research topics in global health

11 global health issues to watch in 2023, according to IHME experts

Published December 20, 2022

As the year 2022 winds down, what is next on the horizon for global health? We turned to our IHME experts for their takes on the most critical health issues to watch in 2023. Entering our fourth year grappling with COVID-19, most of our experts pointed to issues that were impacted in some way by the pandemic, like long COVID and mental health. They also offered potential interventions to address the threats. 

The faculty members and research scientists who shared their insights are professor Mohsen Naghavi , assistant professor Hwme Kyu , assistant professor Angela Micah , affiliate professor Michael Brauer , affiliate assistant professor Alize Ferrari , lead research scientist Liane Ong , lead research scientist Sarah Wulf Hanson, postdoctoral scholar Christian Razo, postdoctoral scholar Ewerton Cousin, and researcher Emma Nichols. Their comments have been lightly edited for clarity.

1. Long COVID

“Long COVID is absolutely a health issue to watch in 2023. The health impact of long COVID often disrupts a person’s ability to engage with school, work, or relationships for months at a time.   “People with long COVID need diagnostic and proper rehabilitation support from primary care physicians. We desperately need more research to find effective treatments as well as preventive measures to reduce the risk of developing long COVID.” — Sarah Wulf Hanson, lead research scientist of the non-fatal and risk quality enhancement team and lead author of the JAMA paper on long COVID     

2. Mental health

“Mental disorders are a leading cause of disability worldwide, with no evidence of a decrease in this burden since 1990. The impact of the COVID-19 pandemic, war, and violence on mental health remains a priority, specifically understanding how these have impacted the prevalence and burden of mental disorders in 2022 onward and how countries should be adapting their mental health response accordingly. 

“Currently in the GBD study, we investigate childhood sexual abuse, intimate partner violence, and bullying victimization as risk factors for mental disorders. Going forward, we need a better understanding of the other risk factors for mental disorders, how these vary across different populations, and how to offer the best opportunities for prevention at the population level.” — Alize Ferrari, affiliate assistant professor and team lead for estimating the burden of mental disorders     

3. Impact of climate change

“Climate change is already affecting the health of millions of people all over the world, and more importantly, climate change will worsen throughout this century. People are experiencing both the direct effects of extreme heat that we measure in the GBD and a myriad of indirect effects. Flooding can force people from their homes and affect their mental health, droughts and storms can impact food security and water availability, and wildfire smoke episodes can increase air pollution. As we know from the pandemic, preparedness is key, and we are far from prepared for the health impacts of a warmer climate.

“Most of the emphasis to date on climate change – and rightly so – has been on what we call mitigation: reducing the emissions that lead to global warming. Yet to date these efforts have been far too modest. We are now at a point where climate change is clearly with us, and much more attention needs to be put on minimizing the impacts on global health through adaptation or enhancing resilience. 

“One aspect of this is improving overall health and enhancing socioeconomic development because we know that those who are more vulnerable will suffer the most. In addition, there are technological solutions that can support adaptation , such as the use of drought-resistant crops, increasing vegetation in cities to reduce the urban heat island effect, or repurposing land use to adapt to rising sea levels. 

“Air pollution is one of the leading global risk factors that we evaluate in the GBD – currently responsible for about 8% of all global mortality – yet it is a problem with known solutions. Increasing the speed at which we address air pollution will save lives today. Those solutions will move the world closer to the net-zero carbon emissions goals that we need to ultimately address the causes of climate change.” — Michael Brauer, affiliate professor and team lead for estimating the burden of environmental, occupational, and dietary risk factors     

4. Cardiovascular disease

“Cardiovascular diseases such as ischemic heart disease and stroke are the leading causes of death globally, accounting for 28% of total deaths in 2021. Additionally, cardiovascular diseases substantially contribute to health loss and the economic burden on health care systems. Most cardiovascular diseases can be prevented by addressing modifiable cardiovascular risk factors such as high blood pressure, high cholesterol, obesity, dietary risks, smoking, and air pollution.” — Christian Razo, postdoctoral scholar on the team estimating cardiovascular disease burden and lead author of a Burden of Proof study on the effects of elevated systolic blood pressure on ischemic heart disease     

5. Lower respiratory infections

“Lower respiratory infections (LRI), especially respiratory syncytial virus (RSV) and influenza, are health issues to watch in 2023.   “ We saw a general decline in influenza and RSV infections in 2020 due to COVID-19 mitigation measures such as mask use and social distancing. With the relaxation of these measures, many young children who haven’t been exposed to RSV in the past couple of years are being infected, resulting in RSV outbreaks . Countries have also experienced a surge in influenza across all ages.    “ Annual influenza vaccination provides an opportunity to reduce the LRI burden attributable to flu. There is no vaccine yet to prevent RSV, but promising vaccine trials are underway . ” — Hmwe Kyu, assistant professor and team lead for estimating the burden of HIV, TB, and select infectious diseases    “ After experiencing significant disruptions to health care systems worldwide due to the COVID-19 pandemic, the increases in respiratory infections and other communicable diseases have been added to the existing burden of chronic non-communicable diseases, creating a dual burden of disease exacerbated by social inequalities observed globally.” — Christian Razo     

6. Poverty’s role in health

“It seems that poverty is the mother of inequality in health. The unequal distribution of resources has expanded due to climate change and increasing violence. Low- and middle-income countries experience worse health outcomes than high-income countries: the life expectancy is 34 years lower, the under-5 mortality around 100 times higher, deaths due to interpersonal violence and suicide are 30 times higher, and deaths attributable to antimicrobial resistance (AMR) are 12 times higher. We must urgently address the impact of poverty on health, life, and death.” — Mohsen Naghavi, professor and team lead for causes of death, shocks, intermediate causes and estimating the burden of AMR     

7. Health systems strengthening

“Strengthening health systems globally remains a critical aspect of what is needed for resilient health systems. This will be particularly relevant as countries refocus their resources and attention after the acute phase of the COVID-19 pandemic.

“I think what is needed is a longer-term commitment from donors and governments – financial and human resources, governance structures, management, information systems – to ensure that interventions are set up for long-term sustainability and can deliver the outcomes that are aspired to across health systems.” — Angela Micah, assistant professor and co-lead of the development assistance for health resource tracking team

“Given the immense strain of COVID-19 on primary care and hospital systems the past two-and-a-half years, attention should be paid to building back up the health care system and enabling frontline workers to do their jobs effectively. Public health leaders and policymakers need to reflect on lessons learned from the pandemic to prevent health care system collapse in the next crisis and to ensure that people who need care can access quality health care.” — Sarah Wulf Hanson     

8. Diabetes

“Diabetes is the fourth main cause of DALYs in Latin America and the Caribbean, and among the top five causes, it is the only one that shows an increase in the age-standardized rate compared to 1990. The burden of diabetes in the Americas is large, increasing, heterogeneous, and expanding, especially in countries in Central Latin America and the Caribbean. 

“Population-based interventions such as taxes and incentives, more informative food labeling, improving the built environment to facilitate exercise, and greater advocacy to inform people of the risk diabetes poses, combined with expanded health education to combat diabetes risk factors, seem the best options. Policies aimed to help avoid weight gain and improve dietary quality are also paramount. 

“Another important aspect is improving the response of health systems in terms of access and quality care. These should include universal access to low-cost insulin and oral anti-diabetic medication to decrease avoidable deaths from acute complications. Health systems should also strive to furnish feedback from their administrative data systems to providers to help orient diabetes care.” — Ewerton Cousin, postdoctoral scholar on the neglected tropical diseases team and lead author of The Lancet Diabetes & Endocrinology paper on diabetes burden in the Americas     

9. Road injuries

“Road injuries are still an important and preventable injury. For people 15-49 years old, road injuries are the leading cause of death .

“Interventions such as helmets, seatbelts, airbags, speed limits, and laws discouraging alcohol-impaired driving do work. But implementation is not the only thing that determines their success – human behavior must adhere to those policies to make them effective." — Liane Ong, lead research scientist and team lead for estimating the burden of injuries, chronic respiratory diseases, neurological disorders, substance use disorders, diabetes and kidney diseases, sensory organ diseases, musculoskeletal disorders, and impairments (BIRDS)     

10. Dementia

“Anticipated trends in population growth and population aging are expected to lead to large increases in the number of people affected by dementia globally, underscoring the public health importance of dementia. To adequately care for those with dementia, appropriate planning for the necessary supports and services required is needed.

“Interventions targeting modifiable risk factors, such as low education, smoking, and high blood sugar, have the potential to reduce the overall societal burden and should be prioritized.” — Emma Nichols, researcher on the BIRDS team and lead author of The Lancet Public Health paper on dementia forecasting     

11. Population aging

“Adapting health systems to support older populations’ needs should be front of mind in 2023. Globally, the proportion of the population that is above 65 is expected to increase in the coming years. While a lot of attention (and rightfully so) has historically focused on diseases that affect children, it will be prudent to begin thinking through and systematically planning for some of these upcoming changes in demography as well, especially in low- and middle-income countries.” — Angela Micah

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Finding a research topic in Global Health (M. Schmitt)

Finding a research topic in Global Health can seem overwhelming initially.  It is important to start off by just exploring all the latest Global Health news and advancements before narrowing down your topic. Take some time to do some research on the most up-to-date news occurring in the field of Global Health. Here are a few recommendations on how to start this process: 1. Global Health Blogs - There are several fantastic Global Health blogs which discuss many of the newest and most innovative Global Health advancements, debates, and projects.  Read over a few of them to get a few leads of possible topics of interest. Once you have a few  ideas of interesting topics you'd like to learn more about, then start looking for academic-based supporting research (including use of the library & journals). A few of my favorite global health blogs include:

• Global Health Report (Christine Gorman)  http://globalhealthreport.blogspot.com/
• Global Health Ideas:  http://globalhealthideas.org/
• Change.org:  http://globalhealth.change.org/blog
• Family Care International:  http://www.familycareintl.org/en/home

2. Stay up-to-date on the news - Several news sources are constantly feeding the most recent Global Health news stories. A few of my favorite Global Health news resources include:

• Kasier Foundation:  http://globalhealth.kff.org/
• Harvard World Health News:  http://www.worldhealthnews.harvard.edu/
• The New York Times (Health News):  http://www.nytimes.com/pages/health/

3. Explore Northwestern Library Resources- Northwestern has remarkable resources in terms of the Global Health related journals and textbooks. Utilize these resources. A few ideas for Global Health related journals located at the Northwestern Library include:

• Global Public Health: An International Journal for Research, Policy, and Practice
• The American Journal Of Public Health
• The New England Journal Of Medicine (Global Health Section)
• The Global Health Magazine (Global Health Council) http://www.globalhealthmagazine.com/

4. Faculty Research - Northwestern has a large amount of a faculty participating in Global Health or Public Health related research year-round.  It is important to familiarize yourself with all the latest faculty research on-going at Northwestern. Why is this importa

Aside from Global Health journals, several resources

Important things to think about when creating a Global Health research proposal:

1. Working or building on exisiting Global Health research projects

    - There are many talented faculty, graduate, and even undergraduate students who are currently or have previously been working on Global Health Research

4. Global Experience - Many of you (especially Global Health minors) have had the opportunity to study Global Health at an international capacity.  While you studying abroad, you are creating contacts and learning hands on at your global site. A great way to create a project is to use these experiences and contacts you have created to build a project.  The benefits to using these established contacts is that you do not have to start from scratch but can build on

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What is global health? Key concepts and clarification of misperceptions

Xinguang chen.

1 Global Health Institute, Wuhan University, Wuhan, China

2 Department of Epidemiology, University of Florida, Florida, USA

3 School of Health Sciences, Wuhan University, Wuhan, China

Don Eliseo Lucero-Prisno, III

4 Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK

Abu S. Abdullah

5 Global Health Research Center, Duke Kunshan University, Kunshan, China

6 Duke Global Health Institute, Duke University, Durham, North Carolina USA

Jiayan Huang

7 School of Public Health, Fudan University, Shanghai, China

Charlotte Laurence

8 Consultant in Global Health, London, UK

Xiaohui Liang

9 School of Public Health, Guangxi Medical University, Guangxi, China

10 Global Health Research Center, Dalian Medical University, Dalian, China

Shaolong Wu

11 School of Public Health, Sun Yat-sen University, Guangzhou, China

Peigang Wang

Tingting wang, yuliang zou.

The call for “W orking Together to Build a Community of Shared Future for Mankind” requires us to improve people’s health across the globe, while global health development entails a satisfactory answer to a fundamental question: “What is global health?” To promote research, teaching, policymaking, and practice in global health, we summarize the main points on the definition of global health from the Editorial Board Meeting of Global Health Research and Policy, convened in July 2019 in Wuhan, China. The meeting functioned as a platform for free brainstorming, in-depth discussion, and post-meeting synthesizing. Through the meeting, we have reached a consensus that global health can be considered as a general guiding principle, an organizing framework for thinking and action, a new branch of sciences and specialized discipline in the large family of public health and medicine. The word “global” in global health can be subjective or objective, depending on the context and setting. In addition to dual-, multi-country and global, a project or a study conducted at a local area can be global if it (1) is framed with a global perspective, (2) intends to address an issue with global impact, and/or (3) seeks global solutions to an issue, such as frameworks, strategies, policies, laws, and regulations. In this regard, global health is eventually an extension of “international health” by borrowing related knowledge, theories, technologies and methodologies from public health and medicine. Although global health is a concept that will continue to evolve, our conceptualization through group effort provides, to date, a comprehensive understanding. This report helps to inform individuals in the global health community to advance global health science and practice, and recommend to take advantage of the Belt and Road Initiative proposed by China.

“Promoting Health For All” can be considered as the mission of global health for collective efforts to build “a Community of Shared Future for Mankind” first proposed by President Xi Jinping of China in 2013. The concept of global health continues to evolve along with the rapid development in global health research, education, policymaking, and practice. It has been promoted on various platforms for exchange, including conferences, workshops and academic journals. Within the Editorial Board of Global Health Research and Policy (GHRP), many members expressed their own points of view and often disagreed with each other with regard to the concept of global health. Substantial discrepancies in the definition of global health will not only affect the daily work of the Editorial Board of GHRP, but also impede the development of global health sciences.

To promote a better understanding of the term “ global health” , we convened a special session in the 2019 GHRP Editorial Board Meeting on the 7th of July at Wuhan University, China. The session started with a review of previous work on the concept of global health by researchers from different institutions across the globe, followed by free brainstorms, questions-answers and open discussion. Individual participants raised many questions and generously shared their thoughts and understanding of the term global health. The session was ended with a summary co-led by Dr. Xinguang Chen and Dr. Hao Li. Post-meeting efforts were thus organized to further synthesize the opinions and comments gathered during the meeting and post-meeting development through emails, telephone calls and in-person communications. With all these efforts together, concensus have been met on several key concepts and a number of confusions have been clarified regarding global health. In this editorial, we report the main results and conclusions.

A brief history

Our current understanding of the concept of global health is based on information in the literature in the past seven to eight decades. Global health as a scientific term first appeared in the literature in the 1940s [ 1 ]. It was subsequently used by the World Health Organization (WHO) as guidance and theoretical foundation [ 2 – 4 ]. Few scholars discussed the concept of global health until the 1990s, and the number of papers on this topic has risen rapidly in the subsequent decade [ 5 ] when global health was promoted under the Global Health Initiative - a global health plan signed by the U.S. President Barack Obama [ 6 ]. As a key part of the national strategy in economic globalization, security and international policies, global health in the United States has promoted collaborations across countries to deal with challenging medical and health issues through federal funding, development aids, capacity building, education, scientific research, policymaking and implementation.

Based on his experience working with Professor Zongfu Mao, the lead Editors-in-Chief, who established the Global Health Institute at Wuhan University in 2011 and launched the GHRP in 2016, Dr. Chen presented his own thoughts surrounding the definition of global health to the 2019 GHRP Editorial Board Meeting. Briefly, Dr. Chen defined global health with a three-dimensional perspective.

First, global health can be considered as a guiding principle, a branch of health sciences, and a specialized discipline within the broader arena of public health and medicine [ 5 ]. As many researchers posit, global health first serves as a guiding principle for people who would like to contribute to the health of all people across the globe [ 5 , 7 , 8 ].

Second, Dr. Chen’s conceptualization of global health is consistent with the opinions of many other scholars. Global health as a branch of sciences focuses primarily on the medical and health issues with global impact or can be effectively addressed through global solutions [ 9 – 16 ]. Therefore, the goal of global health science is to understand global medical and health issues and develop global solutions and implications [ 7 , 9 , 15 , 17 – 19 ].

Third, according to Dr. Chen, to develop global health as a branch of science in the fields of public health and medicine, a specialized discipline must be established, including educational institutions, research entities, and academic societies. Only with such infrastructure, can the professionals and students in the global health field receive academic training, conduct global health research, exchange and disseminate research findings, and promote global health practices [ 5 , 15 , 20 – 23 ].

Developmentally and historically, we have learned and will continue to learn global health from the WHO [ 1 , 4 , 24 , 25 ]. WHO’s projects are often ambitious, involving multiple countries, or even global in scope. Through research and action projects, the WHO has established a solid knowledge base, relevant theories, models, methodologies, valuable data, and lots of experiences that can be directly used in developing global health [ 26 – 29 ]. Typical examples include WHO’s efforts for global HIV/AIDS control [ 13 , 30 – 32 ], and the Primary Healthcare Programs to promote Health For All [ 33 , 34 ].

The definition of Global Health

From published studies in the international literature and our experiences in research, training, teaching and practice, our meeting reached a consensus-global health is a newly established branch of health sciences, growing out from medicine, public health and international health, with much input from the WHO. What makes global health different from them is that (1) global health deals with only medical and health issues with global impact [ 35 , 5 , 36 , 10 , 14 , 2 ] the main task of global health is to seek for global solutions to the issues with global health impact [ 7 , 18 , 37 ]; and (3) the ultimate goal is to use the power of academic research and science to promote health for all, and to improve health equity and reduce health disparities [ 7 , 14 , 15 , 18 , 38 ]. Therefore, global health targets populations in all countries and involves all sectors beyond medical and health systems, although global health research and practice can be conducted locally [ 39 ].

As a branch of medical and health sciences, global health has three fundamental tasks: (1) to master the spatio-temporal patterns of a medical and/or health issue across the globe to gain a better understanding of the issue and to assess its global impact [ 40 – 43 ]; (2) to investigate the determinants and influential factors associated with medical and health issues that are known to have global impact [ 15 , 40 – 43 ]; and (3) to establish evidence-based global solutions, including strategies, frameworks, governances, policies, regulations and laws [ 14 , 15 , 28 , 38 , 44 – 47 ].

Like public health, medicine, and other branches of sciences, global health should have three basic functions : The first function is to generate new knowledge and theories about global health issues, influential factors, and develop global solutions. The second function is to distribute the knowledge through education, training, publication and other forms of knowledge sharing. The last function is to apply the global health knowledge, theories, and intervention strategies in practice to solve global health problems.

