case). Please include higher resolution images as supplementary.

Response:

All supplementary figures have been regenerated at higher resolution (suitable for publication). Captions were revised to indicate their improved availability for close inspection.

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I want to thank the authors for the quick revision and addressing all my earlier concerns. The article reads well and is a valuable contribution to the field.