Journal of Global Health最新文献

{"title":"Operationalising the ESSENCE principles for equitable global health research partnerships in low- and middle-income countries: lessons from the RESPIRE collaboration.","authors":"Hani Salim, Biswajit Paul, Siti Nurkamilla Ramdzan, Rutuja Patil, G M Monsur Habib","doi":"10.7189/jogh.16.03031","DOIUrl":"10.7189/jogh.16.03031","url":null,"abstract":"<p><p>Despite growing calls to decolonise global health, many research capacity strengthening initiatives in low- and middle-income countries (LMICs) remain externally driven, short-term, and focused primarily on individual training rather than sustainable institutional ecosystems. Drawing on experiences from the RESPIRE collaboration across South and Southeast Asia, we reflect on key lessons and enabling mechanisms for operationalising equitable global health research partnerships through the ESSENCE. RESPIRE illustrates how capacity strengthening can move beyond transactional partnerships towards locally anchored, sustainable, and LMIC-led research ecosystems grounded in local leadership, regional peer learning, governance, mentorship, and community engagement. These experiences offer practical lessons for funders, institutions, and partnerships seeking to strengthen equitable research capacity in LMICs.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03031"},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel genomic, transcriptomic, and epidemiologic evidence linking diabetic retinopathy to Alzheimer disease.","authors":"Jing Li, Qian Liu, Qian Ma, Ting Shen, Jiao Xia, Xiongyi Yang, Kun Liu, Na Li, Biao Yan","doi":"10.7189/jogh.16.04311","DOIUrl":"10.7189/jogh.16.04311","url":null,"abstract":"<p><strong>Background: </strong>Diabetic retinopathy (DR) and Alzheimer disease (AD) share metabolic and vascular dysfunctions, but the extent to which they reflect overlapping genetic susceptibility and neurovascular-metabolic regulatory pathways remains unclear. We combined multi-omics analyses with population-based data to examine the genetic convergence, cellular pathways, and longitudinal association between DR and AD.</p><p><strong>Methods: </strong>We performed a two-sample Mendelian randomisation (MR) to estimate the association between genetically predicted DR liability and AD risk. We used Bayesian colocalisation analysis to identify shared genomic loci, and summary-data-based MR (SMR) to detect expression-mediated genes jointly associated with DR and AD. We analysed single-cell RNA sequencing data to characterise shared cellular features and related biological pathways. We also conducted an MR-based mediation analysis to explore whether lipid-related, metabolic, or inflammatory traits mediated the observed DR-AD association, and a longitudinal analysis of the UK Biobank cohort to assess the association between DR and incident AD.</p><p><strong>Results: </strong>With the MR analysis, we found that genetically predicted liability to DR was associated with a modest increase in AD risk. Colocalisation analysis supported a shared genetic signal. We identified three genes with shared expression-mediated associations across DR and AD through SMR. Functional enrichment analyses revealed partially overlapping neurovascular and metabolic pathways. Using MR-based mediation analysis, we found no significant intermediary traits linking DR and AD. Findings from the UK Biobank cohort were directionally consistent with the genetic analyses.</p><p><strong>Conclusions: </strong>Genetic liability to DR is associated with an increased risk of AD and is accompanied by shared expression-mediated effects and convergent neurovascular-metabolic pathways. These findings support the possibility that DR may serve as a clinically accessible indicator of increased neurodegenerative vulnerability.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04311"},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effects of ambient PM_2.5 on respiratory healthcare utilisation in older adults: a time-series study in an industrialising area of Central Thailand.","authors":"Pirawan Wangupadcha, Yuparat Limmongkon, Steven Ronsmans, Lawrence Achilles Nnyanzi, Chananya Jirapornkul","doi":"10.7189/jogh.16.04269","DOIUrl":"10.7189/jogh.16.04269","url":null,"abstract":"<p><strong>Background: </strong>Fine particulate matter (PM_2.5) air pollution is a major environmental health concern and has been associated with adverse respiratory outcomes, particularly among older adults. Evidence regarding the short-term respiratory effects of PM_2.5 in communities near newly industrialising areas in Thailand remains limited. We aimed to examine the short-term association between daily ambient PM_2.5 concentrations and respiratory healthcare utilisation among older adults living near a newly established industrial area in central Thailand.</p><p><strong>Methods: </strong>We conducted a time-series study among residents aged ≥60 years living within a 5 km radius of an industrial area in central Thailand from November 2023 to March 2024. Daily respiratory healthcare visits (ICD-10 codes J00-J99) were obtained from electronic medical records of the local secondary-level hospital. We obtained daily PM_2.5 concentrations and meteorological data from the nearest governmental air-quality monitoring station. Associations between PM_2.5 exposure and respiratory visits were analysed using negative binomial regression models and expressed as incidence rate ratios (IRRs) per 10 μg/m³ increase in PM_2.5. We used single-lag and moving-average models to assess delayed effects, adjusting for temperature, relative humidity, wind speed, day of the week, and temporal trends.