Global Health Security Research Articles

Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis

Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship.

Synthesis and anti-SARS-CoV-2 activity of amino acid modified cephalotaxine derivatives.

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic has triggered a significant impact on global public health security, it is urgent to develop effective antiviral drugs. Previous studies have found that binding to ACE2 is a key step in the invasion of SARS-CoV-2 into host cells, so virus invasion can be inhibited by blocking ACE2, but there are few reports on this kind of specific inhibitor. Our previous study found that Harringtonine (HT) can inhibit the entry of SARS-CoV-2 spike pseudovirus into ACE2h cells, but its relatively high cytotoxicity limits its further development. Amino acid modification of the active components can increase their solubility and reduce their cytotoxicity. Therefore, in this study, seven new derivatives were synthesized by amino acid modification of its core structure Cephalotaxine. The target compounds were evaluated by cell viability assay and the SARS-CoV-2 spike pseudovirus entry assay. Compound CET-1 significantly inhibited the entry of pseudovirus into ACE2h cells and showed less cytotoxicity than HT. Molecular docking results showed that CET-1 could bind TYR83, an important residue of ACE2, just like HT. In conclusion, our study provided a novel compound with more potential activity and lower toxicity than HT on inhibiting the SARS-CoV-2 spike pseudovirus infection, which makes it possible to be a lead compound as an antiviral drug in the future.

Strengthening legal preparedness and response within the global health emergency framework: the role of the GHSA Legal Preparedness Action Package*

The COVID-19 pandemic exposed failings in preparedness and response across the world and a shortfall in global health security. The crisis also highlighted shortcomings in global and regional legal frameworks, including the International Health Regulations (2005) and relevant European Union law, as well as in national public health legislation and emergency plans. Lessons learned from the pandemic converge around strengthening preparedness and response capacities at all levels, with special attention to be paid to legal preparedness, a critical component of public health emergency preparedness. Improving legal capacities at country level is one of the strategic priorities set by the Global Health Security Agenda (GHSA), which established a new Legal Preparedness Action Package (LP AP) in order to elevate attention to and the importance of legal preparedness worldwide. Since 2021 the LP AP has been front and centre in international efforts to bridge the legal preparedness gap at national level. In bringing together technical experts in global health law and government health policy officials from a broad range of countries and partners, the LP AP seeks to set a foundation for legal preparedness by developing technical and capacity-building tools, legal guidelines, policy briefs, information and training. This article aims to illustrate and contextualize the work of the GHSA LP AP and raise awareness about the importance of its contribution to enhanced global health security. It also intends to highlight how its work promotes and develops synergies with parallel initiatives, processes and tools, facilitates regime interaction and harmonization of technical assistance and ultimately ensures consistency of action, methodology and approaches.

Safety and Patient-Reported outcomes of atezolizumab plus chemotherapy with or without bevacizumab in stage IIIB/IV non-squamous non-small cell lung cancer with EGFR mutation, ALK rearrangement or ROS1 fusion progressing after targeted therapies (GFPC 06–2018 study)

BackgroundIn an open-label multicenter non-randomized non-comparative phase II study in patients with stage IIIB/IV non-squamous non-small cell lung cancer (NSCLC), oncogenic addiction (EGFR mutation or ALK/ROS1 fusion), with disease progression after tyrosine-kinase inhibitor and no prior chemotherapy (NCT04042558), atezolizumab, carboplatin, pemetrexed with or without bevacizumab showed some promising result. Beyond the clinical evaluation, we assessed safety and patient-reported outcomes (PROs) to provide additional information on the relative impact of adding atezolizumab to chemotherapy with and without bevacizumab in this population. MaterialsPatients received platinum-pemetrexed-atezolizumab-bevacizumab (PPAB cohort) or, if not eligible, platinum-pemetrexed-atezolizumab (PPA cohort). The incidence, nature, and severity of adverse events (AEs) were assessed. PROs were evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-Core 30 and EORTC QLQ-Lung Cancer 13). ResultOverall, 68 (PPAB) and 72 (PPA) patients were evaluable for safety. Grade 3–4 AEs occurred in 83.8% (PPAB) and 63.9% (PPA). Grade 3–4 atezolizumab-related AEs occurred in 29.4% and 19.4%, respectively. Grade 3–4 bevacizumab-related AEs occurred in 36.8% (PPAB). Most frequent grade 3–4 AEs were neutropenia (19.1% in PPAB; 23.6% in PPA) and asthenia (16.2% in PPAB; 9.7% in PPA). In PPAB, we observed a global stability in global health security (GHS) score, fatigue and dyspnea with a constant tendency of improvement, and a significant improvement in cough. In PPA, we observed a significant improvement in GHS score with a significant improvement in fatigue, dyspnea and cough. At week 54, we observed an improvement from baseline in GHS score for 49.2% of patients. In both cohorts, patients reported on average no clinically significant worsening in their overall health or physical functioning scores. ConclusionPPAB and PPA combinations seem tolerable and manageable in patients with stage IIIB/IV non-squamous NSCLC with oncogenic addiction (EGFR mutation or ALK/ROS1 fusion) after targeted therapies.

