Global Public Health最新文献

This article examines efforts to develop a pandemic treaty through World Health Organization member state agreement from 2021 to 2025, focusing on challenges during the process. The COVID-19 pandemic showed the critical need for strong global agreements to prepare for and respond to health crises, with relevance for policymakers and researchers. Drawing on observations as invited stakeholders, relevant literature, official documents, and reports from other stakeholders, we identify key patterns, themes, and challenges, particularly the competing priorities of countries and difficulties in reaching consensus. Barriers that slowed progress include uneven political commitment, lack of transparency, and exclusion of key stakeholders, which hindered agreements and limited the treaty's potential to address global health threats. Our analysis highlights practical steps for future negotiations, including stronger political engagement, better coordination, greater transparency, and ensuring a broader range of voices and stakeholders are included in the process. Learning from these lessons will be critical for improving global pandemic preparedness and addressing future health challenges.

This research applied a predictive model to analyse the role that vaccination and community factors play in controlling the dengue virus. The study considers epidemiological and environmental data from the city of São Paulo (Brazil) after the start of the TAK-003 vaccination protocol in children aged 10-14 in 2024. The simulation of this study showed that the vaccination policy in São Paulo reduced reported and unreported cases, in addition to reducing the number of deaths. However, only 30% of the target group was covered by current vaccination distributions, indicating the need to expand vaccination coverage for more effective epidemic control. The results also indicate that the TAK-003 vaccine can be effective in long-term strategies. The proposed system dynamics model was used to simulate the different outcomes of the dengue epidemic in two scenarios. The first scenario simulated the development of dengue without vaccination, while the second simulated the results with the current vaccination strategy.

Most data governance frameworks are designed to protect the individuals from whom data originates. However, the impacts of digital practices extend to a broader population and are embedded in significant power asymmetries within and across nations. Further, inequities in digital societies impact everyone, not just those directly involved. Addressing these challenges requires an approach which moves beyond individual data control and is grounded in the values of equity and a just contribution of benefits and risks from data use. Solidarity-based data governance (in short: data solidarity), suggests prioritising data uses over data type and proposes that data uses that generate public value should be actively facilitated, those that generate significant risks and harms should be prohibited or strictly regulated, and those that generate private benefits with little or no public value should be 'taxed' so that profits generated by corporate data users are reinvested in the public domain. In the context of global health data governance, the public value generated by data use is crucial. This contribution clarifies the meaning, importance, and potential of public value within data solidarity and outlines methods for its operationalisation through the PLUTO tool, specifically designed to assess the public value of data uses.

This study aimed to identify the level of male involvement and factors associated with male involvement in the Prevention of Mother-to-Child Transmission of HIV. The study used an explanatory sequential mixed-methods design to assess male involvement in a sample of 566 women aged 18 and above. The study was conducted at three health facilities. A 10-item male partner involvement scale was used in the survey, and focus group discussions with both men and women and key informants were used to collect qualitative data. The weighted mean score for overall male involvement was 2.78 ± 1.40, indicating higher male involvement. Increasing income (p < 0.05), married (p < 0.031), living near a health facility (p = 0.033), HIV couple testing (p = 0.001) and disclosure of HIV results (p < 0.001) were associated with a higher male involvement in PMTCT. Men's busy schedules, lack of knowledge, lack of communication, long waiting times, lack of privacy and PMTCT activities deemed women's responsibility were cited as barriers to male involvement in PMTCT. Efforts are needed to improve male involvement in PMTCT services, focusing on addressing the barriers contributing to low male involvement.

Leprosy, though curable, continues to present physical and psychosocial challenges for those affected. This study explored how individuals affected by leprosy in Malaysia navigated daily life, societal expectations, and personal challenges through the walk-and-talk technique, a participant-led qualitative approach that fostered spontaneous storytelling and reflexivity. By guiding researchers through their environments, participants shaped the narrative, shifting power dynamics and enabling authentic dialogue. Six participants from Kelantan and Selangor shared their everyday activities, aspirations, and coping strategies. Video documentation was used as a supplementary tool to capture non-verbal cues and contextual interactions. Visual, auditory, and field data were transcribed and thematically analysed using NVivo 12, revealing key themes, including resilience and perseverance, employment and economic sustenance, stigma, family support, and community engagement. Work emerged as central to their well-being, fostering dignity and providing financial stability. However, self-imposed stigma limited social inclusion, while strong familial and community bonds provided crucial support. These findings highlighted the effectiveness of the walk-and-talk technique in capturing rich qualitative data and emphasised the need for tailored interventions to address stigma, enhance social inclusion, and support the well-being and economic stability of individuals affected by leprosy.

