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Challenges and Prospects of Sustainability in the Context of Global Health

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A special issue of Sustainability (ISSN 2071-1050). This special issue belongs to the section "Health, Well-Being and Sustainability".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 17882

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Prof. Dr. Vesna Bjegovic-Mikanovic

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Guest Editor

Faculty of Medicine, Centre-School of Public Health and Health Management, University of Belgrade, 11000 Belgrade, Serbia
Interests: health management; health systems research; global health; postgraduate public health education
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ulrich Laaser

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Guest Editor

Section of International Public Health, School of Public Health, Bielefeld University, D-33501 Bielefeld, Germany
Interests: postgraduate public health education; global health; health policy; one Health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We have the opportunity and the pleasure to invite you to contribute to our Special Issue on “Challenges and Prospects of Sustainability in the Context of Global Health”. The recent COVID-19 pandemic underlined once more the global interrelatedness of all our activities. A regionalized, even fragmented world—as it was—is converging rapidly at the beginning of the 21st century. Countries embark increasingly on global arrangements and a globalizing civil society connects across borders, supported by mobile technologies. At the same time, unprecedented waves of migration diversify the Northern societies, depleting the qualified workforce in the South (1).

In a globalized world, there are no isolated places; problems and solutions transcend national borders, require international cooperation, and lead to a growing interconnectedness of countries. Global health is an area for study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide. It emphasizes transnational health issues, determinants, and solutions; involves many disciplines within and beyond the health sciences; and is a synthesis of population-based prevention with individual-level clinical care (2).

Today, the Sustainable Development Goals are a cornerstone for a minimum set of standards in moving toward global equity in health services delivery, and leadership in global health issues encompasses all levels of society.

The global health challenges are numerous and complex and concern the common problems of all people on the planet. Global warming, global divisions, and global security are considered to be of strategic importance, as they represent a generational challenge for sustainable development and future generations' health. Numerous global health challenges are interrelated, such as global warming and natural and human-made disasters, floods, drinking water shortages, and deforestation, contributing to the loss of demographic balance, economic divisions, forced migration, poverty, and hunger endangering entire populations. At the same time, in the analysis of global health problems and challenges, there is a well-known rule that is expressed as a ratio of 10/90 and which represents a considerable limitation in overcoming global health problems: ninety percent of financial resources are directed to improving the health of only 10% of the world's population. The burden of not only contagious but also chronic non-communicable diseases and injuries affects the poorest countries in the world.

Global health requires cooperation, coordination, and opportunities to exchange ideas and learn from experiences and examples of good practice. The goal is to develop joint action that will protect and improve the health of all people in the world. It is an extensive multi-sectoral area that connects the main areas of development policy, humanitarian aid, research and health, trade, and international policy. Today, health has become one of the global priorities, resulting from undoubted scientific evidence on the connection between health and economic development. This approach is reflected in a strong global commitment to the Sustainable Development Goals. Examples of pandemics, such as COVID-19, show how health is becoming a global issue affecting all sectors of the economy and politics and requires coordinated international responses. Stakeholders involved in multilateral cooperation in addressing critical global health issues require additional learning, which encompasses two sectors: the health sector and foreign affairs.

A Global Public Health Curriculum (2nd Edition, 2016), South Eastern European Journal of Public Health (SEEJPH). doi: 10.4119/seejph-1828.
Kоplan PJ, et al. Towards a common definition of global health. The Lancet. 2009;373:1993-5.

Prof. Dr. Vesna Bjegovic-Mikanovic
Prof. Dr. Ulrich Laaser
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Sustainability is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

global health
global burden of disease
pandemics
universal health coverage
peace and solidarity
inclusive health governance
bottom-up initiatives
gender equity

Published Papers (11 papers)

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Editorial

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3 pages, 137 KiB

Open AccessEditorial

Challenges and Prospects of Sustainability in the Context of Global Health

by Vesna Bjegovic-Mikanovic and Ulrich Laaser

Sustainability 2024, 16(7), 3061; https://doi.org/10.3390/su16073061 - 7 Apr 2024

Viewed by 420

Abstract

We introduced this Special Issue entitled “Challenges and Prospects of Sustainability in the Context of Global Health”, published by MDPI, about two years ago with the following excerpt: [...] Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

Research

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17 pages, 283 KiB

Open AccessArticle

Implementation of the UN’s Sustainable Development Goals (SDGs) among the Member Cities of the “Healthy Cities Network” in Israel

by Milka Donchin, Lia Gurewitz and Sima Lissa Wetzler

Sustainability 2024, 16(1), 310; https://doi.org/10.3390/su16010310 - 28 Dec 2023

