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This Viewpoint presents a case study that explored the effects of using a performance-based Memorandum of Understanding (MoU) in public health donor programs to enhance health metrics, program efficiency, and accountability. The MoU between Kebbi State Government in Nigeria and the United States Agency for International Development (USAID) focused on strengthening primary healthcare. It covered Health Systems Strengthening (HSS) indicators, overseen by an Operations Committee (OC) and a high-level Steering Committee (SC). Quarterly and biannual reviews tracked indicators through a dashboard developed by the Integrated Health Program (IHP). Results suggest that the MoU led to better monitoring of primary healthcare (PHC) revitalization, health sector work plan harmonization, and data quality. Dashboard tracking showed improved health facility financing, immunization, antenatal care, and skilled attendants at births. The use of the MoU demonstrated potential for boosting program efficiency, cost-effectiveness, and political commitment for resource mobilization in public health initiatives. Results support recommending MoUs as valuable tools for effective outcome-driven public health funding., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Despite the end of the Cold War, the world still has thousands of nuclear weapons and adversarial relations between the countries that possess them. A nuclear war could cause large and abrupt global environmental change known as nuclear winter, with potentially devastating public health consequences. A significant line of natural science research characterizes nuclear winter and its potential effect on global food security, but less has been done on the human impacts and policy implications. Therefore, this Viewpoint proposes an interdisciplinary research and policy agenda to understand and address the public health implications of nuclear winter. Public health research can apply existing tools developed for the study of other environmental and military issues. Public health policy institutions can help build preparedness and community resilience to nuclear winter. Given the extreme potential severity of nuclear winter, it should be treated as a major global public health challenge to be addressed by public health institutions and researchers., (© 2023. The Author(s).)

National Public Health Institutes (NPHIs) can strengthen countries' public health capacities to prevent, detect, and respond to public health emergencies. This qualitative evaluation assessed the role of the US Centers for Disease Control and Prevention (CDC) in NPHI development and strengthening of public health functions. We interviewed NPHI staff (N = 43), non-NPHI government staff (N = 29), and non-governmental organization staff (N = 24) in seven countries where CDC has supported NPHI development: Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda, and Zambia. Participants identified four areas of support that were the most important: workforce capacity building, technical assistance for key public health functions, identifying institutional gaps and priorities, and funding to support countries' priorities. Participants underscored the need for capacity building directed toward country-driven priorities during planning and implementation. Continued support for NPHI development from CDC and other partners is vital to building stronger public health systems, improving population health, and strengthening global health security., (© 2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Intellectual property law is a crucial determinant of global public health, capable of both endangering and facilitating advances in the health of populations. This Viewpoint explains the most important aspects of the interaction between intellectual property law and public health. We use the plain packaging of tobacco products to illustrate how public health policies may be subject to scrutiny under existing trade and investment law structures. Plain packaging of tobacco products is challenging to implement due to legal complexities and uncertainties surrounding the status of mandated plain packaging for consumer products. While the tobacco industry and its proponents once relied on the denial of scientific evidence to delay legislation and influence consumers, its tactics have shifted to the use of trade threats and investment disputes, directly challenging the sovereignty of governments to enact bona fide public health measures to improve the health of their population.

Public health policymakers face increasingly complex questions and decisions and need to deal with an increasing quantity of data and information. For policy advisors to make use of scientific evidence and to assess available intervention options effectively and therefore indirectly for those deciding on and implementing public health policies, mathematical modeling has proven to be a useful tool. In some areas, the use of mathematical modeling for public health policy support has become standard practice at various levels of decision-making. To make use of this tool effectively within public health organizations, it is necessary to provide good infrastructure and ensure close collaboration between modelers and policymakers. Based on experience from a national public health institute, we discuss the strategic requirements for good modeling practice for public health. For modeling to be of maximal value for a public health institute, the organization and budgeting of mathematical modeling should be transparent, and a long-term strategy for how to position and develop mathematical modeling should be in place.