Unhealthy alcohol use is the greatest risk factor for premature death and disease among young individuals aged 15-49. Two interventions developed by Global Resilience Oral Workshops (GROW), a faith-based substance use recovery/character training programme, show potential in the reduction of alcohol use through specifically targeted character building. These programmes were rolled out in Lusaka and Sinda districts in Zambia among school and community groups. In this article, we conducted focus group discussions among school and community participants and their close relations and friends prior to the program intervention. We also conducted interviews among school staff and programme implementers as well as key informant interviews with cooperating partners. Findings showed that participants had adequate knowledge about the upcoming programme, hoping it would contribute to a reduction in substance use and instil good character. Anticipated challenges in programme implementation included scheduling conflicts, maintaining retention, and managing monetary expectations. There was high anticipation towards the upcoming programme with participants eager to improve their lifestyles. Study findings highlight challenges that need to be addressed for its effectiveness.

When the economy (economic inequality) develops to a certain level, does the impact of economic inequality on health inequality change? Through threshold regression, this study analyses the impact of city-level economic inequality on the absolute and economic-related inequality in under-5 child mortality rate (U5MR) (2001-2012) and maternal mortality rate (MMR) (2001-2015), along with the threshold values for economic development stages and economic inequality. Findings show: For the relationship between economic inequality and absolute inequality in U5MR, as well as economic-related inequality, there exists an economic development threshold effect. For the relationship between economic inequality and absolute inequality in MMR, an economic inequality threshold effect is illustrated. The improvement of economic conditions contributes to alleviating inequality in U5MR. Economic development inequality has a significant impact on the equality of maternal health development, but for enhancing the equality of women's health, health promotion policies may be more feasible.

Africa faces complex, interconnected health challenges like endemic diseases and pandemics, which overwhelm its healthcare systems. This article argues that health diplomacy is a vital tool for tackling these issues through regional collaboration. Health diplomacy, in the African context, means strategic engagement and negotiation among countries, regional bodies, non-state actors, and international partners. The article highlights the urgent need for this approach due to increased cross-border movement, climate change, shared resource constraints, and geopolitical interdependencies. It identifies key areas where health diplomacy is crucial: disease surveillance and control, cross-border healthcare access, harmonizing health policies, and joint procurement of medical supplies. The article also examines the roles of major players like the African Union (AU), Regional Economic Communities (RECs), NGOs, and international organizations. Looking ahead, it outlines strategies to strengthen health diplomacy by leveraging digital health, addressing climate-related health risks, promoting youth and gender inclusion, and securing sustainable financing. The ultimate goal is to build a more resilient and healthier Africa through collective action and sustained regional cooperation.

This paper examines contextual conditions for antimicrobial resistance (AMR) policy implementation in Zimbabwe. As an emerging global sustainability challenge, AMR constitutes risks for human, animal and environmental health as well as the long-term viability of livestock and farming with implications for communities' economic stability and food security. The study uses participatory research workshops as a data generation method, engaging with interdisciplinary groups of students and lecturers at two universities in Zimbabwe. Utilising a combination of One Health approaches and theories of policy integration and coherence as our analytical framework, we outline the concept of agile policies, adapting policy content to contextual conditions. Results illustrate the interplay between social, economic and institutional contexts for AMR policy implementation and how especially economic pressures and social tensions represent obstacles to contextually relevant implementation. Limited resources and infrastructural support as part of monitoring and enforcement efforts related to antimicrobial use pose further challenges. This paper calls for AMR policy to be aligned with economic, agricultural and educational policies. Through such policy coherence and integration, One Health cross-sector collaborations could be developed, resulting in more policies while lessening the compliance costs for communities in implementing AMR policy in their practices.

Before COVID-19, a few studies examined adult vaccination programmes for disease outbreaks in Nigeria. Recent studies explored vaccine uptake factors, but few examined implementation. We aimed to understand factors influencing the implementation and uptake of adult vaccination programmes in Nigeria, through the COVID-19 example, to support subsequent outbreak interventions. We systematically searched seven databases and conducted a meta-ethnography of eight studies published between 2022 and 2024, involving 207 participants. Through reciprocal and refutational translation, higher-order interpretations, a new line of argument and a conceptual model on factors influencing implementation and uptake of COVID-19 vaccination in Nigeria were developed. We reported findings using eMERGe guidance. We developed eight higher-order interpretations operating at individual, health system and policy levels. Four concerned vaccination uptake: an ethical paradox, self-preservation, socioeconomic characteristics and trust. Another four concerned vaccination implementation and uptake: policy actions, local leadership from government, supply chain challenges and health services information. Our findings suggest that improved vaccination programme implementation during disease outbreaks in Nigeria would support enhanced vaccine uptake by adults. Our findings can inform vaccine implementation strategies for successful rollout and uptake of adult vaccines in future outbreaks.