Transnational Health Research Articles

Persistent Global Health Threats: The Impact of Infectious Diseases in Resource-Limited Regions

Abstract Topic: Global Health Introduction: Global health focuses on improving global health equity, involving interdisciplinary collaboration, addressing transnational health issues, and combining population-based prevention with individual-level clinical care. Problem Statement: Infectious diseases like HIV/AIDS, malaria, tuberculosis, and emerging illnesses such as COVID-19 persist as substantial risks to global health, especially in regions with limited healthcare resources where infrastructure may be lacking. Overview: In an increasingly interconnected world, global health stands as a paramount concern, striving to improve health outcomes and realize health equity for all individuals worldwide. This multifaceted endeavor necessitates a comprehensive strategy, integrating efforts to tackle transnational health issues, their determinants, and potential solutions through collaborative interdisciplinary approaches. Key facets of this approach include robust initiatives in disease prevention and control, ensuring universal access to healthcare services and essential medicines, particularly in underserved regions, and addressing the intricate web of social determinants that shape health outcomes, including poverty, education, and access to basic amenities like clean water and sanitation. Effective governance structures are Central to advancing global health, exemplified by institutions such as the World Health Organization, which play pivotal roles in orchestrating coordinated action and setting strategic priorities. Collaboration among diverse stakeholders, including governments, international organizations, non-governmental organizations, and civil society, forms the bedrock of successful global health initiatives. Technology Stack: The integration of technology emerges as a crucial factor in advancing global health. Technological innovations facilitate the dissemination of healthcare information, enable telemedicine services to reach remote populations, and enhance disease surveillance and monitoring capabilities. Technology plays a transformative role in improving healthcare delivery and outcomes worldwide, from mobile health applications to advanced diagnostic tools. Moreover, sustained investment in research and innovation is imperative, driving progress by deepening our understanding of diseases and fostering the development of innovative treatments and technologies. Equally critical is the prioritization of preparedness for health emergencies, characterized by the strengthening of surveillance systems, rapid response capabilities, and the fostering of international cooperation. Conclusion: The persistence of infectious diseases like HIV/AIDS, malaria, tuberculosis, and emerging illnesses such as COVID-19 underscores the ongoing threat to global health, particularly in regions with limited healthcare resources and inadequate infrastructure. Addressing these challenges requires concerted efforts to strengthen healthcare systems, enhance disease surveillance and prevention measures, and improve access to essential healthcare services worldwide. Only through collaborative and proactive approaches we can effectively mitigate the impact of infectious diseases and safeguard the health and well-being of populations across the globe.

The transnational mental health burden of Haiti's alleged collapse: preliminary findings from The Haitian Well-Being Study.

Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women. Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States. Discussions revolved around the definition of mental health, stressors, coping mechanisms, risk and protective factors, and barriers to mental health care. Six principal themes emerged: 1- Chronic Traumatic Stress: continued violence, political instability, unemployment, lack of social support, adverse childhood experiences, family separation, and forced displacement were significant sources of stress. 2- Increased Health Burden: Participants reported experiencing chronic physical and psychological symptoms [i.e., hypertension, anxiety, depression, sleep issues, substance abuse, suicidal ideations, characteristics of post-traumatic stress disorder (PTSD)], which were attributed to Haiti's social, political, and infrastructure collapse. 3- Risk Factors: limited access to mental health services, pervasive hopelessness, scarcity of opportunities, and stigma were identified as significant risks. 4- Future Uncertainty: widespread concerns regarding the future predominated. 5- Multigenerational Concerns: Significant anxiety concerning the mental health and development of children, as well as the functionality of mental health practitioners, was noted. 6- Coping and Protective Factors: Effective coping strategies include mental stimulation, peer support, managing digital consumption, engaging in leisurely activities, such as listening to music, and faith/spirituality. The study's findings underscore the sociopolitical and economic crisis in Haiti, which has resulted in violence and a dismantle of political, educational, financial, and health infrastructures. These factors were identified as the primary source of chronic distress, contributing to widespread mental health issues, adverse physical symptoms, and disruption in daily life. The implications for practice, healing, research & policy are discussed.

