Health Security Research Articles

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...

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.

Investing in health preparedness, response and resilience: a genomics costing tool focused on next generation sequencing

The world has seen unprecedented gains in the global genomic surveillance capacities for pathogens with pandemic and epidemic potential within the last 4 years. To strengthen and sustain the gains made, WHO is working with countries and partners to implement the Global Genomic Surveillance Strategy for Pathogens with Pandemic and Epidemic Potential 2022–2032. A key technical product developed through these multi-agency collaborative efforts is a genomics costing tool (GCT), as sought by many countries. This tool was developed by five institutions – Association of Public Health Laboratories, FIND, The Global Fund to Fight AIDS, Tuberculosis and Malaria, UK Health Security Agency, and the World Health Organization. These institutions developed the GCT to support financial planning and budgeting for SARS-CoV-2 next-generation sequencing activities, including bioinformatic analysis. The tool costs infrastructure, consumables and reagents, human resources, facility and quality management. It is being used by countries to (1) obtain costs of routine sequencing and bioinformatics activities, (2) optimize available resources, and (3) build an investment case for the scale-up or establishment of sequencing and bioinformatics activities. The tool has been validated and is available in English and Russian at https://www.who.int/publications/i/item/9789240090866. This paper aims to highlight the rationale for developing the tool, describe the process of the collaborative effort in developing the tool, and describe the utility of the tool to countries.

Evaluation of a Multisectoral Health Security Alliance Program Through Perceptions of Member States: African Partnership Outbreak Response Alliance (APORA).

U.S. DoD global health engagements offer opportunities for strategic engagement and building capability in collaboration with foreign military and civilian counterparts. Global health engagement activities can take the form of health security alliances and allow the USA and its allies and partners to prepare for, mitigate, and respond to emerging biothreats and other harmful health events that may negatively impact national security. One such example is the African Partnership Outbreak Response Alliance (APORA), which was designed to expand African Partner Nation militaries' infectious disease outbreak response capabilities. This publication evaluates the development, implementation, and outcomes of APORA to better understand the program's effectiveness in developing Partner Nation medical capabilities and the efficacy of health security alliances more broadly. Key informant interviews, focus groups, and questionnaires were used to collect responses from a sample of participants who attended an in-person APORA event in May 2022. The research team conducted thematic analysis of all responses to identify common themes and sub-themes in participants' perspectives and to elucidate findings and recommendations for future endeavors. The analysis determined that participants attended the APORA event primarily to disseminate and apply knowledge, skills, and abilities gained at the event to their own health system structures. Overall, participants indicated that APORA contributed to their countries' military medical and civilian cooperation, as well as their countries' military medical capabilities. Longer-term partners (i.e., 4+ years of APORA membership) agreed more strongly with these sentiments; newer partners (i.e., 1-3 years of APORA membership) were more likely to be neutral or agree to some extent. Participants also valued the opportunity to solidify global, regional, local, and peer partnerships and considered the ability to create partnerships of great importance to their countries' national health security. Language barriers were often listed as a hindrance to event participation and the overall integration of a regional health system response. Participants also cited resource scarcity, network erosion (particularly because of the coronavirus disease 2019 pandemic), and a lack of disseminating and communicating value-add in how APORA could/is providing to their member countries' health systems as key barriers. As a whole, these findings support APORA's objectives to develop and leverage partnerships to support medical capacity building, promote collaboration between military and civilian sectors, and increase access to opportunities and financial resources. Further evaluation is required to capture additional civilian perspectives while continuing to expand upon military perspectives in order to produce more generalizable findings. That said, this study enables key stakeholders to understand how to strengthen and expand future alliances to improve both health and security outcomes.