Follow the money: a global analysis of funding dynamics for global health security.

Global financing for health security was dramatically impacted by COVID-19. Here, we provide an empirical analysis of how that funding changed. Using data from Global Health Security (GHS) Tracking (tracking.ghscosting.org), we analyzed disbursements of direct financial assistance for GHS from 2016 to 2022 to compare pre-pandemic funding (2016-2019) to post-pandemic funding (2020-2022) for preparedness and response during each of the seven World Health Organization-declared public health emergencies of international concern (PHEICs) from 2009 to 2022. Over $165B was disbursed for capacity-building and preparedness activities between January 2016 and December 2022, and over $76B was provided for PHEIC response. Preparedness funding remained evenly distributed since 2016 across regions, with the African region receiving about 70% of total preparedness funding. Indeed, how capacity-building and preparedness funding is distributed has changed remarkably little since 2016, despite unprecedented changes to the funding environment-including markedly increased spending-in response to COVID-19. This suggests we now have a unique opportunity to restructure how funds are tracked for accountability and assessing return on investment moving forward.

Tanzania's first Marburg Viral Disease outbreak response: Describing the roles of FELTP graduates and residents.

Viral Haemorrhagic Fever Outbreak presents a significant public health threat, requiring a timely, robust, and well-coordinated response. This paper aims to describe the roles of the Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) graduates and residents in responding to Tanzania's first Marburg Viral Disease (MVD) outbreak. We performed a secondary data analysis using a range of documents, such as rosters of deployed responders and the TFELTP graduate and resident database, to count and describe them. Additionally, we conducted an exploratory textual analysis of field deployment reports and outbreak situational reports to delineate the roles played by the residents and graduates within each response pillar. A total of 70 TFELTP graduates and residents from different regions were involved in supporting the response efforts. TFELTP graduates and residents actively participated in several interventions, including contact tracing and follow up, sensitising clinicians on surveillance tools such as standard case definitions, alert management, supporting the National and Kagera Regional Public Health Emergency Operations Centres, active case search, risk communication, and community engagement, coordination of logistics, passenger screening at points of entry, and conducting Infection Prevention and Control (IPC) assessments and orientations in 144 Health Facilities. The successes achieved and lessons learned from the MVD response lay a foundation for sustained investment in skilled workforce development. FELTP Training is a key strategy for enhancing global health security and strengthening outbreak response capabilities in Tanzania and beyond.

Photochemical Strategies toward Precision Targeting against Multidrug-Resistant Bacterial Infections.

Infectious diseases pose a serious threat and a substantial economic burden on global human and public health security, especially with the frequent emergence of multidrug-resistant (MDR) bacteria in clinical settings. In response to this urgent need, various photobased anti-infectious therapies have been reported lately. This Review explores and discusses several photochemical targeted antibacterial therapeutic strategies for addressing bacterial infections regardless of their antibiotic susceptibility. In contrast to conventional photobased therapies, these approaches facilitate precise targeting of pathogenic bacteria and/or infectious microenvironments, effectively minimizing toxicity to mammalian cells and surrounding healthy tissues. The highlighted therapies include photodynamic therapy, photocatalytic therapy, photothermal therapy, endogenous pigments-based photobleaching therapy, and polyphenols-based photo-oxidation therapy. This comprehensive exploration aims to offer updated information to facilitate the development of effective, convenient, safe, and alternative strategies to counter the growing threat of MDR bacteria in the future.

