<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1996-3521</journal-id>
<journal-title><![CDATA[Infodir]]></journal-title>
<abbrev-journal-title><![CDATA[Infodir]]></abbrev-journal-title>
<issn>1996-3521</issn>
<publisher>
<publisher-name><![CDATA[Editorial de Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1996-35212021000100017</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La dirección en salud frente a la variabilidad y el cambio climático en Cuba]]></article-title>
<article-title xml:lang="en"><![CDATA[The health management facing variability and climate change in Cuba]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mesa Ridel]]></surname>
<given-names><![CDATA[Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correa Betancourt]]></surname>
<given-names><![CDATA[Idania]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz Bultó]]></surname>
<given-names><![CDATA[Paulo Lázaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Escuela Nacional de Salud Pública (ENSAP)  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Meteorología  ]]></institution>
<addr-line><![CDATA[ La Habana]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<numero>34</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1996-35212021000100017&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1996-35212021000100017&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1996-35212021000100017&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  A nivel global, los peligros climáticos tienen efectos sobre la salud individual, la salud poblacional y el sistema de salud, modulado por determinantes biológicos, psicológicos, socioeconómicos, ecológicos y ambientales que añaden una carga adicional a los esfuerzos de cumplir el encargo social del sector salud. Las investigaciones en Cuba han permitido evidenciar algunos de estos cambios, mientras resaltan la vulnerabilidad a la variabilidad climática. Frente a ese reto, la dirección en salud deberá mantener eficacia en la gestión de instituciones y servicios.  Objetivo:  Reflexionar sobre los peligros asociados a la variabilidad y cambio climático para la salud humana.  Desarrollo:  Se realizó una revisión de artículos de revistas, libros y documentos de la producción científica internacional sobre variabilidad y cambio climático, peligros asociados y efectos en la salud, y de resultados de la experiencia de autores y científicos cubanos reflejados en informes, comunicaciones nacionales, documentos de la implementación de la Tarea Vida y de organismos rectores.  Conclusiones:  La dirección deberá asumir un enfoque práctico, integrador y estratégico, vincular la reducción de riesgo de desastres con acciones de adaptación, e implementar planes de preparación de los directivos, en completo vínculo entre docencia, investigación, asistencia médica y extensión universitaria, existiendo condiciones favorables en el Sistema Nacional de Salud de Cuba para enfrentar con éxito la variabilidad y el cambio climático.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  At a global level, climate hazards have effects on individual health, population health and the health system, modulated by biological, psychological, socioeconomic, ecological and environmental determinants that add an additional burden to efforts to fulfill the social mandate of the health sector. Research in Cuba has revealed some of these changes, while highlighting the vulnerability to climate variability. Faced with this challenge, the health department must maintain efficiency in the management of institutions and services.  Objective:  To reflect on the dangers associated with climate variability and change for human health.  Development:  A review of journal articles, books and documents of international scientific production on variability and climate change, associated dangers and health effects, and results of the experience of Cuban authors and scientists reflected in reports, national communications was carried out. , documents of the implementation of the Life Task and governing bodies.  Conclusions:  The management must take a practical, integrative and strategic approach, link disaster risk reduction with adaptation actions, and implement management preparation plans, in full link between teaching, research, medical assistance and university extension, existing Favorable conditions in the Cuban National Health System to successfully confront variability and climate change.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[administración de los servicios de salud]]></kwd>
<kwd lng="es"><![CDATA[salud pública]]></kwd>
<kwd lng="es"><![CDATA[cambio climático]]></kwd>
<kwd lng="es"><![CDATA[prevención y mitigación]]></kwd>
<kwd lng="es"><![CDATA[adaptación]]></kwd>
<kwd lng="en"><![CDATA[administration of health services]]></kwd>
<kwd lng="en"><![CDATA[public health]]></kwd>
<kwd lng="en"><![CDATA[climate change]]></kwd>
<kwd lng="en"><![CDATA[prevention and mitigation]]></kwd>
<kwd lng="en"><![CDATA[adaptation]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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