Medical Returnees: Somali Canadians Seeking Psychosocial and Spiritual Care in East Africa.

The refugee experience has been associated with increased rates of psychosocial challenges. At the same time, evidence suggests that those who resettled in Western countries including Canada underutilize the formal mental health services in these countries. The low uptake has been attributed to barriers such as language, complexity of the health systems, and differing explanatory models of illness. The same is true for Somali refugees in the West. Studies suggest that Somali refugees prefer spiritual healing for psychosocial illness and that some return to East Africa for such healing. However, little is known about Somali Canadian's experiences with the Canadian mental health services and transnational health seeking. The study aimed to understand psychosocial challenges faced by Somali Canadians, their health seeking behaviors, and service utilization. Because some sought psychosocial services outside the country, fieldwork was conducted in Kenya to provide new evidence on transnational healing services. Ethnographic fieldwork and in-depth interviews were utilized. Thirty-seven interviews of about an hour each were undertaken. Fieldwork in Nairobi focused on spiritual healing centers and medical clinic. The findings reveal important findings regarding psychosocial challenges experienced by participants. It discusses psychosocial illnesses as variedly experienced, challenges with accessing Canadian healthcare services, and seeking culturally appropriate services in East Africa. The study highlights participants and their families struggle with psychosocial distress, the challenges of accessing culturally appropriate services within Canada, the role of spiritual healers and the existence of transnational health seeking practices.

The Transnational Mental Health Burden of Haiti's Alleged Collapse: Preliminary Findings from the Haitian Well-Being Study.

Transnational drug trafficking, political unrest, gang violence, and paramilitarism, which are pervasive in Haiti, have resulted in a mental health crisis for the broader Haitian community. This study explores the mental well-being of Haitians in Haiti and the United States by identifying barriers and facilitators to mental health through the lived experiences of men and women. Four Focus group discussions conducted in April and November 2023 engaged 28 participants (20 women and eight men) aged between 23 and 60 years from locations in Haiti (Port-au-Prince, Cite Soleil, Cayes, Cap-Haitien, Saint-Marc) and the United States. Discussions revolved around the definition of mental health, stressors, coping mechanisms, risk and protective factors, and barriers to mental health care. Six principal themes emerged: 1- Chronic Traumatic Stress: continued violence, political instability, unemployment, lack of social support, adverse childhood experiences, family separation, and forced displacement were significant sources of stress. 2- Increased Health Burden: Participants reported experiencing chronic physical and psychological symptoms (i.e., hypertension, anxiety, depression, sleep issues, substance abuse, suicidal ideations, characteristics of post-traumatic stress disorder [PTSD]), which were attributed to Haiti's social, political, and infrastructure collapse. 3- Risk Factors: limited access to mental health services, pervasive hopelessness, scarcity of opportunities, and stigma were identified as significant risks. 4- Future Uncertainty: widespread concerns regarding the future predominated. 5- Multigenerational Concerns: Significant anxiety concerning the mental health and development of children, as well as the functionality of mental health practitioners, was noted. 6- Coping and Protective Factors: Effective coping strategies include mental stimulation, peer support, managing digital consumption, engaging in leisurely activities, such as listening to music, and faith/spirituality. The study's findings underscore the sociopolitical and economic crisis in Haiti, which has resulted in violence and a collapse of political, educational, financial, and health infrastructures. These factors were identified as the primary source of chronic distress, contributing to widespread mental health issues, adverse physical symptoms, and disruption in daily life. The implications for practice, healing, research & policy are discussed.

