Human footprint is associated with shifts in the assemblages of major vector-borne diseases

Predicting how increasing intensity of human–environment interactions affects pathogen transmission is essential to anticipate changing disease risks and identify appropriate mitigation strategies. Vector-borne diseases (VBDs) are highly responsive to environmental changes, but such responses are notoriously difficult to isolate because pathogen transmission depends on a suite of ecological and social responses in vectors and hosts that may differ across species. Here we use the emerging tools of cumulative pressure mapping and machine learning to better understand how the occurrence of six medically important VBDs, differing in ecology from sylvatic to urban, respond to multidimensional effects of human pressure. We find that not only is human footprint—an index of human pressure, incorporating built environments, energy and transportation infrastructure, agricultural lands and human population density—an important predictor of VBD occurrence, but there are clear thresholds governing the occurrence of different VBDs. Across a spectrum of human pressure, diseases associated with lower human pressure, including malaria, cutaneous leishmaniasis and visceral leishmaniasis, give way to diseases associated with high human pressure, such as dengue, chikungunya and Zika. These heterogeneous responses of VBDs to human pressure highlight thresholds of land-use transitions that may lead to abrupt shifts in infectious disease burdens and public health needs.