Global Stakeholders Research Articles

Assessing Xi Jinping's Vision of Modernization and its Implications for Global Trade Dynamics: A Case Study of the Belt and Road Initiative

Globalization has emerged as a driving force reshaping China's economic, social, and political landscape. This paper aims to dissect the multifaceted impacts of globalization on Chinese society and political culture, specifically focusing on how Xi Jinping's vision of modernization intersects with these transformative dynamics. The synthesis of global influences and local ideologies has triggered profound shifts across various dimensions, including ideological synthesis, socioeconomic restructuring, technological evolution, governance paradigms, diplomatic engagements, and cultural identity. Drawing from a blend of scholarly perspectives, the research delves into the intricate relationship between globalization and China's political culture. It highlights the convergence of global ideas and traditional philosophies, which have catalyzed an evolving political ideology in China. Economically, globalization has facilitated market liberalization, foreign investments, and socioeconomic transformations, necessitating a recalibration of societal structures and aspirations. Moreover, the digital age has democratized communication channels, challenging established political hierarchies and fostering an evolving public discourse. Furthermore, the paper examines China's participation in global networks, emphasizing the consequential adaptations in governance, diplomacy, and the evolving narrative of Chinese identity on the global stage. Additionally, the study explores the intersection of globalization, economic interdependence, and information technology, highlighting their role as catalysts for China's evolving socio-political landscape. Ultimately, this research underscores the significance of understanding the intricate interplay between globalization, Xi Jinping's modernization vision, and the ensuing transformations within Chinese political culture. It serves as a critical lens through which policymakers, scholars, and global stakeholders can comprehend China's evolving trajectory. It offers insights into future scenarios, including the prospect of a more democratic political system within China's global interactions.

Revealing spatiotemporal inequalities, hotspots, and determinants in healthcare resource distribution: insights from hospital beds panel data in 2308 Chinese counties

BackgroundEnsuring universal health coverage and equitable access to health services requires a comprehensive understanding of spatiotemporal heterogeneity in healthcare resources, especially in small areas. The absence of a structured spatiotemporal evaluation framework in existing studies inspired us to propose a conceptual framework encompassing three perspectives: spatiotemporal inequalities, hotspots, and determinants.MethodsTo demonstrate our three-perspective conceptual framework, we employed three state-of-the-art methods and analyzed 10 years’ worth of Chinese county-level hospital bed data. First, we depicted spatial inequalities of hospital beds within provinces and their temporal inequalities through the spatial Gini coefficient. Next, we identified different types of spatiotemporal hotspots and coldspots at the county level using the emerging hot spot analysis (Getis-Ord Gi* statistics). Finally, we explored the spatiotemporally heterogeneous impacts of socioeconomic and environmental factors on hospital beds using the Bayesian spatiotemporally varying coefficients (STVC) model and quantified factors’ spatiotemporal explainable percentages with the spatiotemporal variance partitioning index (STVPI).ResultsSpatial inequalities map revealed significant disparities in hospital beds, with gradual improvements observed in 21 provinces over time. Seven types of hot and cold spots among 24.78% counties highlighted the persistent presence of the regional Matthew effect in both high- and low-level hospital bed counties. Socioeconomic factors contributed 36.85% (95% credible intervals [CIs]: 31.84–42.50%) of county-level hospital beds, while environmental factors accounted for 59.12% (53.80–63.83%). Factors’ space-scale variation explained 75.71% (68.94–81.55%), whereas time-scale variation contributed 20.25% (14.14–27.36%). Additionally, six factors (GDP, first industrial output, local general budget revenue, road, river, and slope) were identified as the spatiotemporal determinants, collectively explaining over 84% of the variations.ConclusionsThree-perspective framework enables global policymakers and stakeholders to identify health services disparities at the micro-level, pinpoint regions needing targeted interventions, and create differentiated strategies aligned with their unique spatiotemporal determinants, significantly aiding in achieving sustainable healthcare development.

Global perspectives of determinants influencing HPV vaccine introduction and scale-up in low- and middle-income countries.

