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WHO has determined a public health emergency of international concern (PHEIC) seven times, and beyond this nomenclature declared COVID-19 to be a pandemic. Under the International Health Regulations (IHR), and through their operationalisation in the joint external evaluation (JEE), governments are urged to create suitable legislation to be able to enact a response to a public health emergency. Whether the pandemic declaration had a greater effect than a PHEIC in encouraging goverments to act, however, remains conjecture, as there is no systemic analysis of what each term means in practice and whether either has meaningful legal implications at the national level. We undertook a legal scoping review to assess the utilisation of PHEIC and pandemic language within national legislation in 28 WHO member states. Data were collected from national websites, JEE reviews, COVID Analysis and Mapping of Policies Tool, Natlex, and Oxford Compendium of National Legal Responses to COVID-19. We found that only 16% of countries have any reference to the PHEIC in national legislation and 37·5% of countries reference the term pandemic. This finding paints a weakened picture of the IHR and PHEIC mechanisms. Having such legalese enshrined in legislation might enhance the interaction between WHO determining a PHEIC or declaring a pandemic and resulting action to mitigate transnational spread of disease and enhance health security. Given the ongoing negotiations at WHO in relation to the amendments to the IHR and creation of the pandemic accord, both of which deal with this declaratory power of the PHEIC and pandemic language, negotiators should understand the possible implications of any changes to these proclamations at the national level and for global health security. [ABSTRACT FROM AUTHOR]

Global and national authorities have not historically approached animal health emergencies through a gendered lens. Yet these events almost certainly have gendered dimensions, such as differential engagement of women or men depending on their culturally accepted or assigned roles for animal care: risk of exposure to zoonoses; and access to emergency resources during response and recovery. Despite the role that gender seems to play with respect to animal health emergencies, little research has been conducted to better understand such dynamics, and little policy has been promulgated to address it in a way that optimizes response while ensuring equitableoutcomes. This piece summarizes 3 key themes that emerged from a panel discussion on gender and animal health emergencies at the World Organisation for Animal Health Global Conference on Emergency Management in April 2023. These themes were differential gendered exposure to pathogens; a lack of equitable gender representation in animal health decision-making; and enhancement of pathways for recognizing gender in national and international actions in preparing for, detecting, and responding to animal health emergencies. Beyond increasing opportunities for women to engage in leadership, the animal health and veterinary communities will benefit from connecting practitioners with gender experts to develop more integrative approaches to emergency preparedness and management. Animal health professionals should also advocate for further research to elucidate gender-specific dynamics in human populations in the context of animal emergencies and the promulgation of evidence-based policies. Such transformative efforts will lead to better outcomes for all people who depend on and provide care for animals. [ABSTRACT FROM AUTHOR]

Global health security is an increasingly complex regime. The failures of global governance and norms of cooperation during the coronavirus disease 2019 (COVID-19) pandemic and the re-entrenchment to nationalist policy-making have created impetus for new governance arrangements, institutions and policy development. These changes include amendments to the International health regulations (IHR), development of a pandemic convention or accord, convening of the High-Level Meeting on Pandemic Preparedness and Response, establishment of the Pandemic Fund, and development of the medical countermeasures platform, among others. These various developments claim to be in synergy with each other, but understanding of regime complexes and forum shifting from international relations reveal the power dyna mics which underlie these processes. I use these concepts to demonstrate how states are transferring negotiations from one institutional location to another in search of more favourable outcomes, or are creating strategic uncertainty within negotiations to avoid future accountability. I further highlight three risks posed by these developments: (i) an increasingly complex landscape for global health security; (ii) erosion of the World Health Organization's authority in global health security; and (iii) dominance of high-income state positions within these negotiations. [ABSTRACT FROM AUTHOR]

Across multiple pandemics, global health governance institutions have struggled to secure the compliance of states with international legal and political commitments, ranging from data sharing to observing WHO guidance to sharing vaccines. In response, governments are negotiating a new pandemic treaty and revising the International Health Regulations. Achieving compliance remains challenging, but international relations and international law research in areas outside of health offers insights. This Health Policy analyses international relations research on the reasons why states comply with international law, even in the absence of sanctions. Drawing on human rights, trade, finance, tobacco, and environmental law, we categorise compliance mechanisms as police patrol, fire alarm, or community organiser models. We show that, to date, current and proposed global health law incorporates only a few of the mechanisms that have shown to be effective in other areas. We offer six specific, politically feasible mechanisms for new international agreements that, together, could create compliance pressures to shift state behaviour. [ABSTRACT FROM AUTHOR]

