Global Public Policy Research Articles

Measuring influencing factors affecting mortality rates during the COVID-19 pandemic

ABSTRACT Background The COVID-19 pandemic has revealed clear deficiencies in global public health policies and healthcare systems when confronted with the emergence of a novel and deadly infectious disease. Objectives With 4 years elapsed since the onset of the pandemic, ample data now exist to analyse the associations between the implementation of diverse public health policies, sociodemographic factors and COVID-19 mortality rates. Methods This study utilised the dataset compiled by ‘Our World in Data’ spanning the period of the COVID-19 pandemic from 2020 to 2022. Stochastic frontier analysis was employed to assess the influencing factors and their relationship with mortality rates resulting from COVID-19 infections across 156 countries or regions. Results This study yielded several key findings: (1) There remains a 33% margin for improvement in the global mortality rate concerning the COVID-19 pandemic; (2) During the initial stage of the pandemic, when an effective vaccine was not yet available, implementing public health control policies could reduce both the infection and mortality rates; (3) Areas characterised by higher population densities, a greater proportion of individuals aged 65 and over, and elevated prevalence rates of diabetes demonstrated higher mortality rates; and (4) Increasing vaccination coverage emerged as an effective strategy for reducing mortality rates. Conclusions As our understanding of the COVID-19 virus improves, global economies and social interactions have gradually returned to normality. It is anticipated that the findings of this study can serve as a valuable reference in combating potential future pandemics caused by unknown viruses.

Public Policies in Development: Analysis of The Goiás Social Program in Goiânia (2023)

Objective: To present information, analyses and discussions about the development of the Goiás Social Program in the city of Goiânia – GO and its respective contribution to achieving the SDGs proposed by the 2030 Agenda. Theoretical Framework: Brazilian Public Policies and Sustainable Development under the global agreement for the development and implementation of sustainability strategies and practices. Methodology: Quantitative and qualitative survey and analysis of data related to the Goiás Social Program, namely, founding legislation, implementation proposal, budget, objectives, structure, beneficiaries and results from the PGS projects and programs developed in the city of Goiânia - GO, on the official PGS pages, and their respective implementing institutions: State Secretariat for Social Development of the Government of the State of Goiás and Municipal Secretariat for Human and Social Development of Goiânia Results and Discussion: The investigation resulted in the identification of projects that, despite the general idea of focusing on sustainability, lacked precise disclosure regarding the publication of the project proposals in full, budget, objectives, structure, beneficiaries and results, made it difficult to analyze the scope and effective contribution of these projects to the achievement of the SDGs of the 2030 Agenda. Implications of the investigation: Sustainability has gained prominence in the global Public Policy Agenda. Investigating the effective contributions of Brazilian public policies in this scenario becomes essential in terms of improving and enhancing its process, whose demands are under a continuous dynamism that requires monitoring the actions developed in compliance with the transformations of these demands resulting from social dynamism. Originality/Value: This investigation presents information on the propositions and structure of the Goiás Social Program, as well as on the management of its implementation in the city of Goiânia - GO.

Application of natural sweetener Stevia rebaudiana in the medical field

Steviol glycoside sweeteners have been isolated and produced for hundreds of years in Bertoni, a South American Asteraceae plant prized for its sweetness. Stevia is becoming more popular among consumers and food manufacturers as a result of diabetes, rising obesity rates, and other related comorbidities, as well as global public policies calling for a reduction in intake of sugar to help control these issues. Low-calorie as well as no-calorie sweeteners, such as Stevia, have this appeal because they are plant-based, have no calories, and have a sugary flavour that is 50 to 350 times sweeter than table sugar, making them an excellent as well as suitable choice for use in foods as well as beverages with lower sugar and calorie content. This plant yields steviol glycoside sweeteners, which are isolated and processed. Current studies on Stevia rebaudiana extract, metabolism, tolerable intake, and safety, steviol glycoside extraction and purification, side effects, as well as the toxicity of Stevia extract are discussed in detail.

