Climate Change, Conflict, and Contagion: Emerging Threats to Global Public Health

The present era is defined by a confluence of crises and a degree of global interconnectedness without historic precedent. A Toxic Triumvirate of climate change, conflict, and contagion have synergistically functioned to cast our collective, global public health into extreme jeopardy. The COVID-19 pandemic, War in Ukraine, and advancing climactic catastrophe have devastated our world: destabilizing nations, severing vital supply lines, and fracturing indispensable health infrastructure. All the while, the threat of nuclear war and the risk of devastating pandemic from emerging infectious disease (EID) grow in the unchecked wounds of low- and middle-income countries (LMIC). Nations of the Global South have been rendered super-vulnerable to the Toxic Triumvirate’s effects through historic global inequity and chronically anemic international support. These “developing” nations are subject to unsustainable extremes of risk secondary to a compounding of hazard. This amplified risk is transmitted through our world via vibrant arteries of commerce that intimately connect us. Our world’s collective health is in a state of jeopardy demanding a vigorous, equitable, and cooperative international response. To chart a course toward a safe future for our children, we must rectify the profound inequities that present our world’s shared Achilles’ heel and invest in the sustainable development of LMIC

The Anthropology of Epidemics

Over the past decades, infectious disease epidemics have come to increasingly pose major global health challenges to humanity. The Anthropology of Epidemics approaches epidemics as total social phenomena: processes and events which encompass and exercise a transformational impact on social life whilst at the same time functioning as catalysts of shifts and ruptures as regards human/non-human relations. Bearing a particular mark on subject areas and questions which have recently come to shape developments in anthropological thinking, the volume brings epidemics to the forefront of anthropological debate, as an exemplary arena for social scientific study and analysis

White Paper 4: Challenges In Biomedicine & Health

Publicado en Madrid, 231 p. ; 17 cm.A lesson that we have learned from the pandemia caused by coronavirus is that solutions in health require coordinated actions. Beside this and other emerging and re-emerging infectious diseases, millions of Europeans are suffering a plethora of disorders that are currently acquiring epidemic dimensions, including cancer, rare diseases, pain and food allergies, among others. New tools for prevention, diagnosis and treatment need to be urgently designed and implemented using new holistic and multidisciplinary approaches at three different levels (basic research, translational/clinical and public/social levels) and involving researchers, clinicians, industry and all stakeholders in the health system. The CSIC is excellently positioned to lead and coordinate these challenges in Biomedicine and Health.Peer reviewe

The Anthropology of Epidemics

Over the past decades, infectious disease epidemics have come to increasingly pose major global health challenges to humanity. The Anthropology of Epidemics approaches epidemics as total social phenomena: processes and events which encompass and exercise a transformational impact on social life whilst at the same time functioning as catalysts of shifts and ruptures as regards human/non-human relations. Bearing a particular mark on subject areas and questions which have recently come to shape developments in anthropological thinking, the volume brings epidemics to the forefront of anthropological debate, as an exemplary arena for social scientific study and analysis

CGIAR Research Program 4: Agriculture for Improved Nutrition and Health

This research program aims to accelerate progress in improving the nutrition and health of poor people by exploiting and enhancing the synergies between agriculture, nutrition, and health through four key research components: value chains, biofortification, control of agriculture-associated diseases, and integrated agriculture, nutrition, and health development programs and policies. With IFPRI and ILRI as co-Lead Centers, this program will also involve 10 other CGIAR Centers. It has an initial 3-year budget of US$191.4 million. The program was approved in December 2011

Animal Welfare - Environment - Sustainable Development Nexus: Scoping Study

A detailed report on the links between animal welfare, environmental health and global sustainability. Issues discussed include climate change, biodiversity, pollution and waste management, one health, sustainable development and just transitions

Expanding the One Health agenda - sustainable livelihoods, zoonotic disease and gender in Nigeria

Livestock production is central to the livelihoods of millions of people in Nigeria, and indeed across the continent. Understanding how livestock based economies function and the issues that constrain them has long been an important task for actors interested in supporting rural development. In recent years, the One Health agenda has provided a new impetus for studying and tackling the interconnections between human, animal and environmental. Whilst this is welcome, it tends to be selective in its modus operandi of intersectoral collaboration as advocated. This new risk repeats the tendencies of earlier scholarship in understanding rural animal production systems as a vertical system. In particular, gender analysis of addressing the growing threats of neglected tropical diseases (NTDs) is lacking in One Health as evidenced in the findings from the study areas of Kachia Grazing Reserve and the Jos Plateau. There is thus a need to illustrate the importance of integrating gender equality into the One Health concept of programmes especially in pastoralist areas. Through the use of a qualitative approach of eliciting needed information by the use of a range of qualitative methods at the community and household levels, this thesis, based on three case studies provides substantial new empirical contributions to this debate. Specificially, chapter four, by exploring the strategies employed by the study population to cope with, as well as to build their resilience to the inadequacies of the Kachia Grazing Reserve, argues that these inadequacies affect gender, gender relations, and livelihoods. As a reinforcement to these assertions, chapter five explores the role of women self help groups in the KGR and argues that these self help groups could be used as instruments in propelling the One Health concept in pastoral areas like that of the KGR. Lastly, chapter six explores the effect of conflict and violence on gender, gender relations and livelihoods in the Jos Plateau and examines how timely and effective delivery of One Health could act as a conflict resolution in conflict and violence inflicted pastoralist areas of the Jos Plateau. This thesis, in a way, gives possible explanation to the reticence of gender in One Health. Thus, in recognition of the potentials of the One Health concept, and in considering the realities on ground and the importance of integrating gender equality in its programme planning and delivery, the analysis of data from the three case studies of this thesis brings into focus the ‘how’ and ‘why’ of gender analysis affects delivery of One Health programmes in local pastoralists communities