Understanding the word “global”

Confusion in understanding the term ‘global health’ has largely resulted from our understanding of the word “global”. There are few discrepancies when the word ‘global’ is used in other settings such as in geography. In there, the world global physically pertains to the Earth we live on, including all people and all countries in the world. However, discrepancies appear when the word “global” is combined with the word “health” to form the term “global health”. Following the word “global” literately, an institution, a research project, or an article can be considered as global only if it encompasses all people and all countries in the world. If we follow this understanding, few of the work we are doing now belong to global health; even the work by WHO are for member countries only, not for all people and all countries in the world. But most studies published in various global health journals, including those in our GHRP, are conducted at a local or international level. How could this global health happen?

The argument presented above leads to another conceptualization: Global health means health for a very large group of people in a very large geographic area such as the Western Pacific, Africa, Asia, Europe, and Latin America. Along with this line of understanding, an institution, a research project or an article involving multi-countries and places can be considered as global, including those conducted in countries involved in China’s Belt and Road Initiative (BRI) [ 26 , 48 – 51 ]. They are considered as global because they meet our definitions of global health which focus on medical and health issues with global impact or look for global solutions to a medical or health issue [ 5 , 7 , 22 ].

One step further, the word ‘global’ can be considered as a concept of goal-setting in global health. Typical examples of this understanding are the goals established for a global health institution, for faculty specialized in global health, and for students who major or minor in global health. Although few of the global health institutions, scholars and students have conducted or are going to conduct research studies with a global sample or delivered interventions to all people in all countries, all of them share a common goal: Preventing diseases and promoting health for all people in the world. For example, preventing HIV transmission within Wuhan would not necessarily be a global health project; but the same project can be considered as global if it is guided by a global perspective, analyzed with methods with global link such as phylogenetic analysis [ 52 , 53 ], and the goal is to contribute to global implications to end HIV/AIDS epidemic.

The concept of global impact

Global impact is a key concept for global health. Different from other public health and medical disciplines, global health can address any issue that has a global impact on the health of human kind, including health system problems that have already affected or will affect a large number of people or countries across the globe. Three illustrative examples are (1) the SARS epidemic that occurred in several areas in Hong Kong could spread globally in a short period [ 11 ] to cause many medical and public health challenges [ 54 , 55 ]; (2) the global epidemic of HIV/AIDS [ 13 ]; and the novel coronavirus epidemic first broke out in December 2019 in Wuhan and quickly spread to many countries in the world [ 56 ].

Along with rapid and unevenly paced globalization, economic growth, and technological development, more and more medical and health issues with global impact emerge. Typical examples include growing health disparities, migration-related medical and health issues, issues related to internet abuse, the spread of sedentary lifestyles and lack of physical activity, obesity, increasing rates of substance abuse, depression, suicide and many other emerging mental health issues, and so on [ 10 , 23 , 36 , 42 , 57 – 60 ]. GHRP is expecting to receive and publish more studies targeting these issues guided by a global health perspective and supports more researchers to look for global solutions to these issues.

The concept of global solution

Another concept parallel to global impact is global solution . What do we mean by global solutions? Different from the conventional understanding in public health and medicine, global health selectively targets issues with global impact. Such issues often can only be effectively solved at the macro level through cross-cultural, international, and/or even global collaboration and cooperation among different entities and stakeholders. Furthermore, as long as the problem is solved, it will benefit a large number of population. We term this type of interventions as a global solution. For example, the 90–90-90 strategy promoted by the WHO is a global solution to end the HIV/AIDS epidemic [ 61 , 62 ]; the measures used to end the SARS epidemic is a global solution [ 11 ]; and the ongoing measures to control influenza [ 63 , 64 ] and malaria [ 45 , 65 ], and the measures taken by China, WHO and many countries in the world to control the new coronaviral epidemic started in China are also great examples of global solutions [ 66 ].

Global solutions are also needed for many emerging health problems, including cardiovascular diseases, sedentary lifestyle, obesity, internet abuse, drug abuse, tobacco smoking, suicide, and other problems [ 29 , 44 ]. As described earlier, global solutions are not often a medical intervention or a procedure for individual patients but frameworks, policies, strategies, laws and regulations. Using social media to deliver interventions represents a promising approach in establishment of global solutions, given its power to penetrate physical barriers and can reach a large body of audience quickly.

Types of Global Health researches

One challenge to GHRP editors (and authors alike) is how to judge whether a research study is global? Based on the new definition of global health we proposed as described above, two types of studies are considered as global and will receive further reviews for publication consideration. Type I includes projects or studies that involve multiple countries with diverse backgrounds or cover a large diverse populations residing in a broad geographical area. Type II includes projects or studies guided by a global perspective, although they may use data from a local population or a local territory. Relative to Type I, we anticipate more Type II project and studies in the field of global health. Type I study is easy to assess, but caution is needed to assess if a project or a study is Type II. Therefore, we propose the following three points for consideration: (1) if the targeted issues are of global health impact, (2) if the research is attempted to understand an issue with a global perspective, and (3) if the research purpose is to seek for a global solution.

An illustrative example of Type I studies is the epidemic and control of SARS in Hong Kong [ 11 , 67 ]. Although started locally, SARS presents a global threat; while controlling the epidemic requires international and global collaboration, including measures to confine the infected and measures to block the transmission paths and measures to protect vulnerable populations, not simply the provisions of vaccines and medicines. HIV/AIDS presents another example of Type I project. The impact of HIV/AIDS is global. Any HIV/AIDS studies regardless of their scope will be global as long as it contributes to the global efforts to end the HIV/AIDS epidemic by 2030 [ 61 , 62 ]. Lastly, an investigation of cardiovascular diseases (CVD) in a country, in Nepal for example, can be considered as global if the study is framed from a global perspective [ 44 ].

The discussion presented above suggests that in addition to scope, the purpose of a project or study can determine if it is global. A pharmaceutical company can target all people in the world to develop a new drug. The research would be considered as global if the purpose is to improve the medical and health conditions of the global population. However, it would not be considered as global if the purpose is purely to pursue profit. A research study on a medical or health problem among rural-to-urban migrants in China [ 57 , 58 , 60 ] can be considered as global if the researchers frame the study with a global perspective and include an objective to inform other countries in the world to deal with the same or similar issues.

Think globally and act locally

The catchphrase “think globally and act locally” presents another guiding principle for global health and can be used to help determine whether a medical or public health research project or a study is global. First, thinking globally and acting locally means to learn from each other in understanding and solving local health problems with the broadest perspective possible. Taking traffic accidents as an example, traffic accidents increase rapidly in many countries undergoing rapid economic growth [ 68 , 69 ]. There are two approaches to the problem: (1) locally focused approach: conducting research studies locally to identify influential factors and to seek for solutions based on local research findings; or (2) a globally focused approach: conducting the same research with a global perspective by learning from other countries with successful solutions to issues related traffic accidents [ 70 ].

Second, thinking globally and acting locally means adopting solutions that haven been proven effective in other comparable settings. It may greatly increase the efficiency to solve many global health issues if we approach these issues with a globally focused perspective. For example, vector-borne diseases are very prevalent among people living in many countries in Africa and Latin America, such as malaria, dengue, and chikungunya [ 45 , 71 , 72 ]. We would be able to control these epidemics by directly adopting the successful strategy of massive use of bed nets that has been proven to be effective and cost-saving [ 73 ]. Unfortunately, this strategy is included only as “simple alternative measures” in the so-called global vector-borne disease control in these countries, while most resources are channeled towards more advanced technologies and vaccinations [ 16 , 19 , 74 ].

Third, thinking globally and acting locally means learning from each other at different levels. At the individual level, people in high income countries can learn from those in low- and mid-income countries (LMICs) to be physically more active, such as playing Taiji, Yoga, etc.; while people in LMICs can learn from those in high income countries to improve their hygiene, life styles, personal health management, etc. At the population level, communities, organizations, governments, and countries can learn from each other in understanding their own medical and health problems and healthcare systems, and to seek solutions for these problems. For example, China can learn from the United States to deal with health issues of rural to urban migrants [ 75 ]; and the United States can learn from China to build three-tier health care systems to deliver primary care and prevention measures to improve health equality.

Lastly, thinking globally and acting locally means opportunities to conduct global health research and to be able to exchange research findings and experiences across the globe; even without traveling to another country. For example, international immigrants and international students present a unique opportunity for global health research in a local city [ 5 , 76 ]. To be global, literature search and review remains the most important approach for us to learn from each other besides conducting collaborative work with the like-minded researchers across countries; rapid development in big data and machine learning provide another powerful approach for global health research. Institutions and programs for global health provides a formal venue for such learning and exchange opportunities.

Reframing a local research study as global

The purpose of this article is to promote global health through research and publication. Anyone who reads this paper up to this point might already be able to have a clear idea on how to reframe his/her own research project or article to be of global nature. There is no doubt that a research project is global if it involves multiple countries with investigators of diverse backgrounds from different countries. However, if a research project targets a local population with investigators from only one or two local institutions, can such project be considered as global?

Our answer to this question is “yes” even if a research study is conducted locally, if the researcher (1) can demonstrate that the issue to be studied or being studied has a global impact, or (2) eventually looks for a global solution although supported with local data. For example, the study of increased traffic accidents in a city in Pakistan can be considered as global if the researchers frame the problem from a global perspective and/or adopt global solutions by learning from other countries. On the other hand, a statistical report of traffic accidents or an epidemiological investigation of factors related to the traffic accidents at the local level will not be considered as global. Studies conducted in a local hospital on drug resistance to antibiotics and associated cost are global if expected findings can inform other countries to prevent abuse of antibiotics [ 77 ]. Lastly, studies supported by international health programs can be packaged as global simply by broadening the vision from international to global.

Is Global Health a new bottle with old wine?

Another challenge question many scholars often ask is: “What new things can global health bring to public health and medicine?” The essence of this question is whether global health is simply a collection of existing medical and health problems packaged with a new title? From our previous discussion, many readers may already have their own answer to this question that this is not true. However, we would like to emphasize a few points. First, global health is not equal to public health, medicine or both, but a newly emerged sub-discipline within the public health-medicine arena. Global health is not for all medical and health problems but for the problems with global impact and with the purpose of seeking global solutions. In other words, global health focuses primarily on mega medical and health problems that transcend geographical, cultural, and national boundaries and seeks broad solutions, including frameworks, partnerships and cooperation, policies, laws and regulations that can be implemented through governments, social media, communities, and other large and broad reaching mechanisms.

Second, global health needs many visions, methods, strategies, approaches, and frameworks that are not conventionally used in public health and medicine [ 5 , 18 , 22 , 34 ]. They will enable global health researchers to locate and investigate those medical and health issues with global impact, gain new knowledge about them, develop new strategies to solve them, and train health workers to deliver the developed strategies. Consequently, geography, history, culture, sociology, governance, and laws that are optional for medicine and public health are essential for global health. Lastly, it is fundamental to have a global perspective for anyone in global health, but this could be optional for other medical and health scientists [ 40 , 41 ].

Global Health, international health, and public health

As previously discussed, global health has been linked to several other related disciplines, particularly public health, international health, and medicine [ 3 , 5 , 7 , 18 , 22 ]. To our understanding, global health can be considered as an application of medical and public health sciences together with other disciplines (1) in tackling those issues with global impact and (2) in the effort to seek global solutions. Thus, global health treats public health sciences and medicine as their foundations, and will selectively use theories, knowledge, techniques, therapeutics and prevention measures from public health, medicine, and other disciplines to understand and solve global health problems.

There are also clear boundaries between global health, public health and medicine with regard to the target population. Medicine targets patient populations, public health targets health populations in general, while global health targets the global population. We have to admit that there are obvious overlaps between global health, public health and medicine, particularly between global health and international health. It is worth noting that global health can be considered as an extension of international health with regard to the scope and purposes. International health focuses on the health of participating countries with intention to affect non-participating countries, while global health directly states that its goal is to promote health and prevent and treat diseases for all people in all countries across the globe. Thus, global health can be considered as developed from, and eventually replace international health.

Challenges and opportunities for China to contribute to Global Health

To pursue A Community with a Shared Future for Mankind , China’s BRI , currently involving more than 150 countries across the globe, creates a great opportunity for Chinese scholars to contribute to global health. China has a lot to learn from other countries in advancing its medical and health technologies and to optimize its own healthcare system, and to reduce health disparities among the 56 ethnic groups of its people. China can also gain knowledge from other countries to construct healthy lifestyles and avoid unhealthy behaviors as Chinese people become more affluent. Adequate materials and money may be able to promote physical health in China; but it will be challenging for Chinese people to avoid mental health problems currently highly prevalent in many rich and developed countries.

To develop global health, we cannot ignore the opportunities along with the BRI for Chinese scholars to share China’s lessons and successful experience with other countries. China has made a lot of achievements in public health and medicine before and after the Open Door Policy [ 49 , 78 ]. Typical examples include the ups and downs of the 3-Tier Healthcare Systems, the Policy of Prevention First, and the Policy of Putting Rural Health as the Priority, the Massive Patriotic Hygiene Movement with emphasis on simple technology and broad community participation, the Free Healthcare System for urban and the Cooperative Healthcare System for rural residents. There are many aspects of these initiatives that other countries can emulate including the implementation of public health programs covering a huge population base unprecedented in many other countries.

There are challenges for Chinese scholars to share China’s experiences with others as encountered in practice. First of all, China is politically very stable while many other countries have to change their national leadership periodically. Changes in leadership may result in changes in the delivery of evidence- based intervention programs/projects, although the changes may not be evidence-based but politically oriented. For example, the 3-Tier Healthcare System that worked in China [ 79 , 80 ] may not work in other countries and places without modifications to suit for the settings where there is a lack of local organizational systems. Culturally, promotion of common values among the public is unique in China, thus interventions that are effective among Chinese population may not work in countries and places where individualism dominates. For example, vaccination program as a global solution against infectious diseases showed great success in China, but not in the United States as indicated by the 2019 measles outbreak [ 81 ].

China can also learn from countries and international agencies such as the United Kingdom, the United States, the World Health Organization, and the United Nations to successfully and effectively provide assistance to LMICs. As China develops, it will increasingly take on the role of a donor country. Therefore, it is important for Chinese scholars to learn from all countries in the world and to work together for a Community of Shared Future for Mankind during the great course to develop global health.

Promotion of global health is an essential part of the Working Together  to Build a Community of Shared Future for Mankind. In this editorial, we summarized our discussions in the 2019 GHRP Editorial Board Meeting regarding the concept of global health. The goal is to enhance consensus among the board members as well as researchers, practitioners, educators and students in the global health community. We welcome comments, suggestions and critiques that may help further our understanding of the concept. We would like to keep the concept of global health open and let it evolve along with our research, teaching, policy and practice in global health.

Acknowledgements

We would like to thank those who had provided their comments for the improvement of the manuscript.

Authors’ contributions

Chen XG wrote the manuscript. LI H organized the meeting, collecting the comments and editing the manuscript. Lucero-Prisno DE integrated all the comments together. Abdullah AS, Huang JY, Laurence C, Liang XH, Ma ZY, Ren R, Wu SL, Wang N, Wang PG and Wang Tt all participated in the discussion and comments of this manuscript. Laurence C and Liang XH both provided language editing. The author(s) read and approved the final manuscript

The work is funded by the journal development funds of Wuhan University.

Ethics approval and consent to participate

Not applicable.

Consent for publication

The manuscript was sent to all the authors and they all agreed to submit it for publication.

Competing interests

The authors declare that they have no competing interests.

Contributor Information

Xinguang Chen, Email: [email protected] .

Hao Li, Email: [email protected] .

Don Eliseo Lucero-Prisno, III, Email: [email protected] .

Abu S. Abdullah, Email: [email protected] .

Jiayan Huang, Email: nc.ude.umhs@gnauhyj .

Charlotte Laurence, Email: moc.tenretnitb@1ecnerualc .

Xiaohui Liang, Email: nc.ude.uhw@gnailhx .

Zhenyu Ma, Email: [email protected] .

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Nan Wang, Email: moc.361@6111hsirehc .

Peigang Wang, Email: moc.361@629gpw .

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Open Philanthropy strives to help others as much as we can with the resources available to us. To find the best opportunities to help others, we rely heavily on scientific and social scientific research.

If you know of any research that touches on these questions, we would welcome hearing from you. At this point, we are not actively making grants to further investigate these questions. It is possible we may do so in the future, though, so if you plan to research any of these, please email us .

Land Use Reform

Open Philanthropy has been making grants in land use reform since 2015. We believe that more permissive permitting and policy will encourage economic growth and allow people to access higher-paying jobs. However, we have a lot of uncertainty about which laws or policies would be most impactful (or neglected/tractable relative to their impact) on housing production.

• Why we care: We think that permitting speed might be an important category to target, but have high uncertainty about this. 
• What we know: There are a number of different studies of the effects of changes in zoning/land use laws (e.g. see a summary here in Appendix A), but we’re not aware of studies that attempt to disentangle any specific changes or rank their importance. We suspect that talking to advocates (e.g. CA YIMBY) would be useful as a starting point.
• Ideas for studying this: It seems unlikely that there have been “clean” changes that only affected a single part of the construction process, but from talking to advocates, it seems plausible that it would be possible to identify changes to zoning codes that primarily affect one parameter more than others. It also seems plausible that this is a topic where a systematic review, combining evidence from many other studies, would be unusually valuable.
• Why we care: We are highly uncertain about how to best encourage more construction, and thus about where to target our grants.
• What we know: there have been many recent changes to permitting requirements, such as the California ADU law that requires cities to respond to permit requests within 60 days and a new law in Florida that requires cities to respond to permit requests quickly or return permitting fees. This blog post by Dan Bertolet at Sightline predates those changes, but is the best summary we’ve seen on the impacts of permitting requirements.
• Ideas for studying this: one might compare projects that fall right below or above thresholds for permitting review (e.g. SEPA thresholds in Washington state), and try to understand how much extra delay projects faced as a result of qualifying for review. It could also be valuable to analyze the effects of the Florida law (e.g. a difference-in-difference design looking at housing construction in places that had long delays vs. short delays prior to the law passing).
• Why we care: Currently, estimates of this value are typically made at the level of the metro area, but it seems plausible that we should be differentiating more – e.g. putting higher values on units built in Manhattan relative to those built in Westchester.
• What we know: there’s a lot of work on the gradient of land/house prices with regards to transit costs across metro areas, but we aren’t aware of work that explicitly tries to estimate within-metro differences ( in the vein of Card, Rothstein, and Yi (2023) , for example) .
• Ideas for studying this: it should be possible to use similar designs looking at moves at a more granular level (e.g. rather than defining effects at the metro level, use changes in distance-weighted job availability). There may also be ways to directly use the land price gradient to estimate this (though in general that will also reflect amenity values).
• Why we care: Some people have proposed that a land value tax could encourage land redevelopment and reduce the economic inefficiency of taxation, but we do not know how well this reflects the real-world impact of land value taxes.
• What we know: Land value taxes have been used in some Pennsylvania cities, and in some countries outside the US. There has also been increasing interest in implementing a land value tax in other places (e.g. this FT editorial ). See here for many more arguments and references related to land value taxation.
• Ideas for studying this: one could use a difference-in-difference design looking at when cities adopt a land value tax (or a split value tax) and examine changes in construction or other outcomes (e.g. volume of land transactions). Alternatively, one could also try a border regression discontinuity looking at differences in land transactions or other metrics at the border between a place that implements a land value tax and one that does not.