Transnational Health and Self-care Experiences of Japanese Women who have taken Oral Contraceptives in South Korea, including Over-the-counter Access: Insights from Semi-structured Interviews

In an increasingly globalized world, the accessibility of healthcare and medication has expanded beyond local healthcare systems and national borders. This study aims to investigate the transnational health and self-care experiences of 11 Japanese women who have resided in South Korea for a minimum of six months and have utilized oral contraceptives, including those that were acquired over-the-counter (OTC). Data were gathered through semi-structured interviews and analyzed by utilizing the NVivo software. The analysis yielded three significant thematic categories, namely (1) experiences and perceptions of obtaining and utilizing contraceptive pills, including OTC access; (2) individual and social perceptions of pills and their accessibility in Japan, insights from actual users; and (3) enhancing pill accessibility, transnational health and self-care experiences and perspectives. Participants acknowledged that oral contraceptives are a global product and experienced communication challenges with healthcare providers as a result of differing understandings of these medications. Additionally, this study identified transnational strategies, such as purchasing an adequate supply of pills just before departure and seeking pills from local families or acquaintances. This study not only highlights the implications of clinical care for transnational patients but also underscores their critical global perspectives on access to oral contraceptives. Furthermore, it proposes two models for improving accessibility within the Japanese healthcare system, even in prescription-only contexts, by introducing OTC options.

Transnational inequities in cardiovascular diseases from 1990 to 2019: exploration based on the global burden of disease study 2019.

To describe the burden and examine transnational inequities in overall cardiovascular disease (CVD) and ten specific CVDs across different levels of societal development. Estimates of disability-adjusted life-years (DALYs) for each disease and their 95% uncertainty intervals (UI) were extracted from the Global Burden of Diseases (GBD). Inequalities in the distribution of CVD burdens were quantified using two standard metrics recommended absolute and relative inequalities by the World Health Organization (WHO), including the Slope Index of Inequality (SII) and the relative concentration Index. Between 1990 and 2019, for overall CVD, the Slope Index of Inequality changed from 3760.40 (95% CI: 3758.26 to 3756.53) in 1990 to 3400.38 (95% CI: 3398.64 to 3402.13) in 2019. For ischemic heart disease, it shifted from 2833.18 (95% CI: 2831.67 to 2834.69) in 1990 to 1560.28 (95% CI: 1559.07 to 1561.48) in 2019. Regarding hypertensive heart disease, the figures changed from-82.07 (95% CI: -82.56 to-81.59) in 1990 to 108.99 (95% CI: 108.57 to 109.40) in 2019. Regarding cardiomyopathy and myocarditis, the data evolved from 273.05 (95% CI: 272.62 to 273.47) in 1990 to 250.76 (95% CI: 250.42 to 251.09) in 2019. Concerning aortic aneurysm, the index transitioned from 104.91 (95% CI: 104.65 to 105.17) in 1990 to 91.14 (95% CI: 90.94 to 91.35) in 2019. Pertaining to endocarditis, the figures shifted from-4.50 (95% CI: -4.64 to-4.36) in 1990 to 16.00 (95% CI: 15.88 to 16.12) in 2019. As for rheumatic heart disease, the data transitioned from-345.95 (95% CI: -346.47 to-345.42) in 1990 to-204.34 (95% CI: -204.67 to-204.01) in 2019. Moreover, the relative concentration Index for overall CVD and each specific type also varied from 1990 to 2019. There's significant heterogeneity in transnational health inequality for ten specific CVDs. Countries with higher levels of societal development may bear a relatively higher CVD burden except for rheumatic heart disease, with the extent of inequality changing over time.

