News Flash 612: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Brown meagre (Sciaena umbra)

News Flash 612

Weekly Snapshot of Public Health Challenges

 

BOOK REVIEW: MY JOURNEY WITH COMMUNITY MEDICINE – A MEMOIR  by Tanushree Mondal

Can Managed Entry Agreements Help LMICs Navigate the Rising Cost of Medicines?

Pharmaceutical Tariffs: Potential Impacts And The Need For Vulnerability Assessments

Critical Medicines and Priority Medical Products should not leave anyone behind

IP: Delhi High Court clears path for generic risdiplam availability in India

Trump ends SA’s HIV and TB research grants

WHO calls for urgent action to address worldwide disruptions in tuberculosis services putting millions of lives at risk

Turning the Tide on Tuberculosis: Ensuring Access, Treatment, and Prevention for All Communities

TB Aid Cuts Endanger Africans Despite Sharp Drop in Deaths, Cases

Promising Phase 3 Trial of Tuberculosis Vaccine is Running Ahead of Schedule

Life-saving services in TB response

Poliovirus detected in sewage samples from 18 districts

NEJM Outbreaks Update — H5N1: A View from the States

Types of data requested to inform May 2025 COVID-19 vaccine antigen composition deliberations

Global and national actions to prevent trade in substandard and adulterated medicines

Reforming humanitarianism can’t be left to today’s decision-makers

Beyond the Stigma: Supporting Mothers with Disabilities

Breaking the Cycle of Early Marriages and Early Motherhood in Roma Communities

Refugee Women’s Healthcare Accessibility: What We Should Know  by Sevil Hakimi 

Tackling racial discrimination in the EU

Migrant deaths in Asia hit record high in 2024, UN data reveals

‘Trapped populations’ need help to escape climate risks

People’s Health Dispatch Bulletin #97: Birthing under capitalism, healing under sanctions 

Decades of progress in reducing child deaths and stillbirths under threat, warns the United Nations 

HRR763. FROM INJUSTICE THE IDEA IS BORN AND FROM HUNGER AND THE HUNGRY THE ACTION IS TO COME. (pamphlet circulated at the Instituto Pedagógico, Universidad de Chile in 1966)

MSF warns of a crisis as the numbers of malnourished children rise in Yemen

Food Security and Water, a Priority for Border Towns in Central America

Optimal dietary patterns for healthy aging

The Dilemmas of Localization for Climate Action: The Struggles of Local NGOs in Accessing Global Platforms in Countries Like South Sudan  by David Odukanga

More Trees BANES-Grow Yourself-Community Tree Nursery Project

Glacier meltdown risks food and water supply of 2 billion people, says UN

 

 

 

 

 

Refugee Women’s Healthcare Accessibility: What We Should Know

IN A NUTSHELL
Author's Note
…Healthcare accessibility for refugee women varies significantly based on geographical location, legal status, and the availability of resources. In host countries, healthcare systems may be overwhelmed, underfunded, or ill-equipped to handle the influx of refugees. Additionally, language barriers and cultural differences can complicate communication, leading to inadequate care. In some regions, refugee women may have access to specific programs aimed at addressing their health needs, such as maternal health services and mental health support. However, these programs are not universally available and often depend on the funding and policies of host countries… 

By Sevil Hakimi RM. PhD

Professor of Maternal and newborn Health, Ege University, Faculty of Health Scienc. Department of Midwifery

Izmir, Turkey

Sevil.hakimi@ege.edu.tr 

Refugee Women’s Healthcare Accessibility

What We Should Know

 

 

Introduction

As a result of persecution, armed conflicts, inadequate healthcare, and human rights violations, over 100 million people worldwide were forcibly displaced from their homes by the end of 2022. Refugee women represent a vulnerable population facing unique health challenges due to their displacement. Access to healthcare services is crucial for their well-being. Women often play a central role in maintaining family health. By ensuring that refugee women have access to healthcare, the health of entire families can improve, leading to better health outcomes for children and partners. Ensuring that refugee women have access to healthcare also benefits public health in host countries. It helps prevent the spread of infectious diseases and contributes to healthier communities overall. Ensuring that refugee women have access to healthcare services aligns with global human rights standards and obligations.

Overview of Refugee Women’s Health Needs

Refugee women often experience a range of health issues, including reproductive health concerns, mental health disorders, and chronic diseases exacerbated by their experiences of trauma and displacement. Many suffer from conditions such as maternal morbidity, sexually transmitted infections, and mental health issues due to the stress of displacement and uncertainty about their future. The trauma of fleeing their homes often leaves refugee women grappling with significant psychological impacts, such as anxiety, depression, and post-traumatic stress disorder (PTSD). These mental health challenges can be compounded by the lack of social support and the stigma associated with mental health in many cultures. Furthermore, the disruption of their lives and loss of community can lead to feelings of isolation and helplessness, making it even more difficult for them to seek help. Access to reproductive health services is also a critical concern, as many refugee women may face barriers in obtaining necessary care during pregnancy and childbirth. Complications can arise due to inadequate prenatal and postnatal care, leading to increased risks of maternal and infant mortality. Additionally, the prevalence of sexual violence in conflict zones leaves many women vulnerable to sexually transmitted infections (STIs), including HIV, yet they often lack access to essential screening and treatment services. Chronic diseases such as diabetes and hypertension can also be exacerbated in refugee populations due to stress, poor nutrition, and limited access to healthcare services. Many refugee women may have pre-existing conditions that go untreated due to the lack of continuity in care and the complexities of navigating healthcare systems in host countries.

Healthcare accessibility for refugee women varies significantly based on geographical location, legal status, and the availability of resources. In host countries, healthcare systems may be overwhelmed, underfunded, or ill-equipped to handle the influx of refugees. Additionally, language barriers and cultural differences can complicate communication, leading to inadequate care. In some regions, refugee women may have access to specific programs aimed at addressing their health needs, such as maternal health services and mental health support. However, these programs are not universally available and often depend on the funding and policies of host countries. The legal status of refugees affects their access to healthcare. In many countries, refugees are entitled to some form of healthcare, but the extent of this access can vary widely. Some nations provide comprehensive health services, while others impose restrictions that limit refugees’ ability to seek care.

Facilitators of Healthcare Access

Community Support Networks

Community organizations and NGOs play a critical role in facilitating access to healthcare for refugee women. These organizations often provide vital resources, including information about available services, transportation assistance, and language translation support. By fostering a sense of community and belonging, these networks can encourage refugee women to seek the care they need.