Viewed by 790

Abstract

The Israeli Healthy Cities Network (IHCN), as one of the accredited networks of the WHO European Healthy Cities Network in its seventh phase, started mapping the level of adoption and efforts that are being made towards achieving the 17SDGs. Data for all 55 member cities was collected from the most recent online national databases. As not all indicators are available in national data sets, an online questionnaire was distributed to all 55 cities’ health coordinators, via e-mail, to acquire the needed data; 45 of the 55 replied (81.8% response rate). All SDG measures were analyzed by socio-economic cluster (SEC) using one-way ANOVA. Implementation of some indicators was checked for association with population size of municipalities, as well as structure and process measures of the healthy cities’ operation. Cities implement between 4 and 14 SDGs, and 98% implement SDG3, while the lowest implementations are of SDG13 (44%) and SDG12 (28%). Cities in higher SECs are in a better position in relation to most SDGs. However, cities in a low SEC can achieve implementation of at least some of the goals through policy and commitment. This study provides municipalities with a baseline for tracking future progress and a tool for mapping gaps in implementation. The methodology and tools presented here could be used by any municipality, as well as by national networks and other governance bodies. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

23 pages, 13423 KiB

Open AccessArticle

Socio-Economic Vulnerability Assessment for Supporting a Sustainable Pandemic Management in Austria

by Vanessa Streifeneder, Stefan Kienberger, Steffen Reichel and Daniel Hölbling

Sustainability 2024, 16(1), 78; https://doi.org/10.3390/su16010078 - 21 Dec 2023

Viewed by 975

Abstract

The outbreaks of a new pandemic in 2019 let humankind face a new type of challenge. People and groups in vulnerable situations were especially affected. Increasing urbanization, climate change, and global travel raise the likelihood of pandemics. COVID-19 has shown that sustainable and well-planned pandemic management is necessary, which also includes and identifies people in vulnerable situations. In this study, a socio-economic vulnerability assessment (VA) for supporting improved pandemic/epidemic risk management at the municipality level in Austria was conducted. The VA provides a holistic overview of the vulnerability under pre-event conditions in Austria, which can be used to support pandemic management. Therefore, we calculated a composite indicator with expert-based weighting. The necessary indicators were defined through a literature review and an expert consortium consisting of practical and scientific members. As a result, an interactive map containing the vulnerability index (VI) for each municipality was created, making it possible to also assess underlying vulnerable factors to support decision-making. The applicability of the VA was shown in the relationship between a high VI in a municipality and a high number of deaths. A limiting factor to the VA was the missing data for health indicators for the whole of Austria. Hence, we provide a list with recommendations on which data should be collected to improve the VA in the future. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

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19 pages, 1267 KiB

Open AccessArticle

A Study of the Effect of Trade Openness on Population Health: Empirical Evidence from China

by Jiayu Ou, Zhiqiang Zheng and Naili Zhang

Sustainability 2023, 15(16), 12571; https://doi.org/10.3390/su151612571 - 18 Aug 2023

Viewed by 1020

Abstract

Currently, the international economy is experiencing profound and intricate transformations, while economic globalization is encountering unprecedented challenges and witnessing a surge in counter-globalization sentiments. Critics express concerns over the potential detrimental effects of trade liberalization on the welfare of low-income groups, particularly in developing countries. China, as the largest developing country, also holds the status of a major trading nation. Using panel data from 285 prefecture-level cities across China during 2000–2019, this study examines how trade openness affects population health to assess the welfare effects of trade openness, providing new theoretical perspectives and empirical evidence to further promote economic globalization and improve human health and well-being. The results show that trade openness can significantly promote population health. And, a series of robustness tests show that the above conclusion is still valid. Trade openness has a greater positive impact on the health of the population of the eastern and central regions, the coastal cities, and high-trade-openness cities. An analysis of the mechanism reveal that trade openness mainly promotes population health through channels such as labor employment, wage income, public health investment, and personal health investment. However, trade openness can also lead to environmental pollution, which has a significant negative impact on population health. Additionally, through threshold effects analysis, it becomes evident that the relationship between trade openness and population health is nonlinear. This implies that there are critical thresholds related to the economic development stage, investment in environmental governance, and environmental infrastructure construction. Falling below or exceeding these thresholds may lead to different interval effects on the impact of trade openness on population health. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

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12 pages, 265 KiB

Open AccessArticle

Socio-Demographic Correlates of Barriers to Access Healthcare Services among Children in Post-Communist Albania

by Iris Mone, Suela Vasil, Albano Alia, Sonela Xinxo, Kliton Muça and Genc Burazeri

Sustainability 2023, 15(11), 8455; https://doi.org/10.3390/su15118455 - 23 May 2023