European policies for public health in border regions: no European mindset as yet

BackgroundThe sudden emergence of COVID-19 in 2020 demonstrated that Europe was not prepared for a public health crisis like this pandemic. In the European Union, matters of health have remained primarily under the jurisdiction of individual Member States. However, certain events, such as the Kohll-Decker ruling on free mobility of health services and the COVID-19 pandemic, compelled the EU to address health matters in border regions. This study examines how EU policies address public health in border regions. To that end, we have drawn from border studies, a field that provides insight into the fluidity and complexity of borders in everyday life. Besides that we used constructivist policy studies as a lens for the analysis of EU policy documents.MethodsA policy discourse analysis was conducted to explore how European policy addresses the development of a transnational, European public health in border regions. Key European policy documents published between 2002 and 2027 were analysed to understand how policies are constructed and problems are framed. The analysis was guided by research questions and the theoretical approach.ResultsThe analysis reveals that, while having limited competences in the field of health care, the EU is slowly developing a rationale and a knowledge base to increase its competences in health care. It also shows that in the field of public health, the EU argues for addressing health determinants and promoting healthy lifestyles, though it does not address health promotion in border regions. The EU’s authority in public health in border regions revolves primarily around addressing physical, biological and chemical threats rather than social health problems.ConclusionThough the EU has carefully developed a transnational perspective on health care, the EU has not developed any authority with respect to transnational public health. Though public health and health promotion in border regions have been confronted with specific challenges, neither specific Member States nor the EU have a transnational collaborative perspective that does justice to the characteristics of border regions. When it comes to public health in border regions, there is no European mindset as yet.

Diffusion of global health norms through a national medical professional movement in the universal healthcare of Thailand.

Commonly, research investigations on social policy reform primarily examine the national processes at the core of policy formation rather than considering their global context. Concerns are raised regarding the diffusion and influence of global health norms on Thai universal health coverage policymaking. The findings demonstrate that global health ideas and actors have an impact on national policymaking and that they can share ideas in a variety of ways, including glocalization, vernacularization, policy learning, and policy entrepreneur intervention, in setting the agenda for national universal health coverage. Global and universal health coverage (UHC) concepts have existed for decades; success would not be possible without the efforts of policy entrepreneurs such as the Rural Doctor Movement, who localize and vernacularize global concepts for implementation. These concepts must be compatible with the national and local sociopolitical contexts in which they exist. The Thai case contributed to a better understanding of the influences of global ideas and actors on transnational health policy transfer, as well as the intervention of the national medical professional movement as policy entrepreneurs in healthcare policymaking and policy change for equity in health.

Adopting a WHO Framework Convention on Tobacco Control-Based Tobacco Control Law in Ethiopia: Sustained Transnational Health Advocacy and Multi-Sectoral Institutionalized Support.

The objective of this study was to document how Ethiopia adopted a WHO Framework Convention on Tobacco Control (FCTC)-based tobacco control law. We analyzed publicly available documents, including news media articles, advocacy reports, and government documents. We triangulated these findings by interviewing nine key stakeholders. Data were analyzed to construct a historical and thematic narrative and analyzed through a retrospective policy analysis. Local and international health advocacy efforts helped introduce and support WHO FCTC-based legislation by (1) educating policymakers about the WHO FCTC, (2) providing legal assistance in drafting legislation, (3) generating local data to counter industry claims, and (4) producing media advocacy to expose industry activity. Health advocates worked closely with government officials to create a multi-sectoral tobacco committee to institutionalize efforts and insulate tobacco companies from the policymaking process. Japan Tobacco International bought majority shares of the government-owned tobacco company and attempted to participate in the process, using standard industry tactics to undermine legislative efforts. However, with health advocacy assistance, government officials were able to reject these attempts and adopt a WHO FCTC-based law in 2019 that included 100% smoke-free indoor places, a comprehensive ban on tobacco advertising, and large pictorial health warning labels, among other provisions. Sustained local health advocacy efforts supported by international technical and financial assistance can help establish WHO FCTC-based tobacco control laws. Applying a standardized multi-sectoral approach can establish coordinating mechanisms to further institutionalize the WHO FCTC as a legal tool to build support with other government sectors and insulate the tobacco industry from the policymaking process.