Treatments now potentially within reach may extend the human lifespan and improve quality of life. We aim to support tractable and cost-effective research on the world’s most burdensome diseases , including cardiovascular disease, infectious diseases, malaria, and others.

• Why we care: Open Philanthropy makes many grants focused on South Asian air quality . However, we still have a lot of uncertainty about the impacts of air pollution. One potentially important variable is the type of pollutant; it would be important for our grantmaking to know if some forms of pollution were much more impactful to reduce than others.
• What we know: We know that the components of PM 2.5 pollution can vary substantially by location. There has been some associational work done on this in the US context, but we are more interested in areas with high baseline PM 2.5 levels.
• Ideas for studying this: there is some existing data on how the components of PM 2.5 pollution vary across India. This could be linked with mortality data for associational studies. One could also use policy changes that changed the makeup of particulate emissions in a certain area as a natural experiment.
• Why we care: Open Philanthropy has made some grants attempting to influence public health regulation. We are interested in knowing how successful other philanthropists have been when making similar grants, and are particularly interested in knowing the effects of Bloomberg’s anti-tobacco advocacy, which we see as one of the most focused (and promising) programs of its type.
• What we know: there has been substantial research on the effects of tobacco policy, but we are not aware of any work that focuses specifically on the effect of Bloomberg’s investments.
• Ideas for studying this: some of Bloomberg’s grantmaking in tobacco is public ; one could use a variety of approaches to assess the impact of those grants (e.g. a synthetic control).
• Why we care: we have made grants on reducing lead exposure in low-income countries in the past and are likely to make more in the future. These grants are made assuming that lead affects both health and income, but we are quite uncertain about the magnitude of the effect of either, especially on health (where we think there is less data). Better estimates of the effect of lead on health would reduce the level of uncertainty around the cost-effectiveness of these grants.
• What we know: according to epidemiological (observational) studies , lead has negative impacts on cardiovascular health (see a helpful systematic review here ). However, there is limited causal evidence on the impacts of lead on cardiovascular disease in humans; our primary evidence comes from a study that leverages exposure to NASCAR races to determine changes in ischemic heart disease in the elderly, but we don’t know much about chronic exposure and are reluctant to rely heavily on a single study.
• Why we care: Open Philanthropy invests in vaccines for a variety of illnesses, with the primary (though not exclusive) goal of reducing mortality. Having better estimates for how properties of vaccines translate to demand and eventual health impact will help us prioritize when to support “good” leads in clinical trials vs. hold out longer for “great” ones.
• What we know: the efficacy of vaccines for different diseases varies considerably, and improved technologies can lead to more promising candidates even for diseases where one or more products are already available.
• Ideas for studying this: one could interact the efficacy of a given year’s vaccine (see data here for example) with propensity to get the flu vaccine to determine how this changed flu dynamics. (Though data from South Asia or sub-Saharan Africa would be even better.)
• Why we care: Much of Open Philanthropy’s grantmaking in global health R&D is focused on preventing malaria in high-risk populations (as are several charities recommended by GiveWell, with whom we work closely on global health). However, we have little causal evidence on the long-run effects of having had malaria, on either health or income. Thus, we do not have a good sense of the true (long-run) value of preventing malaria.
• What we know: a Mendelian study found that the likelihood of stunting increases with each malaria infection.
• Ideas for studying this: Mendelian randomization is a technique that looks at people with different genes to determine the causal impact of genes on observable outcomes. Being heterozygous for the sickle cell variant is symptomless but protective against malaria. Thus, those with sickle cell trait are less likely to get malaria and can be compared against those without the trait to understand the long-run impacts of malaria.
• Why we care: Open Philanthropy is interested in cost-effectively improving health. Fractional dosing has the potential to lower cost and expand coverage of vaccines. If we had better evidence on this topic, OP could know in which cases (if any) to advocate for more fractional dosing.
• What we know: a fractional dose for yellow fever and flu appeared to be non-inferior, but fractional dosing for polio was less successful.
• Ideas for studying this: we are not aware of any systematic review of fractional vaccine trials, but many such trials have been run. Studying this topic could involve simply examining data from past trials, rather than running new trials.
• What we know: as GBD covers all deaths and DALYs in the world, the team behind it necessarily spends limited time researching any one cause of DALYs. While GBD revisions attempt to address issues with previous estimates, we believe that there may still be substantial errors.
• Ideas for studying this: one could look for sharp changes in burden figures between the current and previous GBD studies, or examine a particular cause of death in detail and compare one’s own estimates to those generated by the GBD at different levels of age or geographic aggregation. 
• Why we care: new medications and medical technologies can substantially improve disease burdens and make treating or eliminating an illness more cost-effective. However, different countries adopt technologies at different rates; we are interested in knowing why. Open Philanthropy might then be able to make grants to encourage adoption of particularly promising technologies in underserved areas.
• What we know: it seems that patents, price regulation , and market structure affect drug adoption.
• Ideas for studying this: follow up on the approach in Kyle (2007) . One could extend her estimates to estimate the diffusion of FDA-approved drugs globally via patent filings and then look at predictors of diffusion: disease burden, GDP per capita, price controls, language (English vs. not), and path dependency (whether the same companies sell to the same countries repeatedly).
• Why do we care: Open Philanthropy tries to cost-effectively improve health and income. Migration is often considered to be one of the best ways to improve income; for instance, a person moving from a low-income country to a high-income country might raise their income by a factor of 50. We have previously made grants in both international and internal migration, and are interested in knowing whether there are underutilized migration channels whereby migrants might substantially increase their income. Our understanding is that aging populations are causing some HICs to offer more work visas than they previously offered, but that the uptake of these visas is poorly understood (and may be quite low).
• What we know: there are some international borders that do not require authorization for labor migration (e.g. within the EU, or between India and Nepal). At least one such border includes a low-income country (India/Nepal — India’s per capita GDP is over twice that of Nepal’s), but as far as we are aware, there is no database of such borders.
• Ideas for studying this: we think valuable descriptive papers could gather information on the relative usage levels of different work visas (in HICs or MICs) that could be accessible to people from LMICs, or on migration paths that don’t have caps on work visas (such as India-Nepal). Limiting to the largest HICs for ease of initial study (e.g. US, Japan, Germany, France, UK) would probably still be very valuable.
• Why we care: education may be one of the best ways to increase long-run income. However, most education studies focus only on a small number of treated students; it is less clear what the general equilibrium effects are (that is, effects across an entire city/region/nation). These are important in understanding how valuable education is in raising wages — and if Open Philanthropy should consider education interventions as a cost-effective way of improving income.
• What we know: this question has been examined in both Indonesia and India , but re-examination of these findings has made them seem less robust . In addition, we continue to be surprised that there are so few studies on how large schooling expansions affect wages.
• Ideas for studying this: one might use other large-scale expansions of schooling, such as Ghana’s free senior high school program or the Kenyan schooling expansion studied in Lucas & Mbiti (2012) .
• Why we care: we think that economic growth is likely to be very important, but it isn’t clear how best to produce higher growth rates through philanthropic funding. One idea would be to increase the supply of highly trained policymakers, who might be able to influence policy that affects many people.
• What we know: we’re not aware of work trying to measure the impact of policy training programs, such as the masters program at the Williams Center for Development Economics or the MPA ID at Harvard.
• Ideas for studying this: if you could get access to the admissions data for a program like one of the above examples, you could compare people who were nearly admitted to those who were actually admitted to see whether the programs have an effect on career trajectories. This wouldn’t prove anything directly about growth, but would provide evidence that the programs have some counterfactual effect.

Science and Metascience

• Why we care: many of Open Philanthropy’s decisions are based on social scientific work. As such, we have a vested interest in this work being reliable and replicable. Unreliable or non-replicable work might lead us to make weaker, less impactful funding decisions.
• What we know: the peer review process does not seem to weed out papers with signs of p-hacking , but pre-registration may reduce publication bias .
• Ideas for studying this: one might consider the effects of efforts like the AEA pre-analysis plan registry or the Institute for Replication .
• Why we care: we think that scientific progress is hugely important to growth and health advances. One issue in current science is that scientists spend a huge amount of time on high-stakes grant applications instead of doing science (and that the applications may be excessively long relative to what’s necessary for identifying the best science). If this is true, advocating for changes to the grantmaking process might be a high-leverage opportunity for Open Philanthropy.
• What we know: descriptive data suggests that scientists now spend a huge amount of their time applying for grants, and that spending more time on a grant application does not increase the chance of success.
• Why we care: as above, we believe scientific progress is important to growth and health advances. Therefore, we are interested in making sure scientific funding processes work as well as possible to maximize the amount of impact per federal research dollar. If there are improvements that can be made to how science is funded, Open Philanthropy might fund advocacy for such improvements.
• What we know: Carson, Graff Zivin and Shrader (2023) find that reviewers would prefer to prioritize papers with more variance in review scores, and that if this preference were taken into account it would likely lead to different projects being funded. A review of the literature suggests that peer review of applications can identify some of the most promising ideas, but the level of signal is fairly weak.
• Ideas for studying this: one might look at data on past applications and see how the set of funded projects would have differed given the use of different selection criteria, such as max score or random selection (among projects over a certain level of quality). Alternatively, one could randomize within a specific RFP (so that some proposals are selected under different criteria) or randomize across RFPs (so that you can also see how various selection criteria affect the kinds of applications received). The Institute for Progress is currently studying this in collaboration with NSF.
• Why we care: a large share of the value of academic research comes from its ultimate impact on human decisions, but ultimate decision-makers are usually not academics who are well equipped to read and understand individual academic studies. Open Philanthropy would like to know how decision-makers use academic research, and whether there might be improvements to systematic reviews such that decision-makers could be better informed.
• What we know: We know remarkably little. This study argues that academic citation networks are significantly impacted by literature reviews, and suggests that they help to organize and orient fields. This study finds that policymakers respond more to sets of studies finding the same thing across multiple settings than to individual studies – but the results are mixed.
• Ideas for studying this: we think the rollout of evidence clearinghouses is likely pseudorandom across topics, such that measuring their impact may be tractable with difference-in-difference methods. For example, one could study outcomes across different disease categories as the Cochrane collective rolled out new systematic reviews, starting when it was founded in 1993.
• Why we care: Open Philanthropy has occasionally run prize competitions to try and generate useful knowledge. See, for example, our Cause Exploration Prizes and AI Worldviews Contest . We may run more prizes in the future; as such, we would like to know how likely a prize competition is to gather useful information and how to best attract talented entrants.
• What we know: a 2010 paper argues that proportional prize contests produce more total achievement, but another paper is less prescriptive about ideal prize structure.
• Ideas for studying this: Innocentive has done a lot of prize-like competitions; they might be able to share some useful retrospective data.
• Why we care: we believe that rigorous social scientific research is key to identifying the most impactful and cost-effective interventions and policies in developing countries, some of which we may go on to fund. We are interested in knowing cost-effective ways to produce more of said research. We have funded a new IPA office previously, and might fund more such work in the future if we had more evidence about its impact on research, both overall and specific to the target country.
• What we know: Matt Clancy, who leads our grantmaking in innovation policy , coauthored an article on the extent to which research done in one place can be usefully applied in other places. Obstacles to this include different places having different underlying conditions, as well as evidence that policymakers prefer research conducted in their own countries. The article’s bibliography includes many relevant sources.
• Ideas for studying this: Getcher and Meager (2021) collected data on the openings of developing-country offices for NGOs interested in conducting research within said countries. One could use difference-in-difference design to look at how research production (and RCT production in particular) changes when a new office opens – does it cause an increase in total research in those countries? Is there evidence of substitution from non-RCTs to RCTs? Substitution from neighboring countries to the country with a new office? Do new offices tend to produce research on different topics from existing offices (e.g. focusing more on financial inclusion instead of agriculture)?
• Why we care: Open Philanthropy is often interested in influencing policy. Therefore, we want to learn about what is most likely to influence policymakers’ decision-making. We are quite uncertain what types of evidence are most likely to influence policymakers, or in what venues this evidence is likely to be presented.
• What we know: Policy documents cite a relatively small number of scientific publications. In one study, policymakers do not seem to respond to strength of evidence in deciding what to implement; in another , policymakers cared more about external validity than internal validity; in another , policymakers cared substantially about sample size.
• Ideas for studying this: what evidence do central banks (and other governmental institutions) cite most often, and how does this differ from academic citation practices? Is there additional evidence on what types of evidence best persuade policymakers or are most likely to get cited as part of regulatory decisions? E.g. how do citations from a government agency (e.g. the FTC ) compare to citations in academic work on similar topics?
• Why we care: Open Philanthropy wants to raise income levels across society. Our previous work has suggested that public spending on R&D is one of the most effective ways for governments to increase their countries’ income levels. We are thus interested in knowing how the level of public spending on R&D is set, and if there are tractable ways that Open Philanthropy might advocate for this to be increased.
• What we know: there is relatively little information available about the process of setting national-level priorities, but there is some data available about agenda-setting within NIH.
• Ideas for studying this: we aren’t sure of the best approach. Focusing on particular periods of growth in R&D spending and producing case studies might yield evidence that could be explored in a quantitative way later.

Global Development

• Why we care: Open Philanthropy makes grants in global aid advocacy and is interested in increasing both the amount and efficacy of rich countries’ foreign aid. We are interested to know how much influence agency leadership has on the distribution of aid in order to benchmark how much change we should expect over different time frames.
• What we know: we’re not aware of any work addressing this.
• Ideas for studying this: when a new Administrator is appointed, how much does the distribution of aid change across different categories? Ideally, it would be interesting to compare USAID (which is known to have many Congressional earmarks) to other countries with more flexible aid budgets.
• Why we care: we believe that sustained economic growth is one of the best ways to improve health and income. We are interested in knowing how to obtain this. Growth diagnostics are a common tool for trying to select growth-friendly policies, but we are uncertain how valuable this tool is. We are interested in knowing what additional information is gained from using growth diagnostics – how useful they are, and the extent to which this suggests that countries face common vs. distinct growth challenges.
• What we know: while there are many papers on growth diagnostics, we are not aware of any evaluation of growth diagnostics across countries.
• Ideas for studying this: taking a large body of growth diagnostics from a common source (e.g. the World Bank or Harvard Growth Lab ); using automated methods to measure the similarity of recommendations, compare how similar they are, and determine whether that similarity varies by base GDP (e.g. do similarly rich/poor countries have similar diagnostics?) or region (e.g. do Central Asian countries have similar diagnostics?).
• Why we care: many social changes — such as encouraging migration or expanding one’s moral circle to include farmed animals — are often covered in widely-viewed media channels. We are interested in knowing if such coverage changes minds.
• What we know: media seems to be able to influence decision-making (as with fertility in Brazil ). Blackfish decreased attendance at Seaworld and decreased the value of the company that owned the park.
• Ideas for studying this: we think there is more scope to study individual documentaries or shows (did Waiting for Superman affect views on education? Did Bowling for Columbine affect views on guns?). One could also conduct meta-analyses, looking across a variety of documentaries or shows to look for common effects.
• Why we care: we believe that non-competes are likely to reduce labor mobility and decrease innovation .
• What we know: there are some surveys on the prevalence of non-competes outside the US, but few are recent or comprehensive. Outside of recent work in Italy , we have little information about how prevalent non-competes are, or how harmful they are in labor markets outside the US.
• Ideas for studying this: one could gather information on the prevalence of non-competes and their effects on wages in other large labor markets, like Germany, France, and Spain.

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Global health research projects ..

Global Health research spans a wide range of interrelated and complex public health topics. Please explore our current projects by their primary theme listed below. Be sure to investigate more detailed descriptions of projects that have hyperlinked project titles .  Many project areas overlap, so please explore them all.

Academic Interests of the DGH Faculty

If you are looking for a particular faculty member, research area, or location, please use Ctrl + F or command F to scan the list.

Point of Care Diagnostics

Technology to improve decision making and neonatal outcomes in special neonatal care units (sncus) in india.

There have been major improvements in childhood mortality around the world over the last 20 years, but it has been more difficult to reduce mortality of babies in the first month of life. The study is evaluating how to optimize design and use of medical equipment and point of care diagnostics to improve care of newborns in India.

Patricia Hibberd

Diagnostic and Prognostic Biomarkers for Bacterial Infection in Pediatric Clinical Pneumonia

Bacterial pneumonia is one of the leading causes of childhood mortality, particularly in resource-limited countries. The disease burden can be partially attributed to the lack of an accurate and reliable diagnostic test to allow promptly starting antibiotic therapy. Lack of a diagnostic test also results in accelerated resistance to available antibiotics. Previously, we identified a combination of blood inflammatory proteins that could accurately diagnose bacterial infection in Mozambican children with clinical pneumonia. We are currently validating and improving upon this combinations in Gambian children with clinical pneumonia to further start development of a point-of-care diagnostic test with partners.

Clarissa Valim

Emerging Infectious Disease Surveillance and Research

Geosentinel – the global research and surveillance network of the international society of travel medicine in partnership with the cdc.

This is an emerging infectious global surveillance and research network consisting of 72 sites in 30 countries, which uses travelers, immigrants, and refugees as sentinel indicators of disease outbreaks worldwide. GeoSentinel research major projects include studies of fever etiology and outcomes among travelers, artemisinin resistance, mpox, neurocognitive impact of malaria, and COVID-19.

Davidson Hamer

BU-UL Partnership to Enhance Emerging Epidemic Virus Research in Liberia (BULEEVR)

This grant supports a training program is for Liberian Researchers to combat emerging infectious disease outbreaks, such as Ebola. Faculty at BUMC/BUSPH and the University of Liberia co-mentor trainees.

Andrew Henderson

Global Health Research Training

Fogarty global health training fellowship.

This program provides mentored research opportunities to train and prepare a new cadre of health professionals in the US and LMICs in global health research by enhancing the trainees’ ability to independently plan, implement, and assess innovative clinical or operations research focused on reducing mortality and morbidity associated with HIV/AIDS and associated co-infections, NCDs including cardiovascular disease and diabetes, mental health, and MCHN. Academic partners include Harvard University (Harvard T. H. Chan School of Public Health, Harvard Global Health Institute), Boston University (Schools of Public Health and Medicine), Northwestern University (Center for Global Health, Feinberg School of Medicine) and the University of New Mexico (School of Medicine, Center for Global Health).

Bangladesh, Botswana, Ghana, India, Kenya, Nigeria, Mali, Peru, South Africa, Thailand, Uganda, Zambia

Health Services Research

Indlela: a nudge unit to build capacity in behavioral economics and increase hiv program effectiveness in south africa.

