Globalization and Health最新文献

{"title":"Challenges and barriers to effective COVID-19 screening at Iran's air border crossings: a qualitative study and proposed solutions.","authors":"Hadi Pashapour, Mohtasham Ghaffari, Ali Nikfarjam, Amir Kavousi, Manoochehr Karami","doi":"10.1186/s12992-026-01208-w","DOIUrl":"10.1186/s12992-026-01208-w","url":null,"abstract":"<p><p>BACKGROUND: International air border crossings are crucial for controlling the spread of respiratory pandemics like COVID-19. Effective screening at these points is vital for national health security and meeting global health obligations under the revised International Health Regulations (IHR) 2005. This qualitative study aimed to identify and analyze the challenges, barriers, and proposed solutions in COVID-19 screening and management at Iran’s air border crossings and situates these findings within the context of global health governance and pandemic response frameworks. METHODS: Using purposive sampling, twelve key stakeholders involved in border health management were interviewed between Mar and Nov 2024. Data were collected through semi-structured interviews and supplemented by a field visit to Imam Khomeini International Airport’s border health base and a review of relevant international regulations and recent scholarly literature. Content analysis combined with Fishbone root cause analysis was employed to explore underlying factors. RESULTS: Findings revealed multifaceted challenges including inconsistent implementation of screening protocols, shortage of trained personnel, inadequate technological infrastructure, poor interagency coordination, and legal ambiguities related to data privacy and quarantine enforcement. Behavioral factors such as passenger resistance and limited airline cooperation further undermined screening effectiveness. Additionally, the assessment identified significant gaps in meeting global standards and IHR core capacities (points of entry, public health emergency preparedness and surveillance) at air border points. Proposed solutions emphasized integrated digital platforms for real-time data sharing, enhanced staff training, improved quarantine facilities, legal reforms, and targeted multilingual communication campaigns. CONCLUSION: This study indicates that strengthening air border screening during pandemics requires a multisectoral approach aligned with IHR. Identified human, technical, organizational, legal, and environmental challenges may hinder full compliance with these regulations. Addressing these barriers through practical solutions could improve preparedness and response to health emergencies at both national and international levels.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Market strategies used by private hospital providers to consolidate and increase power; a systematic scoping review and evaluative synthesis.","authors":"Tom Shore, Shaun Larkin, Adam G Elshaug, Preet Kalkat, Jenn Lacy-Nichols","doi":"10.1186/s12992-026-01206-y","DOIUrl":"10.1186/s12992-026-01206-y","url":null,"abstract":"<p><p>BACKGROUND: Hospitals controlled by private firms, like many private sectors, will employ market strategies to safeguard their investments and increase the profitability of the services they provide. These market strategies not only determine their financial success but also influences broader outcomes, including health system performance and population health indicators. Yet, strategies that enhance market influence and profitability may at times diverge from those aimed at improving health outcomes. This raises issues around market power imbalances and concerns that hospitals could prioritise profits over health if forced to choose. This systematic scoping review sought to identify and synthesise scholarly evidence on the market strategies employed by private hospitals to expand and consolidate market power. METHODS: Titles and abstracts of 1,642 English-language articles sourced from seven databases were screened, with 371 articles assessed for eligibility based on whether they identified the use of market strategies within a hospital setting. Data from 133 relevant studies were extracted and analysed thematically using Porter’s ‘Five Forces’ framework. RESULTS: We identified 22 distinct market strategies used by private hospitals, falling under six interconnected strategic objectives: 1) reduce rivalry among existing competitors; 2) raise barriers to market entry by new competitors; 3) counter the threat of market disruptors and drive patient health service usage towards hospital care provided by the hospital; 4) increase hospital buyer power by exerting leverage over upstream actors; 5) Increase hospital seller power by exerting leverage over downstream organisational actors; and 6) increase hospital seller power by exerting leverage over downstream individual actors. Although international in scope, the United States accounted for over two-thirds of the studies included. This partly reflects the dominance of U.S. scholarship in these areas. CONCLUSION: The resulting typological framework offers a structured means of analysing hospital market strategies internationally, within and across jurisdictions. Additionally, it can aid the identification of pertinent public policies, such as those addressing merger control, unfair trading practices, and public procurement. This works to bolster policy-analytic functions that can be influential in rectifying market-power imbalances.