Malnutrition drives infection susceptibility and dysregulated myelopoiesis that persists after refeeding intervention.

Undernutrition is one of the largest persistent global health crises, with nearly 1 billion people facing severe food insecurity. Infectious disease represents the main underlying cause of morbidity and mortality for malnourished individuals, with infection during malnutrition representing the leading cause of childhood mortality worldwide. In the face of this complex challenge, simple refeeding protocols have remained the primary treatment strategy. Although an association between undernutrition and infection susceptibility has been appreciated for over a century, the underlying mechanisms remain poorly understood and the extent to which refeeding intervention is sufficient to reverse nutritionally acquired immunodeficiency is unclear. Here we investigate how malnutrition leads to immune dysfunction and the ability of refeeding to repair it. We find that chronic malnutrition severely impairs the ability of animals to control a sub-lethal bacterial infection. Malnourished animals exhibit blunted immune cell expansion, impaired immune function, and accelerated contraction prior to pathogen clearance. While this defect is global, we find that myelopoiesis is uniquely impacted, resulting in in reduced neutrophil and monocyte numbers prior to and post-infection. Upon refeeding, we observe that animals recover body mass, size, cellularity across all major immune organs, the capacity to undergo normal immune cell expansion in response to infection, and a restoration in T cell responses. Despite this broad improvement, refed animals remain susceptible to bacterial infection, uncoupling global lymphoid atrophy from immunodeficiency. Mechanistically, we find peripheral neutrophil and monocyte numbers fail to fully recover and refed animals are unable to undergo normal emergency myelopoiesis. Altogether, this work identifies a novel cellular link between prior nutritional state and immunocompetency, highlighting dysregulated myelopoiesis as a major driver. We believe these findings illustrate how exposure to food scarcity is an immunologic variable, even post-recovery, which should be accounted for in patient medical history and current global public health policy.

Global public health policy analysis: During the COVID-19 pandemic

The emergence of Covid 19 at the start of 2020 set the alarm for a new pandemic around the world following the turning century. Global efforts to fight against infectious diseases focus on protecting citizens from the virus, preventing the spread of the virus within and through a country, and promoting the idea of the dangers of the virus and ways of self-preservation. On a neurophysiological scale, ideal and effective strategies such as initiating quarantine around the world, in which a limit to the outside world is set, gradually stagnate the spread of the virus and maintain the optimum environment for the sick to recover. The mandatory policy and consensus around the world of wearing a mask and maintaining a six-foot distance substantially curbed the spread of the virus in public. On a microbiological scale, the technological advancement the world experienced in recent years resulted in the rapid development of public preventative treatment, such as vaccines, marking the turning point regarding the gradual decrease in the spread and, subsequently, the rate of death throughout the world. The methods of preventing the spread of disease, as well as protecting the citizens from further damage, have led to an exponential decay of cases regarding the coronavirus.

Dynamic Simulation of Energy Scenarios in the Transition to Sustainable Mobility in the Ecuadorian Transport Sector

In Ecuador, the growth of the transportation sector has significantly increased greenhouse gas emissions. According to experts, this sector currently contributes to 49.8% of total greenhouse gas emissions in this country. This poses significant challenges for environmental sustainability, emphasizing the urgent need for effective strategies to mitigate these emissions and promote environmentally friendly practices. Therefore, this study focuses on developing a dynamic simulation of energy scenarios for the year 2035 in the transportation sector, with the goal of transitioning to sustainable mobility, as fossil fuels are the main pollutants in the country. This study proposes system dynamics models using VENSIM 6.0b software to estimate the total energy demand and pollutant emissions in the transportation sector. The results suggest that if Ecuador aligns with global mobility trends and implements public policies promoting the use of electric vehicles, total CO2 emissions could potentially decrease from 50,161,432 kilobarrels of oil equivalent (kBOE) to 20,589,720 kBOE by the year 2035.