Achieving WHO cervical cancer elimination goals will necessitate efforts to increase HPV vaccine access and coverage in low-and-middle-income countries (LMICs). Although LMICs account for the majority of cervical cancer cases globally, scale-up of HPV vaccine programs and progress toward coverage targets in LMICs has been largely insufficient. Understanding the barriers and facilitators that stakeholders face in the introduction and scale-up of HPV vaccination programs will be pivotal in ensuring that LMICs are equipped to optimize the implementation of HPV vaccination programs. This qualitative study interviewed 13 global stakeholders categorized as either academic partners or global immunization partners to ascertain perspectives regarding factors affecting the introduction and scale-up of HPV vaccination programs in LMICs. Global stakeholders were selected as their perspectives have not been as readily highlighted within the literature despite their key role in HPV vaccination programming. The results of this investigation identified upstream (e.g., financial considerations, vaccine prioritization, global supply, capacity and delivery, and vaccine accessibility, equity, and ethics) and downstream (e.g., vaccine acceptability and hesitancy, communications, advocacy, and social mobilization) determinants that impact program introduction and scale-up and confirmed that strong political commitment and governance are significant in garnering support for HPV vaccines. As LMICs introduce HPV vaccines into their national immunization programs and develop plans for scaling up vaccination efforts, strategic approaches to communications and advocacy will also be needed to successfully meet coverage targets.

Global adoption of 6-month drug-resistant TB regimens: Projected uptake by 2026.

The WHO has issued a call to action urging countries to accelerate the rollout of new WHO-recommended shorter all-oral treatment regimens for drug-resistant TB (DR-TB), which remains a public-health crisis. The all-oral, 6-month BPaL/M regimen comprises 3-4 drugs: pretomanid used in combination with bedaquiline and linezolid, with or without moxifloxacin. This regimen has been recommended by the WHO for use in DR-TB patients instead of ≥9-month (up to 24-month) regimens. This study aims to project this regimen's use, along with its components bedaquiline, pretomanid and linezolid, and other treatments for DR-TB globally through 2026. It is intended to guide global health stakeholders in planning and budgeting for DR-TB interventions. Projected usage could help estimate cost of the individual components of DR-TB regimens over time. Semi-structured interviews were conducted with national TB programme participants in key countries to gather intelligence on established plans and targets for use of various DR-TB treatment regimens from 2023 to 2026. These data informed development of projections for the global use of regimens and drugs. Consistent global growth in the use of shorter regimens in DR-TB treatment was shown: BPaLM reaching 126,792 patients, BPaL reaching 43,716 patients, and the 9-11-month all-oral bedaquiline-based regimen reaching 13,119 patients by 2026. By 2026, the longer all-oral regimen is projected to be used by 19,262 patients, and individualised treatment regimens by 15,344 patients. The study shows BPaL/M will be used in majority of DR-TB patients by 2024, reaching 78% by 2026. However, national efforts to scale-up, case-finding, monitoring, drug-susceptibility testing, and implementation of new treatments will be essential for ensuring they are accessible to all eligible patients in the coming years and goals for ending TB are met. There is an urgent need to engage communities in capacity building and demand generation.

Zoonotic spillover and viral mutations from low and middle-income countries: improving prevention strategies and bridging policy gaps.

The increasing frequency of zoonotic spillover events and viral mutations in low and middle-income countries presents a critical global health challenge. Contributing factors encompass cultural practices like bushmeat consumption, wildlife trade for traditional medicine, habitat disruption, and the encroachment of impoverished settlements onto natural habitats. The existing "vaccine gap" in many developing countries exacerbates the situation by allowing unchecked viral replication and the emergence of novel mutant viruses. Despite global health policies addressing the root causes of zoonotic disease emergence, there is a significant absence of concrete prevention-oriented initiatives, posing a potential risk to vulnerable populations. This article is targeted at policymakers, public health professionals, researchers, and global health stakeholders, particularly those engaged in zoonotic disease prevention and control in low and middle-income countries. The article underscores the importance of assessing potential zoonotic diseases at the animal-human interface and comprehending historical factors contributing to spillover events. To bridge policy gaps, comprehensive strategies are proposed that include education, collaborations, specialized task forces, environmental sampling, and the establishment of integrated diagnostic laboratories. These strategies advocate simplicity and unity, breaking down barriers, and placing humanity at the forefront of addressing global health challenges. Such a strategic and mental shift is crucial for constructing a more resilient and equitable world in the face of emerging zoonotic threats.