Culturally Competent Care

Healthcare providers who are trained in cultural competence can significantly enhance healthcare accessibility for refugee women. Understanding cultural beliefs and practices helps providers deliver more effective care and build trust with patients. Culturally sensitive services can lead to better health outcomes by ensuring that women feel respected and understood.

Integration Programs

Government and NGO-led integration programs that focus on refugee women can improve healthcare access. These programs may include health education, advocacy for rights, and navigation assistance for the healthcare system. By empowering refugee women with knowledge and resources, these initiatives can lead to increased utilization of health services.

Barriers to Healthcare Access

Language and Communication Barriers

Language differences pose a significant barrier to healthcare access for refugee women. Limited proficiency in the local language can hinder their ability to communicate effectively with healthcare providers, leading to misunderstandings and inadequate care. This barrier often results in a reluctance to seek help, especially in urgent situations.

Financial Constraints

Financial barriers, such as lack of insurance or high out-of-pocket costs, can prevent refugee women from accessing necessary health services. In many cases, refugees may not be eligible for state-funded healthcare programs, leaving them to navigate a complex system that may require payment upfront.

Stigma and Discrimination

Refugee women often face stigma and discrimination within healthcare settings. Fear of being judged or treated unfairly can deter them from seeking care, particularly for sensitive issues like reproductive health or mental health. This stigma can be amplified by cultural differences, leading to a reluctance to engage with the healthcare system.

Legal and Policy Barriers

Restrictive immigration policies and legal barriers can further complicate access to healthcare for refugee women. In some host countries, refugees may face challenges in obtaining necessary documentation or may be subject to policies that limit their eligibility for health services. These barriers can exacerbate existing health disparities and lead to poorer health outcomes.

Conclusion

Accessing healthcare is a fundamental right, yet refugee women face numerous challenges that hinder their ability to receive the care they need. While community support, culturally competent care, and integration programs can facilitate access, significant barriers remain. Addressing these issues requires concerted efforts from governments, NGOs, and healthcare providers to create an inclusive and supportive healthcare environment for refugee women. Ensuring equitable access to healthcare services is essential for promoting the health and well-being of this vulnerable population.

 

References

  1. Yeshitila YG, Gold L, Abimanyi-Ochom J, Riggs E, Daba TT, Le H. Effectiveness and cost-effectiveness of models of maternity care for women from migrant and refugee backgrounds in high-income countries: A systematic review. Social Science & Medicine. 2024 Aug 23:117250.
  1. Markey K, Moloney M, O’Donnell CA, Noonan M, O’Donnell C, Tuohy T, MacFarlane A, Huschke S, Mohamed AH, Doody O. Enablers of and Barriers to Perinatal Mental Healthcare Access and Healthcare Provision for Refugee and Asylum-Seeking Women in the WHO European Region: A Scoping Review. InHealthcare 2024 Sep 1 (Vol. 12, No. 17, p. 1742). MDPI.
  1. Rowe A, Bhardwaj M, McCauley M. Maternal multimorbidity-experiences of women seeking asylum during pregnancy and after childbirth: a qualitative study. BMC Pregnancy and Childbirth. 2023 Nov 13;23(1):789.
  1. Banke-Thomas A, Agbemenu K, Johnson-Agbakwu C. Factors associated with access to maternal and reproductive health care among Somali refugee women resettled in Ohio, United States: A cross-sectional survey. Journal of immigrant and minority health. 2019 Oct 1;21:946-53.
  1. Floyd A, Sakellariou D. Healthcare access for refugee women with limited literacy: layers of disadvantage. International journal for equity in health. 2017 Dec;16:1-0.
  1. DeSa S, Gebremeskel AT, Omonaiye O, Yaya S. Barriers and facilitators to access mental health services among refugee women in high-income countries: a systematic review. Systematic reviews. 2022 Apr 6;11(1):62.

 

By the same Author on PEAH

Shadow Pandemic: Women’s Health in the Time of COVID-19

Beyond the Waives: Indirect Effects of Covid-19 on Mothers in Low and Middle-Income Countries

 

 

BOOK REVIEW: MY JOURNEY WITH COMMUNITY MEDICINE – A MEMOIR

IN A NUTSHELL
Author's Note
I have the pleasure of reviewing the Book “My Journey with Community Medicine” as a testimonial to the achievements of Dr M K Sudarshan over the years in his active professional life. The book acts as a powerful instrument of motivation to the students of Community Medicine

By Professor (Dr) Tanushree Mondal *

Editor – APCRI  Journal

Professor of Community Medicine, RG Kar Medical College, Kolkata, India

profcmrgkmc24@gmail.com

 

Book Review

MY JOURNEY WITH COMMUNITY MEDICINE: A MEMOIR

 

MY JOURNEY WITH COMMUNITY MEDICINE: A MEMOIR

Author Dr M.K. Sudarshan

Publisher: Maiya Publishing

Year of Publication: 2025

Pages: 120

Price: PaperBack (India Sales): Rs.450 (incl GST)
eBook (India Sales): Rs. 100
eBook (Outside India Sales): $5

ISBN No.: 978-93-93194-63-3

 

I have the pleasure of reviewing the Book, “My Journey with Community Medicine”. The book is a testimonial to the achievements of Dr M K Sudarshan over the years in his active professional life.

The book has 12 chapters spread over 120 pages. The first chapter delves upon his childhood. The next 2 chapters are concentrated on his MBBS and MD days. The Fourth chapter delves into his experience as a faculty in a medical college from April 1981 to October 2014. The fifth chapter describes his incremental interest in Rabies, and how it culminated into several State, National and International ventures and experiences is depicted along with colourful pictures in the other two chapters namely, the sixth and the seventh respectively. Chapter no. 8 states his vital role in the containment period of Covid-19 and his state level experiences in the State of Karnataka.

The book in itself has a neat cover, with vibrant colours with the photo of the author. In a few place, there are spelling mistakes that can be corrected in the following editions, but the grammar and the syntax are well done with proper alignment.

The ninth chapter deserves a special mention, enumerated as “My Mentors”. It is an interesting read in itself, with the pictures of his Mentors, but how these mentors shaped his life, how they were instrumental in his own being, could have been drawn in a more detailed way. This will in fact, render it as a useful textbook for all the teachers out there who are running their “Student Mentorship programme” in their respective colleges under the NMC guidelines. In this connection, a special mention is felt regarding the incorporation of emotional quotient (EQ) which is becoming very important in today’s world.

