Health Security Policies: A Comparative Study Through Constitutional Frameworks and the Insights of Veronica Rodriguez-Blanco

Managing Education for Food And Health Security: The Experience of EhimeMbano and Isiala Mbano Local Government Areas of Imo State Nigeria

Choking on corruption—reforming Pakistan's health system

The advent of multiple global crises, especially those of climate change, economics, energy, water, food and health evident in 2008, is of considerable moment to those who are suffering their consequences and for those with responsibility and interest in the systems affected. A coalition of parties in the Asia Pacific Region who work in the food and health systems met in August, 2009 in Taiwan and instigated a Food in Health Security (FIHS) Network which might join with other like-minded networks in and beyond the region. Sustainable health has many dimensions, among which food and nutrition is often neglected; there is a wide spectrum of nutritionally-related disorders. Malnutrition remains the global concern for agricultural research and development scientists and linkage with the health sector is key to progress. The disconnect between agricultural and health sectors negatively impacts consumer nutrition and health. Ethical and equity affect food and health systems. Food and health security is attainable only when the underlying social inequities are addressed; it is an ethical issue as reflected in the UN Universal declaration of Human Rights which includes the right to food for health and well-being. Food and health security are part of the larger security agenda and merit corresponding attention. Policy recommendations with immediacy are greater investment in combined food and health research; an Asia Pacific security agenda which emphasizes planetary, human, health and food security as relevant to traditional defence security; and community and household security measures which include maternal literacy, communication technology and entrepreneurial opportunity.

Multisectoral plans and actions at the community level are one of the strategies that are deployed in the primary healthcare (PHC) system for improving the health and wellbeing of the people and also a means of addressing the social determinants of health. Multisectoral actions are also a means of implementing the Health in All Policies (HiAP) policy directions, which Nigeria has agreed to implement. However, there is a paucity of knowledge on the level of multisectoral involvement to ensure health security and promotion at the community level. This paper provides new knowledge on what multisectoral activities for health are undertaken at the community level and what can be done to strengthen them towards achieving universal health coverage in Nigeria. It elaborates on previous and current levels of multisectoral collaboration (MSC) activities for health at the community level. A qualitative cross-sectional case study of three contextually different states in northern (Kano) and southern (Akwa Ibom and Anambra) states in Nigeria. Conceptually, the study was guided by the Expanded Health Systems framework, which recognises potential combinations of collaborations between the non-health sector and other societal partnerships (CSOs, NGOs, community groups, and informal health providers) to directly contribute to community health or indirectly through one or more social determinants of health. The study was also guided by the WHO PHC operational framework, which proposes multisectoral action as one of three key approaches to UHC. Data were collected and triangulated through 103 in-depth interviews with policymakers (health and non-health sectors), formal and informal health providers, and community leaders; 12 focus group discussions with community members (service users) and a review of health and non-health sector policy documents. Thematic data analysis was undertaken. Several community and household-level activities were identified as having been borne out of multisectoral actions. Most activities were initiated by health sector stakeholders in health, whereas others were initiated by non-health sectors (education, environment, agriculture, security, women affairs, social welfare, nutrition, water, sanitation, and hygiene-WASH) or communities. The multisectoral activities contributed to primary healthcare activities and the health security of communities, directly or indirectly, through improving one or several social determinants of health (water supply, housing, environment, security, food, and nutrition). However, most activities, which involved collaborative engagements with non-health sectors, were not backed by any formal, explicit non-health sectoral policies or guidelines. Rather, they were organically initiated and developed to support health security. The support of community leaders and groups facilitated the initiation and sustenance of multisectoral activities, whilst inadequate formal policy backing and funding were the major constraints. Although there are calls in the country for non-health sectors to mainstream health in their sectors, there is yet no clearly established framework or guidelines through which this can be implemented and sustained. A multisectoral action plan for non-communicable diseases has been developed but has not been implemented and evaluated. Multisectoral collaboration for health at the community level is important for harnessing resources from outside the health sector that will be used to enhance the health security of communities. Such MSC is potentially a powerful tool for strengthening primary healthcare, towards UHC, and achieving SDG3, as shown by our findings. However, entrenched and sustained MSC should be undertaken through explicitly intentional policy reforms and their implementation through identifying, promoting, and financing MSC actions.