</p><p><strong>Results: </strong>A total of 924 respiratory healthcare visits were recorded during the study period, with a mean of 6.37 visits per day. The mean daily PM_2.5 concentration was 42.43 μg/m³ (standard deviation = 15.12), substantially exceeding the World Health Organization guideline. Positive associations between PM_2.5 and respiratory visits were observed across several lag days, with the largest effect estimate at lag 4. A 10 μg/m³ increase in PM_2.5 at lag 4 was associated with a 5.5% increase in respiratory healthcare visits (IRR = 1.055, 95% confidence interval = 0.995-1.119), although this association did not reach statistical significance. Subgroup analyses showed numerically larger effect estimates among females and individuals aged 60-69 years; however, interaction tests were not statistically significant.</p><p><strong>Conclusions: </strong>Short-term exposure to ambient PM_2.5 showed a positive but non-significant association with respiratory healthcare utilisation among older adults living near a newly industrialising area. Continued efforts to improve air quality and protect vulnerable populations may help reduce pollution-related respiratory health burdens.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04269"},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of pre-pregnancy body mass index and first-trimester remnant cholesterol level with risk of large for gestational age.","authors":"Lihua Lin, Sisi Zhang, Juan Lin, Xiaomei Wang","doi":"10.7189/jogh.16.04315","DOIUrl":"10.7189/jogh.16.04315","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the associations of pre-pregnancy body mass index (BMI) and first-trimester remnant cholesterol (RC) level with the risk of large for gestational age (LGA) infants.</p><p><strong>Methods: </strong>A prospective cohort study was conducted in Southeastern China, including 11,319 pregnant women. Logistic regression was used to examine the associations of pre-pregnancy BMI and RC level with LGA. Restricted cubic spline regression was applied to assess the dose-response relationship between RC level and LGA risk. Mediation analysis was performed to evaluate the potential mediation role of gestational diabetes mellitus (GDM) in the associations of pre-pregnancy BMI and RC level with LGA.</p><p><strong>Results: </strong>Compared with the reference groups, LGA risk was significantly higher in women with a pre-pregnancy BMI≥24kg/m² (odds ratio (OR) = 1.60; 95% CI = 1.31 ~ 1.95) and those in the highest tertile of RC (OR = 2.09; 95% CI = 1.67 ~ 2.61). No significant multiplicative or additive interactions were observed between BMI and RC level on LGA risk. Gestational diabetes mellitus mediated 0.91% (RC) and 1.15% (BMI) of effects. Population-attributable risk estimates indicated that 6.69 and 19.68% of LGA cases could be attributed to high pre-pregnancy BMI and elevated RC levels, respectively.</p><p><strong>Conclusions: </strong>Elevated RC and pre-pregnancy BMI are independent LGA risk factors, with minimal GDM mediation. Managing lipid profiles, particularly RC, is important even in high-BMI women.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04315"},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic trajectories of serum sodium and urine output and their association with prognosis in sepsis: a group-based multi-trajectory modelling analysis using MIMIC-IV.","authors":"Xiuming Zhuo, Xiaolong Xu, Hongyi Chen","doi":"10.7189/jogh.16.04308","DOIUrl":"10.7189/jogh.16.04308","url":null,"abstract":"<p><strong>Background: </strong>Serum sodium and urine output (UO) are routinely monitored indicators of electrolyte homeostasis, renal perfusion, and organ function in sepsis. However, the prognostic relevance of their combined longitudinal patterns remains unclear.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV database. Group-based multi-trajectory modelling identified combined trajectories of serum sodium and UO across four 24-hour periods during the first 96 hours after intensive care unit admission. Cox regression evaluated associations between trajectory subtypes and 30-day mortality, with subgroup and sensitivity analyses.</p><p><strong>Results: </strong>Among 7127 patients with sepsis, five trajectory subtypes were identified. Subtype 1 was characterised by a mild initial decrease in serum sodium followed by recovery and gradually increasing UO. Compared with subtype 1, subtype 2, characterised by mildly increasing serum sodium and gradually decreasing UO, showed the highest 30-day mortality risk in the fully adjusted model (HR = 1.85; 95% CI = 1.56-2.19, P < 0.001). Higher 30-day mortality was also observed for subtype 3, characterised by relatively stable serum sodium and UO that increased and then decreased (HR = 1.22; 95% CI = 1.03-1.46, P = 0.026); subtype 4, characterised by gradually increasing serum sodium and UO that increased before levelling off (HR = 1.31; 95% CI = 1.10-1.56, P = 0.003); and subtype 5, characterised by gradually decreasing serum sodium and UO that increased before levelling off (HR = 1.53; 95% CI = 1.29-1.82, P < 0.001). Subgroup and sensitivity analyses generally supported these findings.