The final message section underscores professional achievement and staying happy and content in life while pursuing one’s own career.

The book is in itself is a snapshot of the living legend, however, the Summary Section may be forsaken as this would distract the attention of the readers and they would go only through the Summary segment without reading the details inside the book. There can be a section on takeaway messages out of the chapters.

Testimonials may be put in a single place as there is a chapter 12 dedicated for it solely. A special mention may be made to women at the workplace.

Moreover, since it is meant for students of Community Medicine, a special mention of what needs to be done in the future may be incorporated. At the same time, the goal of the national action plan for rabies elimination (NAPRE) needing a flagship may be duly emphasized.

The effort in bringing up such a book in such a compiled fashion and in a comprehensive way is truly laudable. Future plans in bringing out more books highlighting various aspects of his life can be thought of. In a nutshell, the book acts as a powerful instrument of motivation to the students of Community Medicine.

 

REFERENCE

https://maiyapublishing.com/product/my-journey-with-community-medicine-paper-back-within-india/

 

* PROF (DR) TANUSHREE MONDAL profile:

MD, FAIMER (CMC-L), ACME (JIPMER), MAPC (IGNOU), PhD
Professor, Deptt. of Community Medicine,
R G Kar Medical College, Kolkata
Former Deputy Director of Medical Education, GoWB
Former State Public Information Officer (SPIO) under Right to Information Act, for GoWB
Former MEU Coordinator, CC Member, GCP Trainer
Co-Investigator, NMHS -Phase II Megacity Survey (NIMHANS)
Member, Penal & Ethics Committee, West Bengal Medical Council
Member, Health Recruitment Board, GoWB
Editor, Association of Prevention & Control of Rabies in India

The Dilemmas of Localization for Climate Action: The Struggles of Local NGOs in Accessing Global Platforms in Countries Like South Sudan

IN A NUTSHELL
Author's Note
Localization in climate action has been increasingly emphasized as a critical strategy for effective and sustainable responses to climate change, particularly in vulnerable regions like South Sudan. However, despite global commitments to empowering local actors, numerous challenges continue to hinder the meaningful participation of local NGOs in international climate discourse and funding mechanisms. 

This article explores the dilemmas surrounding localization, the barriers faced by local NGOs in accessing global platforms, and the implications for climate action in fragile contexts

By David Odukanga

WASH and Climate Change Advisor 

The Dilemmas of Localization for Climate Action

The Struggles of Local NGOs in Accessing Global Platforms in Countries Like South Sudan

 

The Promise of Localization in Climate Action

Localization aims to shift power, resources, and decision-making to local actors who are best positioned to understand and address the needs of their communities. In theory, this approach enhances the effectiveness, relevance, and sustainability of climate interventions. Global frameworks such as the Paris Agreement and initiatives like the Grand Bargain advocate for increased funding and support for local organizations. However, in practice, significant gaps remain between policy commitments and actual implementation.

Challenges Hindering Local NGOs’ Access to Global Platforms

  1. Funding Barriers: Local NGOs in South Sudan and similar countries struggle to access international climate finance due to stringent eligibility criteria, complex application processes, and a preference for larger international For instance, according to the 2023 South Sudan Humanitarian Response Plan, only 2% of climate adaptation funding was directly allocated to local organizations, with the majority going to international entities (OCHA, 2023).
  2. Capacity Gaps: Many local organizations have deep contextual knowledge but face technical and operational challenges that limit their ability to engage in global climate platforms. Reports indicate that 78% of South Sudanese NGOs lack sufficient financial and administrative capacity to meet international donor requirements (UNDP, 2022).
  3. Limited Representation in Decision-Making: International climate negotiations and high- level policy discussions are often dominated by governments, multilateral agencies, and well-resourced A review of South Sudan’s participation in COP28 showed that only 5% of the country’s delegation comprised local NGO representatives, limiting their influence on decision-making processes (UNFCCC, 2023).
  4. Power Imbalances and Structural Exclusion: Even when local NGOs are involved in climate discussions, they often face tokenistic engagement rather than genuine decision-making power. Large INGOs and donors tend to dictate priorities, sidelining local knowledge and priorities.
  5. Bureaucratic and Political Constraints: In fragile states like South Sudan, political instability and restrictive policies further complicate local NGOs’ operations. Governmental restrictions, cumbersome registration processes, and bureaucratic hurdles limit their ability to receive international funding and collaborate with global partners.

Impacts on Climate Action in South Sudan

The exclusion of local NGOs from global climate platforms has dire consequences for climate action in South Sudan and similar countries. It results in:

  • Misaligned Priorities: Climate interventions often fail to reflect the actual needs and realities of affected communities.
  • Reduced Effectiveness: The reliance on external actors leads to inefficient project implementation, as local organizations are better suited to deliver context-specific
  • Erosion of Local Agency: The marginalization of local NGOs perpetuates dependency on international actors, preventing long-term sustainability and resilience building.
  • Missed Opportunities for Innovation: Many local NGOs develop innovative, indigenous climate adaptation strategies, but their lack of access to global platforms prevents the sharing and scaling up of these solutions.
Bridging the Gap

Recommendations for Meaningful Localization

To address these dilemmas, a shift in global climate governance and funding mechanisms is needed. Key recommendations include:

  • Increasing Direct Funding: International donors should simplify application processes and allocate more direct funding to local NGOs to enhance their capacity and autonomy.
  • Capacity Strengthening Initiatives: Investing in training and mentorship programs can empower local NGOs to navigate global climate finance and advocacy spaces effectively.
  • Ensuring Inclusive Representation: Climate summits and decision-making bodies should allocate seats for local actors, ensuring their voices influence global climate policies.
  • Reforming Bureaucratic Processes: Governments and international institutions should reduce bureaucratic red tape that hinders local NGOs from accessing funds and participating in global discussions.
  • Enhancing Partnerships and Collaboration: Strengthening partnerships between local NGOs, INGOs, and global institutions can create more equitable power dynamics and knowledge exchange.

Conclusion

Localization is essential for effective climate action, yet systemic barriers continue to exclude local NGOs from global platforms. Addressing these challenges requires genuine commitment from international actors, policymakers, and donors to shift power, resources, and decision-making to those most affected by climate change. Only by overcoming these dilemmas can countries like South Sudan harness the full potential of local expertise to build climate resilience and sustainable development pathways.