Considering Vermont\u27s Future in a Changing Climate: The First Vermont Climate Assessment

The Vermont Climate Assessment (VCA) paints a vivid picture of a changing climate in Vermont and calls for immediate strategic planning to sustain the social, economic and environmental fabric of our state. The VCA is the first state-scale climate assessment in the country and speaks directly to the impacts of climate change as they pertain to our rural towns, cities and communities, including impacts on Vermont tourism and recreation, agriculture, natural resources and energy

Cohort study of associations between intestinal protozoa infection and intestinal barrier funcion, nutritional status, and neurodevelopment in infants from Republic of São Tomé

Enquadramento Em lactentes de países de baixo e médio rendimento, Giardia lamblia, Cryptosporidium e Entamoeba hystolitica são agentes prevalentes em infeções intestinais. As interações hospedeiro-parasita podem levar a uma resposta inflamatória da mucosa e aumento da permeabilidade intestinal. Clinicamente, isto pode refletir-se por impacto negativo no crescimento e neurodesenvolvimento. Os efeitos destas infeções intestinais subclínicas na saúde infantil têm sido pouco estudado. Objetivo Analisar, em crianças assintomáticas de São Tomé, as associações entre infeções por parasitas intestinais e a função da barreira intestinal, o estado nutricional e o neurodesenvolvimento. Métodos Foi realizado um estudo coorte de nascimento com seguimento até aos 24 meses de idade. A antropometria foi avaliada mensalmente e incluiu o crescimento atingido (zscores para peso/comprimento, comprimento/idade – CIzs e diferença do comprimento-para-idade – DCI), a velocidade do crescimento (z-scores para velocidade ponderal – VPzs e linear – VLzs) e o risco de desnutrição (aguda e crónica, definida como <-1DP). O neurodesenvolvimento foi rastreado em idades-chave usando o “Bayley Infant Neurodevelopmental Screening”. Os biomarcadores fecais para inflamação (S100A12) e permeabilidade intestinais (alfa-1-antitripsina - A1AT) foram medidos aos 24 meses. A presença de protozoários e helmintas intestinais foi avaliada trimestralmente por técnicas microscópicas Foram usados diferentes modelos estatísticos para estudar associações entre infecções por parasitas intestinais e os resultados das avaliações da função da barreira intestinal, estado nutricional e neurodesenvolvimento. Resultados Foram incluídos 475 recém-nascidos, representado 8,6% dos nados-vivos em São Tomé; 280 (58,9%) completaram os 24 meses de seguimento. Giardia lamblia e helmintas foram os parasitas mais prevalentes. A análise multivariável revelou que: 1) lactentes infetados com Giardia lamblia e helmintas tiveram tendência para aumento de 23,6% e 24,1% no marcador de inflamação intestinal, respectivamente; os infetados por qualquer parasita tiveram tendência para aumento de 33,6% no marcador de permeabilidade; além disso, os níveis de A1AT foram 100% superiores em lactentes com desnutrição aguda e 50% superiores nos com desnutrição crónica; 2) lactentes infetados com Giardia lamblia e helmintas tiveram associação significativa com diminuição no crescimento linear (-0,10 e -0,16 CIzs; e -0,32 e -0,48 de DCI, respectivamente); os infetados com Cryptosporidium spp. tiveram associação significativa com diminuição na velocidade de crescimento ponderal e linear (-0,43 VPzs e -0,55 VLzs); 3) a infecção por Giardia lamblia e a desnutrição crónica associaram-se independentemente e significativamente com 1,69 e 2,37 maior probabilidade de atraso no desenvolvimento, respectivamente. Conclusões Este é o primeiro estudo de coorte de nascimento em São Tomé, pioneiro em estudar associações entre infeções por parasitas intestinais e a função da barreira intestinal, estado nutricional e neurodesenvolvimento. Foi confirmado o papel subestimado dos protozoários e helmintas como agentes etiológicos de infecções intestinais subclínicas. Estas infecções revelaram uma tendência para associação com a disfunção da barreira intestinal e associações significativas com restrição do crescimento linear e neurodesenvolvimento. Estas associações são problemáticas em São Tomé, endémico para Giardia lamblia e helmintas, em contexto de proporção não negligenciável de lactentes marginalmente desnutridos. Estes poderão ter capacidade limitada para reparar lesões da mucosa, com impacto negativo no crescimento e neurodesenvolvimento, ficando comprometido o atingimento do seu pleno potencial.Background Giardia lamblia, Cryptosporidium and Entamoeba hystolitica are prevalent etiologic agents of enteric infections in infants from low- and middle-income countries. Hostparasite interactions may lead to mucosal inflammatory response and increased intestinal permeability. Clinically this can result in a negative impact on growth and neurodevelopment. The effects of these subclinical