</p><p><strong>Conclusions: </strong>Five combined serum sodium and UO trajectory subtypes were identified in sepsis. Subtype 1 was associated with a favourable prognosis, whereas subtypes 2 and 5 carried the highest mortality risks. Early combined trajectories of serum sodium and UO may support prognostic risk stratification, although causal inferences cannot be drawn from this observational study.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04308"},"PeriodicalIF":5.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic completeness: the missing link in antimicrobial stewardship in low- and middle-income countries.","authors":"Qingchun Pan, Xiaohua Chen","doi":"10.7189/jogh.16.03020","DOIUrl":"10.7189/jogh.16.03020","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is accelerating in low- and middle-income countries, yet antibiotic prescribing decisions are often made without diagnostic certainty. Diagnostic completeness - the systematic commitment to obtaining a confirmed diagnosis before initiating treatment - is an overlooked upstream component of antimicrobial stewardship. Without this pre-treatment commitment, downstream antimicrobial management efforts risk being bypassed because diagnostic testing is never ordered. Here, we distinguish diagnostic completeness from diagnostic stewardship: the former concerns whether a diagnosis is pursued before treatment, whereas the latter concerns whether the appropriate diagnostic test is used. Behavioural alerts, hub-and-spoke diagnostics, and incentive redesign are three practical pathways that could strengthen diagnostic completeness in primary care, although each faces well-documented implementation barriers requiring context-specific adaptation. We also address patient-level constraints, equity implications, health system heterogeneity, and empirical therapy in emergency contexts. Diagnostic completeness is a necessity; closing the diagnostic gap will not solve AMR alone, yet without it, stewardship will not suffice.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03020"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of media-reported road traffic crashes involving low-level automated vehicles in China, 2015-2025.","authors":"Min Zhao, Lei Yang, Hengjia Qi, David C Schwebel, Wangxin Xiao, Yu Wu, Peixia Cheng, Guoqing Hu","doi":"10.7189/jogh.16.04245","DOIUrl":"10.7189/jogh.16.04245","url":null,"abstract":"<p><strong>Background: </strong>Low-level automated vehicles (LAVs) have emerged as a new public health challenge, but the epidemiological characteristics of LAV-related crashes remain unknown.</p><p><strong>Methods: </strong>Based on media reports collected by the Automated Road Traffic Crash Data Platform (ARTCDP), we analysed the characteristics of LAV-related crashes in China between 1 January 2015 and 31 August 2025.</p><p><strong>Results: </strong>The ARTCDP captured 4,669 crashes involving LAVs and 324,869 involving other motor vehicles. Compared to other motor vehicles, LAVs were more frequently reported to crash during nighttime (65.3% vs. 29.1%; P < 0.001), on expressways (31.9% vs. 20.2%; P < 0.001), on straight roads without junctions (50.7% vs. 29.4%; P < 0.001), and on rainy days (57.7% vs. 53.6%; P < 0.001). They were primarily reported to crash in economically developed regions, with those in Zhejiang, Guangdong, and Shanghai accounting for 31.6% of all crashes involving LAVs. Furthermore, 20.3% of the LAVs crashes and 16.3% of other motor vehicles crashes were associated with two or more factors. Brake-related issues (48.0% vs. 26.1%; P < 0.01), hazardous road surface condition (55.6% vs. 47.9%; P < 0.01), and distracted driving behaviour (28.7% vs. 9.8%; P < 0.01) more frequently occurred in LAV-involved crashes.</p><p><strong>Conclusions: </strong>Internet-based media reports detected distinct characteristics of road traffic crashes involving LAVs, meriting the attention of policymakers and law enforcement.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04245"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative management of hepatitis C: implementation and outcomes of the 'SMART' model in a general hospital.","authors":"Maoping Li, Wan Hu, Zhongshang Dai, Jie Li, Jing Ma, Yi Li","doi":"10.7189/jogh.16.04241","DOIUrl":"10.7189/jogh.16.04241","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the implementation and outcomes of the hepatitis C (HCV) SMART management model in a tertiary hospital, to provide insights for optimising HCV management globally.</p><p><strong>Methods: </strong>A multidisciplinary HCV working group was established at The Second Xiangya Hospital to implement an in-hospital micro-elimination strategy. Based on post-implementation analysis, the SMART Model was enhanced in July 2022 with improved HCV education, a 'one-step' reflexive nucleic acid testing protocol, and dedicated follow-up specialists. We conducted a retrospective analysis of patients undergoing HCV antibody and RNA testing (January 2020-December 2023), comparing three periods: the Pre-Implementation, Micro-Elimination Model, and SMART Model periods. We analysed HCV RNA testing rates and direct-acting antiviral (DAA) treatment rates using χ² tests and multivariable generalised estimating equations (GEE) to account for department-level clustering.