 

References

  • OCHA (2023). South Sudan Humanitarian Response United Nations Office for the Coordination of Humanitarian Affairs.
  • UNDP (2022). Capacity Needs Assessment of Local NGOs in South United Nations Development Programme.
  • UNFCCC (2023). COP28 Participation Report: South Sudan United Nations Framework Convention on Climate Change.

 

__

By the same Author on PEAH

The Nexus Between Climate Change, Security Impact on Public Health, and WASH in South Sudan 

News Flash 611: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Seagulls

News Flash 611

Weekly Snapshot of Public Health Challenges

 

Sign on to the letter: Exclude Factory Farming from World Bank Financing

Doge occupies US Institute of Peace headquarters after White House guts its board

With US funding loss, WHO forced to make ‘terrible’ programmatic choices

Scoop: UN migration agency cuts more jobs, shutters lifesaving programs

How Many Lives Does US Foreign Aid Save?

MEPs push for health to be a priority investment in the next EU budget

Regulation of Health and Health Care Artificial Intelligence

Tools for Healing: A Journey Through the Centuries from the Etruscan-Roman Era to the Robot. Testimonies from Tuscan Museums  by Esther Diana

Webinar registration: Pandemic Agreement Updates Mar 24, 2025

COVID-19: we’re no better prepared for a pandemic today than we were in 2020

Measles highest in 25 years in Europe, WHO says

Measles Vaccination, Disease Surveillance and Labs Hit Hardest by US Budget Cuts

Five Takeaways and Next Steps from the Immunization Agenda 2030

Is Big Pharma’s pollution deregulation campaign fueling the next pandemic?

FAO warns of ‘unprecedented’ avian flu spread, in call for global action

First vaccine against epizootic haemorrhagic disease recommended for approval

A frightening glimpse into the future of HIV research under Trump

MSF calls for sustained investments to fight against tuberculosis in children

Rate of People With Diabetes in Africa ‘Rising Faster’

EMA qualifies first artificial intelligence tool to diagnose inflammatory liver disease (MASH) in biopsy samples

UN Commission approves WHO recommendations to place psychoactive substances under international control

Epilepsy Patients in Africa Fight Stigma and Neglect

Genocide Watch Report: Hmong at Risk

FIAN International annual report looks back on 2024

HRR762. WHEN ‘GROWTH’ DISPLACED ‘DEVELOPMENT’ AS THE DREAM OF GOVERNMENTS AND ECONOMISTS

Finland again tops global happiness rankings, US falls to lowest position ever

If “Food Is Medicine,” Why Are Hospitals Still Serving Junk?

Restore our Planet – Hunting Animal Traffickers: Tim Santel

South Africa: The Green Connection Welcomes Settlement to Protect African Penguin and Small-Scale Fisher Livelihoods

Nearly 50 million people sign up call for clean air action for better health

The Nexus Between Climate Change, Security Impact on Public Health, and WASH in South Sudan  by David Odukanga

The Year 2024 Was Warmest-Ever on Record – Temperature Rise Likely Exceeded 1.5°C 

 

 

 

 

 

 

 

 

 

The Nexus Between Climate Change, Security Impact on Public Health, and WASH in South Sudan

IN A NUTSHELL
Author's Note
Climate change significantly impacts public health and security, particularly in fragile states such as South Sudan. Rising temperatures, unpredictable rainfall, and extreme weather events have exacerbated water scarcity, reduced water quality, and increased disease burdens. These environmental stressors intensify conflicts over resources, leading to displacement and further strain on Water, Sanitation, and Hygiene (WASH) services. 

According to the United Nations (2023), over 60% of South Sudan's population lacks access to safe drinking water, while 75% depends on unimproved sanitation facilities. Additionally, with the termination of all USAID-funded projects in South Sudan, the already significant funding gaps for WASH services will further widen, exacerbating the existing humanitarian crisis. 

This article highlights the urgent need for climate-resilient infrastructure, integrated policies, and coordinated humanitarian responses to enhance South Sudan's adaptive capacity

By David Odukanga

WASH and Climate Change Advisor 

The Nexus Between Climate Change, Security Impact on Public Health, and WASH in South Sudan

 

Introduction

Climate change is a global crisis with profound implications for security and public health, particularly in vulnerable regions such as South Sudan. The country, already grappling with political instability and economic fragility, faces severe climate-induced challenges that impact access to clean water, sanitation, and hygiene. The increasing frequency of droughts, floods, and erratic rainfall patterns exacerbates water shortages, leading to a rise in waterborne diseases and heightened competition over scarce resources. For instance, the 2021 floods affected over 850,000 people (OCHA, 2021), damaging WASH infrastructure and increasing the spread of waterborne diseases. The withdrawal of USAID funding will likely lead to the closure of essential projects, reduced access to clean water, and an increased burden on humanitarian agencies struggling to fill the void. This interplay between climate change, security, and public health underscores the need for comprehensive and resilient WASH interventions.

Climate Change and Its Impact on WASH Services in South Sudan

South Sudan’s climate is characterized by prolonged dry spells and intense seasonal flooding, both of which severely disrupt WASH services.

Water Scarcity and Quality

Reduced rainfall and prolonged droughts deplete water sources, forcing communities to rely on unsafe water supplies. A report by UNICEF (2022) found that 58% of South Sudanese households consume contaminated water, increasing the risk of diseases such as cholera, typhoid, and diarrhoea.

Flooding and Infrastructure Damage

Heavy floods destroy water infrastructure, contaminate boreholes, and spread pollutants, leading to increased health risks. The 2020 floods, for example, submerged more than 70% of Unity State (UNHCR, 2020), rendering WASH facilities non-functional.

Sanitation Challenges

Disruptions to sanitation facilities due to extreme weather events contribute to open defecation, exacerbating disease outbreaks and further straining health systems.

Security Implications of Climate-Induced Water Scarcity

Climate change-induced water shortages contribute to resource-based conflicts among communities, leading to displacement and heightened security threats.

Resource-Based Conflicts

Competition over diminishing water sources fuels intercommunal violence, exacerbating instability in South Sudan. In 2023, conflicts between pastoralist communities over water and grazing lands in Jonglei and Warrap states resulted in over 500 deaths (International Crisis Group, 2023).