Indlela is the first-of-its-kind unit focused specifically on improving the effectiveness of the public sector in delivering health care and achieving better health outcomes in South Africa. In the unit’s first 3 years it will focus specifically on building capacity to expand the use of behavioral economics within HIV prevention and treatment programs in South Africa and strengthen the ability of health service delivery providers and key research institutions to develop and test contextually appropriate interventions that are informed by behavioral insights. In future years, the scope will expand beyond HIV to include other public health issues in South Africa.

Lawrence Long

South Africa

Providence/Boston Center for AIDS Research (CFAR)

The major goals of this project are to foster HIV Research and collaborations between Brown and Boston University Developing young investigators.

Matthew Fox

US, Ukraine, Kenya, South Africa, the Philippines

Dartmouth-Boston University HIV-TB Research Training for the Infectious Disease Institute at Muhimbili University of Health and Allied Sciences (MUHAS)

The major goals of this project are to train Tanzanian citizens in clinical HIV/AIDS research and to estaqblish san Infectious Dsieases Institute at MUHAS.

Robert Horsburgh

Boston University’s Contributions to the Enhanced Mentor Mother Program (EMMA) Study for USG FY2021-22.

During 2014-2019, BU collaborated with the Walter Reed Project and the Kenya Medical Research Institute to complete a study titled: “Evaluating the effectiveness of implementing Option B+ under routine conditions with and without the PMTCT Patient Coordinator Program: A site-randomized impact evaluation among maternal and child health centers supported by the South Rift Valley PEPFAR program in Kenya.” The focus of this additional grant is to complete final data extraction and analysis for infant HIV testing outcomes (testing and HIV status at 18 months of age).

Bruce Larson

AMBIT: Alternative Models of ART Delivery: Optimizing the Benefits 

Many high HIV-prevalence countries are scaling up differentiated service delivery (DSD) models for providing antiretroviral treatment for HIV. DSD models adjust the location, frequency, provider cadre, and other aspects of service delivery to make HIV treatment more patient-centric and more efficient. Little is known about the true impact of DSD models on the health system or patients, however. AMBIT is a research project in sub-Saharan Africa comprising synthesis of existing data, new data collection, data analysis, and modeling activities aimed at generating information for near- and long-term decision making for scaling up DSD models in Malawi, Zambia, and South Africa.

Sydney Rosen

Malawi, Zambia, South Africa

Evaluating the Cost of Scaling PrEP Access through Novel Delivery (EXPAND). 

Blurb: This is an economic evaluation of three demonstration projects that are testing different service delivery approaches for PrEP in South Africa. Each of the demonstration projects uses a different delivery model to reach populations at increased risk for HIV acquisition to offer them oral PrEP. These models will also be adapted for the delivery of long-acting injectable PrEP as soon as this becomes available in South Africa. The economic evaluation includes qualitative work, baseline assessment, patient costs, and the cost of delivery PrEP from the provider perspective. We also include a cross-cutting component focused on local capacity building in costing and economic evaluations.

Retain6: Models of care for the first 6 months of lo treatment

For HIV-positive patients in sub-Saharan Africa and globally, the first six months after initiating lifelong antiretroviral therapy (ART) pose the greatest risk of loss to follow up. Patients who make it through the first six months have a good chance of being retained on ART for the long term, but many drop out before reaching the six-month point. The Retain6 project aims to develop new models of differentiated service delivery for patients in their first six months on ART, in an effort to improve retention in care during this period.

Zambia, South Africa

CAB-RPV LA Implementation Strategies for High-Risk Populations.

This will be an evaluation of a new injectable antiretroviral treatment for HIV-positive individuals receiving care at the Boston University Medical Center and its associated community-based outreach clinics. It includes qualitative research on preferences of patients and providers and a randomized controlled trial to assess feasibility and impact.

Mari-Lynn Drainoni (BMC)

The SUpporting Sustained HIV Treatment Adherence after INitiation ( SUSTAIN study)

Early detection of poor adherence to antiretroviral treatment (ART) and linkage to support for new patients is critical. The objective of this study is to improve ART adherence, retention and viral outcomes in people commencing ART in the South African public sector, a low-resource setting, over 24 months using five evidence-based adherence strategies to enable rapid identification and management of people with poor adherence. We will test the combinations of these components using a Multiphase Optimization STrategy (MOST) design, which allows us to explore the benefit of various combinations of these five effective and feasible ART adherence monitoring or support components.

Faculty/PI: Lora Sabin (PI), Nafisa Halim (Co-I), Bill MacLeod (Co-I), Allen Gifford (Co-I)

Location: South Africa

Zambia Infant Cohort Study

The ZICS study will determine if antiretroviral regimens used to successfully prevent mother to child transmission of HIV have also decreased morbidity and mortality among the children born to these mothers but who, themselves, have escaped infection with HIV. If not, then further investigation of the cause of poor outcomes in these children will be necessary. We will also determine if the mother’s immune status is a determinant of poor health outcome in their uninfected children, and in their infants early immune status.

Donald Thea

Zambia Infant Cohort Study: Brain Optimized to Survive and Thrive (ZICS-BOOST)

Children exposed to HIV in-utero but uninfected (CHEUs) number 14.8 million globally. In Zambia, an estimated 56,000 CHEUs are born annually, a staggering fraction of the national birth cohort. Multiple studies establish that CHEUs are more neurodevelopmentally vulnerable than HIV-unexposed peers. In Zambia, there are existing effective early childhood developmental (ECD) interventions that target other vulnerable populations, but never trialed specifically for CHEUs. GAP: Research is needed to evaluate the effectiveness of a scalable early childhood development (ECD) intervention for CHEUs. Zambia is scaling up ECD as part of its national strategy, but CHEUs are not currently targeted. There is need to better understand the scope and mechanism of HEU-related neurodevelopmental differences and what interventions are most effective. HYPOTHESIS #1: An ECD intervention delivered by community health workers via bi-weekly home visits will improve neurodevelopmental outcomes in CHEUs. HYPOTHESIS #2: CHEUs have significantly worse neurodevelopmental outcomes than unexposed peers at 24 months, mediated by preterm birth, disease stage or ARV exposure. METHODS: In order to observe differences in neurodevelopment between HIV-exposed and HIV-unexposed children, we will build upon an existing Zambian birth cohort by extending follow-up from 6 months to 2 years (n=450). Neurodevelopmental assessments will be measured by multiple context-validated tools at 12 and 24 months. In addition, a randomized control trial of a bi-weekly community health worker-delivered ECD intervention for CHEUs will be conducted to assess its impact on CHEU neurodevelopment. RESULTS: Pending. IMPACT: Despite growing evidence, HIV-exposure is not currently prioritized as a risk factor for poor development by policy makers or ECD programs. By capitalizing on the wealth of prenatal and infant data collected in our ‘parent’ study, we can investigate the mechanism that links HEU to neurodevelopment and test a potential therapy. Addressing developmental vulnerability in CHEUs is paramount to ensuring that future generations of children are school ready, and able to reach their full developmental potential.

Julie Herlihy

EVIDENCE: Evaluation to Inform Decisions using Economics and Epidemiology

EVIDENCE is a 5-year HIV/AIDS project funded by PEPFAR through USAID. With the project lead in South Africa, the Health Economics and Epidemiology Research Office (HE2RO), we conduct health economics and epidemiology evaluations and provide technical assistance in support of the goals of the South African National Strategic Plan for HIV, TB and STIs (NSP) and the PEPFAR Country Operational Plan. BU faculty and staff work closely with HE2RO on project evaluations, cost modeling, outcomes research, and financial management to improve guidelines, policies, programs, and resource allocation.

Economic Impact of HIV Policy Briefs

This project synthesises the evidence on the economic impact of HIV into a series of 17 policy briefs that can help decision-makers in ministries of finance and health in low- and middle-income countries (LMIC) decide on the future financing of their country’s HIV programme. The project incorporates a series of seminars with an academic and LMIC government staff audience aimed at refining the content and presentation of the briefs, the presentation of the evidence base to LMIC decision makers during a comprehensive workshop, and the publication of the briefs on a website and in peer-reviewed journals.

Gesine Meyer-Rath

infectious disease

Vaccine impact modelling consortium (vimc) 2.0  .

VIMC   is an international community of modelers providing high-quality estimates of the public health impact of vaccination to inform and improve decision making. This project contributes to the estimation of cervical cancer disease burden and human papillomavirus (HPV) vaccine impact in low- and middle-income countries. In addition, this project examines policy-relevant research questions for HPV vaccines in order to advance the research agenda in the field of vaccine impact modeling.

 Allison Portnoy

Low- and middle-income countries worldwide

INSECT: Implementing Novel Strategies for Education and Chagas Testing  

This project, funded by a CDC cooperative agreement, aims to increase Chagas knowledge in the medical community and to roll out screening programs for high-risk populations (such as women of childbearing age from endemic areas) nationwide.

Boston, Massachusetts

Chagas disease biorepository

We have developed a biorepository using biological samples from a cohort of Chagas disease patients at Boston Medical Center. The primary goal of the biorepository is to develop and maintain a large, geographically diverse collection of well-characterized samples to be used as a resource for future Chagas diagnostics research.

Incorporating Behavioral Feedback in the Infectious Disease Transmission Modeling

Transmission dynamic modeling is a powerful tool to understand the epidemiology of infectious diseases and evaluate the impact of control measures. However, the lack of empirical data on human behavior and its temporal variation has hindered the progress and application of these models. Therefore, this project aims to 1) understand how people experiencing acute infections change their social contact patterns over the course of their illness and 2) develop mechanistic models that incorporate these data to generate more reliable estimates of key transmission parameters and intervention impacts. Our project aims to provide policy makers and public health officials with more informed decision-making tools to develop interventions, ultimately leading to improved health outcomes.

Kayoko Shioda

United States

EPISTORM: Real-time Evaluation of Vaccine Effectiveness and Safety

Real-time monitoring of the effectiveness and safety of vaccines is essential for controlling infectious diseases. However, there are both practical and methodological hurdles. Our project aims to address two key challenges: 1) issues with linking public health data from different sources, and 2) analytic challenges associated with evaluating multi-dose vaccines, using causal inference techniques. Boston University has been selected to be part of the national network for outbreak and disease modeling led ( CDC Insight Net ), and this project will be conducted through this network.

Cryptococcal Meningitis Screening in South Africa

Cryptococcal meningitis (CM) is a fungal infection that causes infection in the brain and spinal cord. CM is a leading cause of AIDS-related deaths globally, mainly among patients with low CD4 cell counts. Through screening HIV patients with low CD4 cells counts for cryptococcal antigen (CrAg), it is possible to identify CrAg-positive patients before they develop meningitis. Treating these patients with antifungal medications can then substantially reduce risks of progression to CM and death. Through support from the CDC Foundation (May 2015 – June 2021), the purpose of this program of research has been to evaluate costs and effectiveness of alternative CrAg screening strategies and CM treatment regimens.

Using Behavioral Economics to Improve the Uptake of and Persistence on Pre-exposure Prophylaxis in Men Who Have Sex With Men to Prevent HIV Infection

South Africa’s HIV incidence remains high, in particular amongst populations such as men who have sex with men (MSM) who may be at increased risk. HIV pre-exposure prophylaxis (PrEP) is considered key to reducing incidence in these populations, yet pilot studies show sub optimal uptake and poor persistence amongst those most at risk. This research will focus on understanding why PrEP uptake and persistence amongst MSM in South Africa is low and how the delivery of PrEP to this population could be altered to encourage those most at risk to start treatment using behavioral insights.

Impact of Undernutrition on Immunity Elicited by Vaccines in the Gambia

Moderate and severe undernutrition are highly prevalent in several resource-limited countries. There is conflicting evidence on the impact of undernutrition on the immunity elicited by childhood vaccines, as well as the specific supplements that could be used to overcome vaccine hypo-responses associated with undernutrition. In a pilot project in The Gambia, we are comparing antibody vaccine responses against a panel of EPI vaccines of children with severe wasting and stunting with well-nourished children. Furthermore, through a metabolomics assay, we will assess whether specific amino acid deficiencies are associated with decreased responses in undernourished children.

IPV (intimate partner violence)

Testing the effectiveness of an evidence-based transdiagnostic cognitive behavioral therapy approach for improving hiv treatment outcomes among violence-affected and virally unsuppressed women in south africa.

This study will evaluate the impact of the Common Elements Treatment Approach (CETA), an evidence-based intervention comprised of cognitive-behavioral therapy elements, at improving HIV treatment outcomes among women with HIV who have experienced intimate partner violence (IPV) and have an unsuppressed viral load on HIV treatment. To evaluate CETA, we will conduct a randomized controlled trial of HIV-infected women, with or without their partners, who have experienced IPV and have an unsuppressed viral load to test the effect of CETA in increasing viral suppression and reducing violence.

The Intransigence of Malaria in Malawi: Understanding Hidden Reservoirs, Successful Vectors and Prevention Failures

Under the aegis of the Malawi International Center of Excellence of Malaria Research (ICEMR) program, several cohort studies have been conducted focused on studying malaria control measures and understanding why measures such as bed nets have failed to control malaria in Malawi. Examples of these studies are the one led by Dr. Valim aiming to identify the transmission reservoir group(s) for malaria in Malawi and to assess the impact of current interventions on these human reservoirs. Another study conducted under the aegis of ICEMR aims to assess the effectiveness of the RTS,S malaria vaccine in conjunction with other malaria prophylactic measures.

Maternal and Child Health

Global network for women’s and children’s health research.

The Global Network conducts observational studies and clinical trials in 8 locations in low and middle income countries in Asia, Africa and Central America. The goals of the research are (1) to evaluate whether low-cost, sustainable interventions improve maternal and child health; and (2) build local research capacity and infrastructure. Whenever possible common protocols are implemented in all 8 locations. The Boston University site works with the Lata Medical Research Foundation in Nagpur, India. The grant funds several studies.

Synbiotics for the Early Prevention of Severe Infections in Infants (SEPSIS)

SEPSIS, a collaboration between icddrb (Dhaka), Hospital for Sick Kids (Toronto), and BU consists of a few related studies including an observational cohort of severe infections and the intestinal microbiome in young infants in Dhaka, Bangladesh and a phase II randomized, placebo-controlled trial of the efficacy, safety, and tolerability of neonatal administration of Lactobacillus plantarum ATCC 202195 with or without fructooligosaccharide for one or seven days

Antimicrobial Resistance

A-plus trial: multi-site efficacy and safety trial of intrapartum azithromycin in lmics – amr sub-study and effect of azithromycin on the developing microbiome ..

The Global Network is conducting a trial to evaluate whether Azithromycin given during labor reduces maternal and neonatal infections and mortality. This grant supports studying the effect of azithromycin on development of antimicrobial resistance and the gut and airway microbiome.

Sequencing of Klebsiella pneumoniae isolates from Zambia

Bloodstream isolates (K. pneumoniae and E. coli) from the Sepsis Prevention in Neonates in Zambia study are being sequenced to determine serotypes and antibiotic resistance characteristics.

Non-communicable Diseases

World health organization. global ncd reporting mechanism..

Veronika Wirtz & Peter Rockers

In 2021, the World Health Organization introduced the Global Diabetes Compact, targeting equitable and affordable access to diabetes care, particularly in low- and middle-income countries. Acknowledging the support from the private sector, WHO formulated a list of 31 asks to prioritize expansion of access to essential insulin and related health technologies. Boston University is now supporting WHO in developing a Global Reporting Mechanism (GRM) to encourage the reporting and tracking of industry commitments aligned with the 31 WHO Asks.

Noncommunicable Disease Management in South Africa: Insights from the National Health Laboratory Services (NHLS) Multi-morbidity Cohort.

The K01 Award (K01DK116929) addresses the growing challenge of Type 2 Diabetes Mellitus (T2DM), focusing on care disparities and treatment efficacy, particularly among populations living with and without HIV in low- and middle-income countries. Central to this project is the innovative application of a probabilistic record-linking algorithm to develop a patient cohort from the National Health Laboratory Services (NHLS) database in South Africa, which contains over 68 million laboratory records from more than 30 million individuals and covers conditions like HIV, tuberculosis, diabetes, kidney disease, and cardiovascular disorders from April 1, 2004, to March 31, 2017.

The creation of the NHLS Multi-morbidity Cohort has facilitated in-depth analysis of data including anonymized patient identifiers, demographics, test specifics, and geographic information. This cohort is instrumental for the project’s aims to examine examining the T2DM care cascade in populations with and without HIV, evaluate the Integrated Chronic Disease Management (ICDM) model’s impact on diabetes care using quasi-experimental methods, studying chronic kidney disease progression , and evaluating compliance with national diabetes guidelines . These efforts aim to enhance understanding and improve management of noncommunicable diseases in South Africa.

Alana Brennan

World Bank Global compendium of primary care service delivery models for non-communicable diseases

(link to report should be available in June 2024)

Addressing the challenges within non-communicable disease programs and primary healthcare centers, the World Bank embarked on a project to gather a comprehensive collection of primary care service delivery models for non-communicable diseases. This initiative highlighted the critical need for a cohesive approach to primary healthcare, which includes the promotion, prevention, and management of non-communicable diseases, aiming to improve care across the entire spectrum, from reducing risk factors to managing chronic conditions at the primary care level effectively. The project’s goal was to develop an online, action-oriented collection for the World Bank, filled with innovative design solutions and digital enhancements to boost access, efficiency, effectiveness, and the quality of care for non-communicable diseases. This collection intended to present a wide array of primary healthcare models designed for chronic conditions, supporting countries in their shift towards integrated, chronic care services and moving away from a reliance on acute, episodic care.

The project culminated in a comprehensive matrix featuring 158 models, alongside 60 concise two-page case reports and 15 detailed five-page case reports. These documents collectively highlight a diverse range of primary care service delivery models for non-communicable diseases, spanning various geographic regions and income categories. Sub-Saharan Africa was prominently featured, accounting for 26.6% of the models, with East Asia and the Pacific at 22.8%, and South Asia at 20.2%. Most of these models were found in upper-middle-income and lower-middle-income countries, making up 45.6% and 42.4% of the implementations, respectively. Diabetes stood out as the most common focus, being the target of 50.0% of the models, followed by hypertension at 41.8% and mental health disorders at 38.0%. The main strategies highlighted in these models were task-shifting/task-sharing (40.5%), the integration of new services or conditions (35.4%), and educational or training initiatives (33.5%). The implementation settings varied, with mixed areas being the most common at 41.8%, and rural and urban areas following at 24.7% and 22.1%, respectively. The scale of implementation predominantly ranged from small to medium, accounting for 55.1% of the models, but there were also notable instances of large-scale and national-scale projects at 20.2% and 10.1%, respectively, highlighting the extensive reach and potential impact of these initiatives.

Alana Brennan, Nancy Scott , Sydney Rosen

low-and middle-income countries

Opportunistic screening for hypertension and type 2 diabetes mellitus using COVID-19 infrastructure

South Africa continues to grapple with a substantial burden of non-communicable diseases, particularly type 2 diabetes and hypertension. However, these conditions are often underdiagnosed and poorly managed, further exacerbated by the strained primary healthcare system and the disruptive impact of the COVID-19 pandemic. Integrating non-communicable disease screening with large-scale healthcare initiatives, such as COVID-19 testing and vaccination campaigns, offers a potential solution, especially in low- and middle-income countries. We investigated the feasibility and effectiveness of this integration in two separate cohorts.

