Why should medical students be concerned about global governance?

This article introduces the work of the Lancet-University of Oslo Commission on GlobalGovernance for Health and its parallel Youth Commission, which published their reports in2014. Because the role of socioeconomic conditions in the production of health outcomes and health inequities has already long been recognized, the Commission further examined the “political determinants of health,” particularly the systemic dysfunctions of global governance, especially in areas that are deemed as “non-health” such as trade, finance, agriculture, migration, and security. To support the Commission’s thesis, the Youth Commission then proposed the adoption of the “capability approach” as a guiding framework of global governance for health. First introduced by Amartya Sen, this approach emphasizes on the need for equality in the space of capabilities or freedoms needed to achieve various things that people value. Nevertheless, while the road toward better global governance remains elusive, the next generation of leaders, including medical students, can already be prepared to tackle these seemingly insurmountable challenges. Various ways by which medical students can learn and understand global governance and global health include incorporation into the medical curriculum, internships, and involvement in student organizations with global health orientation. Such modalities are hoped to contribute towards the full reorientation of the health professions to consider, address, and reach out to other sectors that govern the broader, underlying social determinants of health

Invited Perspective: Uncovering the Hidden Burden of Tropical Cyclones on Public Health Locally and Worldwide

As climate change and health researchers of Filipino heritage, we both are all too directly familiar with the cycles of devastation that typhoons (such as Typhoon Haiyan1 in 2013 and Typhoon Noru2 in 2022) and other tropical cyclones can leave in their path. For our families, the destruction wrought by tropical cyclones has manifested as downed trees, damaged or destroyed homes, and uprooted lives. Sadly, such traumatic experiences are commonplace when tropical cyclones make landfall, be it in the Philippines, China, Mexico, the United States, or elsewhere

Planting sustainable seeds in young minds: the need to teach planetary health to children.

No abstract available

Protecting environmental defenders to prevent pandemics

Although the jury remains out with regard to the origin of the ongoing COVID-19 pandemic,1 this global health crisis is a stark reminder of the continuous threat of emerging infectious diseases, and the need to tackle their upstream drivers (eg, deforestation and illegal wildlife trade). However, proposals for preventing pandemics at the source2 tend to focus on high-level policies and actions, with relatively little support afforded to ground-level environmental defenders, who are arguably the most important front-line defence in stopping future zoonotic spillovers. Through sustained involvement in activities that reduce deforestation and biodiversity loss (eg, lobbying against powerful industries or politicians, and patrols to curb illegal harvesting), environmental defenders face increasing duress, ranging from occupational burnout to life-threatening attacks.3 Protecting the welfare of environmental defenders must be part of the solution to preventing future pandemics

Safeguarding planetary health for Southeast Asia's future children

While we continue to deal with the ongoing COVID-19 pandemic, the past months have also revealed the sorry state of our collective planetary health, including in southeast Asia. Weeks after the 2021 UN climate change conference (known as COP26), Malaysia experienced intense flooding at a scale that has never been seen before,1 while the Philippines was once more hit by a super typhoon that killed hundreds and displaced a hundred thousand more.2 In the beginning of 2022, the Stockholm Resilience Centre announced that a fifth planetary boundary has already been breached—chemical pollution, particularly plastic—in addition to climate change, land use change, disrupted biogeochemical flows, and biodiversity loss.3 Southeast Asia is central source of plastic pollution, as most of the top five plastic-polluting countries are located in the region.4 Furthermore, as a biodiversity hotspot, the jungles of southeast Asia offer ideal conditions for another potential zoonotic outbreak, and it is vital to prevent future pandemics at the source.

The Contribution of Islam to planetary health

The human ecosystem interface, embodied by the planetary health paradigm, is deeply embedded in all the world's religions and indigenous traditions.1 Yet, the ongoing planetary health discourse remains predominantly Western-orientated. As calls to decolonise health ensues, there is a need to explore and acknowledge other non-Western perspectives, such as those originating from the Islamic faith.