Forced Displacement

Climate-induced displacement places immense pressure on host communities and humanitarian agencies, increasing the demand for clean water and sanitation services. The International Organization for Migration (2022) estimated that over 1.6 million people were displaced due to climate-related disasters.

Disruptions in Health Services

Security threats hinder access to healthcare facilities, reducing the effectiveness of WASH interventions and increasing vulnerability to disease outbreaks.

Public Health Consequences of Climate Change and WASH Deficiencies

The deterioration of WASH services due to climate change directly impacts public health outcomes in South Sudan.

Increased Disease Burden

Poor water quality and inadequate sanitation contribute to cholera outbreaks, acute watery diarrhoea, and malnutrition, particularly among children and displaced populations. South Sudan recorded over 3,500 cholera cases in 2022 alone (WHO, 2022).

Compromised Maternal and Child Health

Pregnant women and children are disproportionately affected by inadequate WASH services, leading to higher maternal and infant mortality rates. The maternal mortality rate in South Sudan stands at 1,150 per 100,000 live births, among the highest in the world (World Bank, 2023).

Vector-Borne Diseases

Stagnant floodwaters create breeding grounds for mosquitoes, increasing the prevalence of malaria and other vector-borne diseases. Malaria accounts for 33% of all hospital admissions in South Sudan (MSF, 2023).

Strategies for Strengthening Climate-Resilient WASH Systems

To mitigate the impact of climate change on public health and security, South Sudan must adopt integrated and sustainable WASH strategies.

Investment in Climate-Resilient Infrastructure

Building flood-resistant water systems, rehabilitating boreholes, and improving drainage systems are crucial for sustaining WASH services.

Policy and Governance Frameworks

Strengthening policies on climate adaptation, water resource management, and sanitation can enhance resilience.

Community-Based Adaptation

Engaging local communities in WASH interventions ensures sustainability and enhances preparedness for climate-related disasters.

Humanitarian Coordination

With the withdrawal of USAID funding, urgent efforts must be made to secure alternative sources of funding for WASH services. Collaboration between government, international organizations, and NGOs is essential for effective emergency response and long-term resilience building.

Conclusion

The nexus between climate change, security, and public health highlights the urgency of investing in resilient WASH systems in South Sudan. Addressing these interconnected challenges requires a multi-sectoral approach that integrates climate adaptation strategies, conflict resolution mechanisms, and sustainable health interventions. Strengthening WASH services will not only improve public health outcomes but also contribute to stability and resilience in South Sudan’s fragile environment. With the termination of USAID projects, urgent action is required to fill the funding gap to prevent worsening public health crises.

 

References

  • International Crisis Group, Water Scarcity and Conflict in South Sudan.
  • International Organization for Migration (IOM), South Sudan Displacement Overview.
  • Médecins Sans Frontières (MSF), Malaria in South Sudan: A Growing Crisis.
  • OCHA, Flood Impact Assessment in South Sudan.
  • UNHCR, Climate Displacement in Unity State, South Sudan.
  • UNICEF, Water Quality Report: South Sudan.
  • United Nations, Access to Clean Water and Sanitation in South Sudan.
  • WHO, Cholera Outbreak Situation Report.
  • World Bank, Maternal Mortality Trends in South Sudan.

Tools for Healing: A Journey Through the Centuries from the Etruscan-Roman Era to the Robot

IN A NUTSHELL
Author's Note
The 14th-century hospital of San Giovanni di Dio in Florence has, since the late 19th century, evolved into a specialized center predominantly focused on cardiovascular surgery. Decommissioned in 1983, the institution now calls for initiatives aimed at its enhancement, protection, and, above all, its conversion to a social-medical-sanitary use that will rescue it from its evident and growing underutilization. 

This impetus to capture the attention of the relevant authorities has been expressed through an Exhibition, complete with a catalog and parallel events. 

The Exhibition, "Tools for Healing: A Journey Through the Centuries from the Etruscan-Roman Era to the Robot. Testimonies from Tuscan Museums", aims to trace the milestones of progress in Tuscan (and interregional) surgery: from Etruscan-Roman and pre-Columbian surgical instruments, through the 18th-century technological innovations that codified the first specialized branches of medicine, to robotic surgery that represents the future of the discipline

By Dr Esther Diana

Architect, Historian of Healthcare and Healthcare Architecture

Tools for Healing

A Journey Through the Centuries from the Etruscan-Roman Era to the Robot

Testimonies from Tuscan Museums

 

Italian translation HERE

 

From the display of Etruscan-Roman and pre-Columbian surgical instruments viewers have an opportunity to explore the evolution of surgery from the 19th century to the present.

The Exhibition “Tools for Healing: A Journey Through the Centuries from the Etruscan-Roman Era to the Robot. Testimonies from Tuscan Museums” will be held from February 14 to May 9, 2025, at the Biblioteca Marucelliana in Florence, via Cavour 43.

The Exhibition poster

The history (1380 until today) of the ancient hospital of San Giovanni di Dio in Florence is a case study of the history and progress object of the Exhibition.

It is currently awaiting development that reflects its unique healthcare legacy—especially in the field of surgery, which established its reputation as an institution of excellence during the 19th and 20th centuries.

The Exhibition follows a philological storyline divided into four sections, each serving as an thematic synthesis. The first section, “Surgery in Archaeological Evidence”, highlights historical background of the hospital San Giovanni di Dio.

Entrance to the Exhibition

The Etruscan-Roman instrument room

The second section, “From Empirical Surgery to Vesalius”, highlights the crucial role that anatomical advances have played in the development of surgery and medicine in general. In the same space, the third section, “Military Surgery”, is dedicated to treatises by Ambroise Paré (1510-1590) and Giovanni Alessandro Brambilla (1728-1800), and displays three cases from Brambilla’s Armamentarium Chirurgicum.

Giovanni Alessandro Brambilla, Instrumentarium chirurgicum militare viennense, 1781 and urology tools

Finally, the fourth and most extensive section, “The Surgery of the Future”, acts as a bridge between the advancements achieved in the 19th and 20th centuries in general surgery, orthopedics, urology, and cardiac surgery, and the cutting-edge techniques of today and tomorrow: namely, minimally invasive and robotic surgery.

The scientific project and the curation of the Exhibition are led by Architect Esther Diana and Professor Francesco Tonelli, Emeritus in Surgery University of Florence.