ESG concepts in business practice Characteristics and assessment of common ESG frameworks

In today’s business environment, incorporating Environmental, Social, and Governance (ESG) principles into corporate strategies has evolved from being a marginal consideration to a core element of strategic planning. In the study, we characterize and assess ten widely recognized ESG frameworks. The selection of these frameworks is grounded in a literature review, complemented by an analysis of professional websites and forums that offer rankings of prevalent frameworks. Additionally, our own expertise in the field is used in this selection process. Our evaluation of ten key ESG frameworks reveals a spectrum of approaches to sustainability and responsibility. GRI and PRI are noted for their global scope, while SASB provides industry-specific insights but with limited scope. CDP and TCFD excel in environmental and climate aspects, respectively. IFRS Standards are developing a global reach, and IIRC focuses on integrating sustainability with financial reporting. PRI and UNGC are based on voluntary commitment, offering broad frameworks. CDSB and IIRC, while focused, encounter implementation challenges. IFC Performance Standards are comprehensive in project finance. Each framework, with its unique strengths and challenges, varies in global recognition, applicability, and stakeholder relevance, contributing differently to sustainable practices. Key words: environmental, social, and governance (ESG); ESG frameworks; ESG standards; sustainability reporting; business strategy

Peanut hulls, an underutilized nutritious culinary ingredient: valorizing food waste for global food, health, and farm economies-a narrative review.

Peanut hulls (PHs) are an edible food waste that is an underutilized food source for human consumption. While edible and palatable, currently they are mainly diverted to livestock feed or building materials. Here, we describe existing literature supporting human food valorization of PHs, and propose methods to optimize recapturing nutrients (protein, fiber, phenols and other phytonutrients) lost by treating PHs as waste. Incorporated into common foods, PHs could be processed into functional ingredients to improve nutrient-density with anticipated corresponding positive health outcomes associated with increases in plant foods. Valorization of PHs addresses multiple priorities of the UN Sustainable Development Goals using a Food Systems Approach (FSA) including reducing food waste, increasing economic opportunities for farmers, and increasing the availability of healthy shelf-stable foodstuffs to address food security. Recent advances in sustainable food processing technologies can be utilized to safely incorporate PHs into human food streams. We propose future applications that could make meaningful impacts for food availability and the nutritional composition of common foods like bread and plant-based meat alternatives. While the limited literature on this topic spans several decades, no commercial operations currently exist to process PHs for human consumption, and most literature on the topic precedes the technological "green revolution." The approaches outlined in this review may help bolster commercialization of this underutilized and nutritious food potentially improving opportunities for multiple global stakeholders.

INNOVATION METRICS FOR THE 21ST CENTURY: AN INNOVATIONOLOGY-BASED COMPREHENSIVE, MULTIDIMENSIONAL FRAMEWORK

Innovation has become a fundamental driver of economic progress, social well-being, and environmental sustainability in the 21st century. As organizations and policymakers grapple with the complexities of fostering and scaling transformative innovations, the need for robust, multidimensional approaches to measuring innovation performance has become increasingly critical. This article presents a comprehensive innovation metrics framework that is grounded in the emerging field of Innovationology, a transdisciplinary science developed by the author for understanding the multilevel, systemic, and contextual nature of innovation processes and outcomes. Drawing on the Innovationology perspective, the proposed framework transcends traditional financial and output-based measures to capture the intangible, organizational, ecosystem, societal, and sustainability-oriented determinants of innovation success. This multidimensional approach empowers global stakeholders to navigate the evolving innovation landscape, make informed decisions, and unlock the transformative potential of innovation for sustainable progress. Moreover, the article critically examines the limitations of conventional national and global innovation indices, such as the Global Innovation Index (GII) and the Bloomberg Innovation Index, which have long been the primary tools for benchmarking and comparing innovation performance across countries. Recognizing the shortcomings of these static, input-output-oriented models, this study proposes alternative frameworks that better capture the multidimensional, contextual, and systemic nature of innovation performance, drawing on the theoretical foundations of Innovationology. By integrating a diverse set of quantitative and qualitative indicators across multiple levels of analysis, this Innovationologybased innovation metrics framework empowers organizations, policymakers, and innovation ecosystem members to foster a more holistic understanding of their innovation capabilities, identify areas for improvement, and align their innovation efforts with the pressing challenges of the 21st century, ultimately contributing to the realization of the United Nations Sustainable Development Goals.