Facing Global Environmental Change

The Philippines has been a major source of female domestic labor in East Asia. The migration of Filipino female household service or domestic workers contributed to the sustained economic growth in countries like Japan, Hong Kong, PRC, and Singapore, amidst chronic demographic and labor issues. Being literate in the health and social security systems is vital to ensuring the well-being of Filipino migrant workers and the sustainable development of both the Philippines and East Asian countries. This scoping study examines the state of scholarship on health and social security systems literacy of Filipino migrant workers in East Asian countries, specifically Japan, Hong Kong SAR, and Singapore, as well as the Philippines. Using the Six-Stage Methodological Framework for Scoping Review adapted from notable social researchers (Arksey and O’Malley 2005; Levac, Colquhoun and O’Brien 2010; Liu et al. 2015) and the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Extension for Scoping Reviews or PRISMA-ScR, the study searched for published literature on six databases and extracted studies based on criteria for inclusion using Covidence software. This scoping review showed that of the 60 studies analyzed, 25 focused on Japan, 16 on Hong Kong, and eight looked at the case of Singapore (including three, which focused on the Association of Southeast Asian Nations or ASEAN); the remaining 11 were about the health and social security systems in the Philippines for OFWs. The study found no existing conceptualization of migrant health and social security systems literacy in East Asia and the Philippines. While a few studies utilize the term ‘health literacy’, these papers also fail to operationalize the concept in the research. Most health and social security systems studies are concerned with accessibility more than literacy. A few studies that include Filipino migrant workers’ experiences with the health and social security systems of destination countries only go so far as describing such experiences using the words "knowledge", "understanding", and "familiarity." To facilitate consultation as the sixth stage of the scoping review process, the study conducted focus group discussions with Filipino domestic workers in Japan, Hong Kong, and Singapore and semi-structured interviews with select Philippine government agencies. Findings revealed that migrants themselves, governance, social networks, informal channels, and media contribute toward enabling or constraining Filipino migrant workers’ health or social security systems literacy. Most Filipino migrant workers are systems literate only to the extent that they are familiar with and partially understand the basic social and health security schemes offered in destination countries and the Philippines. This study proposes a framework for defining health and social security systems literacy both as a complex process that is intimately tied to the portability of healthcare and social security and as an individual migrant competence that consists of shifting levels of connection to the health and social security systems of the Philippines and destination countries. It offers several research and policy recommendations that advance collaboration between the Philippine government, academics, migrant NGOs, and Filipino migrant workers.

Global food security is a major development challenge dictated by state stability, resilience to geopolitical and economic shocks and is linked to health security. Fragile and failed nation-states are at risk of extreme poverty and lead to war and conflict. Fragile states experience, corrupt financial regimes and are influenced by skewed global market systems and reduced equitable market access that decrease food and health security. This qualitative review describes the critical cross sections of food security, the influence of global market systems and state stability and institutions that form the nexus of global health security. We outline how the manipulation of free market systems and decreased state capacity not only decrease food and health security but also contribute to state fragility and failure. Improved public health policy mechanisms, decreased dependence on foreign financial structures and extractive mechanisms are crucial to improving food and health security at present, and to further increase state stability in the future.

Hyperarid, arid, semiarid, and dry subhumid areas cover approximately 41% of the global land area. The human population in drylands, currently estimated at 2.7 billion, faces limited access to sufficient, affordable, and nutritious food. We discuss the interlinkages among water security, environmental security, energy security, economic security, health security, and food security governance, and how they affect food security in drylands. Reliable and adequate water supply, and the prevention of water contamination, increase the potential for ample food, fodder, and fiber production. Protecting woodlands and rangelands increases food security by buffering the slow onset effects of climate change, including biodiversity loss, desertification, salinization, and land degradation. The protection of natural lands is expected to decrease environmental contamination, and simultaneously, reduce the transfer of diseases from wildlife to humans. Biofuel production and hydroelectric power plants increase energy security but generate land-use conflicts, deforestation, and ecosystem degradation. Economic security generally positively correlates with food security. However, economic growth often degrades the environment, changes tenure rights over natural resources, and stimulates migration to urban areas, resulting in lower food and health security. Moreover, civil unrest, political instability, and armed conflicts disrupt local economies in drylands. Maintaining food security is crucial for health security; conversely, malnourished populations and unresponsive health systems decrease economic security, and adversely affect environmental, energy, and food security. Climate change is expected to deteriorate health security by spreading vector-borne diseases. Effective governance and timely interventions can substantially shorten periods of food insecurity, lower their intensities, and accelerate recovery from inevitable crises, and are therefore crucial in preventing humanitarian crises. Since global drylands population will nearly double by 2050, and since drylands are among the most susceptible areas to climate change, integrated multi-hazard approaches to food security are needed.