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

Community health workers (CHWs) are framed as the link between communities and the formal health system. CHWs must establish trusting relationships with the community and with the broader health service. How to find the optimal balance between the various strands of work for CHWs, and how to formalise this, has been the focus of different studies. We performed an extensive documentary analysis of federal legislation in Brazil to understand the institutionalisation of the CHW workforce in Brazil over the last 3 decades. The paper offers three contributions to the literature: the development and application of an analytical framework to consider the institutionalisation process of CHWs; a historical analysis of the professional institutionalisation of CHW in Brazil; and the identification of the paradoxes that such institutionalisation faces: firstly, institutionalisation focused on improving CHW remuneration created difficulties in hiring and paying these professionals; when CHW are incorporated within state bureaucracy they start to lose their autonomy as community agents; and that the effectiveness of CHW programmes depends on the improvement of clinical services in the most deprived areas. [ABSTRACT FROM AUTHOR]

During health emergencies, neglect of gender experiences and needs can compromise the outbreak response. Ebola in West Africa and Zika in Latin America had gendered effects that were evident during the crises, yet governments and international organizations failed to prioritize a gender-inclusive response. There is the same risk that gender-inclusive responses and knowledge will continue to be neglected during the COVID-19 pandemic. In this article, we examine the drivers of gender exclusion in health emergency response. We ask: where can we locate institutional responsibility for taking gender seriously to inform and improve sustainable disease control? The article addresses this question by turning to feminist institutional theory to explain why gender inclusion in decision-making processes is vital for effective response and post-crisis recovery. We argue that the institutional responsibility to recognize gender within the global health emergency regime lies with the World Health Organization (WHO). WHO has neglected to mainstream gender in the policies and practices that it promotes for the prevention and detection of, and response to, infectious disease outbreaks. WHO is in a position to support gender-inclusive practices, but this requires the technical agency to recognize the value of having a gender-inclusive framework to inform outbreak response, financial models, and recovery. [ABSTRACT FROM AUTHOR]

This article attempts to answer the question of how women experienced the effects of the health measures including the gender-based lockdown and only being able to leave the house with an identity card adopted during covid-19 in Panama, especially as regards paid and unpaid work. The in-depth interview was used as a methodological tool, which was administered to key informants: leaders of women's, trade union and lgbti+ organizations, state officials and staff members of international organizations. Transcripts were analyzed on the basis of feminist academic bibliography together with the legislation, reports, and statistical data. It was thought that the government adopted measures that failed to consider gender inequality, which had effects on the lives of women, such as overburdening them and making work in the home and that of vulnerable women invisible. It also increased their paid workload, insecurity, and economic uncertainty. [ABSTRACT FROM AUTHOR]

In November 2021, the World Health Assembly (WHA) is hosting a special session to discuss the proposed plans for a pandemic treaty. Despite the fact that there are scant details concerning the treaty, the proposal has gained considerable support in both the academic community, and at the international level. While we agree that in the wake of the numerous governance failures during COVID-19, we need to develop appropriate global solutions to be able to prevent, detect, respond to, and recover from future global health crises—and that such mechanisms should be rooted in global equity—we disagree, however, that this pandemic treaty, currently, is the most appropriate way in which to achieve this. Indeed, notions of global community, solidarity, fairness are far removed from the reality that we have seen unfolding in the actions of states responding to the pandemic. This is the crux of the tension with the proposed treaty: the balance between the ideal cosmopolitan worldview held by those in power in global health, and the practice of national security decision-making witnessed in the last 18 months. Indeed, we do not believe that a pandemic treaty will deliver what is being extolled by its proponents, and it will not solve the multiple problems of global cooperation in global health that supporters believe it will. [ABSTRACT FROM AUTHOR]

Operative paragraph 7 of UN Security Council (UNSC) Resolution 2532 (2020) acknowledges 'the critical role that women are playing in the COVID-19 response efforts', the 'disproportionate negative impact the pandemic is having on women and girls', and 'calls for concrete actions to minimise this impact and ensure the full, equal and meaningful participation of women and youth in the development and implementation of an adequate and sustainable response to the pandemic'. This Resolution is clear in its language: states must recognise and respond to the gendered effects of the pandemic. The adoption of Resolution 2532 and subsequently 2565 (2021) is an important opportunity to further integrate health emergencies and UNSC's Women, Peace, and Security (WPS) agenda. The language is deliberate: it offers global health a set of mechanisms on how to integrate gender into complex crises and, in turn, offers WPS a chance to engage with health and pandemics as a security challenge for women and girls. However, as previous health emergencies and the WPS agenda show us, Resolutions are not a panacea: they are political compromises often riddled with contradictions and are dependent on states and the international community to implement them. [ABSTRACT FROM AUTHOR]