Starting with History

In 1380, the Florentine merchant Simone Vespucci founded a hospital in Florence, near his family residence in the Santa Maria Novella district, intended for the impoverished – primarily wool workers. However, political and economic difficulties hindered the development of the institution, which remained essentially an almshouse until 1587.

Its transformation into a healthcare institution began in 1587, when the Grand Duke Francesco de Medici assigned this semi-abandoned facility to the Fatebenefratelli, a Counter-Reformation Order that was strongly supported by the Church and, as a result, warmly received at the Florentine court. The original “hospitaletto dei Vespucci” dedicated to Santa maria dell’Umiltà opened its doors immediately – as evidenced by the early Libri degli Infermi (Books of the Sick) from 1607 – with a ward arranged for 17 beds.

With the backing of the Church and the devoted care of the Brothers, the institution quickly succeeded, and in 1698 it was dedicated to San Giovanni di Dio in honor of the Order’s founder, Juan Ciudad, who was later canonized.

As a religious entity, the hospital was independent of state authority, a status that allowed it to be exempt from the public health regulations imposed during epidemic crises (notably plague and typhus) and to maintain full autonomy until the dissolution of the Order in 1866. This independence, determined in part by the type of care provided by the Brothers – mainly treating fevers (by reducing fever peaks through bloodletting or herbal infusions and decoctions), wounds, cuts, tooth extractions, and realigning limbs after falls or blows – transformed it into a specialist hospital where careful surgical procedures were largely carried out by the friars themselves.

The 17th century, and especially the 18th, represented the “golden age” of the complex, which significantly expanded its structure according to the architectural style typical of the Order – a style also adopted by other hospitals – characterized by an infirmary on the upper floor and a monumental entrance hall with a double, bi-directional staircase.

Monumental entrance hall of San Giovanni di Dio hospital, Florence

Towards Surgical Excellence

By the late 19th century, the hospital had increasingly emphasized its surgical function, bolstered by the presence of highly skilled medical professionals of both outstanding competence and humanity. By 1901, radiology, dentistry, and laboratory services were already in operation; in 1907, Florence’s first nighttime emergency service was established, paving the way for the creation of outpatient clinics in ophthalmology, otorhinolaryngology, urology, general medicine, and pediatrics by 1940.

During the 20th century, surgical activities intensified, particularly in oncological treatments involving complex abdominal and thoracic procedures. In the mid-1950s, a new frontier was opened – the first in Tuscany and among the first in Italy – in vascular and cardiac surgery. In the subsequent years, San Giovanni di Dio became a center of high specialization in these fields, acquiring a heart-lung machine; at that time, it was one of only two in Italy, the other being at Niguarda Hospital in Milan.

The heart-lung machine, 1957

This machine – now exhibited – enabled extracorporeal circulation, allowing surgeons to operate on a still, open heart to correct congenital defects, treat acquired or traumatic conditions, and eventually perform heart and heart-lung transplants.

Early experimental heart-lung machines were developed by John Heysham Gibbon (1903-1973) in 1937 and later applied in humans in 1953, managing to exclude the heart from circulation for approximately thirty minutes.
The exhibited heart-lung machine was purchased in Paris in 1957 for 890,600 Lire. Its cardiac function (circulation) was achieved through a system of keys (“fingers”) that propelled the blood in a coordinated and continuous manner, while its respiratory function (oxygenation) was provided by rotating discs within a cylinder.

The detailed focus on the heart-lung machine in the Exhibition underlines a pivotal moment in surgical practice – a point of departure from traditional methods. While archaeological artifacts show surgical instruments whose general design remains in use even in the 18th and 19th centuries, the heart-lung machine introduces us to a realm of highly technological surgery.

The fourth section of the Exhibition documents the advances achieved from the 18th century onward: the introduction of anesthesia, the discovery of pathogenic microorganisms, the advent of antiseptic and aseptic techniques, the ability to perform blood transfusions thanks to the identification of blood groups and the Rh factor, improvements in suturing techniques, the discovery of antibiotics, and the testing of biocompatible prosthetic materials – all fundamental in ensuring increasingly infection-free, less invasive, and less painful surgical interventions. Surgery has expanded into previously uncharted territories such as the abdomen, thorax, heart, major vessels, and skull. At the end of the 20th century, further innovations from physics and new materials led to the creation of flexible endoscopic instruments, which, using fiber optics or miniaturized cameras, allowed for effective endoscopic surgeries for biopsies, polypectomies, dilation of stenoses, and stone removal.

And finally, the surgery of today, already looking to the future: since development in 2000 of robotic surgery has emerged. This computerized system of sophisticated laparoscopic instruments, controlled by the surgeon from a remote console, offers enhanced three-dimensional and magnified vision, and movement precision that rivals or even surpasses that of the human wrist.

Introduction to robotic surgery

 

Conclusion

In conclusion, this Exhibition has a dual purpose. First, it serves to educate – especially young audiences – about a scientific journey of progress that, although largely overlooked, deserves thorough recognition and study as the outcome of extensive research, dedication, and the commitment of many surgeons who over the centuries have made the well-being of the individual a core ethical and moral principle. Second, as noted at the outset, it aims to prevent an institution of significant historical value from falling into oblivion, or worse, being ensnared by political and real estate speculation. San Giovanni di Dio remains a cherished institution among the people of Florence, awaiting only the acknowledgment of higher authorities to resume its rightful role in healthcare.

News Flash 610: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Beadlet anemone (Actinia equina)

News Flash 610

Weekly Snapshot of Public Health Challenges

  

Health Policy Under The Trump Administration: The First 50 Days

Universities in the Early Decades of the Third Millennium: Saving the World from Itself? – and 1 HOPE-TDR Regional Project Proposals  by George Lueddeke

The G20: How it Works, Why it Matters and What Would be Lost if it Failed

Union Budget (2025-26) and comprehensive primary healthcare system: Another lost opportunity?