An agenda for climate change and mental health in the Philippines

The latest report1 from Climate Cares, based at the Imperial College London, is a welcome addition to the small but slowly growing body of knowledge on the interconnections between climate change and mental health.1 The report identified the different direct and indirect causal pathways, synthesised evidence on current epidemiology and health-system responses from diverse countries, and laid out recommendations for future research, policy, and practice. The report's launch is timely and relevant as the climate crisis intersects with the COVID-19 pandemic, which is also generating a global mental health pandemic

Wet market biosecurity reform : three social narratives influence stakeholder responses in Vietnam, Kenya, and the Philippines

Funding: This research was funded by the Australian Agricultural Centre for International Agricultural Research (ACIAR), grant number LS/2020/204. The funders played no role in the design or implementation of the research. Grant recipients included: KB, RG, SB, TH, CM. All authors received salary support from the grant.In 2020, Covid-19 led to global policy statements promoting bans and reforms to wet markets in Asia and Africa to prevent future pandemics. We conducted a comparative, exploratory qualitative study in 2021 in three countries (Kenya, Vietnam and the Philippines) to understand the social and political dimensions to biosecurity reform at wet markets. This included 60 key informant interviews and rapid ethnographic research in 15 markets, as well as a review of policy documents and online media articles. We found no evidence that the rhetoric of pandemic spillover that emerged in 2020 had any influence on policy or reform efforts apart from those related to Covid-19 infection control. Rather, we identified three main narratives that frame the problem of biosecurity and preferences for reform. The first, a human health narrative, questioned global framings about pandemic risk, viewed markets as sources for food security rather than disease, emphasized the need to strengthen the control of endemic diseases, and conceptualized health through the lens of ‘freshness’ rather than biomedical categories. A second modernization narrative approached biosecurity as part of a broader process of socio-economic development that emphasized infrastructural gaps, spatial arrangements, cleanliness and a conflict between reform and economic interests. A third narrative centered on local livelihoods and the tension between local market stakeholders and biosecurity and modernization efforts. This final narrative called into question the appropriateness of certain regulations and policies, including bans and closures, emphasized the importance of preserving cultural heritage and highlighted the need for collective political action to resist certain veterinary policies. In conclusion, wet market biosecurity strategies occur in the context of three contrasting narratives that emphasize different aspects of health and risk, and reflect different worldviews and interests. Within this context, there is a need for local government to strengthen market management and biosecurity in ways that enhance the agency of market stakeholders and strengthen local livelihoods and food security as part of a pluralistic and democratic politics.Publisher PDFPeer reviewe

Envisioning environmental equity: climate change, health, and racial justice

Climate change has a broad range of health impacts and tackling climate change could be the greatest opportunity for improving global health this century. Yet conversations on climate change and health are often incomplete, giving little attention to structural discrimination and the need for racial justice. Racism kills, and climate change kills. Together, racism and climate change interact and have disproportionate effects on the lives of minoritised people both within countries and between the Global North and the Global South. This paper has three main aims. First, to survey the literature on the unequal health impacts of climate change due to racism, xenophobia, and discrimination through a scoping review. We found that racially minoritised groups, migrants, and Indigenous communities face a disproportionate burden of illness and mortality due to climate change in different contexts. Second, this paper aims to highlight inequalities in responsibility for climate change and the effects thereof. A geographical visualisation of responsibility for climate change and projected mortality and disease risk attributable to climate change per 100 000 people in 2050 was conducted. These maps visualise the disproportionate burden of illness and mortality due to climate change faced by the Global South. Our third aim is to highlight the pathways through which climate change, discrimination, and health interact in most affected areas. Case studies, testimony, and policy analysis drawn from multidisciplinary perspectives are presented throughout the paper to elucidate these pathways. The health community must urgently examine and repair the structural discrimination that drives the unequal impacts of climate change to achieve rapid and equitable action