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An account of health systems resilience to emergencies in Africa: a scoping review.","authors":"Martin Ankomah, Gordon Abekah-Nkrumah, Grace Adjei Okai, Lily Yarney, Anita Asiwome Adzo Baku","doi":"10.1186/s12992-026-01209-9","DOIUrl":"10.1186/s12992-026-01209-9","url":null,"abstract":"<p><p>BACKGROUND: Healthcare systems across Africa continue to face a wide range of shocks. Using Ebola and COVID-19 as case studies, this study examines the various resilience strategies implemented in different countries and synthesises them in a way that can serve as a practical guide to make health systems in Africa more resilient for future emergencies. METHODOLOGY: The study is a scoping review that synthesises evidence from peer-reviewed journal articles and grey literature, structured around a conceptual framework developed by the authors. We focused on various aspects of health system resilience during the Ebola outbreaks and the COVID-19 pandemic in Africa. KEY FINDINGS: This review identifies six key elements vital to health system resilience in Africa: strong leadership and governance, equitable social protection, digital health innovation, trusted community engagement, a sustainable and flexible workforce, and adaptable infrastructure. However, several gaps must be addressed to strengthen resilience against future health emergencies. While political commitment and coordination mechanisms improved integration and awareness, poor decentralisation, weak accountability, and fragmented governance undermined effectiveness. Social protection initiatives and digital tools enabled rapid responses but persistent inequities in access and data gaps hindered their reach. Telemedicine and workforce expansion showed adaptability but lacked sustainability. Community trust and local innovations supported resilience, yet their potential was curtailed by top-down strategies and insufficient institutional support. CONCLUSION: This review emphasises the need for equitable, inclusive, and coherent strategies to strengthen resilient health systems in Africa. It calls for a shift from reactive, fragmented approaches to a long-term system-wide transformation grounded in inclusive governance, equitable social protection, robust digital health systems, a sustainable workforce, integrated and trusted community engagement, and adaptive physical infrastructure. Importantly, the review affirms that addressing deep-seated political, structural, and social inequities is crucial to ensuring resilience does not become an empty concept. The framework developed from this review provides a roadmap for policymakers to embed resilience as a core, institutional principle of long-term health system transformation, rather than a temporary emergency measure.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision-making about bariatric and cosmetic medical tourism from countries with universal healthcare: a rapid systematic review.","authors":"Beth Nichol, Devashish Ray, Louise Tanner, Emily J Oliver, Ivo Vlaev, Falko Sniehotta, Laura McGowan","doi":"10.1186/s12992-026-01207-x","DOIUrl":"10.1186/s12992-026-01207-x","url":null,"abstract":"<p><p>BACKGROUND: A growing number of people are travelling abroad for medical treatments (known as medical tourism; MT), driven by globalisation of the healthcare market. Medical tourists from countries with universal healthcare strain resources when returning with complications which require aftercare or further treatment. This rapid systematic review synthesised literature on decision-making of medical tourists, focusing on cosmetic and bariatric MT as high-demand and high-risk areas, to identify opportunities to support informed decision-making (PROSPERO registration number: CRD420251000992). METHODS: Guided by Cochrane guidance for rapid reviews, three databases (MEDLINE®, PsycINFO, and Web of Science) plus grey literature (Overton) were searched on the 24th February 2025 for qualitative, quantitative, or mixed methods studies that focused on outbound cosmetic or bariatric medical tourists from countries with universal healthcare. Narrative synthesis, thematic synthesis, and triangulation were applied. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of included studies. Public involvement shaped the search methods and data interpretation. RESULTS: A total of 25 studies (12 qualitative, 11 quantitative, and two mixed methods) were included. Quantitative data indicated a primary motivator of cost. Thematic synthesis identified three overarching themes: (1) Medical Tourists as Constrained Consumers: Decision-Making under Systemic Healthcare Limitations, (2) Crowdsourcing Trust: Peer-Produced Evidence and Trusting Strangers in the Absence of Support, and (3) Informed but Invested: Navigating Risk Through Emotional Commitment. Triangulation identified quantitative research gaps particularly around information seeking behaviour and the effect of emotional investment on risk perception. DISCUSSION: Medical tourists are mainly limited in their decision-making by inaccessibility of universal healthcare and, subsequently, cost of treatment. Medical tourists are emotionally invested in receiving surgery, resulting in them minimising perceived risks. Medical tourists also rely heavily on anecdotal information, especially from online communities, in a context of inaccurate information and low social support. Prospective studies with generalisable samples are needed, particularly for bariatric tourism. Limitations include the limited value of available quantitative data in understanding the decision-making process of medical tourists. CONCLUSIONS: Given the strong financial appeal of surgery abroad, efforts to reduce the harms of MT should prioritise harm reduction strategies over deterrence, which leverage the persuasive power of anecdotal evidence and strengthen communication with domestic healthcare providers.