Background: In recent years there have been calls to strengthen health sciences research capacity in African countries. This capacity can contribute to improvements in health, social welfare and poverty reduction through domestic application of research findings; it is increasingly seen as critical to pandemic preparedness and response. Developing research infrastructure and performance may reduce national economies' reliance on primary commodity and agricultural production, as countries strive to develop knowledge-based economies to help drive macroeconomic growth. Yet efforts to date to understand health sciences research capacity are limited to output metrics of journal citations and publications, failing to reflect the complexity of the health sciences research landscape in many settings.Methods: We map and assess current capacity for health sciences research across all 54 countries of Africa by collecting a range of available data. This included structural indicators (research institutions and research funding), process indicators (clinical trial infrastructures, intellectual property rights and regulatory capacities) and output indicators (publications and citations).Results: While there are some countries which perform well across the range of indicators used, for most countries the results are varied-suggesting high relative performance in some indicators, but lower in others. Missing data for key measures of capacity or performance is also a key concern. Taken as a whole, existing data suggest a nuanced view of the current health sciences research landscape on the African continent.Conclusion: Mapping existing data may enable governments and international organizations to identify where gaps in health sciences research capacity lie, particularly in comparison to other countries in the region. It also highlights gaps where more data are needed. These data can help to inform investment priorities and future system needs. [ABSTRACT FROM AUTHOR]

State-enforced curtailment of mobility – through social distancing and national or subnational lockdowns – has become a key tool to reduce COVID-19 transmission. Panama instituted a sex-segregated mobility policy to limit people's circulation whereby women were allowed to leave the home for essential services on Monday, Wednesday, and Friday; and men on Tuesday, Thursday, and Saturday. Through a retrospective analysis of Global Positioning System (GPS) data, this paper presents an overview of aggregate mobility patterns in Panama following the policy implementation. The paper looks at relative mobility for women and men, examining differences by volume and type of movement. The results identify lower visits to all community location categories on women-mobility days; however, we find no statistically significant difference in aggregate mobility to workplaces. The results discuss the implications of these findings and the ethical questions raised regarding the use of sex and gender identity in COVID-19 policies. HIGHLIGHTS Google mobility data provide a novel opportunity to examine population movement during lockdowns. Panamanian men appear less strict than women with stay-at-home orders during the COVID-19 lockdown. Lockdown policies may restrict women's public participation. Public domestic activities may hold new value and inform household bargaining during COVID-19. Policies based on government-indicated sex reproduce inequalities for non-binary individuals. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic affects all countries, but how governments respond is dictated by politics. Amid this, the World Health Organization (WHO) has tried to coordinate advice to states and offer ongoing management of the outbreak. Given the political drivers of COVID-19, we argue this is an important moment to advance International Relations knowledge as a necessary and distinctive method for inclusion in the WHO repertoire of knowledge inputs for epidemic control. Historical efforts to assert technical expertise over politics is redundant and outdated: the WHO has always been politicized by member states. We suggest WHO needs to embrace the politics and engage foreign policy and diplomatic expertise. We suggest practical examples of the entry points where International Relations methods can inform public health decision-making and technical policy coordination. We write this as a primer for those working in response to COVID-19 in WHO, multilateral organizations, donor financing departments, governments and international non-governmental organizations, to embrace political analysis rather than shy away from it. Coordinated political cooperation is vital to overcome COVID-19. [ABSTRACT FROM AUTHOR]

The 2015 to 2017 outbreak of Zika generated global attention on the risk of a spectrum of neurological disorders posed to women and their unborn children - including, but not limited to, microcephaly - that came to be known as congenital Zika syndrome (CZS). In addition to this "glass ceiling" in the design of vector control, policies have not been designed to account for the increased burden of vector control activities on female health workers, upon whom society already places high expectations of care (for their families and their communities). Moreover, the current literature focuses on vector control more broadly, and there have not been comprehensive studies on how gender affects arbovirus control programs in particular. [Extracted from the article]