Upon the commencement of their second term in 2025, the Trump Administration initiated significant policy shifts within health security, driven by an "America First" agenda. This marks a notable departure from the United States' long-standing role as a central and influential leader in global health security. Historically, the US has championed this domain through substantial financial contributions, the sharing of critical technical expertise, and the establishment and support of numerous international health initiatives. This leadership was underpinned by a bipartisan consensus that recognized global health as integral to American values, enhancing its soft power and global standing. Decades of this commitment yielded tangible progress in controlling infectious diseases, strengthening health systems in low- and middle-income countries (LMICs), and fostering essential international cooperation. However, this recent pivot in US policy carries profound implications for the established global health architecture. It is generating a cascade of both tangible and intangible consequences across various health security domains, including funding mechanisms, global health governance, preparedness and response capabilities, outcomes in LMICs, science diplomacy, US soft power, and ultimately, US national security. Given the inherent difficulty in predicting the next pandemic, global solidarity and collective international efforts are paramount. In this, effective prevention and management demand proactive, multidisciplinary preparations worldwide where continued US support and leadership through increased investment in surveillance networks, strengthened international collaboration, and data-driven decisionmaking are instrumental. There is an urgent need for prioritizing global health leadership and ensuring sensible health security policies that reverse the systematic dismantling of established public health infrastructure.

BackgroundWhile sustainability has become a universal precept in the development of global health security systems, supporting policies often lack mechanisms to drive policies into regular practice. ‘On-paper’ norms and regulations are to a great extent upheld by frontline workers who often lack the opportunity to communicate their first-hand experiences to decisionmakers; their role is an often overlooked, yet crucial, aspect of a sustainable global health security landscape. Initiatives and programs developing transdisciplinary professional skills support the increased bidirectional dialogue between these frontline workers and key policy- and decisionmakers which may sustainably narrow the gap between global health security policy design and implementation.MethodsThe International Federation of Biosafety Associations’ (IFBA) Global Mentorship Program recruits biosafety and biosecurity champions across Africa to provide local peer mentorship to developing professionals in their geographic region. Mentors and mentees complete structured one year program cycles, where they are provided with written overviews of monthly discussion topics, and attend optional virtual interactive activities. Feedback from African participants of the 2019–2020 program cycle was collected using a virtual Exit Survey, where aspects of program impact and structure were assessed.ResultsFollowing its initial call for applications, the IFBA Global Mentorship Program received considerable interest from professionals across the African continent, particularly in East and North Africa. The pilot program cycle matched a total of 62 individuals from an array of professional disciplines across several regions, 40 of which were located on the African continent. The resulting mentorship pairs shared knowledge, skills, and experiences towards translating policy objectives to action on the front lines. Mentorship pairs embraced multidisciplinary approaches to harmonize health security strategies across the human and animal health sectors. South-to-South mentorship therefore provided mentees with locally relevant support critical to translation of best technical practices to local capacity and work.ConclusionThe IFBA’s South-to-South Global Mentorship Program has demonstrated its ability to form crucial links between frontline biosafety professionals, laboratory workers, and policy- and decision-makers across several implicated sectors. By supporting regionally relevant peer mentorship programs, the gap between health security policy development and implementation may be narrowed.

Research on "Managing The COVID-19 Pandemic: Health and Food Security of Rohingya Refugees in Kutopalong Camp, Cox's Bazar, Bangladesh" is a recent study that seeks to explain the managing of COVID-19 from both the Bangladesh government and international organizations to Rohingya refugees in the Kutopalong Camp, Cox's Bazar, which focuses on health security and food security. This study seeks to provide a new, more realistic approach on how Rohingya refugees are handled in Kutopalong Camp during COVID-19 and when COVID-19 ends, of co,urse, by incorporating the concept of health security and food security as the theoretical basis of research. The discussion of this research was obtained using qualitative methods as well as comparing with previous research.