enteric protozoa infections on infant health are poorly explored. Aim To analyze the associations between enteric parasitic infections and intestinal barrier function, nutritional status and neurodevelopment in asymptomatic infants in São Tomé. Methods A birth cohort study with a follow-up until 24 months of age was implemented. Anthropometry was assessed monthly and included attained growth (weight-for-length z-score, length-for-age z-score – LAZ, and length-for-age difference – LAD), growth velocity (weight velocity z-score – WAVZ, and length velocity z-score – LAVZ), and risk for undernutrition (wasting and stunting, using the <-1SD cut-off). Neurodevelopment was screened at key ages using the “Bayley Infant Neurodevelopmental Screening” score. Fecal biomarkers for intestinal inflammation (S100A12) and permeability (alpha 1 anti-trypsin - A1AT) were measured at 24 months of age. Enteric protozoa and intestinal helminths were examined quarterly in stool samples using microscopic techniques. Different statistical models were used to explore associations between enteric parasitic infections and the three outcomes: intestinal barrier function, nutritional status, and neurodevelopment. Results A total of 475 neonates were enrolled, representing 8.6% of live-births in São Tomé; 280 (58.9%) infants completed 24 months of follow-up. Giardia lamblia and helminths were the most prevalent parasites. The multivariable analysis showed that: 1) infants with Giardia lamblia and helminths infections had a tendency toward an increase of 23.6 % and of 24.1 % in the inflammatory biomarker, respectively; those infected by any enteric parasite had a tendency toward an increase of 33.6% in the permeability biomarker; additionally, this biomarker was 100% higher in wasted infants and 50% higher in those stunted; 2) infants with Giardia lamblia and helminths infections showed a significant association with a decrease in linear growth (by - 0.10 and -0.16 of LAZ and by -0.32 and -0,48 of LAD, respectively); those with Cryptosporidium spp. infection displayed a significant association with a decrease in weight and length velocities (-0.43 WAVZ and -0.55 LAVZ); 3) Giardia lamblia infection and stunting were independently and significantly associated with a 1.69 and 2.37 increased risk of poor development, respectively. Conclusions This first birth cohort ever performed study in São Tomé is innovative in exploring associations between enteric parasitic infections and the intestinal barrier function, nutritional status and neurodevelopment in infants. The underestimated role of protozoa and helminths as etiologic agents of subclinical enteric infections was confirmed. These parasitic infections showed a tendency of association with intestinal barrier dysfunction and significant associations with decreased linear growth and risk of poor neurodevelopment. In the context of São Tomé, an endemic area for Giardia lamblia and helminths with a non-negligible proportion of marginally undernourished infants such associations are problematic. Affected infants may have a limited capacity to repair mucosal damage, with a negative impact on growth and neurodevelopment, thus jeopardizing the achievement of their full potential

Health of People, Places and Planet. Reflections based on Tony McMichael’s four decades of contribution to epidemiological understanding

This book has three main goals. The first is to celebrate the work of a great public health figure, the late A.J. (Tony) McMichael (1942–2014). The second is to position contemporary public health issues in an interdisciplinary context and in ways that highlight the interdependency between the environment, human institutions and behaviours; a broad approach championed by Tony. The third is to encourage emerging and future public health leaders to advocate for policies and cultural change to sustain and improve human health, from a foundation of objective scholarship. The book’s foreword and 38 chapters were written by people who were inspired by Tony; many of whom worked with him at some point in the last 40 years. Its structure reflects five major public health domains, each of which Tony made major contributions to in an extremely productive academic life: occupational health and safety; environmental and social epidemiology; nutrition and food systems; climate change and health; and ecosystem change and infectious disease. The final section, ‘Transformation’, is dedicated to Tony’s desire for public health scientists to propose adaptive and mitigating solutions to the problems they were observing. Each section contains at least one key publication involving Tony. There is also a selection of artworks from an exhibition which formed part of the conference held to honour Tony at The Australian National University in 2012. This conference formed the first part of Tony’s festschrift, completed by this book