Advances in Nucleic Acid Assays for Infectious Disease: The Role of Microfluidic Technology.

Within the fields of infectious disease diagnostics, microfluidic-based integrated technology systems have become a vital technology in enhancing the rapidity, accuracy, and portability of pathogen detection. These systems synergize microfluidic techniques with advanced molecular biology methods, including reverse transcription polymerase chain reaction (RT-PCR), loop-mediated isothermal amplification (LAMP), and clustered regularly interspaced short palindromic repeats (CRISPR), have been successfully used to identify a diverse array of pathogens, including COVID-19, Ebola, Zika, and dengue fever. This review outlines the advances in pathogen detection, attributing them to the integration of microfluidic technology with traditional molecular biology methods and smartphone- and paper-based diagnostic assays. The cutting-edge diagnostic technologies are of critical importance for disease prevention and epidemic surveillance. Looking ahead, research is expected to focus on increasing detection sensitivity, streamlining testing processes, reducing costs, and enhancing the capability for remote data sharing. These improvements aim to achieve broader coverage and quicker response mechanisms, thereby constructing a more robust defense for global public health security.

The synergistic impact of Universal Health Coverage and Global Health Security on health service delivery during the Coronavirus Disease-19 pandemic: A difference-in-difference study of childhood immunization coverage from 192 countries.

Universal Health Coverage (UHC) and Global Health Security (GHS) are two high-priority global health agendas that seek to foster health system resilience against health emergencies. Many countries have had to prioritize one agenda over the other due to scarce resources and political pressures. To aid policymakers' decision-making, this study investigated the individual and synergistic effects of countries' UHC and GHS capacities in safeguarding essential health service delivery during the COVID-19 pandemic. We used a quasi-experimental difference-in-difference methodology to quantify the relationship between 192 countries' progress towards UHC and GHS and those countries' abilities to provide 12 essential childhood immunization services between 2015 and 2021. We used the 2019 UHC Service Coverage Index (SCI) to divide countries into a "high UHC group" (UHC SCI≥75) and the rest (UHC SCI 75), and similarly used the 2019 GHS Index (GHSI) to divide countries into a "high GHS group" (GHSI≥65) and the rest (GHSI<65). All analyses were adjusted for potential confounders. Countries with high UHC scores prevented a 1.14% (95% CI: 0.39%, 1.90%) reduction in immunization coverage across 2020 and 2021 whereas countries with high GHSI scores prevented a 1.10% (95% CI: 0.57%, 1.63%) reduction in immunization coverage over the same time period. The stratified DiD models showed that across both years, high UHC capacity needed to be augmented with high GHS capacity to prevent a decline in immunization coverage while high GHS alone was able to safeguard immunization coverage. This study found that greater progress towards both UHC and GHS capacities safeguarded essential health service delivery during the pandemic but only progress towards GHS capacity was both a necessary and likely sufficient element for yielding this protective effect. Our results call for strategic investments into both health agendas and future research into possible synergistic effects of the two health agendas.

How emergency digital health and data use investments can strengthen health systems and support global health security