Study 1: Integration of point-of-care screening for type 2 diabetes mellitus and hypertension with COVID-19 rapid antigen screening in Johannesburg, South Africa

In a prospective cohort study at the Germiston taxi rank in Johannesburg, South Africa, we assessed the integration of screenings for type 2 diabetes mellitus and hypertension with rapid antigen tests for COVID-19. The study involved 1,169 participants and included measurements of blood glucose, blood pressure, waist circumference, smoking status, height, and weight. Participants showing elevated blood glucose levels (fasting levels equal to or greater than 7.0 or random levels equal to or greater than 11.1 millimoles per liter) and/or elevated blood pressure readings (diastolic pressure equal to or greater than 90 and systolic pressure equal to or greater than 140 millimeters of mercury) were directed to receive clinical follow-up. Our results indicated an overall diabetes prevalence of 7.1%, incorporating both previously diagnosed individuals and those newly identified with elevated blood glucose measurements. We also observed a hypertension prevalence of 27.9%, which included both known cases and new detections of elevated blood pressure during the study. However, the rates of connecting these individuals to subsequent medical care were low, with only 30.0% of those with elevated blood glucose and 16.3% with elevated blood pressure engaging in follow-up care. This opportunistic approach to screening helped identify potential new diagnoses in 22% of participants, yet it also underscored the necessity for better strategies to ensure these individuals receive the necessary ongoing care, highlighting the critical need for additional research to determine the feasibility and effectiveness of such integrated screening programs on a larger scale.

Study 2: Integration of point-of-care screening for type 2 diabetes mellitus and hypertension into the COVID-19 vaccine programme in Johannesburg, South Africa

In a prospective cohort study at four health facilities in Johannesburg, South Africa, we screened 1,376 participants for hypertension and type 2 diabetes mellitus during COVID-19 vaccination campaigns. This integration aimed to address the significant problem of undiagnosed conditions in a strained healthcare system. We measured blood glucose, blood pressure, waist circumference, smoking status, height, and weight, referring individuals with elevated blood glucose (fasting levels equal to or greater than 7.0 or random levels equal to or greater than 11.1 millimoles per liter) and/or blood pressure (diastolic pressure equal to or greater than 90 and systolic pressure equal to or greater than 140 millimeters of mercury) for further medical evaluation. Our findings showed a 4.1% prevalence of diabetes, combining known cases and new detections of elevated blood glucose levels. The hypertension prevalence was 19.4%, including both existing and newly identified cases of elevated blood pressure. Notably, 46.1% of participants exhibited waist circumferences indicative of metabolic syndrome, more frequently observed in females. Additionally, 7.8% of the screened individuals were potentially newly diagnosed with diabetes or hypertension, emphasizing the importance of integrated screening initiatives. Approximately half of the individuals with newly identified risk factors successfully sought follow-up care within a month, highlighting the effectiveness of using routine healthcare interactions for extensive screenings, particularly vital in settings with limited resources, and underscoring the need to improve linkage to care for efficient management of non-communicable diseases.

Alana Brennan, Gesine Myer-Rath

Assessing the effects of HIV disease on dysglycemia in a cohort of tuberculosis patients in South Africa’s Western Cape

Our planned research will focus on compare rates of dysglycemia (both hyperglycemia and hypoglycemia) in people living with HIV (PLWH) and HIV-uninfected persons receiving tuberculosis (TB) treatment using pilot data from the The Impact of Alcohol Consumption on TB Treatment Outcomes (TRUST) Study . HbA1c’s were only collected at enrollment the TRUST. As such, we will collect blood samples to measure HbA1c and blood glucose levels at patients 18-month study visit. This will allow us to assess changes in blood glucose levels from study enrollment by HIV status. Second, we will assess the role stress and inflammation play in relation to blood sugar levels in PLWH and HIV-uninfected individuals. Research suggests that the hosts immune response to active TB and/or HIV disease results in a prolonged state of systemic inflammation which can have negative metabolic effects. We will collect samples to measure markers of stress and inflammation at the 18-month study visit when all patients will be one year post TB treatment completion and when transient hyperglycemia due to TB infection should be resolved. This will be preliminary data to assess if there are differences in these specific stress and inflammatory markers post TB treatment amongst PLWH and HIV-uninfected individuals and potentially identify underlying mechanism(s) causing abnormal blood sugar levels.

Programme Evaluation of Timor-Leste PEN-HEARTS Intervention

This project will evaluate early implementation in Timor-Leste of PEN-HEARTS, a community-based intervention supported by the WHO designed to improve health outcomes among individuals with non-communicable diseases such as diabetes. Building on a similar evaluation in Bhutan, a BU team of faculty and students will design and implement the evaluation with WHO and Ministry of Health officials in Timor-Leste. The evaluation will use mixed methods and involve data collection in both intervention and comparison sites in four districts of Timor-Leste.

Timor-Leste

Pharmaceutical Policy

Medicines, technologies, and pharmaceutical services.

The Medicines, Technologies and Pharmaceutical Services (MTaPS) project aims to strengthen pharmaceutical systems in low and middle income countries. Boston University is a core partner of the USAID funded MTaPS project led by Management Sciences for Health. The objectives are (1) to generate evidence on the development, implementation and strengthening of data management that can support decision-making in pharmaceutical systems; (2) to develop, implement and evaluation accountability mechanisms in pharmaceutical systems.

Veronika Wirtz

Tuberculosis

Methods to estimate the impact of interventions on the transmission and incidence of tuberculosis.

The major goals of this project are to develop models that can be used to monitor the success of TB interventions. This project is a collaboration with Dr. Helen Jenkins and Dr. Leo Martinez and is led by Dr. Laura White of the BUSPH Department of Biostatistics

Intensified patient-finding intervention to increase the detection of children with tuberculosis

Children with tuberculosis are vastly under detected and under diagnosed. An intensified patient-finding intervention using systematic verbal screening at health facilities was undertaken in two locations to increase the detection of children who may be at high risk for tuberculosis disease. These projects aim to identify gaps along the pediatric tuberculosis care cascade; understand age-specific clinical presentation and risk factors for tuberculosis disease, extrapulmonary presentations, and poor treatment outcomes; refine clinical algorithms to expedite decision-making for treatment initiation; and explore other topics related to pediatric tuberculosis epidemiology.

Meredith Brooks

Pakistan and Bangladesh

SAIA-TB: Using the Systems Analysis and Improvement Approach to Prevent TB in rural South Africa

Description: South Africa estimates 80% of their population has TB infection, and 14% of the population lives with HIV, with an estimated 5-15% of South Africans at high risk of developing TB disease from recent infection or immunocompromised status. Therefore, utilization of routinely collected data to optimize the comprehensive TB care cascade – screening, evaluation, diagnosing, linkage to care, treatment, and TB-free survival – is important to assess at the clinic level to improve clinic flow and patient outcomes. This study—funded by NINR/NIH—will leverage an evidence-based implementation science strategy, the Systems Analysis and Improvement Approach (SAIA), and recent TB cascade analyses piloted in the proposed site, to adapt and evaluate the effectiveness of SAIA-TB using a stepped wedge crossover cluster randomized trial across 12 clinics in rural Eastern Cape, South Africa.

Improving Childhood Tuberculosis Treatment Outcomes and Post-TB Lung Functioning and Quality of Life in Rural South Africa

Description: We will assess the TB care cascade in children, expanding it to include a child-specific definition of post-TB lung disease (PTLD), among children in a high TB/HIV burden setting in Eastern Cape South Africa, and identify risk-factors for completing each step of the newly expanded TB care cascade. Additionally, we will collect rich data regarding nutritional status, air pollutant exposure, lung capacity, and quality of life to estimate their effect on TB disease outcomes and PTLD in children. Funded by the Charles H. Hood Foundation.

Household Contact Tuberculosis Preventive Therapy Programs in Rural Eastern Cape, South Africa (KWIT-TB)

Description: We will assess the geospatial components, including access to care and population-level characteristics to gaps in the TB preventive therapy care cascade.

Adaptive Design to Aid in the Planning of community-based Tuberculosis screening services (ADAPT-TB)

Description: Community-based screening via mobile units can close gaps in missed diagnoses by bringing screening services into communities, making screening more convenient for individuals with limited access to appropriate services. Questions remain, however, about how to efficiently operate these mobile units. Leveraging longstanding relationships in Lima, Peru, including existing collaborations involving mobile screening units, I will collect data from health facilities and mobile screening units to [Aim 1] establish spatial and temporal trends of the local tuberculosis burden and [Aim 2] build neighborhood-level models reflecting local risk of tuberculosis. I will then [Aim 3] develop a baseline decision model via a restless multi-armed bandit framework to make data-driven decisions about where, when, and how long to place the mobile units in the community. The overall goal is to optimize the real-time movement of these units throughout a community to increase the detection of individuals with TB and allocate resources more efficiently. Funded by a Carlin Foundation Award for Public Health Innovation and a Population Health Data Science (PHDS) Seed Funding Award.

Optimizing tuberculosis elimination initiatives for high-risk populations

Certain populations are at increased risk of tuberculosis infection and progression to tuberculosis disease. In Mexicali, Mexico, we are assessing the impact of novel diagnostics for tuberculosis infection testing in three high-risk populations–people who use drugs, household contacts of people with tuberculosis, and people confined to a penitentiary setting–to inform tailored algorithms for tuberculosis testing and initiation of tuberculosis preventive treatment. We also assess gaps identified along the tuberculosis comprehensive care cascade to guide local tuberculosis prevention and management guidelines.

Tuberculosis in teens: a geospatial approach to predict community transmission

Description: Adolescents are a unique population that have been routinely neglected from tuberculosis guidelines. However, due to their ability to spread tuberculosis and their high number of social contacts, adolescents may be a key node fueling cycles of local community tuberculosis transmission in high incidence settings. Through a K01 Award from NIAID, NIH, we use geospatial and genotypic analyses to complete the following objectives: (1) To characterize the spatial heterogeneity of tuberculosis transmission events in adolescents. (2) To predict the spatial distribution of tuberculosis transmission events in adolescents. (3) To estimate and compare, through simulation, the impact of adolescent-tailored screening and treatment interventions on reducing community tuberculosis transmission.

Predictors of Resistance Emergence Evaluation in MDR-TB Patients on Treatment.

Dr. Horsburgh and Dr. Tim Sterling of Vanderbilt are leading a prospective cohort study of patients with MDR-TB. The aims of the study are to determine if decreased TB drug levels predispose to the development of additional drug resistance on treatment and to develop early indicators of such emergence of resistance.

US, India, Brazil

RePORT India Consortium

The major goal of this project is to collaborate with partners in India in clinical studies of tuberculosis infection and disease.

Akshay Gupte

Transmission of Tuberculosis among illicit drug use linkages

The goal of this project is to assess the risk for TB transmission between persons who smoke drugs. This is a prospective cohort study of persons with and without drug use in South Africa.

Karen Jacobson

US, South Africa

Prevention Policy Modeling Lab

The Goal of this Project is to develop cost-effectiveness models for TB prevention. This project is a collaboration with Dr. Nick Menzies at Harvard School of Public Health and Dr. Josh Solomon at Stanford School of Medicine.

DRAMATIC Phase 2 Duration Randomized MDR-TB Treatment Trial

The major goal of this project is to identify a shorter, less toxic treatment for MDR-TB.  This project is a collaboration with Dr. Payam Nahid at University of California, San Francisco. It is randomizing patients with fluoroquinolone-susceptible MDR-TB in Vietnam and the Philippines to four different durations of a 5-drug regimen.

US, Vietnam, the Philippines

Phenotype, Progression and Immune Correlates of Post-Tuberculosis Lung Disease

Pulmonary tuberculosis (PTB) is associated with lung injury which can persist despite successful therapy. Lung sequelae of treated PTB are increasingly recognized as an independent risk factor for chronic obstructive pulmonary disease (COPD) and, an important contributor of excess morbidity and mortality. This project aims to: 1) characterize the early natural history of post-TB lung disease (PTLD) and provide rationale for long-term monitoring and bronchodilator therapy in affected cases, 2) characterize the functional and morphological phenotype of PTLD by serial pulmonary function testing and multi-detector computed tomography, 3) identify immune profiles measured during early, late and post-therapy associated with PTLD.

RePORT-India Lung Health Study

Pulmonary tuberculosis (PTB) is the most common form of TB disease and is characterized by granuloma formation, necrosis, and cavitation in the lung tissue. This lung injury in PTB may affect tuberculosis treatment outcomes. Granulomatous lesions, fibrosis, and cavitation impair drug penetration in affected lung tissue and may lead to persistent foci of bacterial replication and drug resistance. The overall goal of this project is to identify clinical and imaging markers of lung injury that are associated with unfavorable treatment outcomes in PTB.

Multiomic signatures of Lung Injury in Tuberculosis

Pulmonary tuberculosis (PTB) is associated with lung injury which can persist despite successful therapy. Lung sequelae of treated PTB are increasingly recognized as an independent risk factor for chronic obstructive pulmonary disease (COPD) and, an important contributor of excess morbidity and mortality. Furthermore, PTB is characterized by granuloma formation, necrosis, and cavitation in the lung tissue which can impair drug penetration in affected lung tissue leading to persistent foci of bacterial replication, drug resistance and poor treatment outcomes. The overall goal of this study is to explore host metabolomic and genetic signatures associated with lung injury in PTB patients with and without diabetes and HIV.

Point-of-care Questionnaire and mHealth Assisted Diagnosis of Post-TB Lung Disease

Pulmonary tuberculosis (PTB) is associated with lung injury which can persist despite successful therapy. Lung sequelae of treated PTB are increasingly recognized as an independent risk factor for chronic obstructive pulmonary disease (COPD) and, an important contributor of excess morbidity and mortality. Spirometry is the gold standard for diagnosing lung function defects, however it is technically challenging and expensive to perform, and may not be available at the point-of-care in many TB-endemic settings. The overall goal of this project is to develop and validate a questionnaire-based screening algorithm, assisted by machine learning analysis of cough sounds and lung auscultation data, to identify individuals with a high probability of having Post-TB Lung Disease for referral and confirmatory testing.

Effectiveness of Anti-Fibrotic Therapy for Preventing Pulmonary Impairment in COVID-19

COVID-19 is associated with persistent pulmonary impairment despite successful management of acute disease. Of particular interest is pulmonary fibrosis, with several studies reporting reduced FVC, DLCO and anterior reticulation on chest CT. The overall goal of this project is to conduct a retrospective analysis of medical records to measure the association between receipt of antifibrotic therapy (Pirfenidone and/or Nintedanib) and lung impairment following hospital discharge among adults with COVID-19.

Veterans health

Bridging the care continuum for vulnerable veterans across va and community care (bridgecc) queri program.

Led by investigators at the Bedford VA, this project is implementing three evidence-based practices (EBPs) that aim to improve coordinated care between VA and non-VA providers to improve the health of veterans. The EBPs focus on 1) homeless overdose prevention expansion; 2) maintaining independence and sobriety through systems integration and outreach; and 3) post-incarceration engagement to increase social support. Dr. Sabin is guiding the costing components for each EBP.

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More Black Americans die from effects of air pollution

A new study reveals social factors that increase the risk of dying from air pollution and finds stark racial disparities.

July 16, 2024 - By Nina Bai

Snova and 5D Media / Shutterstock.com

Everyone knows that air pollution is bad for health, but how bad depends a lot on who you are. People of different races and ethnicities, education levels, locations and socioeconomic situations tend to be exposed to different degrees of air pollution. Even at the same exposure levels, people’s ability to cope with its effects — by accessing timely health care, for example — varies.

A new study by Stanford Medicine researchers and collaborators, which takes into account both exposure to air pollution and susceptibility to its harms, found that Black Americans are significantly more likely to die from causes related to air pollution, compared with other racial and ethnic groups. They face a double jeopardy: more exposure to polluted air along with more susceptibility to its adverse health effects because of societal disadvantages.

“We see differences across all factors that we examine, such as education, geography and social vulnerability, but what is striking is that the differences between racial-ethnic groups — partially due to our methodology — are substantially larger than for all of these other factors,” said Pascal Geldsetzer , MD, PhD, assistant professor of medicine and lead author of the study published July 1 in Nature Medicine .

The results demonstrate how air pollution can drive health inequities, contributing a large portion to the difference in mortality rates among different groups.

Yet, by the same token, the researchers say that reducing air pollution could be a powerful and achievable way to address these inequities.

Fine particles

Air quality throughout the U.S. has improved dramatically over the last few decades, thanks in large part to regulations such as the Clean Air Act , which sets limits on air pollutants emitted by industries and other sources.

Among the pollutants most linked to health, and the focus of the new study, is fine particulate matter, referred to as PM2.5 because it includes particles less than 2.5 micrometers in diameter. These particles are small enough to enter the bloodstream and affect vital organs.

“It’s very well recognized that PM2.5 is the biggest environmental killer globally,” said Tarik Benmarhnia, PhD, associate professor at the University of California, San Diego’s Scripps Institution of Oceanography and the senior author of the study.

Pascal Geldsetzer

Exposure to these fine particles can exacerbate asthma and chronic obstructive pulmonary disease in the short term, and in the long term contribute to heart disease, dementia, stroke and cancer.

In 1990, 85.9% of the U.S. population was exposed to average PM2.5 levels above 12 micrograms per cubic meter — the threshold set by the Environmental Protection Agency. In 2016, only 0.9% of the population was exposed to average levels above the threshold. (In February, the agency lowered the limit to 9 micrograms per cubic meter.)

Despite these significant improvements, not all communities have benefitted equally.

Benefits may vary

In the new study, the researchers wanted to see just how much PM2.5 levels contributed to mortality in people of different races and ethnicities, education, location (metropolitan or rural) and socioeconomic status.

They used existing county-level data on mortality along with census-tract-level data on PM2.5 air pollution and population from 1990 to 2016. They employed models derived from previous epidemiological studies, known as concentration-response functions, that linked certain deaths to air pollution levels. They chose a model that accounted for differences in susceptibility among racial and ethnic groups.

“Concentration-response functions are essentially saying, if you get exposed to this much more air pollution, then you would expect, on average, this much more risk of death,” Geldsetzer said.

Though deaths related to PM2.5 levels fell overall, some groups remained more affected than others. The researchers found higher rates of PM2.5-attributable mortality in people with less education; those living in large metropolitan areas; and those who were more socially vulnerable due to housing, poverty and other factors. People in the Mountain West states were less likely to die from PM2.5 pollution than people in other regions.

But the starkest disparities appeared when researchers sorted the data by race and ethnicity.

In 1990, the PM2.5-attributable mortality rate for Black Americans was roughly 350 deaths per 100,000 people, compared with less than 100 deaths per 100,000 people for each of the other races. By 2016, PM2.5-attributable mortality had fallen for all groups. Black Americans experienced the largest decline, to around 50 deaths per 100,000 people, yet were still the highest among all groups.