As a result of a legal mechanism called discovery, the authors accumulated millions of internal corporate and trade association documents related to the introduction of new products and chemicals into workplaces and commerce. What did these private entities discuss among themselves and with their experts? The plethora of documents, both a blessing and a curse, opened new sources and interesting questions about corporate and regulatory histories. But they also posed an almost insurmountable challenge to historians. Thus emerged ToxicDocs, possible only with a technological innovation known as "Big Data." That refers to the sheer volume of new digital data and to the computational power to analyze them. Users will be able to identify what firms knew (or did not know) about the dangers of toxic substances in their products-and when. The database opens many areas to inquiry including environmental studies, business history, government regulation, and public policy. ToxicDocs will remain a resource free and open to all, anywhere in the world. [ABSTRACT FROM AUTHOR]

This paper reviews the court-released discovery documents obtained from litigation against Monsanto over its herbicide Roundup and through Freedom of Information Act requests (requests to regulatory agencies and public universities in the United States). We sought evidence of corporate malfeasance and undisclosed conflicts of interest with respect to issues of scientific integrity. The findings include evidence of ghostwriting, interference in journal publication, and undue influence of a federal regulatory agency. [ABSTRACT FROM AUTHOR]

In the era of evidence-based policies, many public health professionals use data to explain complex ideas across academic disciplines, social groups, and players with different perspectives. We are looking for strategies for public health professionals to codify ethics and intellectual humility as core elements aiming to reflect on our own limitations, to create productive dialogs, and to offer our readers actionable data-driven suggestions. In November of 2022, the American Public Health Association celebrated its 150th anniversary with an in-person attendance meeting at the Boston Convention Centers. We invited Bertha Estella, the first author of the selected paper, to share her experience in public health research, training, and practice [[1]]. [Extracted from the article]

Denialist scientists played an outsized role in shaping public opinion and determining public health policy during the recent COVID pandemic. From early on, amplification of researchers who denied the threat of COVID shaped public opinion and undermined public health policy. The forces that amplify denialists include (1) Motivated amplifiers seeking to protect their own interests by supporting denialist scientists, (2) Conventional media outlets giving disproportionate time to denialist opinions, (3) Promoters of controversy seeking to gain traction in an 'attention economy,' and (4) Social media creating information silos in which denialists can become the dominant voice. Denialist amplification poses an existential threat to science relevant to public policy. It is incumbent on the scientific community to create a forum to accurately capture the collective perspective of the scientific community related to public health policy that is open to dissenting voices but prevents artificial amplification of denialists. [ABSTRACT FROM AUTHOR]

Research papers on New Delhi metallo-β-lactamase (NDM-1) provoked considerable but very different media coverage in the United Kingdom (UK) and India. We describe how the media represented this research using qualitative thematic analysis of contemporary coverage by daily newspapers in the UK and India. Fifty-four UK and 187 Indian articles mentioned NDM-1, describing it as the 'new super superbug' resistant to most antibiotics. They emphasised the role of medical tourism to the Indian subcontinent. In both countries, blame was framed abstractly as arising from the general misuse of antibiotics. In India, controversy about using New Delhi to name the organism dominated coverage, with officials seeking to discredit the two studies and media coverage characterised by denial and outrage, developing into theories of conspiracies to undermine tourism. Researchers must seek to anticipate the way that their work may be reported and proactively engage with the media to maximise the public health impact of their findings. [ABSTRACT FROM AUTHOR]

An editorial is presented on the history of asbestos and gold mining in Southern Africa and Australia. It expresses the view that mining effects the health of miners, national archives impacted by Southern Africa's constitution, and miners are diagnosed with the asbestos disease and there's court case on energy services company Cape PLC.

Statements on conflicts of interest provide important information for readers of scientific papers. There is now compelling evidence from several fields that papers reporting funding from organizations that have an interest in the results often generate different findings from those that do not report such funding. We describe the findings of an analysis of correspondence between representatives of a major soft drinks company and scientists researching childhood obesity. Although the studies report no influence by the funder, the correspondence describes detailed exchanges on the study design, presentation of results and acknowledgement of funding. This raises important questions about the meaning of standard statements on conflicts of interest. [ABSTRACT FROM AUTHOR]

This paper seeks to contribute to the ongoing policy debate about mandated posting of health department hygiene ratings for establishments that sell food. Posted restaurant hygiene ratings, or 'scores on doors,' exemplify a public health transparency policy in the form of words, letters, numbers, or symbols displayed at entrances to food-serving establishments summarizing their most recent health inspection. After describing the scope of restaurant hygiene inspections and the problem of foodborne illness, this paper critically examines the 'mandation' debate on economic, practical, ethical, and legal aspects. It concludes that mandated posting of hygiene ratings, if done properly, is a potentially effective public policy that fosters transparency, population health, and informed consumer choice. [ABSTRACT FROM AUTHOR]