COVID‐19 Infection Risk Assessment in a Kindergarten Utilizing Continuous Air Quality Monitoring Data

Researchers and transnational public health organizations have recognized aerosol transmission as an essential route of COVID‐19 transmission. Therefore, improving ventilation systems is now adopted as a core preventive measure. As young children aged 2–6 in kindergartens generally lack vaccine protection and multiple infection clusters have been identified during the pandemic, we aimed to quantify the risk of aerosol transmission in kindergartens in Taipei, Taiwan. From August to November 2021, we conducted on‐site visits and continuously monitored indoor air quality indicators including carbon dioxide (CO2) in a kindergarten located in northern Taiwan. We utilized the Wells–Riley model to estimate the basic reproduction number (R0) of each classroom and staff office, with input parameters including the number of occupants, duration of their stay, and indoor/outdoor CO2 concentration. Contagious settings were defined as those where the R0 estimate exceeded 1. We conducted a scenario/sensitivity analysis to assess the effect of simulated improvement measures. During school hours, the average concentration of CO2 in each classroom and the staff office was often more than 400 ppm higher than the outdoor levels. The R0 estimates gradually increased from Monday to Friday and throughout school hours, corresponding to the hourly and daily distribution of the CO2 concentration, which could not dissipate completely during off‐duty time. The R0 estimates during school hours ranged from 3.01 to 3.12 in classrooms with a maximum of 30 occupants. To lower the R0 estimate, it is imperative to substantially reduce the number of occupants, the duration of their stay, and indoor CO2 concentration. The risk of outbreaks of cluster infections in kindergartens should not be underestimated. Feasible strategies to mitigate this risk should include improving ventilation systems through engineering control and limiting the number of indoor occupants and their time staying indoor through administrative control.

Towards achieving transnational research partnership equity: lessons from implementing adaptive platform trials in low- and middle-income countries.

Use of adaptive clinical trials, particularly adaptive platform trials, has grown exponentially in response to the coronavirus disease (COVID-19) pandemic. Implementation of these trials in low- and middle-income countries (LMICs) has been fostered through the formation or modification of transnational research partnerships, typically between research groups from LMICs and high-income countries (HICs). While these partnerships are important to promote collaboration and overcome the structural and economic disadvantages faced by LMIC health researchers, it is critical to focus attention on the multiple dimensions of partnership equity. Based on informal literature reviews and a meeting with leaders of one of the multinational COVID-19 adaptive platform trials, we describe some important considerations about research partnership equity in this context. We organize these considerations into eight thematic categories: 1) epistemic structures, 2) funding, 3) ethics oversight, 4) regulatory oversight, 5) leadership, 6) post-trial access to interventions, data, and specimens, 7) knowledge translation and dissemination, and 8) research capacity strengthening and maintenance. Within each category we review normative claims that support its relevance to research partnership equity followed by discussion of how adaptive platform trials highlight new dimensions, considerations, or challenges. In aggregate, these observations provide insight into procedural and substantive equity-building measures within transnational global health research partnerships more broadly.

The Impact of Cultural Health Capital on Market Choice Along the Texas-Mexico Border.

Transnational cultural health capital (CHC) includes individual resources such as skills and behaviors patients use to manage healthcare exclusion and negotiate care. This study examines the impact of CHC on decisions by Hispanic people who live in El Paso, Texas, to utilize one or more markets for healthcare. We expand on the current literature and present novel findings by quantifying several aspects of CHC that may contribute to cross-border health-seeking behaviors in this vulnerable group which tends to suffer various health disparities and limited access to health insurance. Results support the hypotheses related to how the various cultural, social, and economic resources that comprise CHC affect market choices. This research has significant implications for understanding how border residents may mitigate a lack of accessibility and affordability for healthcare, developing transnational health policy, and aiding healthcare providers to understand their patients' choice(s) of healthcare markets.

