Narrow Results

Significance: Over 80% of cervical cancer cases occur in lower-to-middle income countries (LMIC’s). This is partly because current screening techniques lack affordability, accessibility, and/or reliability for use in LMIC’s. Aim: To develop an optical technique for cervical cancer screening that is affordable, accessible, and reliable for use in LMIC’s. Approach: We developed a portable diffuse reflectance spectroscopy (DRS) system, which costs $<\$2500$ USD to manufacture, and employs a Raspberry Pi to extract the absorption (${\mu }_a$) and reduced scattering (${\mu }_s^{\prime }$) coefficients of biological tissue. The system was subject to travel and intentional rough handling. It was further used to capture 320 DRS spectra taken from 64 tissue-mimicking phantoms. Two users collected phantom data, one “expert”, and one “novice” in biomedical optics. The system was also used to collect 335 spectra from colon, small intestine, and rectal tissue of a fresh ex vivo porcine specimen. A previously described artificial intelligence model was used to extract optical properties, and a GradientBoostingClassifier identified the organ of origin for ex vivo spectra. Results: System alignment was robust to intentional rough handling and travel. Phantom ${\mu }_a$ and ${\mu }_s^{\prime }$ were predicted with average root-mean square error of $<10\%$, regardless of user. Regarding ex vivo data, the system predicted the organ of origin with 80–90% accuracy. Statistical differences between predicted ${\mu }_a$ were observed in all three organs ($p<0.001$–0.03), and between ${\mu }_s^{\prime }$ in two organs ($p<0.001$–0.07). Conclusions: The DRS system has the potential to be affordable, reliable, and accessible for cervical screening in LMIC’s.

Research in France Gets Put on Hold.

How Biotechnology Can Improve Global Health.

From North America to Asia, With Rich Biologics Experience to Boot.

Sir George Radda – Heralds the Future Direction of Biomedical Research in Singapore.

NUS' "Virus Catcher" Awarded Direct Grant from the Gates Foundation.

Over the past few decades, knowledge management (KM) has become well-established in many fields, particularly in business. Several KM models have been at the forefront of promoting KM in businesses and organisations. However, the applicability of these traditional KM models to the global health field is limited by their focus on KM processes and activities with few linkages to intended outcomes. This paper presents the new Knowledge Management for Global Health (KM4GH) Logic Model, a practical tool that helps global health professionals plan ways in which resources and specific KM activities can work together to achieve desired health program outcomes. We test the validity of this model through three case studies of global and field-level health initiatives: an SMS-based mobile phone network among community health workers (CHWs) and their supervisors in Malawi, a global electronic Toolkits platform that provides health professionals access to health information resources, and a netbook-based eHealth pilot among CHWs and their clients in Bangladesh. The case studies demonstrate the flexibility of the KM4GH Logic Model in designing various KM activities while defining a common set of metrics to measure their outcomes, providing global health organisations with a tool to select the most appropriate KM activities to meet specific knowledge needs of an audience. The three levels of outcomes depicted in the model, which are grounded in behavioural theory, show the progression in the behaviour change process, or in this case, the knowledge use process, from raising awareness of and using the new knowledge to contributing to better health systems and behaviours of the public, and ultimately to improving the health status of communities and individuals. The KM4GH Logic Model makes a unique contribution to the global health field by helping health professionals plan KM activities with the end goal in mind.

This paper discusses the manner and the extent to which countries of the Global South have engaged in the fight against pandemics. It shows how Southern countries, like their brothers in the North, played a significant role in the fight against diseases such as AIDS. It unveils that despite its multilateral engagement in global health from the 2000s following its domestic health crisis, the Chinese government engaged in several bilateral health projects to fight pandemics in Southern countries. Using the Chinese-funded HIV/AIDS Traditional Chinese Medicine (TCM) research and treatment project in Tanzania as its focal point, the paper examines the history of the project from its inception in 1987 to its decline in 2014, and shows the contexts that influenced its establishment, practice, and perceptions by patients. The paper argues that although the Sino-Tanzanian HIV/AIDS TCM research and treatment project was less impactful in addressing the disease and transmitting medical knowledge to local researchers and practitioners, it realized the contribution of countries of the Global South to global health. More importantly, the use of TCM in fighting HIV/AIDS demonstrated the prospects of traditional medicine in addressing global health challenges.