Responsibility of the Radiologists as a Clinician: RCRT Perspective and Short Message of the ESR International Forum 2023, Vienna, Austria

The European Society of Radiology (ESR) internal forum is held in the European Congress of Radiology (ECR) every year and this year, under the theme "Responsibility of the Radiologists as a Clinician", on March 3, 2023. The representatives of twenty-two international societies were invited to present their perspectives and discussions as ESR's global society stakeholders.

An international consensus study to identify "what" outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research.

Development of a standardized set of topic-specific outcomes known as a Core Outcome Set (COS) is important to address issues of heterogeneity in reporting research findings in order to streamline evidence synthesis and clinical decision making. The aim of the current international consensus study is to identify "what" outcomes to include in the Core Outcome Set for Endodontic Treatments (COSET). Outcomes of various endodontic treatments (non-surgical root canal treatment, surgical endodontics, vital pulp treatmentand revitalization procedures) performed on permanent teeth were considered. A standard validated methodology for COS development and reporting was adopted. The process involved identification of existing outcomes through four published scoping reviews. This enabled creation of a list of outcomes to be prioritized via semi-structured patient interviews, e-Delphi processand a consensus meeting with a range of relevant global stakeholders. Outcomes were prioritized using a 1-9 Likert scale, with outcomes rated 7-9 considered critical, 4-6 are important and 1-3 are less important. Outcomes rated 7-9 by ≥70% and 1-3 by <15% of participants were considered to achieve consensus for inclusion in the COS. The outcomes that did not achieve consensus in the first round were considered for further prioritization in the second Delphi round and consensus meeting. Final decisions about the outcomes to include in COSET were made by voting during the consensus panel meeting using the Zoom Poll function. A total of 95 participants including patients contributed to the COS development process. The consensus panel recommended, with strong consensus, eight outcomes shared across all treatment modalities for inclusion in COSET: pain; signs of infection (swelling, sinus tract); further intervention/exacerbation; tenderness to percussion/palpation; radiographic evidence of disease progression/healing; function; tooth survival; and patient satisfaction. Additional treatment specific outcomes were also recommended. Many of the outcomes included in COSET are patient reported. All should be included in future outcomes studies. COSET identified outcomes that are important for patients and clinicians and validated these using a rigorous methodology. Further work is ongoing to determine "how" and "when" these outcomes should be measured.

Impact of State-Owned Capital Participation on ESG Performance of Private Enterprises

As global investors and stakeholders increasingly prioritize environmental, social, and governance (ESG) performance, corporate social responsibility and sustainability have become crucial factors in determining corporate success. In the context of China’s robust economy, the involvement of state-owned capital exerts a profound impact on the ESG performance of private enterprises. This paper, starting from the perspective of ESG, analyzes how state-owned capital participation influences the ESG performance of private enterprises. Additionally, it proposes recommendations for the involvement of state-owned enterprises in private enterprises, aiming to foster the sustainable development of private enterprises and enhance their social responsibility.

Taking the leap toward human-specific nonanimal methodologies: The need for harmonizing global policies for microphysiological systems

With a recent amendment, India joined other countries that have removed the legislative barrier toward the use of human-relevant methods in drug development. Here, global stakeholders weigh in on the urgent need to globally harmonize the guidelines toward the standardization of microphysiological systems. We discuss a possible framework for establishing scientific confidence and regulatory approval of these methods.

CAPTURA Regional Workshop Proceedings (28-30 June 2022, Virtual).