Flash heating process for efficient meat preservation

Maintaining food safety and quality is critical for public health and food security. Conventional food preservation methods, such as pasteurization and dehydration, often change the overall organoleptic quality of the food products. Herein, we demonstrate a method that affects only a thin surface layer of the food, using beef as a model. In this method, Joule heating is generated by applying high electric power to a carbon substrate in <1 s, which causes a transient increase of the substrate temperature to > ~2000 K. The beef surface in direct contact with the heating substrate is subjected to ultra-high temperature flash heating, leading to the formation of a microbe-inactivated, dehydrated layer of ~100 µm in thickness. Aerobic mesophilic bacteria, Enterobacteriaceae, yeast and mold on the treated samples are inactivated to a level below the detection limit and remained low during room temperature storage of 5 days. Meanwhile, the product quality, including visual appearance, texture, and nutrient level of the beef, remains mostly unchanged. In contrast, microorganisms grow rapidly on the untreated control samples, along with a rapid deterioration of the meat quality. This method might serve as a promising preservation technology for securing food safety and quality.

Food insecurity and its relationship to mental health and oral health in older adults.

Poor oral health disproportionately affects low-income older adults, for whom food insecurity and poor mental health may affect dental health. We explored the associations between food insecurity, mental health, and dental health. Furthermore, we examined whether mental health impacted the associations between food insecurity and dental health. We conducted a cross-sectional study with a convenience sample of 226 older adults (aged 50+), employing survey and dental screening data. Participants were recruited from seven community-based organisations in Washington State, USA. We calculated descriptive statistics and conducted Chi-square tests, t tests, and logistic regression analyses to assess the associations between aspects of dental health (untreated decay, gum disease, and unmet dental needs), mental health (depression and cognitive function), and food insecurity. In our sample, food insecurity was observed in 28.4%, 40.6% had untreated decay, 31.6% gum disease, and 42.5% unmet dental needs. Food insecurity was associated with a higher occurrence of untreated decay and unmet dental needs. Participants experiencing food insecurity had higher odds of gum disease (aOR = 2.3; 95% CI: 1.1, 5.2) and unmet dental needs (aOR = 3.2; 95% CI:1.4, 7.6). Greater gum disease due to food insecurity was observed among individuals with lower levels of cognitive impairment. Food insecurity is associated with poorer oral health among older adults and cognitive function may modify this relationship. These findings underscore the importance of addressing both food insecurity and cognitive impairment as integral components of efforts to improve the oral health of older adults.

Barriers to Enrollment of National Health Insurance Scheme in Uttargaya Rural Municipality, Rasuwa

The Social Health Security Program (SHSP) is a social protection program of the Government of Nepal that aims to enable all citizens to access quality and effective healthcare services without any financial burden. A cross-sectional household-based and quantitative in-nature study was conducted in Rasuwa district. This study's population was residents of Uttargaya rural municipality wards no 4 and 5. How different factors are related to SHI enrolment. Ethnicity (p=&lt;0.001), religion (p=&lt;0.001), IWI grade (p=0.010), know about health insurance (p=&lt;0.001), the behavior of service providers (p=&lt;0.001), neighbors enrollment (p=&lt;0.001), discussed SHI with neighbors (p=0.001), and family members agreed to enroll (p=0.002) were significantly associated with enrollment in SHI whereas others factors did not show any significant association with enrollment in social health insurance. This study found that enrollment was significantly associated with different independent variables. Poor knowledge of SHI, unfriendly behaviors of service providers, lack of trust, and unaffordability of premium costs were identified as barriers. Furthermore, Inappropriate timing of premium collection, limited services point, feeling that enrollment was not necessary, long queue, inadequate number of enrollment assistant and mandatory refer card were also reasons for not enrolling in SHI.

Social Determinants of Health and College Food Insecurity.

In recent years, many students have faced economic hardship and experienced food insecurity, even as universities strive to create more equitable pathways to college. There is a need for a more holistic perspective that addresses the complexity of food insecurity amongst college students. To this end, we examined the relationship between the social determinants of health, including college food insecurity (CoFI) and childhood food insecurity (ChFI), and their relationship with well-being measures. The study sample was a convenience sample that included 372 students at a public university who responded to an online survey in fall 2021. Students were asked to report their food security status in the previous 30 days. We used the following analytical strategies: chi-square tests to determine differences between food secure (FS) and food insecure (FI) students; binary logistic regression of CoFI on student demographics and ChFI; and ordinal or binary logistic regression for well-being measures. Black students, off-campus students, first-generation students, in-state students, and humanities/behavioral/social/health sciences majors were more likely to report CoFI. FI students were more likely to have experienced ChFI and to have lower scores on all well-being measures. ChFI was associated with four well-being measures and its effects were mediated by CoFI. College student health initiatives would benefit from accounting for SDOH, including ChFI experiences and its subsequent cumulative disadvantages experienced during college.

