On July 7, the Pan American Health Organization (PAHO) published a "public health situation analysis on the potential health impacts of the El Niño climate phenomenon (2026–2027)." It is a document that serves as a "map of preparedness" for health authorities across Latin America and the Caribbean. Six diseases are named as carrying the highest risk — cholera, leptospirosis, malaria, dengue, Zika and chikungunya — and, on top of them, heat stress, respiratory illness from wildfire smoke, and challenges to mental health are spelled out. For me, having worked in the world of health care, it was the treatment of "mental health" that caught my eye most this time.
What happened
El Niño's effects are not uniform from region to region. It is expected to bring torrential rain and flooding to the Pacific coasts of Colombia and Ecuador and to the Bolivian highlands, while in the Amazon basin and along the Caribbean coast, on the contrary, drought is expected to worsen. This asymmetry complicates how infectious-disease risk is distributed.
When floods occur, drinking water is contaminated and cholera and leptospirosis spread more easily. The pools of water left behind once the water recedes become breeding grounds for mosquitoes, pushing up the risk of transmitting malaria and dengue. When drought concentrates people around limited water sources, the risk of zoonotic diseases also rises. And if the medical infrastructure itself is damaged by floods or landslides, more people will be unable to reach care when they need it. PAHO's document organizes this chain of events by disease and by region.
Context — the significance of explicitly addressing mental health
What makes this analysis different from earlier climate-risk documents is that it positions the impact on mental health not as an "add-on concern" but as a major risk. Failed harvests, flooded homes, evacuation from familiar land — such experiences give rise to lasting anxiety, a sense of loss, and post-traumatic stress (PTSD). Especially among rural and coastal-lowland residents and Indigenous communities, livelihoods and the foundations of daily life are tied directly to the climate, and the depth of the blow is on a different scale from that felt by urban residents.
When we speak of the health impacts of disasters, infectious diseases and injuries are counted first, but what erodes people's lives over months and years is often the psychological side. Whether local health systems can bring even that into their field of view will determine the real substance of these recommendations.
The question — the gap between recommendations and the capacity to carry them out
The actions PAHO asks of each country's health authorities are realistic: strengthening early surveillance of climate-sensitive diseases, integrating climate information with health information, expanding telemedicine, securing safe drinking water, and community-level risk communication. None of them are flashy, but they are all known to be the most cost-effective interventions for preventing outbreaks.
The problem is the funding and the people needed to carry them out. Shrinking health budgets for Latin America due to cuts in U.S. foreign aid, cuts to PAHO's own budget, fiscal constraints in each country — the headwinds are piling up. Even if recommendations are issued, if the capacity to implement them does not keep pace, preparedness ends as a plan on paper.
My perspective
As a physical therapist, and as a researcher of social security systems who has watched how disasters and disability intersect, there is one perspective I want to add: the ones for whom evacuation life is the harshest are people with disabilities and those living with chronic illness. Medicines that need refrigeration; medical equipment that depends on electricity, such as ventilators and dialysis; regular rehabilitation and outpatient visits. These cannot easily be maintained in shelters or temporary housing. PAHO's document does not spell this out directly, but recommendations such as "monitoring the nutritional status of vulnerable groups" can be read as having such people in mind.
When I was living in Costa Rica, I saw up close how a local clinic became cut off by rainy-season flooding. However fine the system may be, medical care stops reaching people the moment a single road is severed. "Preparing" for El Niño means, I believe, not only weather forecasting and disease surveillance, but deciding in peacetime how to deliver care, to the very end, to the people who can least move.
Glossary
El Niño = Spanish for "the boy (the Christ Child)." It got its name because the warming of the sea off Peru appears around Christmastime. enfermedades sensibles al clima = climate-sensitive diseases, a group of diseases whose outbreaks are governed by climatic conditions. salud mental = mental health, one of the keywords of this PAHO document.
The health risks of El Niño are not a threat that "might come." From this very moment, now that the dry season has begun, they have already started.
References
- PAHO publishes analysis on the potential health impacts of the El Niño phenomenon in the Americas (PAHO, 2026-07-07) — paho.org
- PAHO Warns El Niño Could Trigger Major Health Challenges Across the Americas (fundsforNGOs, 2026-07-08) — news.fundsforngos.org
- La OPS advierte que el fenómeno de El Niño "tendrá importantes repercusiones sanitarias" (Infobae, 2026-07-08) — infobae.com
- 2026 El Niño Health Risks: Six Extreme Weather Threats Facing the Americas (Direct Relief, 2026-06) — directrelief.org
- OPS advierte impacto del Fenómeno del Niño en brotes, hospitales y salud mental (Consultor Salud) — consultorsalud.com
※ This article is the author’s commentary based on public information. Please confirm the latest figures, dates and procedures with governments and primary sources. Quotations are kept minimal and sources are cited.