Global and national actions to prevent trade in substandard and adulterated medicines

Unregulated advanced therapy medicinal products pose serious risks to health

Germany’s Future Coalition Faces a Tough Choice on Global Development as US and UK Pull Back

Thousands of cholera patients treated in Sudan’s White Nile State

Rabies in India: Current Scenario and Prospects of Elimination  by Tanushree Mondal and M.K. Sudarshan

Dissolving Drug Offers New HIV Treatment Hope for Babies

Strengthening Africa’s mpox diagnostic capacity for enhanced epidemic preparedness and response

NEJM Outbreaks Update — H5N1

Discovery of Mosquito Molecular Mechanism Opens Door to New Antimalaria Strategies

Many pregnancy-related complications going undetected and untreated – WHO

Three vaccinations that are critical to women’s health

Statement for International Women’s Day 2025

Despite ‘Rising Misogyny’, UN Commission Adopts Declaration on Gender Equity

WHO injects fresh support into DR Congo vaccination drive

People’s Health Dispatch Bulletin #96: From Argentina to Palestine, the battle for health and justice continues 

HRR761. DO NOT UNDERESTIMATE (OR OVERESTIMATE) THE SIGNIFICANCE OF THE COURT OF PUBLIC OPINION

Navigating the Complexity of Food Insecurity Screening

US Preventive Services Task Force Recommendations for Screening for Food InsecuritySilver Linings Amid a Cloudy Future

Chemical and Pollution Event: The Right to Know – Modernising the Rotterdam Convention | Road to 2025 BRS COPs 19 March 2025

Water Crisis and Environmental Risks: The Impact of Canal Expansion and Corporate Farming in Pakistan

US retreat from climate leadership is a betrayal of global responsibility

Western Climate Hypocrisy Exposed by NATO Energy Policy

Scoop: Brazil hammers out details of forest fund ahead of COP30

Northern India Dominates Global Air Pollution Rankings

Majority of the world’s population breathes dirty air, report says

Cities face ‘whiplash’ of floods, droughts as temperatures rise, study warns

 

 

 

 

 

 

 

 

Rabies in India: Current Scenario and Prospects of Elimination

IN A NUTSHELL
Author's Note
India has the highest burden of human rabies, as annually an estimated 20,000 deaths are known to occur and this accounts for nearly one-third of the annual global burden of about 55,000 to 60,000 deaths. This article turns the spotlight on what this scourge means for India whereby prospects of (and difficulties in) eliminating dog mediated human rabies from India by 2030 are taken into consideration

By Professor (Dr) Tanushree Mondal

Editor – APCRI  Journal

Professor of Community Medicine, RG Kar Medical College, Kolkata, India

profcmrgkmc24@gmail.com

Dr. M.K. Sudarshan*

Founder President and Mentor

APCRI, Bangalore, India

Email: mksudarshan@gmail.com

Rabies in India

Current Scenario and Prospects of Elimination

 

Rabies is a practically 100% fatal disease and the very few who have survived are with residual neurological disabilities for the rest of their lives.  Rabies is caused by a virus known as rhabdovirus that is present in the saliva of rabid animals.  Following bites, scratches and even licks on wounds by rabid animals, the virus is deposited in the wound/s.  If timely and proper lifesaving post –bite/ exposure prophylaxis (PEP) is not received by the rabies exposed person, then the virus travels via the nerves and reaches the brain. This usually takes about 3 weeks to 3 months, known as incubation period. Subsequently the person manifests with symptoms of the disease like fever, headache, body ache, fear of water (hydrophobia), fear of breeze (aerophobia), fear of light (photophobia), spasm or paralysis, etc and ordinarily survives for 2 to 5 days. In the majority, the death is very painful and agonizing.

The Current Scenario

The burden of human rabies

India has the highest burden of human rabies, as annually an estimated 20,000 deaths (1) are known to occur and this accounts for nearly one-third of the annual global burden of about 55,000 to 60,000 deaths (2). The principal vector of the disease is dogs accounting for 99% human rabies globally and 97% in India. The other animals involved in rabies transmission in India are cats (2%) and wild animals (1%) like mongoose, jackals, wild dogs and others. But this figure is now two decades old and not tenable. Interestingly, another national multicentric rabies survey done recently in 2022-23 by Indian Council of Medical Research has shown that 5726 human rabies are estimated to occur annually in the country (3), which appears realistic but needs its acceptance by Government of India. The sooner it happens it is good for India.  This is because in the last two decades much progress has been made like the sheep brain/Semple vaccine was discontinued and replaced by modern rabies vaccines in 2005, cost–effective intra-dermal rabies vaccination (IDRV) was introduced in 2006, vast improvents in the logistics of rabies biologics following better transportation and communications and lastly, there is an overall upliftment in the socio-economic status of the people.  All these have contributed to the reduced number of human rabies deaths in the country. 

The dogs and their role in disease transmission

As per Indian ethos and constitution, all living beings have a right to live and co-exist in the society. The dogs are popular pets in 11.3 % households in India (4). Also, there are a large proportion of dogs in the neighbourhood known as community dogs, also referred to as stray/street dogs. It is estimated that there are about 90 million dogs in the country of which 30 million are pets and 60 million community dogs/strays. In 2001, for the safety and welfare of these stray dogs under the prevention of cruelty to animals act (PCA 1960), animal birth control (ABC) rules were passed in the parliament that ensure no harm is done to stray dogs and the civic municipal bodies take care of them.

The World Health Organization – Association for Prevention and Control of rabies in India (WHO –APCRI) national multicentric rabies surveys done in 2003 and 2017 showed that 96.2% and 83% of human rabies deaths respectively in the country were following dog bites.

Figure 1: A dog chasing a motorcyclist, a common sight in the cities of India 

The WHO – APCRI national multicentric survey of 2003 showed an estimated 17.4 million animal bites occurred annually in India. However, two decades later in 2022-23, the national multicentric survey of Indian Council of Medical Research (ICMR), showed it to be around 9.1 million, but this survey had some limitation like the effect of the ongoing Covid pandemic in the country, etc.

Unfortunately, rarely there are instances of unsupervised infants and toddlers and the very old being mauled to death by pack of dogs in the communities.  Also, the sudden and unexpected aggression by street dogs have led to injuries, maiming and even human deaths due to accidents.  As a result, often there are conflicts in the populations about having strays on the streets. The animal welfare organizations (AWOs) are very protective and vocal about welfare of stray dogs in the country. Recently, as per the guidelines of animal welfare board of India (AWBI), there are attempts by civic bodies in the country to feed these stray dogs timely in the day at designated places by identified and trained community volunteers and that is expected to reduce aggression of the street dogs.