National and international organizations recommend creation of environments that support physical activity where people live, work, play, study, and travel. Policy changes can lead to activity-supportive environments and incentives. Research on environmental and policy influences on physical activity is well underway in many countries. An important use of the research is to inform policy debates, but the “translation” of research to policy is an emerging science. The papers in this supplement were presented at the 2008 Active Living Research Conference whose theme was “Connecting Active Living Research to Policy Solutions.” The papers include evaluations of policy initiatives and research that suggests promising new policies. Commentaries propose principles for improving the translation of research to policy. Improving the rigor of research, asking policy-relevant questions, presenting country-specific data, and effectively communicating findings to policy makers are likely to contribute to greater impact of research on policy processes.Journal of Public Health Policy (2009) 30, S1–S15. doi:10.1057/jphp.2008.59 [ABSTRACT FROM AUTHOR]

The World Health Organization's (WHO) Global Strategy to reduce harmful use of alcohol sets a voluntary target of reducing the harmful use of alcohol by 10% in about 10 years. Using the WHO criteria, this paper critically assesses the alcohol control policy of the Federal Democratic Republic of Ethiopia and sets out recommendations for major improvement for protecting the health of the population.

The ways historians assemble primary material from which to learn how industry has failed to protect workers and the environment is changing dramatically. Increasingly, historians focus concern on the evolution of the internet and the demise of paper records. The authors of "Monsanto, PCBs," and the Creation of a "World-Wide Ecological Problem" (2018) are also founders of ToxicDocs.org. This web-based resource provides an entirely new degree of transparency. Readers of their article may look at any document they cite by clicking on the reference. Those with or without expertise in science can now judge these authors' analysis, and much more: entertain new lines of inquiry, ask new questions, obtain new insights, and publish well-documented pieces that offer new knowledge and insight to enrich our understanding, not only of the PCB story, but also industry's general behavior when using or marketing toxic substances. [ABSTRACT FROM AUTHOR]

For the past three decades, we have written on the history of occupational and environmental health, authoring books and articles on lead poisoning, silicosis, asbestosis, and angiosarcoma of the liver, among other diseases. One book, Deceit and Denial, focused specifically on the chemical and lead industries. Because of the rarity of historians who study this history, we have been asked to testify on behalf of workers who allege harm from these industrial materials and by state, county, and local governments who seek redress for environmental damages and funds to prevent future harm to children. In about 2010, we began testifying in law suits brought by individuals who claimed that they had suffered from cancers, specifically non-Hodgkin's lymphoma, because of polychlorinated biphenyls (PCBs) in their bodies. At that time, we wrote a Report to the Court about industry knowledge of the dangers of PCBs to workers and the environment. More recently, we have been approached by attorneys representing government agencies on the West Coast of the United States which are seeking funds to abate PCB pollution in their ports, bays, and waterways. The focus of these lawsuits is the Monsanto Corporation, the sole producer of PCBs in the United States from the 1930s through 1977. Through these law suits, an enormous trove of previously private Monsanto reports, papers, memos, letters, and studies have been made available to us and this paper is the result of our examination of these hundreds of thousands of pages. The documents from this collection (with the exception of privileged materials that Monsanto has not made public, and upon which we have not relied) are available on www.ToxicDocs.org , the website we have developed with Professor Merlin Chowkwanyun of Columbia's Mailman School of Public Health. (Almost all of the references that are from this collection can be accessed by readers by clicking on the reference hyperlink.) This monograph is adapted from a report to the court that was originally produced for litigation on behalf of plaintiffs in PCB lawsuits. We are grateful to the Journal of Public Health Policy for publishing this detailed examination of these documents and we hope it will stimulate further research into this important, and now public, archive of industry records. [ABSTRACT FROM AUTHOR]

Domestic violence (DV) is a serious public health concern, affecting women's health and well-being. An international governance framework, through the United Nations' Sustainable Development Goals and national policies in India have committed the country to attempt elimination of violence against women. Even so, efforts remain starkly inadequate for altering conditions under which women experience DV. This review paper aims to develop an evidence-based, integrated life cycle model to alter conditions that perpetuate DV and related vulnerabilities in society. The analyses identify and determine community-based innovative practices and policies. We propose a collaborative 'R5 model' to incorporate a multi-stage response to break the cycle of gendered vulnerability. The model identifies five stages of vulnerability in the lives of victims of violence: rescue, recovery, rehabilitation, resilience, and reform. This approach can result in promoting a proactive state-society engagement to uphold the rights and the welfare of women. We recommend the 'R5 model' to bridge the global SDG targets, national policies, and local practices. [ABSTRACT FROM AUTHOR]