Alcohol-associated liver disease and public health policies.

Alcohol-associated liver disease (ALD) rates have increased substantially in the United States (US) and elsewhere around the globe. These increases are largely the result of increases in alcohol use. While there are many levels at which alcohol use interventions can be implemented in order to reduce alcohol use and its negative health consequences, public policy initiatives have emerged as a powerful way to intervene across a population. In this narrative review, we will review major US national as well as worldwide alcohol related public health policies with a particular focus on describing how such policies have influenced rates of ALD and its complications and outcomes. We will describe global alcohol public health policy frameworks, review key alcohol policy models, describe existing notable policies and their impacts, and highlight gaps in ALD policy literature where further research and policy interventions could reduce rates mortality from ALD.

Global, Regional, and National Burdens of Stroke in Children and Adolescents From 1990 to 2019: A Population-Based Study.

Stroke is one of the leading causes of death among children, yet evidence on stroke incidence and prognosis in this population is largely neglected worldwide. The aim of this study was to estimate the latest burden of childhood stroke, as well as trends, risk factors, and inequalities from 1990 to 2019, at the global, regional, and national levels. The Global Burden of Disease 2019 study was utilized to evaluate the prevalence, incidence, years lived with disability, years of life lost (YLLs), and average annual percentage changes in stroke among populations aged 0 to 19 years from 1990 to 2019. The global age-standardized incidence of stroke increased (average annual percentage change, 0.15% [95% uncertainty interval, 0.09%-0.21%]), while YLLs decreased substantially (average annual percentage change, -3.33% [95% uncertainty interval, -3.38% to -3.28%]) among children and adolescents between 1990 and 2019. Ischemic stroke accounted for 70% of incident cases, and intracerebral hemorrhage accounted for 63% of YLLs. Children under 5 years of age had the highest incidence of ischemic stroke, while adolescents aged 15 to 19 years had the highest incidence of hemorrhagic stroke. In 2019, low-income and middle-income countries were responsible for 84% of incident cases and 93% of YLLs due to childhood stroke. High-sociodemographic index countries had a reduction in YLLs due to stroke that was more than twice as fast as that of low-income and middle-income. Globally, the burden of childhood stroke continues to increase, especially among females, children aged <5 years, and low-sociodemographic index countries, such as sub-Saharan Africa. The burden of childhood stroke is likely undergoing a significant transition from being fatal to causing disability. Global public health policies and the deployment of health resources need to respond rapidly and actively to this shift.

The UNDP’s Global Human Development reports Public Policies of the 1990s for the Development of its people in the world

The concept of Human Development (HD) is a process of enlarging people's choices. In principle, these choice can be infinite and change over time. But at all levels of development, the three essential ones as per United Nations Organization (UNO)’s United Nations Development Programme (UNDP) are for people to lead a long and healthy life, to acquire knowledge and to have access to resources needed for a decent standard of living. If these essential choices are not available, many other opportunities remain inaccessible. But HD does not end there. However, the UNDP’s yearly global Human Development Reports (HDRs) public policies had been focusing on these themes since the first global HDR in 1990 to the global HDR report of 2021-2022. Moreover, in every year, the main focused themes had been different. The research study analysis found that the UNDP’s 1990s global HD reports public policies had been intellectually contributed immensely for the better development of its people during the globalization.

A systematic review of public policy implementation during the Covid‐19 pandemic: Current topics and future directions

AbstractThe Covid‐19 pandemic greatly impacted global public policy implementation. There is a lack of research synthesizing the lessons learned during Covid‐19 from a policy perspective. A systematic review was conducted following PRISMA guidelines to examine the literature on public policy implementation during the Covid‐19 pandemic in order to gain comprehensive insights into current topics and future directions. Five clusters of topics were identified: lessons from science, crisis governance, behavior and mental health, beyond the crisis, and frontlines and trust. Extensive collaboration among public health departments emerged as a significant research theme. Thirty recommendations for future research were identified, including the examination of frontline worker behavior, the use of just tech in policy implementation, and the investigation of policies driving improvements in global public health. The findings indicate that current research on public policy implementation during the Covid‐19 pandemic extends beyond health and economic crisis‐related policies. However, further studies in a post‐pandemic context are needed to validate the identified topics and future directions.