Abstract This commentary is focused on a body of research examining a subset of the United States Agency for International Development (USAID) global vaccine delivery investments made during the emergency phase of the coronavirus disease 2019 pandemic (COVID-19). Taken together, the research illustrates the importance of the digital health enabling environment—the presence or absence of conditions that allow digital health investments to thrive—as a contributor to an effective emergency response and as a determinant of whether digital investments deployed during an emergency can contribute to stronger health systems and increased preparedness for future health shocks. The commentary distills findings from this journal supplement into three high-level insights and offers recommendations to translate these insights into actions that can improve future health emergency responses and strengthen health systems. Abrégé Ce commentaire se concentre sur un corpus de recherche examinant un sous-ensemble des investissements mondiaux de l’USAID dans la livraison de vaccins réalisés pendant la phase d’urgence de la pandémie de COVID-19. Prise dans son ensemble, la recherche illustre l’importance de l’environnement propice à la santé numérique – la présence ou l’absence de conditions permettant aux investissements en santé numérique de prospérer – en tant que facteur contribuant à une intervention d’urgence efficace et permettant de déterminer si les investissements dans le numérique réalisés pendant une urgence peuvent jouer un rôle positif dans le renforcement des systèmes de santé et l’amélioration de la préparation aux futurs chocs sanitaires. Le commentaire tire des conclusions présentées dans ce supplément de revue trois enseignements de haut niveau et formule un certain nombre de recommandations pour traduire ces enseignements en actions susceptibles d’améliorer les futures interventions d'urgence sanitaire et de renforcer les systèmes de santé. Resumen Este comentario se centra en un corpus de investigaciones sobre un subconjunto de las inversiones que USAID realizó para la entrega de vacunas en todo el mundo durante la fase de emergencia de la pandemia de COVID-19. En conjunto, las investigaciones demuestran la importancia del entorno propicio para la salud digital, es decir, la presencia o ausencia de condiciones que permitan que las inversiones en salud digital prosperen, como factor que contribuye a una respuesta de emergencia efectiva y como determinante de si las inversiones digitales implementadas durante una emergencia pueden contribuir a fortalecer los sistemas de salud y aumentar la preparación para futuras crisis de salud. El comentario resume los hallazgos de este suplemento de revista en tres ideas de alto nivel y ofrece recomendaciones para traducir estas ideas en acciones que puedan mejorar las futuras respuestas a emergencias sanitarias y fortalecer los sistemas de salud.

Inhibitory interactions of the 2,3-dihydro-6,7-dihydroxy-1H-isoindol-1-one scaffold with Bunyavirales cap-snatching endonucleases expose relevant drug design features

The World Health Organization (WHO) identifies several bunyaviruses as significant threats to global public health security. Developing effective therapies against these viruses is crucial to combat future outbreaks and mitigate their impact on patient outcomes. Here, we report the synthesis of some isoindol-1-one derivatives and explore their inhibitory properties over an indispensable metal-dependent cap-snatching endonuclease (Cap-ENDO) shared among evolutionary divergent bunyaviruses. The compounds suppressed RNA hydrolysis by Cap-ENDOs, with IC50 values predominantly in the lower μM range. Molecular docking studies revealed the interactions with metal ions to be essential for the 2,3-dihydro-6,7-dihydroxy-1H-isoindol-1-one scaffold activity. Calorimetric analysis uncovered Mn2+ ions to have the highest affinity for sites within the targets, irrespective of aminoacidic variations influencing metal cofactor preferences. Interestingly, spectrophotometric findings unveiled sole dinuclear species formation between the scaffold and Mn2+. Moreover, the complexation of two Mn2+ ions within the viral enzymes appears to be favourable, as indicated by the binding of compound 11 to TOSV Cap-ENDO (Kd = 28 ± 3 μM). Additionally, the tendency of compound 11 to stabilize His+ more than His- Cap-ENDOs suggests exploitable differences in their catalytic pockets relevant to improving specificity. Collectively, our results underscore the isoindolinone scaffold's potential as a strategic starting point for the design of pan-antibunyavirus drugs.

A Delphi study to assess the effect of changes in language between the first and second editions of the WHO’s Joint External Evaluation

IntroductionCountries use the WHO Joint External Evaluation (JEE) tool—part of the WHO International Health Regulations (2005) Monitoring and Evaluation Framework—for voluntary evaluation of global health security (GHS) capacities. After releasing...

Can you patent the sun? Towards a sui generis inclusive right to manage the relationship between intellectual property and Commons

Abstract This paper, by adopting the Covid-19 vaccine as a case study, argues that some pharmaceutical drugs should be considered as Commons, ie goods that are managed and owned by the public at large, and not as private property—exclusivity—of pharmaceutical companies. The reasons of such a strong argument are, on the one side, the conspicuous public-funding contribution to develop Covid-19 vaccines and other essential life-saving treatments, and, on the other side, the search for a human and equity-oriented Global Health Security. It is true that, from a legal perspective, vaccines can be patented, leading to questionable practices in the pharmaceutical industry, such as patent thickets. However, an alternative and fairer path, which would result in the theorization of a Commons for the vaccine, can be pursued. In particular, the actual types of Commons in the IP law field—the public domain, exceptions/limitations to patents and open innovation instruments such as IP pledges—present some issues in relation to enforceability. By forwarding the concept of ‘negative spaces’ to the patent realm, these spaces should not only claim to not enforce IP but also be able to ‘enforce that non-enforcement’. Therefore, this paper, by building on the work of the author Dusollier, advances the idea that from the inclusivity, which is the typical feature of every Commons, a sui generis inclusive right can be envisaged and applied in the context of the vaccine, by rethinking the relationship between IP and Commons.