To deliver on the 2030 Agenda and the seventeen development goals, while facing complex health challenges, we need research and education that extend across multiple scientific fields. This will enable researchers from a variety of disciplines to meet, identify research issues, apply for funding, and conduct interdisciplinary research. In addition, student involvement is key in achieving the 2030 Agenda’s global goals – and beyond. Challenges include, climate change and child health, non-peaceful societies, gender inequalities and health.

The Swedish Institute for Global Health Transformation (SIGHT) was founded in 2017 at the Royal Swedish Academy of Sciences with the support of the Bill & Melinda Gates Foundation. SIGHT’s mission is to promote an interdisciplinary approach in research and education in the field of global health. In order to deliver on the commitment to global health among researchers and students in various scientific fields and at universities and colleges across Sweden, SIGHT has established SIGHT Fellows, a mentoring programme for academic researchers. In collaboration with universities, established research institutions, and other stakeholders, SIGHT Student Network holds dynamic meetings for students from a variety of disciplines and universities to contribute to delivering the UN’s sustainability goals.

Non-communicable chronic diseases (NCDs) are currently the largest global cause of adult mortality, one of the principal burdens of disease in developed and underdeveloped countries. Their main causes are well known, tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. The prevalence of these risk factors is directly related to the activities of transnational corporations (TNCs). For example, just the TNC budgets dedicated to advertising risky consumption are larger than the budget of the World Health Organization.

A literature survey shows that NCDs have important long-term macroeconomic impacts, whose detailed evaluation has only just begun. The sheer burden on the working and aged population implies strong impacts on labor, saving and investment, as well as increased human capital depreciation. These will all impact long-term economic growth. It is a research priority to quantify these impacts. However, in the context of globalization, NCD is developing faster than its rigorous analysis.

Research results show that what is needed is preventive action. This requires a global institutional framework capable of controlling NCD risk factors, which can also promote health and economic growth in general. Developing legal mechanisms to slow the negative impact of the deficient nutrition transition would be a step in that direction. Global markets need to be balanced with global governance holding TNCs responsible for their impact, promoting cooperative solutions when available, and taxing them so that they carry their fair share of social weight.

COVID-19 has brought the attention to the study of past pandemics to ascertain if there are common trends across pandemics and what one might anticipate in the future. This chapter reviews pandemics through the lens of economic history to see their linkages with income, inequality, migration, and globalization. Pandemics tend to be supply-side shocks that depress incomes, either through lockdowns or mass mortality, by constraining the supply of labor. Pandemics also tend to increase inequality in the short run due to the disproportionate impact of economic and mortality dislocations on the poor. However, when mortality shocks have been large, the aftermath of the pandemic could also reduce inequality due to the rising bargaining power of scarce labor. Migrant flight from cities is one of the most stylized facts of pandemics, leading to supply-side disruptions and delayed economic recoveries. Globalization may not have caused more frequent pandemics, but the occurrence of a pandemic has often led to restrictions on the movement of people and slowed down globalization. The COVID-19 pandemic shares some of these features of past pandemics but also differs in its mortality profile, and hence, the economic repercussions also differ to some extent.

In this chapter, we study the role of individuals’ confidence in healthcare institutions on curative and preventive demand for healthcare during the COVID-19 pandemic in India. Specifically, we collate data on pre-pandemic self-reported measures of confidence in healthcare institutions in the private and public sectors and correlate these measures to aspects of demand for healthcare during the pandemic. We find that confidence in healthcare is positively correlated with demand for healthcare, which implies that policymakers must seek to establish credible health care institutions for COVID-19 care to tackle this major public health problem. This is because, in the absence of such credible institutions, which are perceived to be better service providers, the demand for health care is likely to be low, which can mask the actual infection rates leading to underreporting of infections and low vaccine take-up. We present a conceptual framework based on a simple microeconomic theoretical model that can help understand such behavior and use historical data on self-reported confidence measures from a large nationally representative household survey, along with rapidly incoming COVID-19 data, to perform our empirical analysis.