Brazil's Zika virus crisis (2015–17), following hot on the heels of the Ebola outbreak (2014–15), dominated newsfeeds and high-level discussions amid governments, the UN system and beyond, with emerging fears relating to Congenital Zika Syndrome (CZS), embodied by microcephaly. However, beyond the ensuing panic in Latin America facing a generation of Zika babies, the outbreak demonstrates key developments in our understanding of the interaction between health and security, based on the Copenhagen School's securitization approach. It suggests that unlike previous diseases that were securitized, it was not the virus that was the cause of the security threat, nor how many people were affected, but a combined concern over where (in Brazil at a time of domestic political crisis), when (immediately post-Ebola), who (foetuses and babies), how (unknown disease characteristics) and what was the existential threat (the vectorized unknown). This article shows these developments for global health security through empirical analysis of the multiple securitization processes that occurred within Brazil for the Zika virus, at the subnational and federal levels. [ABSTRACT FROM AUTHOR]

Linking health and security has become a mainstream approach to health policy issues over the past two decades. So much so that the discourse of global health security has become close to synonymous with global health, their meanings being considered almost interchangeable. While the debates surrounding the health–security nexus vary in levels of analysis from the global to the national to the individual, this article argues that the consideration of health as a security issue, and the ensuing path dependencies, have shifted in three ways. First, the concept has been broadened to the extent that a multitude of health issues (and others) are constructed as threats to health security. Second, securitizing health has moved beyond a rhetorical device to include the direct involvement of the security sector. Third, the performance of health security has become a security threat in itself. These considerations, the article argues, alter the remit of the global health security narrative; the global health community needs to recognize this shift and adapt its use of security-focused policies accordingly. [ABSTRACT FROM AUTHOR]

Policies and public health efforts have not addressed the gendered impacts of disease outbreaks.[1] The response to coronavirus disease 2019 (COVID-19) appears no different. Although sex-disaggregated data for COVID-19 show equal numbers of cases between men and women so far, there seem to be sex differences in mortality and vulnerability to the disease.[2] Emerging evidence suggests that more men than women are dying, potentially due to sex-based immunological[3] or gendered differences, such as patterns and prevalence of smoking.[4] However, current sex-disaggregated data are incomplete, cautioning against early assumptions. Experience from past outbreaks shows the importance of incorporating a gender analysis into preparedness and response efforts to improve the effectiveness of health interventions and promote gender and health equity goals. [Extracted from the article]

Self-reported social mixing patterns are commonly used in mathematical models of infectious diseases. It is particularly important to quantify patterns for school-age children given their disproportionate role in transmission, but it remains unclear how the structure of such social interactions changes over time. By integrating data collection into a public engagement programme, we examined self-reported contact networks in year 7 groups in four UK secondary schools. We collected data from 460 unique participants across four rounds of data collection conducted between January and June 2015, with 7,315 identifiable contacts reported in total. Although individual-level contacts varied over the study period, we were able to obtain out-of-sample accuracies of more than 90% and F-scores of 0.49–0.84 when predicting the presence or absence of social contacts between specific individuals across rounds of data collection. Network properties such as clustering and number of communities were broadly consistent within schools between survey rounds, but varied significantly between schools. Networks were assortative according to gender, and to a lesser extent school class, with the estimated clustering coefficient larger among males in all surveyed co-educational schools. Our results demonstrate that it is feasible to collect longitudinal self-reported social contact data from school children and that key properties of these data are consistent between rounds of data collection. [ABSTRACT FROM AUTHOR]

Medical humanitarianism and global health are two distinct but co-dependent spheres of global health security. Their actors differ in their units of analysis, understanding of neutrality, and organizational capacities. While health underpins the normative principles of humanitarian action, humanitarian ideas, and notably medical humanitarian organizations, are absent from global health security planning. This article develops the work of Lakoff [‘Two regimes of global health’, Humanity, 1(1), 59-79 (2010)], distinguishing between these two governance spheres and how this had stark consequences in the 2014/15 Ebola outbreak in Liberia and Sierra Leone, framed as a problem of global health but which rapidly became a humanitarian crisis. Such a frame excluded medical humanitarian organizations from the initial global strategy and resulted in the creation of a new organization (UMMEER - United Nations Mission for Ebola Emergency Response) and the involvement of militaries to bridge the health-humanitarian divide. Reconciling the distinct but co-dependent relationship between medical humanitarianism and global health is fundamental to effective delivery of global health security. [ABSTRACT FROM AUTHOR]