Going Above and Beyond: Insights into the Lived Experiences of International Online Business Management Education in Times of Transnational Health Crises

Cet article propose de nouvelles perspectives sur les expériences vécues par les enseignants du supérieur, à distance et en présentiel, en période de crise sanitaire transnationale. En conséquence, cette étude ethnographique longitudinale étudie et présente une perspective émique en appui sur 17 mois d’observation des participants d’une population particulière — des étudiants en business management du premier cycle, apprenant en ligne et en présentiel dans une université de sciences appliquées située à Berlin — afin de conceptualiser les processus de réflexion des enseignants en appliquant des analyses thématiques. Cette combinaison permet la création d’une ethnographie riche ou, comme Geertz (1973) l’appelle, d’une « thick description », qui ne se limite pas uniquement à l’apprentissage en ligne. Ainsi, l’importance de cette étude réside dans sa contribution à une meilleure compréhension de la manière dont les crises transnationales ont modifié et remodelé le rôle des enseignants dans l’enseignement supérieur, qui visent néanmoins à internationaliser les études de leurs apprenants en repensant leurs approches pédagogiques en période de mobilité physique limitée. Cet article se concentre donc davantage sur les moyens, comme l’influence personnelle de l’enseignant, l’ouverture internationale ou encore l’incarnation de l’internationalisation, par lesquels les enseignants du supérieur construisent et comprennent leurs réalités vécues, et moins sur le nombre d’occurrences mesurables (Cunliffe, 2008). Enfin, donner un sens aux « thick descriptions » construites par les enseignants ne reproduit pas la sphère d’étude d’avant la crise, mais façonne plutôt un environnement en évolution rapide, contemporain, instantané et multidimensionnel résultant d’une accessibilité permanente (Bob, Bradshaw, Twining & Walsh, 2010 ; Gatson & Zweernik, 2004). Selon cette compréhension ontologique, cette recherche ethnographique interprétative analyse les enseignants dans leur contexte naturel, spécifique à la crise, en fonction de la façon dont ils construisent leurs réalités vécues, et, donc, dont ils donnent différentes significations à leurs interactions dans des contextes distincts (Denzin & Lincoln, 2003 ; Kromer, 2018).

"Maybe it's an Indo thing": Transnational health experiences of Indonesian women living in Australia.

Migrant health-seeking behaviour is understood to be influenced by transnationalism. This paper explores how transnationalism influences health seeking behaviour among Indonesian women living in Perth, Western Australia. Using a participatory action research approach, we conducted five focus groups with 21 women from Indonesia living in Perth. Transnational practices were common amongst Indonesian women. Transnational health-seeking (seeking Indonesian resources in Australia); transnational social support (between countries); and transnational healthcare (return to Indonesia) were common practices amongst Indonesian women. Transnational social networks were a critical source of health information and support. Findings suggest public health interventions may be improved through utilization of transnational social networks.

Towards achieving transnational research partnership equity: lessons from implementing adaptive platform trials in low- and middle-income countries

Background: Use of adaptive clinical trials, particularly adaptive platform trials, has grown exponentially in response to the coronavirus disease (COVID-19) pandemic. Implementation of these trials in low- and middle-income countries (LMICs) has been fostered through the formation or modification of transnational research partnerships, typically between research groups from LMICs and high-income countries (HICs). While these partnerships are important to promote collaboration and overcome the structural and economic disadvantages faced by LMIC health researchers, it is critical to focus attention on the multiple dimensions of partnership equity. Methods: Based on informal literature reviews and meetings with leaders of one of the multinational COVID-19 adaptive platform trials, we describe what can be learned about research partnership equity from these experiences. Results: We organize these considerations into eight thematic categories: 1) epistemic structures, 2) funding, 3) ethics oversight, 4) regulatory oversight, 5) leadership, 6) post-trial access to interventions, data, and specimens, 7) knowledge translation, and 8) research capacity strengthening and maintenance. Within each category we review the normative claims that support its relevance to research partnership equity followed by discussion of how adaptive platform trials highlight new dimensions, considerations, or challenges. Conclusion: These observations provide insight into procedural and substantive equity-building measures within transnational global health research partnerships more broadly.