Early and contemporary drivers of the HIV-1 group M pandemic.

HIV emerged silently taking time to spread and become visible only through geographically isolated clusters of life-threatening immunodeficiency, known as AIDS since the early 80s. The clusters of infection expanded, overlapping to evolve into a pandemic that is ongoing and almost as silent. Phylogenetic analysis places the emergence of HIV-1 group M, the subtype responsible for the pandemic, in the human population more than 100 years ago. Once established, the rate and direction of spread of HIV-1 from local, to national, to contemporary pandemic proportions have varied over time and place. The literature presents many theories on the emergence and drivers of the spread of the virus over the past century. Here, historical evidence and phylogenetic models are reviewed to seek clarity on the emergence, geographic spread and key world events that mark the progression of the HIV-1 pandemic. This narrative review places particular focus on: war (both its direct and indirect affects), trade and economic expansion, changes in sexual behaviors, and public health policy. Investigating the impact of major world events and policy on the emergence and spread of HIV-1 may aid better understanding of what influences the viruses transmission dynamic. By identifying multilateral targets that influence transmission, up-scaled efforts to effectively control, if not remove, HIV-1 from the human population become a possibility. Suggestions for revisions in HIV-1 global public health policy are discussed. Refocused efforts to tackle HIV-1 transmission and replace the need to manage the pathology of this terrible disease are both ethically and economically just.

Oxy-biodegradable plastics in freshwater environments: degradation and biofouling

Growing concern about the impact of plastic pollution on the environment has led to the creation of global public policies and the consumption of “environmentally friendly” products, such as oxy-biodegradable plastics. In this context, “greenwashing” practices can arise, i.e., the product promises more environmental benefits than it actually offers, which can lead to superfluous use, inappropriate disposal, and the generation of microplastics (MPs). However, the scientific literature lacks studies that evaluate the behavior of oxy-biodegradable plastic when exposed to the freshwater environment. In this respect, the aim of the current study was to evaluate the degradation process of oxy-biodegradable plastic bags made from high-density polyethylene (HDPE) in river water. To this end, the current study aimed to assess whether these bags actually meet the label information (which corresponds to the complete degradation of material) or whether they correspond to greenwashing practices. The physical and chemical alterations, and the formation of biological communities that occurred on the surface of the plastic material when exposed to natural aging and submerged in freshwater were monitored using mid-infrared absorption spectroscopy with attenuated total reflectance (FTIR-ATR) and scanning electron microscopy (SEM). The characterization of the samples after 180 days of exposure showed that the oxy-biodegradable bags were not completely degraded, with only fragmentation of the material and generation of MPs. In addition, it was also observed that microorganisms present in the water easily colonized the plastic surface from the start of the experiment. In this way, the oxy-biodegradable bags analyzed correspond to a greenwashing practice, which is extremely harmful, since it can influence the increase in consumption of these products, generating greater improper disposal of these materials, and consequently the generation of MPs and the formation of biofilms, which can carry pathogenic microorganisms to the aquatic biota and to humans.