Cited by 1 | Viewed by 1313

Abstract

Access to healthcare services is an essential component of promoting public health and sustainable development. Our aim was to assess socio-demographic correlates of barriers to accessing healthcare services among children in Albania, a post-communist country in Europe. An online survey was conducted in September 2022, including a nationwide representative sample of 7831 school children (≈54% girls) ranging from grades six to nine from all regions of Albania. A structured and anonymous questionnaire was administered to all children inquiring about a range of potential barriers to accessing healthcare services. Overall, about 42% of the children reported that they had barriers to accessing healthcare services. There were no gender differences, but there were significant ethnic differences (51% among Roma/Egyptian children vs. 42% among the general sample of the children); urban/rural differences (46% rural vs. 39% urban); and socio-economic differences (52% among children with a lower maternal education vs. 31% among children with a higher maternal education; 66% among children from poor families vs. 35% among children with a higher family income). In transitional Albania, children residing in rural areas, children from Roma and/or Egyptian communities, and especially those pertinent to low socio-economic families report considerably more barriers to accessing healthcare services, which is a cause of concern. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

11 pages, 268 KiB

Open AccessArticle

Societal Trust Related to COVID-19 Vaccination: Evidence from Western Balkans

by Smiljana Cvjetkovic, Vida Jeremic Stojkovic, Stefan Mandic-Rajcevic, Sanja Matovic-Miljanovic, Janko Jankovic, Aleksandra Jovic Vranes, Aleksandar Stevanovic and Zeljka Stamenkovic

Sustainability 2022, 14(20), 13547; https://doi.org/10.3390/su142013547 - 20 Oct 2022

Cited by 3 | Viewed by 1506

Abstract

The lower rates of COVID-19 vaccination in Western Balkans countries could be partially explained by societal distrust of its citizens, jeopardizing the sustainability of COVID-19 vaccination programs. The aim of the study was to determine the level and predictors of societal trust in five countries of the region. Using an online questionnaire, data were obtained from 1157 respondents from Albania, Bosnia and Herzegovina, Montenegro, North Macedonia, and Serbia. The instrument included a socio-demographic questionnaire, a measure of vaccination behavior, and a scale measuring societal trust. Being a significant determinant of the COVID-19 vaccination behavior in all countries, societal trust considerably varied from country to country (F (24, 4002) = 7.574, p < 0.001). It was highest in North Macedonia (Mean = 3.74, SD = 0.99), and lowest in Albania (Mean = 3.21, SD = 1.03). Younger, female, less religious, and higher educated tended to have more pronounced societal trust in Serbia. In North Macedonia, younger age and lower health literacy predicted societal trust, while in Bosnia and Herzegovina, educational level was the single predictor. In Montenegro and Albania, higher societal trust was significantly predicted by lower health literacy only. The results provide evidence that the determinants of societal trust in Western Balkans vary across countries, indicating the need for different approaches in communication campaigns. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

Review

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13 pages, 277 KiB

Open AccessReview

The Food Systems, One Health, and Resilience (FOR) Approach—Led by the FOR-Runners

by Dorit Nitzan, Bindu Nishal Andreuzza and Deepanwita Chattopadhyay

Sustainability 2023, 15(18), 13889; https://doi.org/10.3390/su151813889 - 19 Sep 2023

Viewed by 2081

Abstract

The COVID-19 pandemic, adverse effects of climate change, the ongoing war in Ukraine, and other threats have been calling on all relevant stakeholders from varied disciplines to collaborate via the One Health approach, addressing the health of people, animals, plants, and their shared environment. This narrative review examines the need to add two more dimensions to the One Health approach: food systems and resilience, thus laying down the foundation of the Food System, One Health, and Resilience (FOR) approach. By doing so, all FOR approach elements would benefit from collaborative, multisectoral, transdisciplinary, planet-based, and system-focused efforts. Addressing more comprehensive determinants that positively impact resilience and sustainability would upgrade the One Health approach. We share some examples of academic institutions and innovation hubs that use this approach to improve access to adequate, safe, nutritious, and sustainable diets for all on our planet. We call on other FOR stakeholders, including governing institutions, to embrace the FOR approach and join the “FOR-runners”. It is suggested to widen the FOR community by including the doers, the food system’s workers, and consumers and to create the needed common grounds to drive for solutions rooted in equitable, just, locally tailored, inclusive, and sustainable solutions that withstand emergencies. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

17 pages, 1290 KiB

Open AccessReview

Health Diplomacy as a Tool to Build Resilient Health Systems in Conflict Settings—A Case of Sudan

by Sanjay Pattanshetty, Kiran Bhatt, Aniruddha Inamdar, Viola Dsouza, Vijay Kumar Chattu and Helmut Brand

Sustainability 2023, 15(18), 13625; https://doi.org/10.3390/su151813625 - 12 Sep 2023