HACD3 Prevents PB1 from Autophagic Degradation to Facilitate the Replication of Influenza A Virus.

Influenza A virus (IAV) continues to pose serious threats to the global animal industry and public health security. Identification of critical host factors engaged in the life cycle of IAV and elucidation of the underlying mechanisms of their action are particularly important for the discovery of potential new targets for the development of anti-influenza drugs. Herein, we identified Hydroxyacyl-CoA Dehydratase 3 (HACD3) as a new host factor that supports the replication of IAV. Downregulating the expression of HACD3 reduced the level of viral PB1 protein in IAV-infected cells and in cells that were transiently transfected to express PB1. Silencing HACD3 expression had no effect on the level of PB1 mRNA but could promote the lysosome-mediated autophagic degradation of PB1 protein. Further investigation revealed that HACD3 interacted with PB1 and selective autophagic receptor SQSTM1/p62, and HACD3 competed with SQSTM1/p62 for the interaction with PB1, which prevented PB1 from SQSTM1/p62-mediated autophagic degradation. Collectively, these findings establish that HACD3 plays a positive regulatory role in IAV replication by stabilizing the viral PB1 protein.

Novel antiviral approaches for Marburg: a promising therapeutics in the pipeline.

Marburg virus disease (MVD) presents a significant global health threat, lacking effective antivirals and with current supportive care offering limited therapeutic options. This mini review explores the emerging landscape of novel antiviral strategies against MVD, focusing on promising therapeutics currently in the development pipeline. We delve into direct-acting antiviral approaches, including small molecule inhibitors targeting viral entry, replication, and assembly, alongside nucleic acid antisense and RNA interference strategies. Host-targeting antivirals are also considered, encompassing immune modulators like interferons and cytokine/chemokine modulators, broad-spectrum antivirals, and convalescent plasma and antibody-based therapies. The paper then examines preclinical and clinical development for the novel therapeutics, highlighting in vitro and in vivo models for antiviral evaluation, safety and efficacy assessments, and the critical stages of clinical trials. Recognizing the challenges of drug resistance and viral escape, the mini review underscores the potential of combination therapy strategies and emphasizes the need for rapid diagnostic tools to optimize treatment initiation. Finally, we discuss the importance of public health preparedness and equitable access to these promising therapeutics in achieving effective MVD control and global health security. This mini review presents a comprehensive overview of the burgeoning field of MVD antivirals, highlighting the potential of these novel approaches to reshape the future of MVD treatment and prevention.

Selection of Key Socio-Economic Factors for Establishing Relese Criteria Patients after Radioioidine Therapy

Purpose: To assess the association between socioeconomic factors and release criteria after iodine-131 radionuclide therapy in different countries. Material and methods: 15 countries and 104 socioeconomic characteristics were selected for the study. The association between characteristics and the residual activity level at which a patient may be released for different countries was established according to the value of Pearson product moment correlation coefficient (r&gt;0.3). A linear regression model was constructed for the selected characteristics using Microsoft Excel analysis package. The model was used to calculate the acceptable activity level at which a patient may be released for Russia. Results: A fundamental difference between the model used for calculation of release criteria after radionuclide therapy with iodine-131 in Russia and the model recommended by the Nuclear Regulatory Commission was shown: the use of the effective half-life in the second one. Replacing the physical halflife by the effective half life allows increasing the discharge criteria of patients after therapy with Na131I by 30 %. A moderate correlation was found between the value of acceptable activity at patient discharge after radioactive iodine therapy and the following socioeconomic characteristics: scientific activity (r=0.32), quality of higher education (r=0.36), Global Health Security Index (r=0.34), length of roads (r=0.36), population growth rate (r=0.36), average housing area (r=0.38), and average salary per year (r=–0.33). A linear regression was constructed using the factors listed above. The following recommended value of activity and effective dose rate at patient discharge from hospital was obtained: 0.6 GBq and 30 µSv/hour. Conclusion: The study demonstrates that the release criteria for radioactive iodine therapy used in the Russian Federation (0.4 GBq and 20 µSv/h) do not correspond to the standard of living achieved in Russia, which is reflected by the socio-economic factors considered in the paper. The proposed arguments raise the task of revising the currently used model with a consequent increase in the discharge criteria. It was observed that the release criteria in the world are independent of some factors that are directly related to population exposure. The need to develop a unified objective algorithm for establishing release criteria, which takes into account different socio-economic status of states and can be applied for different radionuclides and radiopharmaceuticals, including innovative ones, has been identified.