Since the emergence of HIV/AIDS and SARS, Thailand has understood the security threat posed by disease and has responded by investing in the country's disease control infrastructure, such as through the development of the Field Epidemiology Training Program (FETP), improving pandemic preparedness, and collaborating with other states, international organizations, non-governmental organizations and private initiatives to ensure health security. This has led to the creation of a multi-stakeholder subregional governance network for disease control. However, underpinning this network is the individual transformation of Thailand, which, beyond acting as a norm entrepreneur, has scaled up its activities in disease control to become a would-be leader in disease control in mainland Southeast Asia. By using Lake's conceptions of hierarchy and Nolte's understanding of regional power, this article shows how Thailand has taken on this leadership role and has been able to dominate the normative processes of subregional disease control and in doing so has strengthened its own economic and national security. Moreover, this article draws conclusions for regional governance more broadly, through examining power dynamics between states within the arrangement. [ABSTRACT FROM AUTHOR]

The World Health Organization's (WHO) reputation became irrefutably damaged during the Ebola outbreak, with a general consensus in the global health community that it fell short of its leadership responsibilities. This commentary offers a brief synopsis of the WHO's role during the outbreak and suggests that the disease outbreak demonstrates the tension that exists between the organization's normative and operational roles in health crises. While the WHO did offer some normative leadership during the Ebola outbreak, as per its constitution, it did not provide an effective operational response, yet nor did it have a mandate to do so. This division between the normative and operational was further highlighted by the discrepancy between what the global community expects the WHO to do in a health emergency, and what it is able to do with its financial and organizational constraints. Finally, the commentary considers the introduction of the WHO Health Emergency Programme, but suggests that this too may suffer from the same structural concerns that need to be addressed if the WHO is to continue in the role the global health community expects it to play, as both a normative and operational leader in global disease control. [ABSTRACT FROM AUTHOR]

Combating threats of infectious diseases has been increasingly framed as a global shared responsibility for a multi-actor framework of states, international organisations and nongovernmental actors. However, the outbreak of Ebola Virus Disease (EVD) has shown that this governance framework has not been able to limit the spread of this virus, despite the normative and legislative changes to global disease control. By unbundling the concept of responsibility, this article will assess how global shared responsibility may have failed because accountability does not fall on any one state or stakeholder, highlighting an inherent weakness in the global disease governance regime. The paper concludes that a move towards multiple responsibilities may prove a more effective mechanism for ensuring global health security. [ABSTRACT FROM AUTHOR]

The Zika outbreak of 2015-7 is a lens to analyse the positioning of abortion within in global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n = 49); content analysis of women's enquiries to a medical abortion telemedicine provider; and, policy analysis of (inter)national-level Zika response and abortion policies. We consider this within literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such service clandestinely. • Zika affected reproductive decision making, but did not impact abortion regulation. • Epidemiological framing ignored reproductive dimensions of emergency responses. • Conservative forces instrumentalized disability concerns to oppose abortion rights. • Women sought abortions clandestinely, citing Zika as a justification. • Abortion provision must form part of health emergency planning and response. [ABSTRACT FROM AUTHOR]

The evolution and contemporary challenges of health research (HR) in Madagascar are poorly documented. We aim to gain insights on the factors that shape Madagascar's National Health Research System (NHRS) to better understand their influence. We conducted a qualitative case study, which included a documentary review and semi- structured interviews with 38 key informants. We carried out a thematic analysis and used the WHO/AFRO NHRS Barometer to structure the presentation of the results. There is no legislative framework to support HR activities and institutions. There is, however, a policy document outlining national priorities for HS. Human resources for HR are insufficient, due to challenges in training and retaining researchers. International collaboration is almost the only source of HR funding. Collaborations contribute to developing human and institutional capacity, but they are not always aligned with research carried out locally and the country's priority health needs. Incomplete efforts to improve regulation and low public investment in research training and research implementation reflect an insufficient commitment to HR by the government. Negotiating equitable international partnerships, the availability of public funding, and aligning HR with national health priorities would constitute a solid basis for the development of the NHRS in Madagascar. [ABSTRACT FROM AUTHOR]