Combating Poverty and Social Inequality in 2023 a Global Imperative for Equitable Development and Social Justice

&#x0D; In the last decade, poverty and social inequality have become increasingly pressing global challenges, exacerbated by the impact of the global economy, climate change, and the digital revolution. Rising inequality and unequal distribution of wealth not only hinder economic growth but also give rise to social and political instability. The fight against this problem requires a deep understanding of its causal factors and impact on global development. This research aims to analyze the factors that cause poverty and social inequality and their impact on global development, with a focus on solutions to overcome these problems. The research methodology uses a descriptive qualitative approach, with data obtained from relevant literature studies and in-depth analysis of the phenomenon. Data was collected from previous research results and processed through qualitative analysis to build a comprehensive understanding. The research results show that global economic factors, climate change, technology, public policy, and socio-cultural factors are the main causes of poverty and inequality. Its impact on global development includes stunting economic growth, social instability, and reduced access to health and education services. This research also finds that the solution to this problem requires international cooperation, innovative policies from governments, active contributions from the private sector, and the participation of non-governmental organizations. A multidisciplinary and participatory approach, as well as the use of technology and innovation, is needed to create sustainable solutions. Overall, this research provides new insights into strategies for achieving more inclusive and equitable development amidst current global challenges.

Actors, alterations, and authorities: three observations of global policy and its transnational administration

Abstract This Special Issue and its seven contributions seek to shift the gaze of public policy scholarship toward the authorities, legitimacies, and influences of transnational actors on the creation and implementation of global policy and its transnational administration. It is, in large part, both a demonstration of the analytical and explanatory value of accounting for the influence of non-state actors on global issues as well as a normative reflection on what this means for already tenuous connections between publics and those that make decisions on their behalf in global forums. This Issue breaks with heterodox public policy approaches that center on the capabilities of states and international organizations to determine and to deliver global public policy and outcomes. Instead, we widen our gaze to capture the influence of transnational actors such as global commissions, transnational public–private partnerships, philanthropic foundations, non-government organization networks, domestic associations with global influence, quasi-judicial authorities, and global citizen activists. The articles discuss the impact of transnational actors on the policy and administrative spaces of global actors and states alike. By dispensing with the notion that the state and state-created international organizations are the primary locus for public policy and public administration scholarship, the included papers conclude with the implications for scholarship on transnational actor authorities and legitimacies.

Africa in Global Public Policy: Theoretical Perspectives and the Role of International Law in Shaping Public Policy in Africa

Africa in Global Public Policy: Theoretical Perspectives and the Role of International Law in Shaping Public Policy in Africa

Overview of global healthcare policies for patients with chronic kidney disease: an integrative literature review.

Chronic kidney disease is a progressive and irreversible loss of kidney function and considerably affects the lives of patients and their families. Its high incidence necessitates efficient public policies for prevention and treatment. However, policies for chronic kidney disease education and awareness are scarce. To evaluate global public policies for the prevention and treatment of chronic kidney disease adopted in various regions, aiming to comprehend the differences between various models. This integrative review followed PRISMA recommendations and included papers published between 2016 and 2021 across several databases. The 44 selected articles were categorized into three themes: structural and financial aspects of the organization of renal healthcare, access to renal healthcare or management of chronic kidney disease, and coping strategies for chronic kidney disease or kidney health. Critical analysis of the papers revealed global neglect of kidney disease in political agendas. Considerable policy variations exist between different countries and regions of the same country. Our research highlighted that free and universal health coverage, especially for the most vulnerable patients, is crucial for accessing treatment owing to the prohibitively high treatment costs. Social, economic, and ethnic inequalities strongly correlate with disease occurrence, primarily affecting minority groups who lack health support, especially for the prevention and treatment of chronic kidney disease.

The CEPH aging cohort and biobank: a valuable collection of biological samples from exceptionally long-lived French individuals and their offspring for longevity studies