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Pride not profit': A commercial determinants of Indigenous health case study from Australia.","authors":"Karen Hill, Troy Walker, Fiona Mitchell, Alessandro Crocetti, Sarah Sheridan, Laura Thompson, Jennifer Browne","doi":"10.1186/s12992-026-01197-w","DOIUrl":"10.1186/s12992-026-01197-w","url":null,"abstract":"<p><strong>Background: </strong>The role of the commercial sector in driving population health outcomes is gaining attention; yet the influence of commercial entities and practices on Indigenous health is underexplored. This case study examined the separate legal disputes between Clothing The Gaps (an Aboriginal business, social enterprise and B-Corp) and two for-profit commercial clothing companies, investigating their potential impact on Aboriginal health and wellbeing, and how Aboriginal business and advocacy can overcome powerful commercial interests.</p><p><strong>Methods: </strong>This qualitative case study combined data from interviews with key informants (n = 3) and data extracted from media articles and stakeholder submissions (n = 74) to the Senate Select Committee on the Aboriginal Flag. Data were analysed for key themes with Aboriginal researchers central to the analysis process.</p><p><strong>Results: </strong>Findings suggest that the legal avenues taken by two non-Indigenous companies were enabled by Australia's existing legal and regulatory systems, coupled with notable resource disparities. WAM Clothing and GAP Inc. asserted their legal rights against Clothing The Gaps to protect their respective branding and profits. The 'Free The Flag' campaign demonstrated how Aboriginal business advocacy can garner public and political support to counter profit-focused commercial interests.</p><p><strong>Conclusions: </strong>This case study underscores the importance of recognising the impact of the commercial sector's lawful pursuit of their intellectual property on Indigenous peoples' rights, culture, health and wellbeing, and on the transformative potential of Aboriginal-led advocacy campaigns. Further work is needed to safeguard Indigenous cultural and intellectual property rights, and to investigate the diverse industries influencing Indigenous peoples' health and wellbeing.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corporate influence on food and nutrition policies in Latin America and the Caribbean: key determinants and policy directions.","authors":"Ariadna Villalobos-Pérez, Vania Lara-Mejía, Florence L Théodore, Lizbeth Tolentino-Mayo","doi":"10.1186/s12992-026-01198-9","DOIUrl":"10.1186/s12992-026-01198-9","url":null,"abstract":"<p><p>BACKGROUND: In Latin America and the Caribbean (LAC), diets are increasingly dominated by ultra-processed products (UPPs). Although public health policies aimed at reducing UPPs consumption show promise, these are often undermined by corporate influence. Understanding how countries respond to this influence is essential for strengthening food policy development in LAC. OBJECTIVE: Examine how different sectors (government, academia, and civil society organizations) respond to corporate influence throughout the public policy cycle and analyze the key determinants that enable or constrain industry power across six analytical environments in five LAC countries, with the aim of informing actionable policy directions. METHODS: The study follows two sequential and complementary components: (1) policy mapping conducted to assess the progress of six health, food, and nutrition policies within the policy cycle in LAC countries, and (2) a qualitative component consisting of in-depth interviews with key informants from Guatemala, Paraguay, Argentina, Jamaica and Barbados; conducted between May 2024 and May 2025. Data analysis followed a constant comparative approach to identify cross-cutting patterns and context-specific insights. RESULTS: Policy progress varies substantially across food policies and countries. For example, taxation on sugar-sweetened beverages is generally advanced, while marketing restrictions on unhealthy products remain at earlier stages. Regarding the qualitative component, fifteen informants were interviewed; Argentina and academia were the most represented. Based on informants´ responses, corporate strategies and counterstrategies were identified and classified into six environments, each comprising determinants that either constrain corporate power or hinder efforts to address it. These encompassed: (1) political and governance processes; (2) legal and regulatory frameworks, as evidenced in Argentina and Jamaica; (3) narrative and communication strategies leveraging media; (4) knowledge production and dissemination characterized by misleading or suppressed information; (5) advocacy efforts, notably observed in Argentina and the Caribbean; and (6) a