Recent developments in antibiotic contamination of animal products, soil, and water worldwide

Abstract Antimicrobial resistance (AMR), facilitated by antibiotic consumption, remains one of the biggest threats to global health and food security. The burgeoning AMR has an estimated forecast of 10 million deaths and 100 trillion USD economic losses annually worldwide by 2050 if no urgent actions are taken. The indiscriminate use of antibiotics in food animal production plays an expressive role in the AMR crisis. This paper compiles information regarding antibiotics and AMR in animals, animal-derived products, and agriculture-impacted environment. A holistic approach is needed to mitigate the burden of AMR within the context of human-animal-environment. Currently there are few approaches to this problem such as nanotechnology, anaerobic digestion, biochar composting, and alternatives to antibiotic treatments (like herbal plant extracts, probiotics, vaccines, enzymes, and antimicrobial peptides) have been developed. However, there are gaps in knowledge about AMR and areas for improvement are obvious. There is no a clear path to put an end to the persistent trends of AMR. Despite the trends for stricter regulation on the use of antibiotics worldwide, they find their way into food animal production, water, and soil as a result of misuses in many countries. We need to acknowledge the antibiotic contamination and/or AMR as a silent pandemic, and we are challenged to adopt a global approach to reducing and improving their use.

Research on the effects of ocean current on nuclear wastewater in Japan

According to reports, the Fukushima Daiichi Nuclear Power Station nuclear pollution water drainage project has been completed. Subsequently, Tokyo Electric Power will directly discharge nuclear wastewater into the ocean through a subsea tunnel connecting the land. These nuclear wastewater will be discharged to the waters near the Tropic of Cancer, which is greatly affected by the Japanese warm current, and nuclear wastewater will be taken around the world through ocean currents. German research institutions point out that within a month from the date of discharge of Fukushima nuclear wastewater, its radioactive material will spread to most of the Pacific Ocean, which will seriously affect global fish migration, ocean fisheries, human health and ecological security. Due to the impact of the global ocean current, China's East China Sea, the Yellow Sea and the Bohai Sea will also be affected by nuclear waste water pollution. Based on this, this text will start from the impact of the El Nino warm current on the flow of nuclear wastewater, and will soon explain the impact of Japan's dumping of nuclear wastewater on global security, and from a personal perspective on the current view of environmental protection and governance.

Need for standardization and compliance to treatment protocols for COVID-19 within the African Region of the World Health Organization

COVID-19 pandemic changed the face of global health and brought about new issues in global health security and economy. The World Health Organization published guidelines for clinical management of COVID-19 four months after declaration of COVID-19 as a pandemic. Scholarly reviews and studies from member states within WHO AFRO reveals significant deviation from the WHO published protocols on COVID-19. Assessment of national treatment protocols of 30 of 47 WHO AFRO member states showed widespread inappropriate use of antimicrobial agents for patients, which may worsen the global and concerning threat of antimicrobial resistance. There is need for adopting interventions that optimize antimicrobial use in the context of pre- and post-pandemic preparedness to ensure long-term effectiveness and sustainability for antimicrobials. Treatment guidelines are to be adopted or adapted depending on best clinical evidence available. Non-compliance with guidelines might lead to mismanagement of infectious diseases with attendant negative consequences including antimicrobial resistance and misdirection of critical resources and supplies amongst others.

"Innovative Advancement for Combating Genetic Cum Gender Linked Diseases and Insuring Global Health Security"

"Innovative Advancement for Combating Genetic Cum Gender Linked Diseases and Insuring Global Health Security"