Prospects of elimination of dog mediated human rabies from India by 2030

The World Health Organization and other UN agencies in 2015 together pledged to eliminate dog mediated human rabies from the world by 2030, and the slogan is zero by thirty.  That is to eliminate 99% of the global burden of human rabies by 2030. Consequently, in sync with the global plan, in 2021 Government of India, despite the ongoing Covid-19 pandemic, launched the national action plan for rabies elimination (NAPRE) (5). As India has a federal structure, based on the NAPRE, the states have commenced state action plans for rabies elimination (SAPRE) by 2030.  To prioritize and accelerate the progress, from 2024, rabies free cities action plans are being implemented (6). The key components of all of these are – providing free rabies post – exposure prophylaxis (PEP) to all rabies exposed individuals timely, correctly and completely; mass dog vaccination (MDV) covering 70% of the dogs in the community, dog population management (DPM), promoting responsible pet ownership and advocacy, awareness, education, and operational research. The key elements for achieving these are – 3Ps i.e. prevention, promotion and partnership.

In view of large reservoir of rabies in the dog population in the country, federal structure and varying degrees of progress and performances by the states, inadequate resources and weak intersectoral coordination and cooperation, the elimination of dog mediated human rabies by 2030 appears difficult. Hence, it is recommended that the zero by thirty action plan be implemented as a 100% centrally sponsored programme with the same vigour and force of polio eradication. Only then tangible benefits will be seen soon on the ground.

 

References

  1. Assessing burden of rabies in India: WHO sponsored national multi-centric rabies survey 2003. Association for Prevention and Control of Rabies in India https://www.researchgate.net/publication/45261915_Assessing_Burden_of_Rabies_in_India_WHO_Sponsored_National_Multicentric_Rabies_Survey_2003
  2. WHO Expert Consultation on Rabies: WHO TRS N°1012 Third report, 14 April 2018 https://www.who.int/publications/i/item/WHO-TRS-1012
  3. Estimates of the burden of human rabies deaths and animal bites in India, 2022–23: A community-based cross-sectional survey and probability decision-tree modelling study. Jeromie Wesley VivianThangarajet al The Lancet Infectious Diseases Volume 25, Issue 1, January 2025, Pages 126-134 https://www.sciencedirect.com/science/article/abs/pii/S1473309924004900
  4. APCRI –WHO Indian Multicentric Rabies Survey , 2017 http://apcri.in/pdf/WHO-APCRI%20Rabies%20Survey,%202017%20-%20Final%20Report.pdf
  5. National Action Plan for Dog Mediated Rabies Elimination from India by 2030 https://rr-asia.woah.org/app/uploads/2022/12/india-napre-rabies.pdf
  6. Ministry of Health and Family Welfare. Government of India. Operational Guidelines. Rabies Free City Initiative. A Step Towards Rabies Free India by 2030.https://ncdc.mohfw.gov.in/wp-content/uploads/2024/11/Rabies-Operational-Guidelines_25th-Sept_24.pdf

 

* Dr M. K. Sudarshan profile: 

Founder, President and Mentor, Association for Prevention and Control of Rabies in India,
Former Professor, Principal and Director, Kempegowda Institute of Medical Sciences (KIMS), Bangalore, 
Chief Editor, Indian Journal of Public Health 
Member, WHO Expert Advisory panel on Rabies & Expert Consultations on Rabies, Member of National Technical Advisory Committee (NTAC) on Rabies
Leader in Health Research in India
Chairman, National Expert Consultation on Rabies and Chairman, Karnataka State Covid-19 Technical Advisory Committee (TAC) and Chair, South East Asia Region(SEAR)- Rabies Technical Advisory Group.
Recipient of Dr. B C Roy Doctor's Day for Excellence in Medical Education (2010), Lifetime Achievement Award (2013), Best Community Health Professional Award (2014), Rajyotasava Award (2021), Eminent Teacher Award from Rajiv Gandhi University of Health Sciences, Karnataka(2022), National Medical Recognition Award (2022) and Honorary Doctorate (D.Sc. Honoris Causa) in Science from Rajiv Gandhi University of Health Sciences (2023) and Dr I.C. Tiwari Memorial Lifetime Achievement Award (2025).

‘Universities in the Early Decades of the Third Millennium: Saving the World from Itself?’ and 1 HOPE-TDR Regional Project Proposals

IN A NUTSHELL
Author's Note
A re-proposal here of an invited chapter published in 2020 and focused on the re-conceptualisation of the university/higher education purpose and scope inside a ‘One Health’ overarching perspective. As divisive forces are increasingly placing institutions and society, indeed the world, at risk, the importance of 'seeing the big picture' and potential consequences of human folly, appears to be even more urgent and relevant today as it was a few years ago

George Lueddeke

 By George Lueddeke PhD

Global Lead, International One Health for One Planet Education & Transdisciplinary Research Initiative (1 HOPE-TDR)

Independent advisor in Higher, Medical and One Health education / research

Southampton, United Kingdom

‘Universities in the Early Decades of the Third Millennium: Saving the World from Itself?’ and 1 HOPE-TDR Regional Project Proposals

 

In support of Operationalising 1 HOPE-TDR  project proposals across global regions and  associated terms of reference, integrated as  ‘cultivating an active care for the world and with those with whom we share it’ [UNESCO] ,  find a PDF copy  below of an invited chapter titled Universities  in the early Decades of the third Millennium: Saving the World from itself?

Universities in the Early Decades of the Third Millennium

Summarised in the Abstract, the chapter, published in 2020, argued “for the re-conceptualisation of the university/higher education purpose and scope focusing on the development of an interconnected ecological knowledge system (recognising the interdependence of the 17 UN global goals) with a concern for the whole Earth -and beyond.”

Main themes (and chapter page references) include:

  • The university in the first two millennia: historical perspectives and takeaways (pp. 230-233)
  •  Existential challenges facing the planet and society in the twenty-first century (pp. 234-237)
  • War: “Humanity’s Greatest Failure” (pp.237-238)
  •  Social progress and the university (pp.238-239)
  • Toward a new worldview (pp. 239-245)
  • The international ‘One Health for One Planet Education initiative’ (pp.245-247)
  •  Re-imagining the university in the twenty-first century (pp. 247-249)
  • Reflection on teaching and learning in the ecological university (pp. 249-252)
  • The university: saving the world from itself?
  • Concluding comments: choosing our future (pp.256-260)
  • References (pp.260-266)

 

As divisive forces are increasingly placing institutions and society, indeed the world, at risk, the importance of ‘seeing the big picture’ and potential consequences of human folly, appears to be even more urgent and relevant today as it was a few years ago