# Sentinel Physicians for the Environment: A Chilean Perspective to Address Global Health and Climate Resilience

## TL;DR

Sentinel Physicians for the Environment (SPEs) offer a scalable model to detect and respond to climate-related health threats in primary care, enhancing global health resilience.

## Contribution

The SPE model bridges environmental surveillance and clinical practice, offering a globally applicable framework for climate-resilient primary health care.

## Key findings

- SPEs can detect climate-related health risks like heatwaves and air pollution in primary care settings.
- The model is transferable to diverse health systems without requiring high financial investment.
- Chile's implementation provides a replicable pathway for integrating environmental health into policy and practice.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Sentinel Physicians for the Environment (SPEs) provide an innovative and scalable approach for identifying and responding to environmental health threats—such as air pollution, heatwaves, wildfires, vector-borne diseases and antimicrobial resistance—directly within primary care, where most health needs are first detected worldwide.The model addresses a global gap in early detection of environmentally driven health risks by linking clinical observation with community-based monitoring across diverse health system settings.

Sentinel Physicians for the Environment (SPEs) provide an innovative and scalable approach for identifying and responding to environmental health threats—such as air pollution, heatwaves, wildfires, vector-borne diseases and antimicrobial resistance—directly within primary care, where most health needs are first detected worldwide.

The model addresses a global gap in early detection of environmentally driven health risks by linking clinical observation with community-based monitoring across diverse health system settings.

Public health significance—Why is this work of significance to public health?
Drawing on the emerging SPEs initiative in Chile and its relevance across Latin America, this work demonstrates that primary healthcare providers can act as frontline sentinels for climate-related and pollution-driven health impacts—an approach that is transferable to many other regions worldwide.The article advances a globally applicable framework for embedding environmental health capacity into Primary Health Care (PHC) systems, bridging the longstanding divide between environmental surveillance structures and everyday clinical practice.

Drawing on the emerging SPEs initiative in Chile and its relevance across Latin America, this work demonstrates that primary healthcare providers can act as frontline sentinels for climate-related and pollution-driven health impacts—an approach that is transferable to many other regions worldwide.

The article advances a globally applicable framework for embedding environmental health capacity into Primary Health Care (PHC) systems, bridging the longstanding divide between environmental surveillance structures and everyday clinical practice.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers?
Integrating SPEs into primary care can enhance preparedness, early warning and community resilience to environmental hazards in heterogeneous health systems across the world.The regional momentum generated around the 2025 Santiago Declaration offers a replicable model of governance and collaboration that countries outside Latin America may adopt to systematically incorporate environmental health into policy and practice.

Integrating SPEs into primary care can enhance preparedness, early warning and community resilience to environmental hazards in heterogeneous health systems across the world.

The regional momentum generated around the 2025 Santiago Declaration offers a replicable model of governance and collaboration that countries outside Latin America may adopt to systematically incorporate environmental health into policy and practice.

Climate change and environmental degradation are intensifying health risks across Latin America, placing increasing pressure on primary health care (PHC) systems. Physicians working at community level are often the first to observe climate- and environment-related health effects, yet operational models that link clinical practice, environmental surveillance and community engagement remain insufficiently defined. This article adopts a policy-oriented narrative synthesis approach, drawing on peer-reviewed literature, policy documents, institutional records, memoranda of understanding, and outputs from professional seminars and stakeholder meetings conducted between 2024 and 2025 to develop an evaluable operational framework. Chile is examined as a case study, while the proposed framework is situated within a broader Latin American perspective. We conceptualise the model of Sentinel Physicians for the Environment (SPEs) as an operational framework embedded within PHC, structured around four core pillars: surveillance, prevention, communication and advocacy. The model clarifies how SPEs can contribute in practical terms to addressing major climate-related health threats, including heatwaves, air pollution, wildfires, vector-borne diseases, migration-related vulnerability, antimicrobial resistance and zoonotic risks. The Chilean experience illustrates feasible implementation pathways, distinguishing actions already undertaken, initiatives under development and proposed future steps. The SPE model offers a pragmatic and scalable approach to strengthening climate-resilient primary health care in Latin America. By leveraging existing PHC structures and community trust, SPEs can enhance early detection, risk communication and preparedness without requiring complex technologies or high financial investment, providing a transferable contribution to public health practice and policy, with clear implications for future evaluation.