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.

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.

Medical Report Management and Distribution System on Blockchain

The security and effective management of health records is a key issue for today's digitized healthcare environment. In terms of data security, integrity and accessibility, traditional centralized systems face challenges. We propose a novel system of medical report management and dissemination using the Block-chain technology, as well as SHA1 encryption for addressing these issues. In order to store hashed medical reports, our system uses a decentralized block-chain network to ensure tamper-proof and immutable records. SHA1 is used to hash every medical report, generating a unique identifier that's stored on the Block-chain. The integration of Flask, Python's lightweight web framework, facilitates the creation of an easy user interface to interact with a system easily. Secure storage, effective distribution and granular control of medical reports are among the key features of our system. In order to maintain the integrity and confidentiality of data, patients, physicians or authorized persons should be able to use secure means for accessing and updating their healthcare records. The use of SHA1 increases system security by providing a reliable cryptographic hash. Our system is aimed at simplifying the management and distribution of medical reports, thereby improving efficiency and patient outcomes in addition to enhanced data protection and integrity. By ensuring security, transparency and decentralized solutions, we are confident that the proposal for a medical records management system has the potential to revolutionize this area.

Estimation of redox-sensitive metals in Lafarge cement company’s area in Akamkpa Nigeria: Assessment of ecological health risk

Toxic compounds such as redox-sensitive metals usually contaminate the soil. They are implicated in the causation of oxidative stress, a precursor of human diseases and ecological extinction. Having uncontaminated soil serves as the link between plant and animal health quality, and a sustainable ecosystem. Geological accumulation and spatial distribution of redox-sensitive metals in agricultural land can significantly hinder soil fertility, ecological health, food safety, and food security. This study used the soil samples from farmlands near the Lafarge industrial area at Mfamosing, Akamkpa local government area of Cross River State, Nigeria, to assess eight redox-sensitive metals (Cadmium, Chromium, Copper, Nickel, Lead, Arsenic, Cobalt, and Zinc), their spatial distribution, and geo-accumulation. The redox-sensitive metals were screened with an atomic absorption spectrophotometer connected with mass spectroscopy. A geographic information system (GIS) and ArcMap version 10:8:2 was used to infer the risk of the industrial area regarding geo-accumulation, and spatial distribution of redox-sensitive metals in the farmlands. The result shows Cd, Cr, Cu, Ni, Pb, As, Co and Zn have different concentrations among the samples. Three samples - MS2, MS3, and MS8, had the highest arsenic concentration, while samples Ms1, Ms2, Ms5, and Ms8, had the second-highest concentrations of Cadmium, Lead, and Chromium, respectively. The polluted area was moderately contaminated and distributed with other metals - Cu, Ni, and Co, respectively. Comparing these results with those of non-industrial areas, one can infer that the Lafarge industrial area is more contaminated with redox-sensitive metal. To advance this investigation, some microorganisms within the area can be used to verify a metal-hazard impact on the ecosystem and monitor the rise in redox-sensitive metals to predict the risk.

Enantioselective biomarkers of maize toxicity induced by hexabromocyclododecane based on submicroscopic structure, gene expression and molecular docking