These relative trends were consistent throughout the country. In 96.6% of counties, Black Americans had the highest PM2.5-attributable mortality.

Among all the factors the researchers considered, race was the most influential in determining mortality risk from air pollution. They found that Black Americans have more exposure to air pollution, and its effects on mortality are amplified by factors such as poverty, existing medical conditions, more hazardous jobs, and lack of access to housing and health care.

Race and racism play into many of these amplifying factors, the researchers noted.

“Racism is an upstream driver of all these components of social inequality,” Benmarhnia said.

Taking action

“Air pollution is increasingly being recognized in public health as a cause of adverse health consequences that’s larger than people initially thought,” Geldsetzer said.

Harmful levels of PM2.5 can be imperceptible, but experienced day after day, year after year, they contribute to disease. And climate change means more wildfires (which produce particularly toxic fine particles) combined with extreme heat, increasing health risks.

“Even today there is a lot of resistance toward trying to reduce air pollution,” Benmarhnia said, citing the recent Supreme Court ruling against a plan to limit air pollution drifting across state lines.

Environmental policies should reduce air pollutants as much as possible, the researchers said, but also need to address the fact that some communities are more susceptible — something that major environmental organizations are not yet doing.

The silver lining is that the groups who suffer more from increasing air pollution would also benefit more from decreasing air pollution.

For every unit of reduction in PM2.5, for example, the associated mortality risk would decrease more for Black Americans than for other groups, helping close the racial gap.

“We want to emphasize how air pollution is a very good way to reduce health disparities, because it’s actionable,” Benmarhnia said. “We know we can do something about air pollution.”

The study received funding from the National Institutes of Health (grants R01AI127250, R01HD104835 and R01CA228147), the Robert Woods Johnson Foundation and the California Environmental Protection Agency.

About Stanford Medicine

Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu .

Hope amid crisis

Psychiatry’s new frontiers

How to Spot a Market-Driven Epidemic

Overconsumption of harmful products like cigarettes and sugar costs millions of lives. New research suggests public health officials can respond more effectively to these threats by recognizing them earlier.

Cigarette sales in the U.S. have fallen by 82 percent from their peak, evidence that consistent public health messaging can be effective in reducing the impact of harmful products. Photo by Johannes Plenio/Pixabay

Published July 26, 2024 under Research News

Companies that profit from unhealthy products such as cigarettes and sugar often follow a familiar playbook of denial and resistance to extend their sales. Their strategies are often so effective that public health awareness takes decades to catch up, fueling public health crises that seem almost impossible to control. 

But a new study led by Duke policy experts argues that understanding the phases of these market-driven epidemics may help science move more quickly to stop them, potentially saving millions of lives. 

“Experience over the last several decades has demonstrated that it is possible to make dramatic changes in the consumption of these products, thereby saving countless lives,” says Jonathan Quick, M.D., an adjunct professor with the Duke Global Health Institute who led the research, which was published this week in the open access journal PLOS Global Public Health. “Such achievements are possible through a combination of good science, public health action and public engagement.”

The research introduces the concept of a market-driven epidemic to explain the misuse and overconsumption of unhealthy, often addictive products. These include consumer products such as alcohol, cigarettes and ultra-processed foods, which are widely marketed and consumed despite significant evidence of harmful health effects, as well as products like prescription opioids or even social media, which can be dangerous when overused. Such market-driven epidemics contribute to nearly 23 million deaths worldwide each year and cost global health systems trillions of dollars, according to the study.

Quick and co-authors studied three such products – cigarettes, prescription opioids, and sugary foods and beverages. In each case, companies aggressively marketed products despite proven harms and actively resisted public health efforts to control them, the researchers note. 

Yet in each of those cases, a tipping point did come. From the peak of consumption, U.S. cigarette sales have fallen by 82 percent and use of prescription opioids has dropped by 62 percent. Even consumption of sugar has declined by 15 percent as consumers shift away from soft drinks and sugary beverages. 

“ We can save lives by recognizing these market-driven epidemics earlier and acting more decisively to control them.

Eventually, overwhelming evidence of harms and the consistent messaging of public health authorities are enough to overcome corporate marketing and resistance, the authors assert. 

“Progress in combatting market-driven epidemics is possible with concerted efforts by public health leaders, researchers, professional associations, civil society organizations, journalists and well-informed pop culture figures,” says Eszter Rimányi, a recent epidemiology graduate from the University of North Carolina-Chapel Hill who was the study’s first author. 

But that evolution can take time. Among the three cases the researchers studied, the gap between suspicion of harm and the consumption tipping point ranged from one to five decades. 

            Understanding the patterns of these market-driven epidemics can help public health officials recognize them more quickly, the authors note. The research describes five phases that these epidemics predictably follow: market development, evidence of harm, corporate resistance, mitigation and market adaptation. Companies also used similar tactics in resisting concerns about the safety of their products, including denying harm, discrediting critics, commissioning counter-science, and mounting legal and public relations challenges.

Thinking about the use of these products as an epidemic can give public health officials a new, action-oriented strategy to bend the consumption curve and reduce the social costs of harmful products, says Quick,, whose 2018 book, The End of Epidemics, outlined approaches for minimizing the effects of infectious disease epidemics. Co-authors on the study include DGHI policy professor Gavin Yamey, M.D., as well as public health scholars from Ghana, Canada and South Africa. 

“We can save lives by recognizing these market-driven epidemics earlier and acting more decisively to control them,” says Quick. 

• Health information/communications ,
• Health policy and systems ,
• Substance use ,
• United States
• Jonathan Quick ,
• Gavin Yamey

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Influential Researchers at UCF Contribute to Impacts in Field, U.S. News Global Rankings

With top rankings across optics and photonics, health and education, UCF researchers are forces of influence through their highly cited research.

By Nicole Dudenhoefer ’17 | July 24, 2024

Behind every groundbreaking discovery lies a dedicated researcher whose work resonates across their field. These influential studies not only advance understanding of critical topics but also inspire innovative solutions across disciplines.

“Our top rankings underscore our dedication to research excellence and innovation.” — Winston Schoenfeld, vice president for research and innovation

Recently, U.S. News & World Report ranked UCF among its 2024-25 Best Global Universities — highlighting UCF’s excellence in education across many areas. Among these rankings, UCF received quite a few for highly cited publications.

“We pride ourselves on the impactful research of our faculty, staff and students,” says Winston Schoenfeld, UCF’s vice president for research and innovation. “Our top rankings underscore our dedication to research excellence and innovation, and I am delighted to see a number of our UCF researchers recognized among the most cited in their fields.”

From optics and photonics to health and education, the fingerprints of UCF’s highly cited researchers leave marks on advancements in their fields.

Harnessing Light: Applications of Optics and Photonics

UCF is a global leader in optics and photonics, ranking No. 29 in the world , according to U.S. News & World Report . UCF also ranks among the top 10 in the nation for the field — as well as No. 5 for total optics publications, optics citations and the number of optics publications among the 10% most cited.

These citations are a reflection of advancements in technologies used daily, such as liquid crystal displays (LCDs) and glass.

Several faculty in UCF’s College of Optics and Photonics are highly-cited researchers in their field. One of whom is Pegasus Professor Shin-Tson Wu, whose work has been cited more than 52,000 times, according to Google Scholar (the source used for all following citation counts). Wu’s pioneering research has led to cutting-edge display technologies, including smartphones, tablets, computers, TVs, and, more recently, augmented reality and virtual reality — making them more energy-efficient, vibrant and versatile. This year, Wu received UCF’s inaugural Medal of Societal Impact for his contributions to the field.

“My main priority is not myself,” Wu says. “I am delighted to see my research making impact to the society. A rich life to me is not just about money. It’s helping others have better lives.”

“I am delighted to see my research making impact to the society. A rich life to me is not just about money. It’s helping others have better lives.” — Shin-Tson Wu, Pegasus Professor

Kathleen Richardson, whose expertise is in high tech glass design and fabrication has earned her over 17,800 citations, established and directs UCF’s Glass Processing and Characterization Laboratory. At the lab, she and a team of students design and process novel glass and glass ceramic materials for diverse applications. The unique optical properties embedded in the materials have a vast field of applications from thermal imaging instrumentation on a Mars rover to optical phase change materials that change their physical state once triggered by an outside source such as light, which may be useful for detecting toxic leaks.

“Most people don’t realize the role glass plays in our lives,” Richardson said in a 2022 article about her involvement with the United Nation’s Year of Glass. “From Egyptian glass art to infrared security cameras made possible because of glass with special properties, glass has changed our lives. And only now is glass really being recognized for its versatile and renewable possibilities as a sustainable option for challenging problems.”

Fueling Optimal Performance: Nutrition and Exercise Science

Human health and quality of life is another area UCF faculty help improve through their curriculum, research and published work.

UCF ranks No. 92 for Public, Environmental and Occupational Health — placing the university in the top 18% of institutions worldwide, according to the U.S. News & World Report . This year’s ranking is also a 72-spot advancement from the previous ranking.

Researchers, including those in the College of Health and Human Performance (CHPS), at UCF are No. 1 in the nation for the percentage of total publications that are among the 10% most cited in public, environmental and occupational health, and No. 5 in the world.

Jeff Stout, the founding Director of UCF’s School of Kinesiology and Rehabilitation Sciences, is one of the world’s leading researchers on of creatine and other dietary supplements and nutritional interventions for performance enhancement — with nearly 27,000 career citations. The Pegasus Professor has researched ways to use nutrition and exercise to improve health for older adults experiencing muscle loss and reduced mobility. His work has also focused on sarcopenia, a condition characterized by loss of muscle mass and function that typically begins after 30.

“The goal of my research is to figure out what is the most optimal way, from both nutritional and exercise perspectives, to slow down the loss of strength and muscle as we age.” — Jeff Stout, Pegasus Professor

“The goal of my research is to figure out what is the most optimal way, from both nutritional and exercise perspectives, to slow down the loss of strength and muscle as we age. This is crucial because the quality of our life in later years is directly affected by these factors,” says Stout. “You want to maintain as much muscle, strength and functionality as possible. Skeletal muscle is very important to overall health. It’s a reservoir of nutrients that our body needs when under stress.”

Some of the most significant findings Stout has discovered include that a combination of resistance training and consuming protein daily promotes muscle growth. Additionally, research shows that consuming 1.4 grams to 2 grams of protein per kilogram of body weight helps adults who exercise regularly maintain sufficient muscle mass.

Excellence in research also extends to staff and leadership at UCF.

With over 21 years of faculty experience at various R1 institutions, Joel Cramer joined UCF’s CHPS in 2022 as senior associate dean for academic and faculty affairs.

His research spans human skeletal muscle health and metabolism across the lifespan. His more recent work aims to identify slower-digesting carbohydrates that don’t spike blood sugar, or insulin levels, which can aid in understanding of diabetes and related diseases. Much of his research, which has been cited more than 15,000 times, has also been sponsored by the USDA and nutritional supplement companies.

“A lot of food products and dietary supplements that are on the market are not particularly well-regulated and anything that we can do to improve the science of understanding of those products is good, so the impact is great for the consumer,” he says.

Cramer’s research impacts extend across the campus community, as he has a passion for supporting young researchers. On Aug. 8, he’ll be broadening that reach across research and faculty support when he becomes UCF’s interim vice provost for faculty excellence.

“It takes a lot of hard work at the beginning [of researchers’ careers] to be, first, published and then cited,” Cramer says. “Understanding and navigating those waters is probably the No. 1 thing I can contribute the most here in the world of university metrics for scholarship.”

Enhancing Education: Improving Student and Teacher Outcomes

For the first time, U.S. News & World Report ranks UCF in the category of Education and Education Research — placing the university at No. 94 in the world. UCF also ranks in the top 40 in the nation. UCF’s College of Community Innovation and Education faculty have earned the university the No. 2 in the nation and No. 4 in the world rankings for the percentage of highly cited papers that are among the top 1% in education and educational research . Learning sciences is a field that aims to advance learning for all, from English to engineering, and research in this area has an exponential impact. For over 10 years, Assistant Professor Michelle Taub has studied positive and negative influences on learning, which has led her to become one of the most highly cited researchers in her field.

With nearly 2,400 career citations, much of the self-described data nerd’s work explores self-regulation, which involves learners’ ability to monitor and regulate their thought, emotional and motivational processes.

To help enhance students’ learning experiences, researchers across disciplines reach out to Taub for her expertise on learning. At UCF, she’s helping engineering faculty enhance foundation course teaching for students. She’s also supporting the UCF Coastal FCI’s Gulf Scholars Program, which aims to recruit students invested in addressing critical problems facing the Gulf of Mexico region.

“My goal is to help learners and that’s a goal that other people are sharing.” — Michelle Taub, assistant professor

“My goal is to help learners and that’s a goal that other people are sharing,” Taub says. “It’s a really good feeling [when other faculty reach out for collaborative projects] because that demonstrates I’m not just doing the research for me to do the research, but it’s actually research that is helping students and teachers.”

Her expertise is also being leveraged on studies with researchers at other institutions, as she’s a co-principal investigator on a North Carolina State University project aimed at enhancing math and special education, as well as interest in STEM careers, through a video game embedded within a fraction curriculum.

Careers in STEM are growing twice as fast as non-STEM careers, with 11.2 million projected position available by 2023, according to the Bureau of Labor Statistics. While there are many efforts happening nationally to increase students’ interest, access, and success in STEM, research around this topic is critical to making sure the most effective strategies are being implemented.

Professor and Lockheed Martin Eminent Scholar Chair Sarah Bush’s research, which she’s been building on for nearly 15 years, aims to improve STE(A)M education, particularly mathematics. As a former middle school mathematics teacher, Bush knows firsthand the experiences and pressures students and educators face in classrooms.

With over 2,100 career citations, one of her most influential works relates to the benefit of informal learning experiences, such as summer programs, on students’ STEM learning and interest in STEM careers. These experiences have been shown to provide context and purpose to formal learning, provide opportunity and access to STEM education for students, and extend STEM content learning and engagement. This work has been part of Bush’s research as a member of the STEM Rocks Research Collective, which consists of STEM education professionals across more than a dozen institutions in the United States.

“The goal of my research, across numerous STE(A)M education projects and programs, has been to examine how meaningful integration of the STE(A)M disciplines empowers educators and students to be advocates and empathetic solution seekers as they pursue transformational ideas that continue advancing our world,” she says.

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Pegasus magazine.

For a decade, UCF-based nonprofit Limbitless Solutions has transformed kids’ lives through bionic limbs. 

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Digital Medicine in Psychiatry and Neurology - Chances and Challenges for Mobile Scalable Monitoring and Intervention

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Psychiatric and neurological diseases are a major global health burden. Enhancing the efficacy of diagnostics and treatments for patients suffering from these conditions is crucial and digital medicine has enormous potential to achieve this. Utilizing a multidisciplinary approach, digital medicine integrates medical knowledge, behavioral psychology, human-computer interaction, software engineering, data science, and, increasingly, artificial intelligence (AI). Relevant technological advances include internet- and mobile-based interventions, smart sensors, and generative AI. Applications of these advances can provide more effective and personalized healthcare delivery. Health care policies in some European countries have further paved the way for reimbursable Digital Health Applications (DIHAs) that can be prescribed by medical doctors and psychotherapists. Digital medicine is hence set to transform and potentially revolutionize health care, particularly in psychiatry, neurology, and pain medicine, which due to the nature of these respective medical fields, have shown to be at the forefront of digital medicine developments. This Research Topic aims to explore and discuss digital technologies that allow patients and physicians to understand, treat or potentially prevent psychiatric or neurological diseases. Given the increasing need to adapt technology across diverse settings, this Research Topic will also focus on use and development of cutting-edge and novel technologies such as VR/AR for rehabilitation in neurological and pain management contexts. We also welcome submissions that explore the implementation of digital medicine in low-resource environments, contributing to global health equity. A specific focus within this topic is on children and adolescents. As digital natives, this emerging generation interacts seamlessly with technology, yet tailoring digital medicine to meet their specific needs and requirements poses significant challenges. We specifically invite submissions that explore digital health applications designed for this young demographic, seeking insights into innovative solutions that can enhance their medical care through technology. Themes in scope include, but are not limited to: - Participatory research aiming for a better understanding of specific patient needs and a more patient-centered design of digital medicine - Applications that use generative AI for communication purposes (e.g., large language models) to facilitate patient physician interactions, support diagnostics or improve treatment conditions or healthcare delivery processes - Interdisciplinary Integration and Advanced Technologies - integration of fields such as AI, psychology, psychiatry and software engineering into patient care. - Children and Adolescents specific digital medicine innovation and discussion on unique challenges in this demographic - Digital monitoring and deep phenotyping (e.g., using data from digital applications that employ questionnaires and/or record physiological data through wearable sensors) - Internet- and mobile-based interventions ranging from stand-alone mobile applications to teletherapeutic approaches and blended care approaches. - Digital diagnostic procedures or algorithms aiming at supporting the diagnostic process via diagnostic predictions, decision support, structural changes, enabling remote assessment or other innovations - Platform technologies and tools that aim to improve interoperability and harmonizing data from different sources Ethical, Global Health Economy, and Policy Challenges - ethical dilemmas emerging from digital interventions, the adaptation of digital health in varying global contexts, and the policies shaping the future of digital medicine, particularly in low-resource settings. Submissions may be Original Research, Clinical Trial, Study Protocols, Systematic Reviews or Methods articles that investigate aspects of digital medicine in psychiatry, neurology, or pain medicine. To foster debate, we also welcome Opinion and Perspective articles that survey the field and its progress towards clinical utility. Moreover, we cordially invite submissions that discuss aspects related to ethical considerations, health policy aspects or regulatory challenges and needs, also in light of recent regulatory developments in the context of AI and medical products. Topic Editor Lars Masanneck has received research funding from Roche, Biogen and the German Multiple Sclerosis Foundation (DMSG). The other Topic Editors declare no competing interests in relation to the Research Topic subject.

Keywords : Digital medicine, Digital monitoring, Digital therapeutics, Neurology, Psychiatry

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WHO’s goal: Forward looking and prioritized global health research

Research for health is a global endeavour, and WHO has a unique role to play in ensuring that these efforts can help improve health for all.

WHO provides leadership, calling on the wider scientific community to engage behind global health concerns. This is based on a deep understanding of the needs of countries, and rigorous assessment by international experts.

WHO has three key objectives to promote forward-looking and prioritized global health research:

Anticipating scientific, technological, and epidemiological shifts

To stay on top of scientific and technological advancements and epidemiological trends, WHO must anticipate new trends, technologies, research, and discoveries in medical and public health. 

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Emerging technologies offer great health opportunities but also pose potentially significant challenges. The WHO Foresight function provides ongoing monitoring of emerging technologies to spot potential risks and come up with strategies for prevention and mitigation.

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The best ideas are not just the brightest, but the one that actually get implemented and make an impact. WHO provides leadership on policies in research to ensure access and scale-up. 

Having the right research policy is a key step towards ensuring health research has actual impact. This means that research priorities match real-world problems. At WHO, Research for Health works to ensure that the needs of countries are clearly articulated, and then communicated to the research community.