Background: The Zika outbreak provides pertinent case study for considering the impact of health emergencies on abortion decision-making and/or for positioning abortion in global health security debates.Main Body: This paper provides a baseline of contemporary debates taking place in the intersection of two key health policy areas, and seeks to understand how health emergency preparedness frameworks and the broader global health security infrastructure is prepared to respond to future crises which implicate sexual and reproductive rights. Our paper suggests there are three key themes that emerge from the literature; 1) the lack of consideration of sexual and reproductive health (SRH) services in outbreak response 2) structural inequalities permeate the landscape of health emergencies, epitomised by Zika, and 3) the need for rights based approaches to health.Conclusion: Global health security planning and response should specifically include programmatic activity for SRH provision during health emergencies. [ABSTRACT FROM AUTHOR]

This article analyzes two longitudinal datasets (October – December 2020; April 2021) of 1,000 and 900 women in Kenya and Nigeria, respectively, alongside in-depth qualitative interviews with women at risk of changes to time use, to study two pandemic issues: women's substitution of paid for unpaid work and how these shifts compromise their mental health. Women devote more time to domestic care (30–38 percent), less time to employment (29–46 percent), and become unemployed (12–17 percent). A rise in domestic work is correlated with depressive (Nigeria) and anxiety symptoms (Kenya and Nigeria). Women with greater agency (Kenya) and fewer children (Nigeria) are less likely to report a domestic burden or loss in paid activities. Social protection programs may fill the void of assistance traditionally provided by informal networks in the short term, while campaigns shifting norms around household work may preserve women's economic participation in the long term. HIGHLIGHTS Women in Kenya and Nigeria reported increases in domestic labor amid the pandemic. Women's agency is negatively associated with the domestic burden and a reduction in paid activities in Kenya. Women in households with two or more children face greater domestic burdens and losses in paid activities in Nigeria. Increases in domestic work render women more likely to be anxious (Kenya and Nigeria) and depressed (Nigeria). [ABSTRACT FROM AUTHOR]

The Bangladesh government issued a lockdown throughout the country from March–May 2020 in response to the COVID-19. The sudden lockdown caused economic ruptures across the country due to job loss. We conducted a comprehensive analysis of the outbreak through 40 in-depth interviews with men and women living in three Dhaka informal settlements from January to November 2021 to identify gaps to mitigate negative downstream effects of global pandemic policies. In this paper, we explore the critical importance of social networks as coping mechanisms for those who lost livelihood due to COVID-19 lockdown. Due to the congested living conditions in informal settlements, many established residents foster close, trusting relationships, and a strong sense of community. Formal and informal networks in urban slums, whether reciprocal or strategic, played an integral role as a way of coping during times of scarcity. We found limited analysis in public health literature on the resilience of these social networks and its impact on health and wellbeing. Our paper attempts to unpack the ways our respondents drew on their own social networks to combat the socio-economic and emotional health challenges brought on by a lack of adequate formalized support as part of the pandemic response. [ABSTRACT FROM AUTHOR]

Sexual and reproductive health needs and access are often neglected during health emergencies. The 2015/2016 Zika epidemic is an example of priorities shifting to the detriment of women's health needs. The internet is a key tool for abortion knowledge sharing and seeking in countries where abortion is not legally available and it is also a key resource for tele-health. Yet, we know very little about how people use the internet, and the type of information searched for, to access abortion information and services. The aim of this study is to analyse to what extent and how the internet was used as a resource for abortion information during the Zika outbreak and its aftermath in Brazil in 2015/2016. Using Google Trends and Analytics data, we analyse contextually-specific abortion searches using standardised terms that reflect the overall representation of searches at that time alongside weekly levels of Zika incidence. The results show a heightened use of combined search terms for abortion and Zika, as well as abortion and microcephaly, suggesting a rise in abortion information searching linked to the epidemic. These searches were highly correlated with the level of Zika incidence. This study confirms the use of the internet for information seeking during a public health emergency. It demonstrates the need for appropriate internet resources to improve access to abortion information, especially in countries where abortion is highly restricted and stigmatised. [ABSTRACT FROM AUTHOR]