The increasing aging of the human population is currently and for the coming decades a major public health issue in many countries, requiring the implementation of global public health policies promoting healthy and successful aging. Individuals are not equal in the face of aging and some can present exceptional healthspan and/or lifespan, which are notably influenced by both genetic and environmental factors. Research and studies on human aging, healthy aging and longevity should rely in particular on cohorts of long-lived individuals, also including biological samples allowing studies on the biology of aging and longevity. In this manuscript, we provide for the first time a complete description of the CEPH (Centre d’Etude du Polymophisme Humain) Aging cohort, an exceptional cohort recruited during the 90s to 2000s, including more than 1700 French long-lived individuals (≥ 90 years old) born between 1875 and 1916 as well as for some of them their siblings and offspring. Among the participants, 1265 were centenarians, including 255 semi-supercentenarians ([105–110] years old) and 25 supercentenarians (≥ 110 years old). The available anthropometric, epidemiologic and clinical data for the cohort participants are described and especially the collection of blood-derived biological samples associated with the cohort which includes DNA, cryopreserved cells and cell lines, plasma, and serum. This biological collection from the first cohort of centenarians in the world is an inestimable resource for ongoing and future molecular, cellular, and functional studies aimed at deciphering the mechanisms of human (successful) aging and longevity.

Unsettling Human (In)Security: Challenging Neglect and Making the Unapparent Appear

The concept of human security, introduced to the global public policy lexicon in 1994, did two things. First, it challenged conventional and dominant state-centric approaches to security to rethink security in universal people-centred terms. Second, in its focus on human life and dignity, it called for a profound transition in security thinking to make all people everywhere matter. This article argues that the development of human security within the UN system has not sufficiently met these objectives. Through an analysis of three key human security sectors— food security, health security and disaster events—it reveals how conventional approaches to human security can be implicated in neglect, invisibility and marginalisation such that those already facing insecurity are made worse off still. A critical human security lens demonstrates that foregrounding recognition, solidarity and agency can help to expose invisibilities and encourage strategies to make people count.

Numbers as Utopia: Sustainable Development Goals and the making of quantified futures

In this article, we argue that number-making is a mode of imagining political futures – not only futures that are probable but, crucially, futures that are desired. In this way, rather than simply a mode of ‘technicising’ policy challenges, quantification fleshes out the utopian dream of a better world. Global governance is faced with the paradox of, on one hand, the utopian aspiration of the Sustainable Development Goals to create a perfect world (free of poverty, inequality, diseases and climate disaster) and, on the other hand, the dystopian effects of inaction – both tracked carefully through a complex network of indicators. This article focuses on the materiality of the Sustainable Development Goals as a productive device through which a monitoring agenda such as the Sustainable Development Goals has become ever more influential and has led to the emergence of a global public policy space.

Translational Systems Approach to Clinical Dental Research: A Primer for Precision and Personalized Oral Health in Resource-Constrained Settings

Resource-constrained regions such as sub-Saharan Africa urgently need to leverage innovative approaches to dental care provision and research, using available scarce resources. Even though a lot of clinical dental research has emerged in Africa, from the use of clinical dental samples (or data) and carried out by dental healthcare personnels, the principles of clinical dental research (CDR) and the embellishment of a translational dental research (TDR) pipeline is not widely used and considered. Neither has this principle trickled down to curriculum-integrated mechanisms at many academic dental schools on the continent. Equipping future dental professionals with robust clinical dental research skill need to be implemented in an integrated and systematized manner on the continent. It is therefore important to define the precise parameters of CDR and what it should entail, as well as what the exact purpose of carrying out such research should be. Furthermore, key concepts in TDR, as well as precision and personalized oral health (PPOH) need to be established, in the era of precision and omics-based dentistry. Hence, this paper discusses an integrative implementation framework and models for optimizing the use of TDR for cost effective CDR in resource-limited settings. We also proposed the utilization of a CDR and TDR model that uses a systems-oriented, multiscale integration of CDR, TDR and PPOH within the clinical dental practice settings, dental research environments, as well as incorporation of these concepts into the pedagogical curriculum of undergraduate and postgraduate dental training programs. Using the proposed integrative implementation framework for CDR and TDR in resource-constrained regions, it is envisaged that cost- and labour-effective practices will be instituted. Not least, effective incorporation of PPOH and one health into CDR and TRD will hopefully translate into beneficial global oral public health policies and systems reform in Africa.