At WHO we promote an end-to-end approach in research policy. Working with local health systems and communities is needed to better understand the delivery and uptake of new products and to achieve widespread and equitable access. WHO can help broker multinational studies, foster regulatory harmonization, and promote dialogue among all stakeholders.

Taking knowledge from evidence to impact

Through a global network for evidence-informed health policy-making and tailored country support, WHO brings together researchers, policy-makers and implementers to translate evidence into improved health policies and programmes.

Public health problems are often complex and require nuanced, context-specific solutions and tailored implementation strategies. To make a difference for patients, communities and medical professionals, reliable evidence on how to tackle a health issue needs to be synthesized, reflected in a local context, and effectively communicated between researchers and decision-makers.

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• Published: 07 April 2020

What is global health? Key concepts and clarification of misperceptions

Report of the 2019 GHRP editorial meeting

• Xinguang Chen 1 , 2 ,
• Hao Li 1 , 3 ,
• Don Eliseo Lucero-Prisno III 4 ,
• Abu S. Abdullah 5 , 6 ,
• Jiayan Huang 7 ,
• Charlotte Laurence 8 ,
• Xiaohui Liang 1 , 3 ,
• Zhenyu Ma 9 ,
• Zongfu Mao 1 , 3 ,
• Ran Ren 10 ,
• Shaolong Wu 11 ,
• Nan Wang 1 , 3 ,
• Peigang Wang 1 , 3 ,
• Tingting Wang 1 , 3 ,
• Hong Yan 3 &
• Yuliang Zou 3  

Global Health Research and Policy volume  5 , Article number:  14 ( 2020 ) Cite this article

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The call for “W orking Together to Build a Community of Shared Future for Mankind” requires us to improve people’s health across the globe, while global health development entails a satisfactory answer to a fundamental question: “What is global health?” To promote research, teaching, policymaking, and practice in global health, we summarize the main points on the definition of global health from the Editorial Board Meeting of Global Health Research and Policy, convened in July 2019 in Wuhan, China. The meeting functioned as a platform for free brainstorming, in-depth discussion, and post-meeting synthesizing. Through the meeting, we have reached a consensus that global health can be considered as a general guiding principle, an organizing framework for thinking and action, a new branch of sciences and specialized discipline in the large family of public health and medicine. The word “global” in global health can be subjective or objective, depending on the context and setting. In addition to dual-, multi-country and global, a project or a study conducted at a local area can be global if it (1) is framed with a global perspective, (2) intends to address an issue with global impact, and/or (3) seeks global solutions to an issue, such as frameworks, strategies, policies, laws, and regulations. In this regard, global health is eventually an extension of “international health” by borrowing related knowledge, theories, technologies and methodologies from public health and medicine. Although global health is a concept that will continue to evolve, our conceptualization through group effort provides, to date, a comprehensive understanding. This report helps to inform individuals in the global health community to advance global health science and practice, and recommend to take advantage of the Belt and Road Initiative proposed by China.

“Promoting Health For All” can be considered as the mission of global health for collective efforts to build “a Community of Shared Future for Mankind” first proposed by President Xi Jinping of China in 2013. The concept of global health continues to evolve along with the rapid development in global health research, education, policymaking, and practice. It has been promoted on various platforms for exchange, including conferences, workshops and academic journals. Within the Editorial Board of Global Health Research and Policy (GHRP), many members expressed their own points of view and often disagreed with each other with regard to the concept of global health. Substantial discrepancies in the definition of global health will not only affect the daily work of the Editorial Board of GHRP, but also impede the development of global health sciences.

To promote a better understanding of the term “ global health” , we convened a special session in the 2019 GHRP Editorial Board Meeting on the 7th of July at Wuhan University, China. The session started with a review of previous work on the concept of global health by researchers from different institutions across the globe, followed by free brainstorms, questions-answers and open discussion. Individual participants raised many questions and generously shared their thoughts and understanding of the term global health. The session was ended with a summary co-led by Dr. Xinguang Chen and Dr. Hao Li. Post-meeting efforts were thus organized to further synthesize the opinions and comments gathered during the meeting and post-meeting development through emails, telephone calls and in-person communications. With all these efforts together, concensus have been met on several key concepts and a number of confusions have been clarified regarding global health. In this editorial, we report the main results and conclusions.

A brief history

Our current understanding of the concept of global health is based on information in the literature in the past seven to eight decades. Global health as a scientific term first appeared in the literature in the 1940s [ 1 ]. It was subsequently used by the World Health Organization (WHO) as guidance and theoretical foundation [ 2 , 3 , 4 ]. Few scholars discussed the concept of global health until the 1990s, and the number of papers on this topic has risen rapidly in the subsequent decade [ 5 ] when global health was promoted under the Global Health Initiative - a global health plan signed by the U.S. President Barack Obama [ 6 ]. As a key part of the national strategy in economic globalization, security and international policies, global health in the United States has promoted collaborations across countries to deal with challenging medical and health issues through federal funding, development aids, capacity building, education, scientific research, policymaking and implementation.

Based on his experience working with Professor Zongfu Mao, the lead Editors-in-Chief, who established the Global Health Institute at Wuhan University in 2011 and launched the GHRP in 2016, Dr. Chen presented his own thoughts surrounding the definition of global health to the 2019 GHRP Editorial Board Meeting. Briefly, Dr. Chen defined global health with a three-dimensional perspective.

First, global health can be considered as a guiding principle, a branch of health sciences, and a specialized discipline within the broader arena of public health and medicine [ 5 ]. As many researchers posit, global health first serves as a guiding principle for people who would like to contribute to the health of all people across the globe [ 5 , 7 , 8 ].

Second, Dr. Chen’s conceptualization of global health is consistent with the opinions of many other scholars. Global health as a branch of sciences focuses primarily on the medical and health issues with global impact or can be effectively addressed through global solutions [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Therefore, the goal of global health science is to understand global medical and health issues and develop global solutions and implications [ 7 , 9 , 15 , 17 , 18 , 19 ].

Third, according to Dr. Chen, to develop global health as a branch of science in the fields of public health and medicine, a specialized discipline must be established, including educational institutions, research entities, and academic societies. Only with such infrastructure, can the professionals and students in the global health field receive academic training, conduct global health research, exchange and disseminate research findings, and promote global health practices [ 5 , 15 , 20 , 21 , 22 , 23 ].

Developmentally and historically, we have learned and will continue to learn global health from the WHO [ 1 , 4 , 24 , 25 ]. WHO’s projects are often ambitious, involving multiple countries, or even global in scope. Through research and action projects, the WHO has established a solid knowledge base, relevant theories, models, methodologies, valuable data, and lots of experiences that can be directly used in developing global health [ 26 , 27 , 28 , 29 ]. Typical examples include WHO’s efforts for global HIV/AIDS control [ 13 , 30 , 31 , 32 ], and the Primary Healthcare Programs to promote Health For All [ 33 , 34 ].

The definition of Global Health

From published studies in the international literature and our experiences in research, training, teaching and practice, our meeting reached a consensus-global health is a newly established branch of health sciences, growing out from medicine, public health and international health, with much input from the WHO. What makes global health different from them is that (1) global health deals with only medical and health issues with global impact [ 35 , 5 , 36 , 10 , 14 , 2 ] the main task of global health is to seek for global solutions to the issues with global health impact [ 7 , 18 , 37 ]; and (3) the ultimate goal is to use the power of academic research and science to promote health for all, and to improve health equity and reduce health disparities [ 7 , 14 , 15 , 18 , 38 ]. Therefore, global health targets populations in all countries and involves all sectors beyond medical and health systems, although global health research and practice can be conducted locally [ 39 ].

As a branch of medical and health sciences, global health has three fundamental tasks: (1) to master the spatio-temporal patterns of a medical and/or health issue across the globe to gain a better understanding of the issue and to assess its global impact [ 40 , 41 , 42 , 43 ]; (2) to investigate the determinants and influential factors associated with medical and health issues that are known to have global impact [ 15 , 40 , 41 , 42 , 43 ]; and (3) to establish evidence-based global solutions, including strategies, frameworks, governances, policies, regulations and laws [ 14 , 15 , 28 , 38 , 44 , 45 , 46 , 47 ].

Like public health, medicine, and other branches of sciences, global health should have three basic functions : The first function is to generate new knowledge and theories about global health issues, influential factors, and develop global solutions. The second function is to distribute the knowledge through education, training, publication and other forms of knowledge sharing. The last function is to apply the global health knowledge, theories, and intervention strategies in practice to solve global health problems.

Understanding the word “global”

Confusion in understanding the term ‘global health’ has largely resulted from our understanding of the word “global”. There are few discrepancies when the word ‘global’ is used in other settings such as in geography. In there, the world global physically pertains to the Earth we live on, including all people and all countries in the world. However, discrepancies appear when the word “global” is combined with the word “health” to form the term “global health”. Following the word “global” literately, an institution, a research project, or an article can be considered as global only if it encompasses all people and all countries in the world. If we follow this understanding, few of the work we are doing now belong to global health; even the work by WHO are for member countries only, not for all people and all countries in the world. But most studies published in various global health journals, including those in our GHRP, are conducted at a local or international level. How could this global health happen?

The argument presented above leads to another conceptualization: Global health means health for a very large group of people in a very large geographic area such as the Western Pacific, Africa, Asia, Europe, and Latin America. Along with this line of understanding, an institution, a research project or an article involving multi-countries and places can be considered as global, including those conducted in countries involved in China’s Belt and Road Initiative (BRI) [ 26 , 48 , 49 , 50 , 51 ]. They are considered as global because they meet our definitions of global health which focus on medical and health issues with global impact or look for global solutions to a medical or health issue [ 5 , 7 , 22 ].

One step further, the word ‘global’ can be considered as a concept of goal-setting in global health. Typical examples of this understanding are the goals established for a global health institution, for faculty specialized in global health, and for students who major or minor in global health. Although few of the global health institutions, scholars and students have conducted or are going to conduct research studies with a global sample or delivered interventions to all people in all countries, all of them share a common goal: Preventing diseases and promoting health for all people in the world. For example, preventing HIV transmission within Wuhan would not necessarily be a global health project; but the same project can be considered as global if it is guided by a global perspective, analyzed with methods with global link such as phylogenetic analysis [ 52 , 53 ], and the goal is to contribute to global implications to end HIV/AIDS epidemic.

The concept of global impact

Global impact is a key concept for global health. Different from other public health and medical disciplines, global health can address any issue that has a global impact on the health of human kind, including health system problems that have already affected or will affect a large number of people or countries across the globe. Three illustrative examples are (1) the SARS epidemic that occurred in several areas in Hong Kong could spread globally in a short period [ 11 ] to cause many medical and public health challenges [ 54 , 55 ]; (2) the global epidemic of HIV/AIDS [ 13 ]; and the novel coronavirus epidemic first broke out in December 2019 in Wuhan and quickly spread to many countries in the world [ 56 ].

Along with rapid and unevenly paced globalization, economic growth, and technological development, more and more medical and health issues with global impact emerge. Typical examples include growing health disparities, migration-related medical and health issues, issues related to internet abuse, the spread of sedentary lifestyles and lack of physical activity, obesity, increasing rates of substance abuse, depression, suicide and many other emerging mental health issues, and so on [ 10 , 23 , 36 , 42 , 57 , 58 , 59 , 60 ]. GHRP is expecting to receive and publish more studies targeting these issues guided by a global health perspective and supports more researchers to look for global solutions to these issues.

The concept of global solution

Another concept parallel to global impact is global solution . What do we mean by global solutions? Different from the conventional understanding in public health and medicine, global health selectively targets issues with global impact. Such issues often can only be effectively solved at the macro level through cross-cultural, international, and/or even global collaboration and cooperation among different entities and stakeholders. Furthermore, as long as the problem is solved, it will benefit a large number of population. We term this type of interventions as a global solution. For example, the 90–90-90 strategy promoted by the WHO is a global solution to end the HIV/AIDS epidemic [ 61 , 62 ]; the measures used to end the SARS epidemic is a global solution [ 11 ]; and the ongoing measures to control influenza [ 63 , 64 ] and malaria [ 45 , 65 ], and the measures taken by China, WHO and many countries in the world to control the new coronaviral epidemic started in China are also great examples of global solutions [ 66 ].

Global solutions are also needed for many emerging health problems, including cardiovascular diseases, sedentary lifestyle, obesity, internet abuse, drug abuse, tobacco smoking, suicide, and other problems [ 29 , 44 ]. As described earlier, global solutions are not often a medical intervention or a procedure for individual patients but frameworks, policies, strategies, laws and regulations. Using social media to deliver interventions represents a promising approach in establishment of global solutions, given its power to penetrate physical barriers and can reach a large body of audience quickly.

Types of Global Health researches

One challenge to GHRP editors (and authors alike) is how to judge whether a research study is global? Based on the new definition of global health we proposed as described above, two types of studies are considered as global and will receive further reviews for publication consideration. Type I includes projects or studies that involve multiple countries with diverse backgrounds or cover a large diverse populations residing in a broad geographical area. Type II includes projects or studies guided by a global perspective, although they may use data from a local population or a local territory. Relative to Type I, we anticipate more Type II project and studies in the field of global health. Type I study is easy to assess, but caution is needed to assess if a project or a study is Type II. Therefore, we propose the following three points for consideration: (1) if the targeted issues are of global health impact, (2) if the research is attempted to understand an issue with a global perspective, and (3) if the research purpose is to seek for a global solution.

An illustrative example of Type I studies is the epidemic and control of SARS in Hong Kong [ 11 , 67 ]. Although started locally, SARS presents a global threat; while controlling the epidemic requires international and global collaboration, including measures to confine the infected and measures to block the transmission paths and measures to protect vulnerable populations, not simply the provisions of vaccines and medicines. HIV/AIDS presents another example of Type I project. The impact of HIV/AIDS is global. Any HIV/AIDS studies regardless of their scope will be global as long as it contributes to the global efforts to end the HIV/AIDS epidemic by 2030 [ 61 , 62 ]. Lastly, an investigation of cardiovascular diseases (CVD) in a country, in Nepal for example, can be considered as global if the study is framed from a global perspective [ 44 ].

The discussion presented above suggests that in addition to scope, the purpose of a project or study can determine if it is global. A pharmaceutical company can target all people in the world to develop a new drug. The research would be considered as global if the purpose is to improve the medical and health conditions of the global population. However, it would not be considered as global if the purpose is purely to pursue profit. A research study on a medical or health problem among rural-to-urban migrants in China [ 57 , 58 , 60 ] can be considered as global if the researchers frame the study with a global perspective and include an objective to inform other countries in the world to deal with the same or similar issues.

Think globally and act locally

The catchphrase “think globally and act locally” presents another guiding principle for global health and can be used to help determine whether a medical or public health research project or a study is global. First, thinking globally and acting locally means to learn from each other in understanding and solving local health problems with the broadest perspective possible. Taking traffic accidents as an example, traffic accidents increase rapidly in many countries undergoing rapid economic growth [ 68 , 69 ]. There are two approaches to the problem: (1) locally focused approach: conducting research studies locally to identify influential factors and to seek for solutions based on local research findings; or (2) a globally focused approach: conducting the same research with a global perspective by learning from other countries with successful solutions to issues related traffic accidents [ 70 ].

Second, thinking globally and acting locally means adopting solutions that haven been proven effective in other comparable settings. It may greatly increase the efficiency to solve many global health issues if we approach these issues with a globally focused perspective. For example, vector-borne diseases are very prevalent among people living in many countries in Africa and Latin America, such as malaria, dengue, and chikungunya [ 45 , 71 , 72 ]. We would be able to control these epidemics by directly adopting the successful strategy of massive use of bed nets that has been proven to be effective and cost-saving [ 73 ]. Unfortunately, this strategy is included only as “simple alternative measures” in the so-called global vector-borne disease control in these countries, while most resources are channeled towards more advanced technologies and vaccinations [ 16 , 19 , 74 ].

Third, thinking globally and acting locally means learning from each other at different levels. At the individual level, people in high income countries can learn from those in low- and mid-income countries (LMICs) to be physically more active, such as playing Taiji, Yoga, etc.; while people in LMICs can learn from those in high income countries to improve their hygiene, life styles, personal health management, etc. At the population level, communities, organizations, governments, and countries can learn from each other in understanding their own medical and health problems and healthcare systems, and to seek solutions for these problems. For example, China can learn from the United States to deal with health issues of rural to urban migrants [ 75 ]; and the United States can learn from China to build three-tier health care systems to deliver primary care and prevention measures to improve health equality.

Lastly, thinking globally and acting locally means opportunities to conduct global health research and to be able to exchange research findings and experiences across the globe; even without traveling to another country. For example, international immigrants and international students present a unique opportunity for global health research in a local city [ 5 , 76 ]. To be global, literature search and review remains the most important approach for us to learn from each other besides conducting collaborative work with the like-minded researchers across countries; rapid development in big data and machine learning provide another powerful approach for global health research. Institutions and programs for global health provides a formal venue for such learning and exchange opportunities.

Reframing a local research study as global

The purpose of this article is to promote global health through research and publication. Anyone who reads this paper up to this point might already be able to have a clear idea on how to reframe his/her own research project or article to be of global nature. There is no doubt that a research project is global if it involves multiple countries with investigators of diverse backgrounds from different countries. However, if a research project targets a local population with investigators from only one or two local institutions, can such project be considered as global?

Our answer to this question is “yes” even if a research study is conducted locally, if the researcher (1) can demonstrate that the issue to be studied or being studied has a global impact, or (2) eventually looks for a global solution although supported with local data. For example, the study of increased traffic accidents in a city in Pakistan can be considered as global if the researchers frame the problem from a global perspective and/or adopt global solutions by learning from other countries. On the other hand, a statistical report of traffic accidents or an epidemiological investigation of factors related to the traffic accidents at the local level will not be considered as global. Studies conducted in a local hospital on drug resistance to antibiotics and associated cost are global if expected findings can inform other countries to prevent abuse of antibiotics [ 77 ]. Lastly, studies supported by international health programs can be packaged as global simply by broadening the vision from international to global.

Is Global Health a new bottle with old wine?

Another challenge question many scholars often ask is: “What new things can global health bring to public health and medicine?” The essence of this question is whether global health is simply a collection of existing medical and health problems packaged with a new title? From our previous discussion, many readers may already have their own answer to this question that this is not true. However, we would like to emphasize a few points. First, global health is not equal to public health, medicine or both, but a newly emerged sub-discipline within the public health-medicine arena. Global health is not for all medical and health problems but for the problems with global impact and with the purpose of seeking global solutions. In other words, global health focuses primarily on mega medical and health problems that transcend geographical, cultural, and national boundaries and seeks broad solutions, including frameworks, partnerships and cooperation, policies, laws and regulations that can be implemented through governments, social media, communities, and other large and broad reaching mechanisms.