In response to the global threat of antimicrobial resistance (AMR), the Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia (CAPTURA) project worked with microbiology laboratories, pharmacies, and local governments in South Asia and Southeast Asia to expand the volume of historical and current data available on AMR and antimicrobial use and to identify gaps in data and areas for quality improvement. When the CAPTURA project completed its country-level engagement in the first half of 2022, the consortium brought together local, regional, and global AMR stakeholders for a virtual regional workshop to review data outputs from the project and share strategies to inform national and regional efforts to combat AMR. This paper summarizes the main topics presented in the workshop held from 28 to 30 June 2022. As such, it highlights lessons learned from the project and strategies to fight AMR. Although CAPTURA has been invaluable to countries and information from the project is already being used, barriers concerning data quality and sharing remain. Regional-level initiatives should continue to build on the momentum gained from the CAPTURA project in supporting national-level surveillance and data quality improvements to inform critical decisions around planning, policies, and clinical care. Project findings have highlighted that issues with antimicrobial resistance and use are wide ranging across countries. Going forward, building on the current foundations and tailoring approaches to meet local needs and capacities will be fundamental in combatting AMR.

Closing the birth registration gap for Every newborn facility birth: literature review and qualitative research

ABSTRACT Background Birth registration is vital to provide legal identity and access to essential services. Worldwide, approximately 166 million children under five years (just under 25%) are unregistered, yet >80% of all births occur in health facilities in most low- and middle-income countries (LMIC). Objectives This study, conducted in association with UNICEF, aims to review facility-based birth registration initiatives, and provide recommendations to close the gap between facility birth and birth registration rates in LMIC. Methods A literature review covering published and grey literature was conducted to identify facility-based initiatives to increase birth registration rates. Semi-structured in-depth interviews were conducted by audio-call with six key global stakeholders to identify additional initiatives, and further insights for barriers and enablers to close the gap. Results Academic databases and grey literature search yielded 21 studies meeting pre-specified inclusion criteria. Nine barriers preventing birth registration were identified and grouped into three themes: health system, governmental, and societal barriers. Facility-based birth registration initiatives resulted in an increase in birth registration rates. Importantly, health promotion within communities also increased demand for birth registration. In-depth interview respondents provided further detail and supported data found in literature review. Synthesis of the literature and stakeholder interviews noted enablers including inter-sectoral collaboration between health sector and civil registration ministries e.g., placing civil registration offices in health facilities or allowing medical doctors to act as registrars. Conclusion Facility-based birth registration initiatives can increase birth registration rates in LMIC. Initiatives need to address both supply and demand side of birth registration to improve facility-based birth registration rates. A multi-sectoral approach within governments, and alignment with multiple stakeholders is vital.

HTA32 When Should the Conduct of RWE Studies Be Prioritized for Reimbursement: Insights from Canadian and Global Stakeholders

HTA32 When Should the Conduct of RWE Studies Be Prioritized for Reimbursement: Insights from Canadian and Global Stakeholders

Accelerating Pneumococcal Conjugate Vaccine introductions in Indonesia: key learnings from 2017 to 2022

Despite high pneumococcal disease and economic burden in Indonesia and interest to introduce pneumococcal conjugate vaccine (PCV), there were challenges in establishing a comprehensive strategy to accelerate and enable the introduction in country in the early 2010s. Starting in 2017, Clinton Health Access Initiative and partners supported the government of Indonesia with evidence-based decision-making and implementation support for introducing PCV into the routine immunization program. Indonesia has since accelerated PCV roll out, with nationwide reach achieved in 2022. On the path to PCV introduction, several challenges were observed that impacted decision making on whether and on how to optimally roll out PCV, resulting in significant introduction delays; including (1) a complex country context with a devolved government structure, fragmented domestic funding streams, and an imminent transition out of major immunization donor (Gavi) support; (2) strong preference to use domestically sourced products, with limited experience accessing global pooled procurement mechanism including for vaccines; and (3) concerns around programmatic feasibility and sustainability. This case study documents key insights into the challenges experienced and how those were systematically addressed to accelerate new vaccine introduction in Indonesia, with support from local and global stakeholders over time. The learnings would be beneficial for other countries yet to introduce critical new vaccines, in particular those with similar archetype as Indonesia e.g., middle-income countries with domestic manufacturing capacity and/or countries recently transitioning out of Gavi support.