Viewed by 1721

Abstract

Attacks on health have become a significant concern for non-belligerents of war, including healthcare personnel and facilities, as witnessed in the ongoing Sudan conflict. About 1.5 billion people in fragile and conflict-affected settings (FCAS) have a heightened need for essential health services. Conflicts often lead to the disruption of the building blocks of health systems, a lack of access to health facilities, the failure of essential medical supply chains, the collapse of political, social and economic systems, the migration of health care workers, and upsurges in illness. While health indicators often decline in conflict, health can also bring peace and harmony among communities. An investment in building resilient health systems and health diplomacy is a neutral starting point for mitigating the repercussions of conflicts. The international commitment towards Sustainable Development Goals (SDGs) provides the impetus to emphasise the relationship between health and peace with the amalgamation of SDG 3, SDG 16, and SDG 17. The inspection of how health diplomacy should be used as a ‘tool for peace’ and not as leverage in conflict settings must be reiterated by the international community. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

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19 pages, 1042 KiB

Open AccessReview

Content Focus and Effectiveness of Climate Change and Human Health Education in Schools: A Scoping Review

by Lira Ramadani, Sudeepa Khanal and Melanie Boeckmann

Sustainability 2023, 15(13), 10373; https://doi.org/10.3390/su151310373 - 30 Jun 2023

Cited by 2 | Viewed by 1737

Abstract

The creation of standardized, impactful, evidence-based curricula and resources addressing climate change and health issues in schools is seen as vital in combating the impending risks of climate change on human health. A scoping review of the literature was conducted to identify peer-reviewed studies related to climate change and health education in schools and to examine their content focus and evaluation. The search covered five electronic databases and considered English peer-reviewed publications from 2000 to May 2022. Nine studies met the inclusion criteria, representing various countries and employing different study designs. Climate change and health adaptation content dominated the included studies with varying foci, including heatwaves, disaster preparation, flood education, vector-borne diseases, and general climate change and health adaptation. Other studies utilized climate change and health topics to develop skills, employ the use of information and communication technologies within curricula, and highlight the interconnectedness between the environment and health. Although heterogenous in their methodology, the intervention studies and evaluations included (five out of nine) found that interventions impacted knowledge, awareness or perception. Two studies also highlighted the intergenerational learning potential of the interventions. While there is a growing body of research in the field, more research is necessary to measure their effectiveness and thereby develop suitable educational strategies. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

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Other

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18 pages, 626 KiB

Open AccessSystematic Review

Health Equity in Climate Change and Health Policies: A Systematic Review

by Sudeepa Khanal, Lira Ramadani and Melanie Boeckmann

Sustainability 2023, 15(13), 10653; https://doi.org/10.3390/su151310653 - 6 Jul 2023

Cited by 3 | Viewed by 2519

Abstract

The complex interconnections between climate change policies and health equity are well established, and policy research to understand the health impacts of climate change in multiple domains is growing. Policy analysis theories/frameworks are an important aspect of policy analysis. Many frameworks exist to understand the health equity considerations in policies across various disciplines and the health impacts of climate change-related policies in the health and climate change sectors. However, a closer examination is required to understand whether there is explicit attention to health equity issues in relation to climate change policies in an integrated way. This systematic review attempted to identify existing health equity-focused policy analysis frameworks for understanding health equity considerations in climate change and public health policies. Eight papers were identified through five database searches. Policy analysis frameworks exploring the integration of health equity and climate change are fragmented, and frameworks encompassing several aspects of the policy-making process could not be found. Problem framing and policy-focused solutions were common approaches to understanding health equity in climate change policies. Concepts of social determinants of health and social justice were central to the intersection of climate change and health equity. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

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16 pages, 320 KiB

Open AccessPerspective

Challenges to Global Health Emerging from the COVID-19 Pandemic

by Tit Albreht

Sustainability 2023, 15(9), 7633; https://doi.org/10.3390/su15097633 - 6 May 2023

Cited by 2 | Viewed by 2557

Abstract

The COVID-19 pandemic deepened challenges and opened new fronts where old and unresolved problems met with new problems triggered by the pandemic itself. There are several issues, problems, and challenges related to the post-COVID world we are in. This paper discusses some of them from different perspectives and elaborates on the future challenges and their solutions, which need to be tackled. Apart from the pre-existing problems, we are now also facing new military conflicts, interrupted supply chains, even in medicines supplies, as well as the worsening of climate change, further complicated by the military conflicts and a potential new global economic crisis. The COVID-19 pandemic left the world with many uncertainties about the future as there seem to be few answers ready to tackle the combination of the fallout of the COVID-19 pandemic coupled with the pre-existing problems and challenges. Inequalities in terms of socio-economic differences and inequalities in health are driving disease burden, which will again be marked by the population aging and non-communicable diseases (NCDs). Global collaboration and the joint search for solutions to global challenges have become inevitable. Research into behavioral determinants of health and health promotion are essential in understanding the sources of controversy regarding and resistance to proven public health interventions. Full article

(This article belongs to the Special Issue Challenges and Prospects of Sustainability in the Context of Global Health)

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