Second, global health needs many visions, methods, strategies, approaches, and frameworks that are not conventionally used in public health and medicine [ 5 , 18 , 22 , 34 ]. They will enable global health researchers to locate and investigate those medical and health issues with global impact, gain new knowledge about them, develop new strategies to solve them, and train health workers to deliver the developed strategies. Consequently, geography, history, culture, sociology, governance, and laws that are optional for medicine and public health are essential for global health. Lastly, it is fundamental to have a global perspective for anyone in global health, but this could be optional for other medical and health scientists [ 40 , 41 ].

Global Health, international health, and public health

As previously discussed, global health has been linked to several other related disciplines, particularly public health, international health, and medicine [ 3 , 5 , 7 , 18 , 22 ]. To our understanding, global health can be considered as an application of medical and public health sciences together with other disciplines (1) in tackling those issues with global impact and (2) in the effort to seek global solutions. Thus, global health treats public health sciences and medicine as their foundations, and will selectively use theories, knowledge, techniques, therapeutics and prevention measures from public health, medicine, and other disciplines to understand and solve global health problems.

There are also clear boundaries between global health, public health and medicine with regard to the target population. Medicine targets patient populations, public health targets health populations in general, while global health targets the global population. We have to admit that there are obvious overlaps between global health, public health and medicine, particularly between global health and international health. It is worth noting that global health can be considered as an extension of international health with regard to the scope and purposes. International health focuses on the health of participating countries with intention to affect non-participating countries, while global health directly states that its goal is to promote health and prevent and treat diseases for all people in all countries across the globe. Thus, global health can be considered as developed from, and eventually replace international health.

Challenges and opportunities for China to contribute to Global Health

To pursue A Community with a Shared Future for Mankind , China’s BRI , currently involving more than 150 countries across the globe, creates a great opportunity for Chinese scholars to contribute to global health. China has a lot to learn from other countries in advancing its medical and health technologies and to optimize its own healthcare system, and to reduce health disparities among the 56 ethnic groups of its people. China can also gain knowledge from other countries to construct healthy lifestyles and avoid unhealthy behaviors as Chinese people become more affluent. Adequate materials and money may be able to promote physical health in China; but it will be challenging for Chinese people to avoid mental health problems currently highly prevalent in many rich and developed countries.

To develop global health, we cannot ignore the opportunities along with the BRI for Chinese scholars to share China’s lessons and successful experience with other countries. China has made a lot of achievements in public health and medicine before and after the Open Door Policy [ 49 , 78 ]. Typical examples include the ups and downs of the 3-Tier Healthcare Systems, the Policy of Prevention First, and the Policy of Putting Rural Health as the Priority, the Massive Patriotic Hygiene Movement with emphasis on simple technology and broad community participation, the Free Healthcare System for urban and the Cooperative Healthcare System for rural residents. There are many aspects of these initiatives that other countries can emulate including the implementation of public health programs covering a huge population base unprecedented in many other countries.

There are challenges for Chinese scholars to share China’s experiences with others as encountered in practice. First of all, China is politically very stable while many other countries have to change their national leadership periodically. Changes in leadership may result in changes in the delivery of evidence- based intervention programs/projects, although the changes may not be evidence-based but politically oriented. For example, the 3-Tier Healthcare System that worked in China [ 79 , 80 ] may not work in other countries and places without modifications to suit for the settings where there is a lack of local organizational systems. Culturally, promotion of common values among the public is unique in China, thus interventions that are effective among Chinese population may not work in countries and places where individualism dominates. For example, vaccination program as a global solution against infectious diseases showed great success in China, but not in the United States as indicated by the 2019 measles outbreak [ 81 ].

China can also learn from countries and international agencies such as the United Kingdom, the United States, the World Health Organization, and the United Nations to successfully and effectively provide assistance to LMICs. As China develops, it will increasingly take on the role of a donor country. Therefore, it is important for Chinese scholars to learn from all countries in the world and to work together for a Community of Shared Future for Mankind during the great course to develop global health.

Promotion of global health is an essential part of the Working Together  to Build a Community of Shared Future for Mankind. In this editorial, we summarized our discussions in the 2019 GHRP Editorial Board Meeting regarding the concept of global health. The goal is to enhance consensus among the board members as well as researchers, practitioners, educators and students in the global health community. We welcome comments, suggestions and critiques that may help further our understanding of the concept. We would like to keep the concept of global health open and let it evolve along with our research, teaching, policy and practice in global health.

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The work is funded by the journal development funds of Wuhan University.

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Chen XG wrote the manuscript. LI H organized the meeting, collecting the comments and editing the manuscript. Lucero-Prisno DE integrated all the comments together. Abdullah AS, Huang JY, Laurence C, Liang XH, Ma ZY, Ren R, Wu SL, Wang N, Wang PG and Wang Tt all participated in the discussion and comments of this manuscript. Laurence C and Liang XH both provided language editing. The author(s) read and approved the final manuscript

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Chen, X., Li, H., Lucero-Prisno, D.E. et al. What is global health? Key concepts and clarification of misperceptions. glob health res policy 5 , 14 (2020). https://doi.org/10.1186/s41256-020-00142-7

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• At the  United Nations Conference on Sustainable Development (Rio+20)  in Rio de Janeiro, Brazil, in June 2012, Member States adopted the outcome document  "The Future We Want"  in which they decided, inter alia, to launch a process to develop a set of SDGs to build upon the MDGs and to establish the  UN High-level Political Forum on Sustainable Development . The Rio +20 outcome also contained other measures for implementing sustainable development, including mandates for future programmes of work in development financing, small island developing states and more.
• In 2013, the General Assembly set up a 30-member  Open Working Group  to develop a proposal on the SDGs.
• In January 2015, the General Assembly began the negotiation process on the  post-2015 development agenda . The process culminated in the subsequent adoption of the  2030 Agenda for Sustainable Development , with  17 SDGs  at its core, at the  UN Sustainable Development Summit  in September 2015.
• Sendai Framework for Disaster Risk Reduction  (March 2015)
• Addis Ababa Action Agenda on Financing for Development  (July 2015)
• Transforming our world: the 2030 Agenda for Sustainable Development  with its 17 SDGs was adopted at the  UN Sustainable Development Summit  in New York in September 2015.
• Paris Agreement on Climate Change  (December 2015)
• Now, the annual  High-level Political Forum on Sustainable Development  serves as the central UN platform for the follow-up and review of the SDGs.

Today, the  Division for Sustainable Development Goals (DSDG)  in the United Nations  Department of Economic and Social Affairs (UNDESA)  provides substantive support and capacity-building for the SDGs and their related thematic issues, including  water ,  energy ,  climate ,  oceans ,  urbanization ,  transport ,  science and technology , the  Global Sustainable Development Report (GSDR) ,  partnerships  and  Small Island Developing States . DSDG plays a key role in the evaluation of UN systemwide implementation of the 2030 Agenda and on advocacy and outreach activities relating to the SDGs. In order to make the 2030 Agenda a reality, broad ownership of the SDGs must translate into a strong commitment by all stakeholders to implement the global goals. DSDG aims to help facilitate this engagement.

Follow DSDG on Facebook at  www.facebook.com/sustdev  and on Twitter at  @SustDev .

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Every year, the UN Secretary General presents an annual SDG Progress report, which is developed in cooperation with the UN System, and based on the global indicator framework and data produced by national statistical systems and information collected at the regional level.

Please, check below information about the SDG Progress Report:

• SDG Progress Report (2024)
• SDG Progress Report (2023)
• SDG Progress Report (2022)
• SDG Progress Report (2021)
• SDG Progress Report (2020)
• SDG Progress Report (2019)
• SDG Progress Report (2018)
• SDG Progress Report (2017)
• SDG Progress Report (2016)

Please, check here for information about SDG indicators and reports: https://unstats.un.org/sdgs#

Additionally, the Global Sustainable Development Report is produced once every four years to inform the quadrennial SDG review deliberations at the General Assembly. It is written by an Independent Group of Scientists appointed by the Secretary-General.

• Global Sustainable Development Report (2019)
• Global Sustainable Development Report (2023)

SDGs Icons. Downloads and guidelines.

• Download SDGs icons according to guidelines at this link .
• Please send inquiries to: United Nations Department of Global Communications

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New study highlights global disparities in activity limitations and assistive device use

by McMaster University

A new study of more than 175,000 people in 25 countries revealed that individuals in low- and middle-income countries face greater challenges with daily activities and are less likely to use assistive devices compared to those in high-income countries. These findings raise concerns about the global burden of disability, particularly in low-income countries.

Despite decreases in death and cardiovascular disease rates and increases in life expectancy worldwide, people in low and middle-income countries still experience significantly worse health outcomes than those in high-income countries . Less is known, however, about the global prevalence of disabilities and how they differ between countries.

In the first prospective study of its kind, participants were surveyed about limitations in mobility, vision, and hearing. The study found that activity limitations are common worldwide, with the most frequent being difficulties in walking, bending, and seeing. A third of the participants reported at least one limitation, with these issues being particularly prevalent among older adults and women.

Activity limitations were more common in low and middle-income countries compared to high-income countries, including two-times higher walking impairment and five-times higher visual impairment.

"Current data on activity limitations and how they affect health around the world are limited," said Raed Joundi, first author of the study and a scientist at the Population Health Research Institute (PHRI), a joint research institute of McMaster University and Hamilton Health Sciences. "Our research aimed to fill this gap by looking at the prevalence of basic activity limitations, the use of assistive devices, and health outcomes in 25 countries."

The study is part of the ongoing Prospective Urban Rural Epidemiological (PURE) study, coordinated by PHRI and led by Salim Yusuf, senior scientist at PHRI. Published in The Lancet on July 25, 2024, the study collected data from participants aged 35 to 70 years old using standardized questionnaires and followed them for an average of 11 years and up to 20 years.

Activity limitations in daily life can be alleviated or rectified by using low-cost devices such as canes or glasses. However, the research showed that despite the much higher percentage of people with activity limitations in low and middle-income countries, the use of simple devices like canes or walkers, glasses, and hearing aids was less than half of that in high-income countries.

"Having access to assistive devices when needed, like glasses and walking aids, is essential for achieving a person's potential despite having disabilities and improving quality of life," stated Yusuf. "The limited access to assistive devices in low and middle-income countries represents an important opportunity for health policies and interventions."

Movement limitations were linked to serious health problems. For example, difficulties with walking were associated with higher risks of death and other health issues, including cardiovascular disease, pneumonia, and falls.

"The striking differences between high-income and low and middle-income countries in our study highlight the need for policies and programs to make sure people with disabilities have access to simple assistive devices and other resources needed to maintain their health" added Joundi.

"We also need to better understand the factors contributing to these activity limitations and develop public health strategies to prevent them from happening in the first place, so people can live longer, healthier, and happier."

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One Health: a holistic approach to improving the health of people, animals and the environment

November / december 2020 | volume 19, number 6.

• November / December 2020 Global Health Matters newsletter [PDF <1M]

Spillover events, where diseases jump from animals to humans, are increasing in frequency. Humans have acquired MERS coronavirus through close contact with camels.

Focus on One Health research

• Prawn farming reduces disease, provides food source in Senegal
• Scientists in Tanzania show bacterial zoonoses, not malaria, often the cause of febrile diseases
• Research improves health among Mongolian livestock herders

Researchers may never discover exactly how the current novel coronavirus outbreak began, but they agree that as humans have changed the way they interact with animals and the environment, emerging infectious diseases are rapidly growing in frequency. Accelerating rates of deforestation, human settlements encroaching on forests, global trade and travel, and livestock production are thought to be the underlying drivers of so-called “spillover” events, when diseases jump from animals to humans. For example, bats are one of the species suspected to be the source of the virus that causes COVID-19, while viruses in bats and other animals spurred the Ebola outbreak that began in 2014, MERS in 2012 and SARS in 2002, and others. Constant mutations jeopardize existing vaccines and treatments.

With 70% of emerging infectious diseases originating in animals, there is increasing urgency to prioritize the study of zoonotic diseases. “To anticipate threats for humans, we’ve got to partner with people in other disciplines including animal and environmental health,” said Dr. Gregory Gray, a Fogarty grantee and epidemiologist at Duke University.

The One Health movement aims to integrate the efforts of multiple disciplines to improve health for people, animals and the environment. It has become a global effort, including annual conferences that bring scientists and policymakers together to consider how to control existing and emerging infectious diseases. Since the majority of diseases that occur in humans also affect animals, it's important that the biomedical research workforce includes multidisciplinary practitioners with a broad understanding of subjects such as animal anatomy, physiology, pharmacology, epidemiology, behavior science and infectious diseases. Communication strategies and public outreach are also critical to develop interventions such as educational programs for workers to improve hygiene and increase use of personal protective equipment, development of rapid diagnostics and vaccines, and improved food safety measures.

NIH’s zoonotic research is based at Rocky Mountain Laboratories in Montana. Part of the National Institute of Allergy and Infectious Diseases, it’s a state-of-the-art biomedical facility designed for investigations of highly pathogenic viruses. Fogarty supports studies of emerging global threats through its Ecology and Evolution of Infectious Diseases program, a partnership with the National Science Foundation. The initiative supports efforts to understand the underlying ecological and biological mechanisms that govern relationships between environmental changes and the emergence and transmission of infectious diseases. Funded researchers explore how environmental events such as habitat alteration, biological invasion, climate change and pollution alter the risks of disease outbreaks in both animals and humans.

As outbreaks of emerging infectious diseases - such as the current COVID-19 pandemic - increase in frequency and impact, scientists and policymakers are calling for an increased emphasis on global preparedness.

More Information

• NIH One Health resources:
• NIH Veterinary Division of Veterinary Resources: Educational training and professional resources
• NIH Office of Research Infrastructure Programs
• NIH Physician-Scientist Workforce Report 2014: Chapter 5 - Veterinarian-Scientists
• Other U.S. Government One Health resources:
• U.S. Centers for Disease Control and Prevention (CDC): One Health
• U.S. Food and Drug Administration (FDA):
• A Pandemic and a Call to Action for One Health: The FDA One Health Initiative , June 11, 2020
• One Health: It’s for All of Us
• U.S. Department of Agriculture (USDA): One Health
• One Health resources from others:
• Duke University One Health Training Program
• One Health Commission
• One Health Global Network
• One Health Initiative
• One Health Platform
• WHO Tripartite Zoonosis Guide
• World Bank: One Health
• World Organisation for Animal Health (OIE) One Health resources

Resources and publications related to the article Prawn farming reduces disease, provides food source in Senegal :

• Fact sheet: Schistosomiasis , WHO
• About Schistosomiasis , CDC
• Profile: Dr. Susanne Sokolow via Stanford University Woods Institute for the Environment
• Grant: Effects of agricultural expansion and intensification on infections via NIH RePORTER
• Related program: Ecology and Evolution of Infectious Diseases Initiative (EEID)
• Grant: Emergence and biological control of schistosomiasis via NIH RePORTER
• Related publications featuring the results of the intervention:
• How to identify win-win interventions that benefit human health and conservation Nature Sustainability , November 16, 2020
• Precision mapping of snail habitat provides a powerful indicator of human schistosomiasis transmission Proceedings of the National Academy of Sciences , November 12, 2019
• Agrochemicals increase risk of human schistosomiasis by supporting higher densities of intermediate hosts Nature Communications , February 26, 2018
• Reduced transmission of human schistosomiasis after restoration of a native river prawn that preys on the snail intermediate host Proceedings of the National Academy of Sciences , August 4, 2015

Resources and publications related to the article Scientists in Tanzania show bacterial zoonoses, not malaria, often the cause of febrile diseases :

• Profile: Dr. John Crump via University of Otago
• NIAID/NIH grant: Investigating Febrile Deaths in Tanzania (INDITe) via NIH RePORTER
• NIAID/NIH grant: Acute HIV-1 Infections Network Core via NIH RePORTER
• Fogarty/NIH grant: The Impact and Society Ecology of Bacterial Zoonoses in Northern Tanzania: Under via NIH RePORTER
• Related Fogarty program: Ecology and Evolution of Infectious Diseases Initiative (EEID)
• Related publication: Fever, bacterial zoonoses, and One Health in sub-Saharan Africa Clinical Medicine , September 2019
• Related publication: Mixed Methods Survey of Zoonotic Disease Awareness and Practice among Animal and Human Healthcare Providers in Moshi, Tanzania PLOS Neglected Tropical Diseases , March 4, 2016
• Related publication: Global burden of human brucellosis: a systematic review of disease frequency PLOS Neglected Tropical Diseases , October 25, 2012
• Campaign: Not Every Fever is Malaria (Tanzania) via Compass

Resources and publications related to the article Research improves health among Mongolian livestock herders :

• Profile: Dr. Gregory Gray via Duke University Global Health Institute
• Grant: One Health Innovation Fellowships for Zoonotic Disease Research in Mongolia , including related publications, via NIH RePORTER
• Related publication: Knowledge and practices surrounding zoonotic disease among Mongolian herding households Pastoralism , April 20, 2020
• Related publication: Potential risk factors for zoonotic disease transmission among Mongolian herder households caring for horses and camels Pastoralism, January 29, 2018
• Related Fogarty program: Framework Programs for Global Health Innovation

To view Adobe PDF files, download current, free accessible plug-ins from Adobe's website .

Related Fogarty Programs

• Framework Programs for Global Health
• Ecology and Evolution of Infectious Diseases (EEID)

Related Global Health Research Topics

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JSmol Viewer

Global trends in the research and development of petrochemical waste gas from 1981 to 2022.

1. Introduction

2. data sources and analysis methods, 2.1. data sources, 2.2. analysis methods, 3. results and discussion, 3.1. contributions of top producers, 3.1.1. global research situation, 3.1.2. contribution of institutions and journals, 3.2. scientific research cooperation, 3.2.1. analysis of cooperation networks across countries, 3.2.2. analysis of cooperation networks across institutions, 3.2.3. analysis of author cooperation networks, 3.2.4. document co-citation analysis, 3.3. research hotspots and emerging trends in pwg, 3.3.1. research hotspots, 3.3.2. emerging trends, 4. discussion and conclusions, 4.1. future research directions, 4.2. policy recommendations, 4.3. limitations, 4.4. conclusions, supplementary materials, author contributions, data availability statement, conflicts of interest.

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Wu, M.; Liu, W.; Ma, Z.; Qin, T.; Chen, Z.; Zhang, Y.; Cao, N.; Xie, X.; Chi, S.; Xu, J.; et al. Global Trends in the Research and Development of Petrochemical Waste Gas from 1981 to 2022. Sustainability 2024 , 16 , 5972. https://doi.org/10.3390/su16145972

Wu M, Liu W, Ma Z, Qin T, Chen Z, Zhang Y, Cao N, Xie X, Chi S, Xu J, et al. Global Trends in the Research and Development of Petrochemical Waste Gas from 1981 to 2022. Sustainability . 2024; 16(14):5972. https://doi.org/10.3390/su16145972

Wu, Mengting, Wei Liu, Zhifei Ma, Tian Qin, Zhiqin Chen, Yalan Zhang, Ning Cao, Xianchuan Xie, Sunlin Chi, Jinying Xu, and et al. 2024. "Global Trends in the Research and Development of Petrochemical Waste Gas from 1981 to 2022" Sustainability 16, no. 14: 5972. https://doi.org/10.3390/su16145972

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