Recent policy focus is on the 'non-obvious' role of community-based organisations in tackling causes of poor health, such as social exclusion. Men's Sheds are a type of community-based organisation offering health and wellbeing benefits to men, despite this not being the explicit reason they exist. A qualitative study was conducted in Scotland to identify sustainability challenges that impact on the ability of Sheds to become a formal healthcare service. Findings showed that a reliance on ageing and retired volunteers to undertake operational tasks and generate income to fund activities affected the ability of Sheds to sustain and develop. Further, members preferred their Sheds to remain informal and flexible to fit their specific needs. Although Sheds are recognised for their health and wellbeing benefits to men, policymakers must recognise that formalising their activities might detract from the Shed's primary aims. This paper summarises specific policy implications and recommendations, taking into consideration tensions between the expectations placed on Sheds to expand into formal healthcare delivery, and the needs of Shed users. Highlights: Men's Shed are known for their ability to contribute to men's health and wellbeing. The potential of Shed to take on a formal healthcare role is questionable because of a reliance on ageing and retired volunteers and a preference to remain informal. Policymakers must recognise that although Sheds might be well placed to offer formal health care this may detract from their primary aims. [ABSTRACT FROM AUTHOR]

A well-articulated institutional health research agenda can assist essential contributors and intended beneficiaries to visualize the link between research and community health needs, systems outcomes, and national development. In 2011, Tanzania's Muhimbili University of Health and Allied Sciences (MUHAS) published a university-wide research agenda. In developing the agenda, MUHAS leadership drew on research expertise in its five health professional schools and two institutes, its own research relevant documents, national development priorities, and published literature. We describe the process the university underwent to form the agenda and present its content. We assess MUHAS's research strengths and targets for new development by analyzing faculty publications over a five-year period before setting the agenda. We discuss implementation challenges and lessons for improving the process when updating the agenda. We intend that our description of this agenda-setting process will be useful to other institutions embarking on similar efforts to align research activities and funding with national priorities to improve health and development. [ABSTRACT FROM AUTHOR]

This paper seeks to contribute to a more nuanced discourse on vaccination policy. Current polarization between either mandatory and entirely voluntary is misleading, as virtually all immunization programs feature a combination of instruments that comprise mandatory and voluntary elements. We develop this argument by presenting five case studies from the European Union (EU). By systematically acknowledging the nuances of political and institutional varieties, we build the case for reframing the terms of the debate in the EU and beyond. [ABSTRACT FROM AUTHOR]

This paper addresses an important topic, energy poverty in healthcare facilities. We try to provide an interesting perspective on bringing together two SDGs. The SDG 7, which seeks to ensure access to affordable, sustainable, and modern energy for all, is interlinked with Goal 3 on Health. The literature studies as well as data on the subject are sparse. Nevertheless, a systematic documentation of the levels and variation in access to energy at the health-facility level is important for designing effective policies to improve the quality of healthcare and the ultimate health of the population. Using the 2012-2013 Senegal Service Provision Assessment (SCSPA), we assessed energy access in health facilities and health systems' performance. Data were also geocoded using ArcGIS 10.3 to give a snapshot of the situation. [ABSTRACT FROM AUTHOR]

This article discusses the importance of data visuals in public health research and practice. Data visuals, such as infographics and scientific visualizations, are powerful tools for conveying information and promoting understanding. However, it is crucial for public health professionals to ensure that their visuals are clear, intuitive, and trustworthy. The article introduces a set of principles for creating effective data visuals, including evidence, efficiency, emphasis, and ethics. It also explores the limits and biases of human perception and the application of Gestalt principles in data visualization. The article concludes by introducing a new article format called Visual Brief, which combines data-driven images with supportive narratives to present key points to readers. [Extracted from the article]

The current Bush Administration has made dramatic changes in US domestic and international reproductive health policies. This paper discusses the issues involved in some of these changes, and it considers likely developments in this area during the remainder of George W Bush's second term. The first section of the paper defines the term reproductive health and presents a framework for classifying reproductive health policies. The second section examines changes that the Administration has made in domestic family planning policies. The third section looks at analogous changes in American assistance for reproductive health internationally. The final section considers the implications of these trends for future policy and women's health. [ABSTRACT FROM AUTHOR]

The paper presents an analysis of policy directives needed to respond to threats of harm (e.g., violence against third parties) that may arise in the course of conducting descriptive epidemiological research with high-risk populations. It identifies two key areas where new policies must be developed to guide researchers conducting such investigations. The paper recommends that: (1) an NIH consensus panel be convened to set standards, analogous to Common Toxicity Criteria (CTC) criteria, to classify the severity of different types of indirect, non-research-related risk; and (2) case-based training modules be developed and incorporated into public health research ethics courses and training programs, to enhance researcher judgments in determining the likelihood of harm in different situations. In addition, researchers, Institutional Review Boards (IRBs) and community advisory groups must consider the issue of staff safety and the effectiveness of available responses to reduce the threat of harm. The author reviews and discusses implications for informed consent and IRB review.Journal of Public Health Policy (2006) 27, 293–308. doi:10.1057/palgrave.jphp.3200084 [ABSTRACT FROM AUTHOR]