Hexabromocyclododecane (HBCD), as a monitored chemical of the Chemical Weapons Convention, the Stockholm Convention and the Action Plan for New Pollutants Treatment in China, raises significant concerns on its impact of human health and food security. This study investigated enantiomer-specific biomarkers of HBCD in maize (Zea mays L.). Upon exposure to HBCD enantiomers, the maize root tip cell wall exhibited thinning, uneven cell gaps, and increased deposition on the cell outer wall. Elevated malondialdehyde (MDA) indicated lipid peroxidation, with higher mitochondrial membrane potential (MMP) inhibition in (+)-enantiomer treatments (47.2%–57.9%) than (−)-enantiomers (14.4%–37.4%). The cell death rate significantly increased by 37.7%–108.8% in roots and 16.4%–62.4% in shoots, accompanied by the upregulation of superoxide dismutase isoforms genes. Molecular docking presenting interactions between HBCD and target proteins, suggested that HBCD has an affinity for antioxidant enzyme receptors with higher binding energy for (+)-enantiomers, further confirming their stronger toxic effects. All indicators revealed that oxidative damage to maize seedlings was more severe after treatment with (+)-enantiomers compared to (−)-enantiomers. This study elucidates the biomarkers of phytotoxicity evolution induced by HBCD enantiomers, providing valuable insights for the formulation of more effective policies to safeguard environmental safety and human health in the future.

A Review of Bioactive Compound Effects from Primary Legume Protein Sources in Human and Animal Health

The global demand for sustainable and nutritious food sources has catalyzed interest in legumes, known for their rich repertoire of health-promoting compounds. This review delves into the diverse array of bioactive peptides, protein subunits, isoflavones, antinutritional factors, and saponins found in the primary legume protein sources—soybeans, peas, chickpeas, and mung beans. The current state of research on these compounds is critically evaluated, with an emphasis on the potential health benefits, ranging from antioxidant and anticancer properties to the management of chronic diseases such as diabetes and hypertension. The extensively studied soybean is highlighted and the relatively unexplored potential of other legumes is also included, pointing to a significant, underutilized resource for developing health-enhancing foods. The review advocates for future interdisciplinary research to further unravel the mechanisms of action of these bioactive compounds and to explore their synergistic effects. The ultimate goal is to leverage the full spectrum of benefits offered by legumes, not only to advance human health but also to contribute to the sustainability of food systems. By providing a comprehensive overview of the nutraceutical potential of legumes, this manuscript sets a foundation for future investigations aimed at optimizing the use of legumes in the global pursuit of health and nutritional security.

Evolving Adult ADHD Care: Preparatory Evaluation of a Prototype Digital Service Model Innovation for ADHD Care

Background: Given the prevalence of ADHD and the gaps in ADHD care in Australia, this study investigates the critical barriers and driving forces for innovation. It does so by conducting a preparatory evaluation of an ADHD prototype digital service innovation designed to help streamline ADHD care and empower individual self-management. Methods: Semi-structured interviews with ADHD care consumers/participants and practitioners explored their experiences and provided feedback on a mobile self-monitoring app and related service innovations. Interview transcripts were double coded to explore thematic barriers and the enablers for better ADHD care. Results: Fifteen interviews (9 consumers, 6 practitioners) revealed barriers to better ADHD care for consumers (ignorance and prejudice, trust, impatience) and for practitioners (complexity, sustainability). Enablers for consumers included validation/empowerment, privacy, and security frameworks, tailoring, and access. Practitioners highlighted the value of transparency, privacy and security frameworks, streamlined content, connected care between services, and the tailoring of broader metrics. Conclusions: A consumer-centred approach to digital health service innovation, featuring streamlined, private, and secure solutions with enhanced mobile tools proves instrumental in bridging gaps in ADHD care in Australia. These innovations should help to address the gaps in ADHD care in Australia. These innovations should encompass integrated care, targeted treatment outcome data, and additional lifestyle support, whilst recognising the tensions between customised functionalities and streamlined displays.

The Perspectives of Healthcare Professionals on the Strategies, Challenges, and Community Responses to Health System Response and Interventions Towards Lassa Fever Infections and Mortality in Sierra Leone.