This chapter provides an overview of the research produced so far on the effects of the COVID-19 pandemic on mental health. A preponderance of largely observational evidence suggests that the disease hurts mental health both directly and indirectly. Direct effects include damage to the brain and nervous system, as well as psychological trauma from near-death experiences. Indirect effects operate through the fear and guilt of infecting loved ones, the loss of loved ones and major life experiences, social isolation and loneliness, school closures, job loss, and burnout from increased caretaking responsibilities. Particularly acute effects on specific groups of people, from children and adolescents to healthcare workers, are highlighted. The chapter concludes with lessons and silver linings that can help us reduce the negative effects future pandemics have on mental health.

Seroprevalence studies estimate the share of population that has been infected by a virus and can provide valuable information for policymakers as they respond to a pandemic, especially in its early stages. The spread of COVID-19 globally, as measured by seroprevalence studies, has been considerably more extensive than what is perceived from the case numbers reported by governments worldwide. The inability to incorporate evidence from such studies in a timely manner contributed to missed opportunities in the policy response to COVID-19. In this chapter, we discuss the potential role that seroprevalence studies can play in providing timely evidence for policy-making as well as the factors that lead to impediments in the adoption of such evidence. Building on our own experience with conducting some of the earliest seroprevalence studies in India, we describe the challenges of policy-making in crises and of incorporating uncertainty into this process, and we also examine some of the technical challenges in conducting these studies. In addition, we discuss policy responses that could be informed by evidence from such studies and highlight the lessons learned that might inform efforts in a future crisis, should it ever occur.

The aim of this chapter is to explore the stakes at play in relation to the proposed COVID-19 IP waiver, assess what other factors affect access to COVID-19 vaccines, diagnostics, and therapeutics worldwide, and briefly discuss initiatives taken at different levels to improve access to countries lagging behind. With 458 million cases of COVID-19 diagnosed worldwide and more than 6 million deaths by March 2022, the question is whether lifting intellectual property rights (IPRs) restrictions is the solution to unlock the sanitary crisis in developing countries. Policymakers need to be attentive to the impact and role of patents as incentive mechanism and be open to address patent system reforms, but attention should also be paid to IP-related voluntary initiatives and the advantages conferred by other factors, such as first mover advantages, reliance on prior scientific advances, market exclusivity provided by regulatory approvals, advanced purchase agreements, “vaccine nationalism,” data exclusivity from clinical trials, and know-how protected by secrecy. A global approach and more empirical evidence are needed to address the inequalities derived from this pandemic in order to be prepared for the next.

COVID-19 has shown that clinical trials need to be efficient, adaptable, and provide high-fidelity data that are actionable for public health officials and clinicians to deliver safe and effective interventions. Traditional fixed design trials, such as prospective randomized, double-blind clinical trials, need large sample sizes, are subjected to multiple study protocols for every interventional arm, take time to complete, and are expensive. In addition, they are not flexible enough to add or delete study arms during the course of the trial. Standard clinical trials are performed through sponsor-specific networks of clinical sites, with each trial and sponsor essentially competing with others for trial subjects to validate their therapeutic platform. Adaptive trials are more flexible and dynamically adjustable based on the accumulated results. This approach focuses on the best treatment, individual drug, or a combination among various options for a disease instead of focusing on the best single drug for a disease. Adaptive trials are often more efficient, cost-effective, and need fewer trial participants as futile treatment arms may be stopped early. Fewer patients may need to be randomized to a less promising treatment, and smaller study cohorts may be required to address the trial’s questions. Global health consortiums, governments, and multilateral institutions have the opportunity to collaborate and conduct adaptive trials, via established global clinical trial networks, to study and identify disease-outcome-driven interventions.

Access to healthcare is a key challenge facing people around the world during the COVID-19 pandemic. Many innovative telemedicine solutions have been implemented to enhance access to healthcare during the pandemic. An ecosystem of telemedicine with adequate infrastructure and country-specific practice guidelines has been developed. An exponential increase in teleconsultations, corresponding to the pandemic surges, has been observed around the world. This chapter focuses on a comprehensive teleophthalmology solution developed during the pandemic by the LV Prasad Eye Institute. The infrastructure and resources required to develop a mobile teleophthalmology solution are outlined. Lessons learned in delivering care through teleophthalmology during the pandemic are shared.