</p><p><strong>Results: </strong>A total of 355,191 patients were screened, with 4,355 (1.23%) testing anti-HCV-positive. Males and patients born before 1997 had significantly higher positivity rates. Blood-borne transmission was the predominant risk factor in the pre-1997 cohort. The Micro-Elimination Model increased the HCV RNA testing rate (53.76% vs. 58.33%, P = 0.014) but not the DAA treatment rate (65.33% vs. 64.21%, P = 0.780). In contrast, the SMART Model significantly improved both outcomes: the RNA testing rate rose to 77.10% (P < 0.001) and the DAA treatment rate to 71.29% (P = 0.044). Multivariable GEE analysis identified age <60 years, care in the Department of Infectious Diseases, and the SMART Model as positive independent predictors for both HCV RNA testing and DAA treatment initiation.</p><p><strong>Conclusions: </strong>The SMART Model significantly enhanced HCV diagnosis and treatment rates while improving clinical management. Future efforts should focus on disseminating this model to optimise healthcare resources and strategies.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04241"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity as a protective factor for insomnia: systematic review, meta-analysis, and quality assessment of observational studies.","authors":"Chao-Qun Xie, Fang-Fang Xie, Jia-He Cui, Ling-Jun Kong, Fei Yao, Min Fang","doi":"10.7189/jogh.16.04196","DOIUrl":"10.7189/jogh.16.04196","url":null,"abstract":"<p><strong>Background: </strong>While meta-analyses of randomised controlled trials have demonstrated the therapeutic effects of physical activity (PA) on insomnia, the real-world associations between different levels and domains of PA and insomnia symptoms remain unclear. We aimed to examine these associations in the general population.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of observational studies. We searched PubMed, MEDLINE, EMBASE, APA PsycINFO, CINAHL, and the Cochrane Library up to 5 August 2024, including studies that examined the association between PA and insomnia symptoms in the general population. We calculated pooled effect sizes using a random-effects model and performed subgroup analyses by PA intensity and domain. We assessed publication bias using funnel plots.</p><p><strong>Results: </strong>We included 27 risk estimates. Compared with low PA, high PA was not significantly associated with insomnia risk (odds ratio (OR) = 0.96; 95% confidence interval (CI) = 0.85-1.09). Moderate PA was associated with a 7% lower risk of insomnia (OR = 0.93; 95% CI = 0.87-1.00). Subgroup analyses showed significant variation across activity domains, with occupational PA associated with a 21% higher risk of insomnia (OR = 1.21; 95% CI = 1.02-1.43). There was no evidence of publication bias.</p><p><strong>Conclusions: </strong>Moderate levels of PA are associated with a modest reduction in insomnia risk, whereas occupational PA may increase the risk. These findings highlight the importance of considering both the intensity and domain of PA in relation to sleep health.</p><p><strong>Registration: </strong>PROSPERO: CRD42023417826.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"04196"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research waste before research begins: the problem of research-priority mismatch in low- and middle-income countries.","authors":"Farrokh Habibzadeh","doi":"10.7189/jogh.16.03028","DOIUrl":"10.7189/jogh.16.03028","url":null,"abstract":"<p><p>Scholarship on research waste has concentrated on what goes wrong after a question has been chosen: flawed design, selective reporting, publication bias, and the slow attrition of findings that never reach the people who could use them. A more upstream loss has drawn far less scrutiny - the commitment of scarce resources to questions poorly matched to the needs of the populations expected to benefit from them. In this viewpoint, I argue that such research-priority mismatch is itself a distinct form of waste, and that its costs fall most heavily on low- and middle-income countries, where research budgets are thin and the opportunity cost of every funded project is correspondingly steep. Drawing on work in meta-research, scientometrics, responsible research assessment, and science policy, I examine how academic incentives can favour internationally visible topics over locally consequential ones, and how publication-based promotion, journal prestige, and bibliometric indicators can quietly entrench that preference. To name priority mismatch as waste is not to reject international collaboration or curiosity-driven inquiry; it is to ask for proportion between global participation and local relevance. I close with a review of ongoing reforms in funding, evaluation, and academic reward that might draw research investment back toward public benefit.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"16 ","pages":"03028"},"PeriodicalIF":5.5,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}