Lassa fever is a critical public health issue in Sierra Leone that demands appropriate health system responses and interventions to mitigate infections and reduce mortality. A qualitative study was conducted to delve into healthcare workers' experiences with Lassa fever management and interventions across diverse healthcare settings in Sierra Leone, including the Eastern Province and Freetown's Directorate of Health Security and Emergency (DHSE). Engaging ten key informants through purposive sampling, the study employed NVivo version 10 for a detailed thematic analysis using Query and Coding to systematically identify, classify, and organize key themes regarding knowledge, diagnostics, management roles, and community impact. The findings indicate a well-informed healthcare workforce but highlight gaps in early detection, diagnostic accuracy, and procedural standardization. Concerns were raised about the potential overestimation of disease incidence due to improved diagnostics, suggesting a historical under-detection of Lassa fever. The analysis underscores the need for a multifaceted management approach, emphasizing international collaboration and culturally sensitive community engagement to effectively tackle the disease. A significant concern identified is the high mortality rate resulting from delayed referrals and communication challenges within the health system, leading to actionable recommendations for enhancing Lassa fever response strategies. The study's thematic analysis provides a nuanced understanding of the challenges and areas for improvement, emphasizing the critical role of healthcare professionals in combating Lassa fever. Combating Lassa fever in Sierra Leone demands an integrative strategy that extends beyond medical interventions to encompass educational and infrastructural enhancements. This research pays homage to the commitment of healthcare professionals, underscoring the importance of sustained support and recognition of their essential contributions to advancing Lassa fever management and interventions.

SARS-CoV-2 prevalence in wildlife 2020–2022: a worldwide systematic review and meta-analysis

The widespread transmission of SARS-CoV-2 in humans poses a serious threat to public health security, and a growing number of studies have discovered that SARS-CoV-2 infection in wildlife and mutate over time. This article mainly reports the first systematic review and meta-analysis of the prevalence of SARS-CoV-2 in wildlife. The pooled prevalence of the 29 included articles was calculated by us using a random effects model (22.9%) with a high heterogeneity (I2 =98.7%, p=0.00). Subgroup analysis and univariate regression analysis found potential risk factors contributing to heterogeneity were country, wildlife species, sample type, longitude, and precipitation. In addition, the prevalence of SARS-CoV-2 in wildlife increased gradually over time. Consequently, it is necessary to comprehensively analyze the risk factors of SARS-CoV-2 infection in wildlife and develop effective control policies, as well as to monitor the mutation of SARS-CoV-2 in wildlife at all times to reduce the risk of SARS-CoV-2 transmission among different species.

Innovations in public health surveillance: An overview of novel use of data and analytic methods.

Innovative data sources and methods for public health surveillance (PHS) have evolved rapidly over the past 10 years, suggesting the need for a closer look at the scientific maturity, feasibility, and utility of use in real-world situations. This article provides an overview of recent innovations in PHS, including data from social media, internet search engines, the Internet of Things (IoT), wastewater surveillance, participatory surveillance, artificial intelligence (AI), and nowcasting. Examples identified suggest that novel data sources and analytic methods have the potential to strengthen PHS by improving disease estimates, promoting early warning for disease outbreaks, and generating additional and/or more timely information for public health action. For example, wastewater surveillance has re-emerged as a practical tool for early detection of the coronavirus disease 2019 (COVID-19) and other pathogens, and AI is increasingly used to process large amounts of digital data. Challenges to implementing novel methods include lack of scientific maturity, limited examples of implementation in real-world public health settings, privacy and security risks, and health equity implications. Improving data governance, developing clear policies for the use of AI technologies, and public health workforce development are important next steps towards advancing the use of innovation in PHS.

마약류 치료기술 국내 도입 우선순위

Objectives: To determine Korean national priority for research and development planning for drug abuse and substance use disorder treatment. Methods: A Delphi survey methodology was employed, involving 19 experts in the field of addiction. Their potential priorities were assessed based on the size of the problem, urgency, effectiveness, budget size, and feasibility of research execution. Results: After three rounds, the expert consensus was reached for 13 research plans of universal therapeutic agenda and 7 plans for specific drugs. These included developing guidelines for children and adolescents on substance use, a community-based long-term management program, and the development of intervention programs and clinical guidelines for stimulant, cannabis, and opioid use disorders. However, consensus was not reached for research on therapeutic options such as digital therapeutics. Conclusion: This study highlights priority areas for systematic and effective development of treatment programs and research agenda against illicit use of drugs. By integrating insights from multidisciplinary experts, a comprehensive research and development blueprint is proposed to address drug use, which is on the rise and threatening public health and social security in the Republic of Korea.

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.