Vegetables are essential components of a balanced diet, providing vital nutrients and bioactive compounds that support human health and well-being. They are rich sources of vitamins, protein, minerals, dietary fiber, secondary metabolites, enzymes, and antioxidants such as ascorbic acid, flavonoids, and polyphenols. However, modern agricultural practices, soil fertility depletion, and prolonged use of nitrogen-dominated chemical fertilizers have led to a decline in the nutritional, nutraceutical, and organoleptic quality of many vegetables. There is an urgent need to restore their original nutrient density to ensure optimal human nutrition and health security. This study examined the effects of different ratios of chemical fertilizers and organic nutrient sources, in combination with Plant Growth-Promoting Microorganisms (PGPMs), on the nutritional and organoleptic quality of cultivated vegetables. The results showed that replacing chemical fertilizers with organic sources in the presence of PGPMs significantly enhances nutritional and sensory attributes. Notable improvements include increased crude fat, ash, crude fiber, total sugars, calcium, iron, zinc, and manganese, along with a higher organoleptic score and antioxidant content. In conclusion, integrating organic nutrient sources with PGPMs leads to substantial improvements in nutritional density, organoleptic properties, and nutraceutical value, with a significant boost in antioxidant content. These strategies not only enhance vegetable quality but also contribute to dietary diversity and reduce nutrient deficiencies, ultimately promoting global health and food security.

As combined new factors could further complicate the food supply and health security for regional countries, new perspective on human security should be prioritized on securing health security in the region. In recent years, food production and supply has been affected by unpredictable climate change and unaccountable manmade factors in the region. With increased pressure from food security issues, personal health and human security is badly affected. It poses a threat to human security and becomes a concern of all states. In the new era, the pressing reality for all countries is that there is no exception for anyone before a pandemic. Threats to human security become not only a national security issue but also a transnational challenge.

The present study has attempted to examine the livelihood status of nine agro-climatic zones (ACZs) in the State of Uttar Pradesh in India. The United National Development Programme’s (UNDP) methodology has adopted to develop a practical, innovative and ready-to-use sustainable livelihood security index (SLSI) for different ACZs. A total of 84 rational indicators were employed that covered seven dimensions of livelihood security, i.e. infrastructure security, agricultural sustainability, economic security, social security, food security, environmental security, and health security. The quintile estimation was also employed to identify low productive districts with reference to Uttar Pradesh. The performance of ACZs in terms of estimated indices for different dimensions of SLSI has also compared and ranked across developmental indicators. Study findings revealed that Bundelkhand zone has the lowest livelihood security than that of other ACZs. Least access of basic amenities, least social and health security, and higher reliance on agriculture for livelihoods were the main influencing indicators responsible for lower livelihood security in Bundelkhand zone. At the same time, better infrastructural and health facilities and least reliance on agriculture for livelihoods were main contributing indicators for the highest livelihood security in Vindhyan Zone. The present study’s findings also matched with the results of studies conducted by the Planning Commission and NITI Aayog. The policy insights from the analysis suggest the need for prioritising vulnerable and less developed ACZs to arrest regional imbalances, prevent overexploitation and to leverage the unutilised potential of the districts.

Challenges for food and health security encompass food production and distribution, smallholder income generation, access to health care, harmful child care practices and epidemics (e.g. HIV), and tackling of the coexistence of undernutrition and caloric over-nutrition. The recently re-defined primary health care approach addresses the whole field of nutrition and health security. In general, Asia has more experience with technologies in various fields than Africa. But Africa has more experience in humanitarian approaches to emerging food and health crises. Objectives of the Asian-African collaboration need to be differentiated into one area where the public sector is developing and strengthened, and another area where the private sector can promote food and health security with its specific advantages and constraints. In the field of hunger and disease prevention, both sides can benefit from the exchange of knowledge and concepts. Whereas in the Western world drugs and technologies became major factors in health care and food production, the potential of Asia and Africa lies in optimizing the utilization of indigenous plants and protecting the biodiversity of the natural resources. As an example, the vegetable bitter gourd is presented: it can be grown almost everywhere and it exerts anti-obese and anti-diabetic effects. This is of extreme importance for those who do not have access to modern drug treatment for diabetes mellitus. Asian-African collaboration in food and health security provides a great opportunity as both sides can benefit from different experiences and opportunities in order to meet the challenges in food and health security.