cross-cutting, cross-sectoral collaboration to present a unified response to corporate influence. CONCLUSION: Findings indicate that the UPPs industry operates across multiple environments and is shaped by country-specific contexts. Nevertheless, promising responses include transparency and conflict-of-interest mechanisms, strengthened civil society advocacy, and cross-sectoral collaboration to counter corporate influence. These strategies require adaptation to national and local conditions. CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian mines, global issues: examining health impacts, demanding action.","authors":"Denise L Spitzer, Erlinda Castro-Palaganas, Penelope Simons, Kenesh Dzhusupov, Flavio Wittlin, Jean Grassman, Janelle Baker, Ronald Labonté","doi":"10.1186/s12992-026-01204-0","DOIUrl":"10.1186/s12992-026-01204-0","url":null,"abstract":"<p><p>BACKGROUND: While a global player in the mining and metals sector, there is little regulatory oversight by Canada of Canadian mining companies in relation to their transnational activities. Much mineral exploration and mining take place in remote and rural areas inhabited by Indigenous and other minoritized and/or marginalized communities, and has been linked to worsening health, social, and environmental conditions. Few effective legal mechanisms exist to monitor, investigate, and provide effective remedies for their harmful impacts. METHODS: Three focal mining communities representing different mining life stages were studied: exploratory phase (Philippines), midlife (Brazil), and a transitioning to end-stage that has now been reinvigorated post-nationalization (Kyrgyz Republic). A qualitative approach based on locale-specific community consultations was employed with analysis informed by a theoretical framework based on the commercial, political, and social determinants of health, environmental justice, and their interactive and embodied impacts. RESULTS AND DISCUSSION: The community consultations yielded the following notable findings: a failure to acknowledge Indigenous rights (all sites); intimidation and harassment of local residents raising objections (Brazil and Philippines); the centrality of mines entrench social and economic inequities —including pre-existing ones (all sites); prior experience and knowledge of harms linked to extractive resource industries affect perception and resistance to mines (Brazil and Philippines) and the presence of widespread illness and disease among miners (Brazil and Kyrgyz Republic). Participants expressed support for community-driven mining and health studies documenting long-term occupational and environmental health impacts, particularly respiratory and water-borne illnesses. CONCLUSIONS: Despite the lethargy, obfuscation, and refusal of the Canadian government to take action on the global interests and actions of its corporations operating abroad, local efforts to resist the experienced and potential harms of transnational Canadian mining operations are noteworthy. Canada must comply with its binding international human rights obligations and move beyond its failed policy approach to addressing the harmful impacts of these endeavours. Future research must be conducted with and be accountable to local communities. CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient organizations involvement in healthcare: a rapid review and conceptual framework.","authors":"Arianna Gentilini, Iva Parvanova, Samra Ghazi, Kristy M Scarfone, Jillian Kohler","doi":"10.1186/s12992-026-01205-z","DOIUrl":"10.1186/s12992-026-01205-z","url":null,"abstract":"<p><strong>Background: </strong>Patient organizations have become increasingly influential in the healthcare sector, offering unique insights into unmet health needs, disease impact, and patients' quality of life. These groups have evolved from advocates for access to treatment, as seen during the HIV/AIDS crisis, to active participants in the research and policy-making processes. Despite growing recognition of their critical role, a comprehensive understanding of their interactions with various healthcare actors remains limited.</p><p><strong>Main body: </strong>This rapid review aims to map the landscape of patient organization involvement in healthcare, particularly in high-income settings. We conducted a systematic search of MEDLINE, focusing on literature published between 2000 and 2024, and identified 61 relevant articles. The analysis revealed that patient organizations interact with a range of actors, including pharmaceutical companies, healthcare professionals, payers, health technology assessment bodies, and regulatory agencies. Key themes were identified around conflicts of interest, especially with regards to the pharmaceutical industry, where concerns about transparency and independence were prevalent. The review also highlighted the vital role patient organizations play in research and development, regulatory approval processes, and reimbursement decisions. The conceptual framework developed from this review outlines these interactions across the pharmaceutical lifecycle, emphasizing the varied and significant contributions of patient organizations.