From Imperialism to the “Golden Age” to the Great Lockdown: The Politics of Global Health Governance

This article reviews the state of the literature on the politics of global health governance and associated political dynamics of actors involved in this issue space. We identify seven eras in the field, beginning with the period of empire and colonialism and ending with the COVID-19 outbreak. The field of global health has long had a focus on infectious disease, often rooted within a state-centered approach to transnational global health problems with recurrent debates about whether and how restrictions on trade and travel should be imposed in the wake of disease outbreaks. This statist focus is in tension with more cosmopolitan visions of global health, which require broader health system strengthening. In the mid-2000s, a golden age emerged with the influx of new financing and political attention to addressing HIV/AIDS and malaria, as well as reducing the risk posed by infectious disease outbreaks to economies of the Global North. Despite increased awareness of noncommunicable diseases and the importance of health systems, events of recent years (including but not limited to the COVID-19 outbreak) reinforced the centrality of states to global health efforts and the primacy of infectious diseases.

When the cat is away: How institutional autonomy, low salience, and issue complexity shape administrative action

AbstractPolitical issues sometimes display an intriguing combination of high degrees of complexity, low political saliency, and high levels of administrative autonomy. This article investigates how this type of issues shapes the relationship between politicians and the public service. More specifically, we advance the notion of “administrative action space” to describe the emergence of collaborative governance when directives from the political level are intermittent or absent. Using an illustrative case on the administration of measures to address antimicrobial resistance (AMR), a transnational public health issue in Europe, we find that senior public servants nested in epistemic communities play a leading role in driving agency and facilitating governance of complex but low‐salient issues when administrative autonomy is extensive.

United by Contagion: How Can China Improve Its Capabilities of Port Infectious Disease Prevention and Control?

The rapid development of the social economy and science and technology has led to more frequent transnational movements of people, goods and vehicles. At the same time, various cross-border risks have significantly increased. The rapid global spread and continuous mutation of Coronavirus Disease 2019 (COVID-19) have again exposed the international community’s extreme vulnerability to major transnational public health emergencies. China started a “war against the epidemic” with tight quarantine regulations and border restrictions on people, vehicles and international goods. However, it also revealed the weaknesses in and incapacity for disease prevention and control at ports in terms of obstructed performance of the whole chain of public agencies, incompatible laws and regulations, lack of key technologies, and difficulties in international cooperation. Combined with persuasive data, this paper systematically illustrates how transnational infectious diseases lead humans to be “united by contagion”. On this basis, this paper makes a targeted analysis of the deficiencies of port epidemic prevention and control in China’s fight against COVID-19 and suggests corresponding countermeasures and reflections.

Diagnosing Unsettled Stasis in Transnational Communication Design: An Exploration of Public Health Emergency Communication

ABSTRACT This article builds four composite characters from the international Zika response to demonstrate each role’s position relative to inclusive health communication. I argue that a lack of jurisdictional stasis is at play in decision-making practices about transnational risk communication approaches. During emergency health responses, this lack of jurisdictional stasis functions to maintain the status quo in order for stakeholders to leverage their power in prioritizing local deliberations in transnational public health discourse and decision making.

How Should Clinicians Express Solidarity With Asylum Seekers at the US-Mexico Border?

Migrants along the US-Mexico border have been subjected to transnational violence created by international policy, militaristic intervention, and multinational organizational administration of border operations. The COVID-19 pandemic compounded migrants' vulnerabilities and provoked several logistical and ethical problems for US-based clinicians and organizations. This commentary examines how the concept of transnational solidarity facilitates analysis of clinicians' and migrants' shared historical and structural vulnerabilities. This commentary also suggests how actions implemented by one organization in Tijuana, Mexico, could be scaled more broadly for care of migrants and asylum seekers in other transnational health care settings.