The article discusses the responsibility of the public health community to address the threat of nuclear war and the catastrophic consequences it would have on human health. It highlights the historical role of the health community in raising awareness about the dangers of nuclear weapons and the need for primary prevention. The article also discusses the increased likelihood of nuclear war due to geopolitical tensions, cyber terrorism, and the climate crisis. It emphasizes the importance of dismantling nuclear weapons and calls on the public health community to support disarmament efforts and advocate for the elimination of nuclear arsenals. [Extracted from the article]

Populations living in fragile and conflict-affected settings (FCS) endure serious hardship, often including witnessing or having direct exposure to violence. These experiences adversely affect the mind, body, and spirit, and diminish the capacity of individuals and communities to take full advantage of economic empowerment opportunities. A small but growing number of programs have begun to combine psychosocial support with livelihood support in FCS, with some promising indication that this combination can enhance project outcomes. This paper assesses evidence to generate a 'hypothesis of change' that combining psychosocial with livelihood support can improve development outcomes in FCS. We reviewed evaluations of three categories of programs: (i) those that provide psychosocial support and assess impact on economic empowerment, (ii) those that provide livelihood support and assess impact on psychosocial well-being, and (iii) those that combine both types of support and assess impact on one or both outcomes. [ABSTRACT FROM AUTHOR]

This paper describes accelerating development of programs in global health, particularly in North American academic institutions, and sets this phenomenon in the context of earlier programs in tropical medicine and international health that originated predominantly in Europe. Like these earlier programs, the major focus of the new global health programs is on the health needs of developing countries, and perhaps for this reason, few similar programs have emerged in academic institutions in the developing countries themselves. If global health is about the improvement of health worldwide, the reduction of disparities, and protection of societies against global threats that disregard national borders, it is essential that academic institutions reach across geographic, cultural, economic, gender, and linguistic boundaries to develop mutual understanding of the scope of global health and to create collaborative education and research programs. One indication of success would be emergence of a new generation of truly global leaders working on a shared and well-defined agenda--and doing so on equal footing.

This introduction to Tanzania's health system and acute workforce shortage familiarizes readers with the context in which health professions education takes place. The paper touches on poverty rates, population growth, and characteristics of the health system. The critical shortage of trained health staff is a major challenge facing the health sector, aggravated by low motivation of the few available staff. Other challenges facing the health sector include lack of effective staff supervision, poor transport and communication infrastructure and shortage of drugs and medical equipment. We recommend appropriate action be taken by the government and other stakeholders to provide more financial and human resources for the sector while ensuring their efficient and effective utilization to improve services delivery. [ABSTRACT FROM AUTHOR]

Since the first meeting of the American Public Health Association in 1873, epidemiology and epidemiologists have been central to the activities of the organization. At that meeting, the most prominent American physician of the time, Austin Flint, presented a classic paper entitled "Relations of Water to the Propagation of Fever." In that remarkable paper, Flint reinterpreted observations on the North Boston, N.Y. typhoid fever epidemic made 30 years earlier in which he had correctly concluded that the epidemic had been propagated by contagion, but incorrectly concluded that transmission was not the result of contaminated drinking water. During the last quarter of the 19th century and the first quarter of the 20th, Annual Meetings of the APHA were frequently the locus for reports of epidemic investigations and the Journal of the Association was the vehicle for their publication. When the Association was reorganized to include discipline-oriented sections, the Epidemiology Section was among the first to be established. At the time, 1929, the Section was the only meeting place (outside the small and exclusive American Epidemiological Society) for epidemiologists to exchange ideas and information. The Section was also a place where public health policies were hotly debated. After World War II, academic departments of epidemiology increasingly focused the field on methodological issues and etiological investigations. Furthermore, new organizations and a plethora of epidemiological journals flooded the field. Thus, the Epidemiology Section has remained a major center for translating epidemiological knowledge into policy and is likely to intensify that function in the future.

In this article, the authors discuss the released paper entitled "Closing the Gap in a Generation," by the Commission on Social Determinants of Health (CSDH) of the World Health Organization. They note that the report provides clear evidence for action and its recommendations will probably be followed by many countries to tackle health inequalities within. They emphasize that the most important structural sources of social stratification are income, education and occupation.