</p><p><strong>Conclusion: </strong>This review underscores the need for more transparency and meaningful engagement of patient organizations in healthcare decision-making. While their involvement has been primarily studied in the context of pharmaceutical industry relations, further research is needed to explore their interactions with other relevant actors. Addressing funding challenges and expanding research beyond well-studied regions are crucial for fully understanding and optimizing the role of patient organizations in healthcare.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13141336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Africa's Critical Role in Shaping and Implementing the Pandemic Agreement's PABS Annex in an Era of Fragmentation.","authors":"Nelson Aghogho Evaborhene","doi":"10.1186/s12992-026-01190-3","DOIUrl":"10.1186/s12992-026-01190-3","url":null,"abstract":"<p><p>The adoption of the World Health Organization Pandemic Agreement in May 2025 marked a political commitment to stronger global pandemic preparedness. Its credibility, however, depends on the successful negotiation and implementation of the Pathogen Access and Benefit Sharing annex under Article 12, to be finalized by April 2026. The COVID 19 pandemic exposed the failures of voluntary global health mechanisms, as African countries rapidly shared pathogen samples and sequence data yet faced severe delays in access to vaccines, diagnostics, and therapeutics. The PABS annex therefore represents the core test of whether the Agreement can move beyond symbolic equity toward enforceable obligations. This commentary argues that African countries enter the PABS negotiations with an unusual convergence of leverage: early scientific contributions, expanding regulatory and manufacturing capacity, and coordinated diplomacy through the African Union and Africa CDC. In a fragmented multilateral environment dominated by high income state interests, the central challenge is not recognition but conversion of capacity into binding rules. African negotiators have responded by pushing for standardized contracts, traceability of pathogen materials and sequence information, and compliance mechanisms that condition access on enforceable benefit sharing. Drawing on Africa’s institutional readiness, the paper contends that the continent is positioned not merely to influence the PABS annex, but to co-design its operational architecture. Whether this potential is realized will determine if the Pandemic Agreement corrects past inequities or reproduces them under a new legal form.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"22 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understandings and practices of solidarity in global health: a scoping review of the literature.","authors":"Jae-Eun Noh, Barbara Prainsack, Elias Weiss, Bridget Pratt","doi":"10.1186/s12992-025-01170-z","DOIUrl":"10.1186/s12992-025-01170-z","url":null,"abstract":"<p><p>BACKGROUNDS: Rising interest in solidarity in global health reflects a growing need to understand why and how it can shape global health policy, practice, and research. This study seeks to review existing studies on solidarity in relation to global health and to identify gaps in current knowledge. METHODS: We conducted a scoping review of papers published between 2007 and 2024 to explore how solidarity is conceptualised and practised in the context of global health. Our search, guided by the key concepts of solidarity and global health, identified 752 studies across four databases: SCOPUS, PubMed, Global Health, and Google Scholar. Following a rigorous screening and full-text review process, 83 peer-reviewed journal articles meeting the inclusion criteria were selected for thematic review. This analysis focused on examining the relationships between solidarity and global health problems, norms, and practices. RESULTS: The majority of the 83 reviewed articles were theoretical or conceptual in nature (63.9%) and predominantly authored by individuals affiliated with institutions in high-income countries (65.1%). The articles spanned multiple disciplines, with philosophy and applied ethics, including bioethics, being the most prominent (34.9%). Our findings indicate a growing interest in incorporating non-Western perspectives on solidarity and health into recent scholarship. The literature at the intersection of solidarity and global health showed that solidarity is often broadly defined–frequently without explicit reference to global health–and conceptualised in diverse ways, although some agreement exists on its core components. Solidarity’s focus on relationality and interdependence was found to align well with decolonial, feminist or ecological approaches. However, this review also identified a significant gap between the conceptualisation of solidarity and its practical implementation, largely due to structural barriers that impede its translation into action, often leading to undesirable outcomes. CONCLUSION: This review underscores the conceptual and practical potential of solidarity to reshape some of the foundational assumptions, objectives, and processes of global health. However, substantial work is still needed to clarify more nuanced understandings of solidarity within the global health context, to establish a comprehensive and prescriptive framework that guides an understanding of genuine solidarity and its applications while avoiding merely rhetorical uses and adverse outcomes, and to address the structural barriers that hinder their practical application. CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"22 1","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}