The Journey of Data Within a Global Data Sharing Initiative: A Federated 3-Layer Data Analysis Pipeline to Scale Up Multiple Sclerosis Research.

Investigating low-prevalence diseases such as multiple sclerosis is challenging because of the rather small number of individuals affected by this disease and the scattering of real-world data across numerous data sources. These obstacles impair data integration, standardization, and analysis, which negatively impact the generation of significant meaningful clinical evidence. This study aims to present a comprehensive, research question-agnostic, multistakeholder-driven end-to-end data analysis pipeline that accommodates 3 prevalent data-sharing streams: individual data sharing, core data set sharing, and federated model sharing. A demand-driven methodology is employed for standardization, followed by 3 streams of data acquisition, a data quality enhancement process, a data integration procedure, and a concluding analysis stage to fulfill real-world data-sharing requirements. This pipeline's effectiveness was demonstrated through its successful implementation in the COVID-19 and multiple sclerosis global data sharing initiative. The global data sharing initiative yielded multiple scientific publications and provided extensive worldwide guidance for the community with multiple sclerosis. The pipeline facilitated gathering pertinent data from various sources, accommodating distinct sharing streams and assimilating them into a unified data set for subsequent statistical analysis or secure data examination. This pipeline contributed to the assembly of the largest data set of people with multiple sclerosis infected with COVID-19. The proposed data analysis pipeline exemplifies the potential of global stakeholder collaboration and underlines the significance of evidence-based decision-making. It serves as a paradigm for how data sharing initiatives can propel advancements in health care, emphasizing its adaptability and capacity to address diverse research inquiries.

The Effectiveness of National Government Regulation of Large Companies

&#x0D; This study investigates the dynamic interplay between transnational corporations (TNCs) and their regulatory landscape. TNCs, as major players in the global economy, significantly influence both economic growth and the trajectory of domestic firms in less developed countries. However, this influence isn't always positive. The central theme of this paper is the challenges and complexities national governments face in regulating these corporate giants. Given the backdrop of neoliberalism and globalisation, the regulatory environment is ever-evolving and demands intricate analyses. Key to this is the development of robust governance frameworks which are imperative for striking a harmonious balance among the interests of TNCs, nation-states, and wider global stakeholders. An exemplary case is dissected to provide tangible insights into the discussed phenomena. The paper wraps up with insightful observations that shed light on potential future directions.

Turning the promise of multipurpose prevention technologies into a market reality: a commentary.

The promise of multipurpose prevention technologies (MPTs) for the prevention of HIV and unintended pregnancy are on the horizon. While many are still in clinical development, others are closer to becoming a realistic, accessible option for users, like the dual prevention pill (DPP). Researchers, governments, donors, and implementers will have to collaboratively address systemic challenges to successfully introduce and scale-up MPTs. To ensure the rollout of MPTs is successful, the global community should address user and country-specific needs, coordinate with advocates and policymakers, and set a realistic plan for product introduction and scale-up that considers the needs of both family planning (FP) and HIV programs, while laying the groundwork for future new product introduction. To achieve these aims, global and regional stakeholder coordination should emphasize country-led, person-centered decision-making while addressing: (1) procurement and supply chain barriers; (2) the potential burden on health systems; and (3) the impact on current programs.

A blockchain-based approach to the challenges of EU’s environmental policy compliance in aquaculture: From traceability to fraud prevention

In light of the current global scenario, regulatory requirements, and stakeholder expectations for the aquaculture supply chain are more demanding than ever. The latest EU strategies for aquaculture aim to ensure its economic, environmental, and social long-term sustainability through green, technological, and social transformations. This objective is as ambitious as it is complex, involving not only the enhancement of key sustainability aspects but also the assurance of transparency, trust, and security standards across the entire supply chain. In this context, the present paper proposes a novel blockchain framework, along with the strategic implementation of smart contracts, specifically designed to effectively address the prevalent environmental challenges within the aquaculture supply chain.