Background: Health research governance is an essential function of national health research systems. Yet many African countries have not developed strong health research governance structures and processes. This paper presents a comparative analysis of national health research governance in Botswana, Kenya, Uganda and Zambia, where health sciences research production is well established relative to some others in the region and continues to grow. The paper aims to examine progress made and challenges faced in strengthening health research governance in these countries.Methods: We collected data through document review and key informant interviews with a total of 80 participants including decision-makers, researchers and funders across stakeholder institutions in the four countries. Data on health research governance were thematically coded for policies, legislation, regulation and institutions and analysed comparatively across the four national health research systems.Results: All countries were found to be moving from using a research governance framework set by national science, technology and innovation policies to one that is more anchored in health research structures and policies within the health sectors. Kenya and Zambia have adopted health research legislation and policies, while Botswana and Uganda are in the process of developing the same. National-level health research coordination and regulation is hampered by inadequate financial and human resource capacities, which present challenges for building strong health research governance institutions.Conclusion: Building health research governance as a key pillar of national health research systems involves developing stronger governance institutions, strengthening health research legislation, increasing financing for governance processes and improving human resource capacity in health research governance and management. [ABSTRACT FROM AUTHOR]

Gender norms, roles and relations differentially affect women, men, and non-binary individuals' vulnerability to disease. Outbreak response measures also have immediate and long-term gendered effects. However, gender-based analysis of outbreaks and responses is limited by lack of data and little integration of feminist analysis within global health scholarship. Recognising these barriers, this paper applies a gender matrix methodology, grounded in feminist political economy approaches, to evaluate the gendered effects of the COVID-19 pandemic and response in four case studies: China, Hong Kong, Canada, and the UK. Through a rapid scoping of documentation of the gendered effects of the outbreak, it applies the matrix framework to analyse findings, identifying common themes across the case studies: financial discrimination, crisis in care, and unequal risks and secondary effects. Results point to transnational structural conditions which put women on the front lines of the pandemic at work and at home while denying them health, economic and personal security – effects that are exacerbated where racism and other forms of discrimination intersect with gender inequities. Given that women and people living at the intersections of multiple inequities are made additionally vulnerable by pandemic responses, intersectional feminist responses should be prioritised at the beginning of any crises. [ABSTRACT FROM AUTHOR]

The authors comment on their study on the effect of civil-military cooperation during the Ebola outbreak in West Africa by conducting interviews with various people including health care workers, between February and September 2015. Topics cited include programs that worked and failed in Liberia and Sierra Leone, the role of the military during global health crises and the controversy of incorporating civil-military cooperation in health as a regular activity.

Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID-19 response indicators have ignored one of the most well documented secondary effects of the pandemic – its disproportionate effects on women. This paper analyzes pandemic preparedness and response indicators from a feminist perspective to understand how indicators might consider the secondary effects of the pandemic on women and other equity deserving groups. Following a discussion of the tensions that exist between feminist methodologies and the reliance on indicators by policymakers in preparing and responding to health emergencies, we assess the strengths and weakness of current pandemic preparedness and COVID-19 response indicators. The risk with existing pandemic preparedness and response indicators is that they give only limited attention to secondary effects of pandemics and inequities in terms of who is disproportionately affected. There is an urgent need to reconceptualize what 'successful' pandemic preparedness and response entails, moving beyond epidemiological and economic measurements. We suggest how efforts to design COVID response indicators on gender inclusion could inform pandemic preparedness and associated indicators. • A feminist perspective on debates about the use of indicators in global health. • Pandemic preparedness and response indicators consideration of gender is limited. • COVID-19 has led to the development of innovative gender-based approaches. • These can be built upon through greater integration of feminist approaches. [ABSTRACT FROM AUTHOR]

The article addresses the association of gender bias with the poor global health of women. Topics discussed include under-representation of women in leadership, decision making, and senior research roles; initiatives such as Women in Global Health for gender balance in workplaces; and feminist research agenda that can advance gender equality in global health.

Pandemics such as COVID-19 are gendered with regard to who is infected, who dies, who provides care, who is secured against violence and economic change, and who leads and makes decisions.[1] Vaccines are no different and there is a need to address male bias in vaccine development to make women safe from deadly diseases.[2] For example, clinical trials that are not done in both men and women can raise adverse outcomes during implementation due to sex-based differences in immunological response.[3] The excitement and awe at the speed of COVID-19 vaccine development and delivery needs to be attentive to the social and political dynamics in which the vaccine is delivered - women's work and their security are at the heart of this. As has been seen during COVID-19 thus far, violence against health-care workers exists[11] and might be amplified over access to the finite resource of COVID-19 vaccines. Graph Debate over COVID-19 vaccines has rightfully focused on discovery and development, vaccine hesitancy, and equitable access. [Extracted from the article]

A letter to the editor is presented regarding provision of resources to the World Health Organization (WHO) by its member states so that WHO can continue to be a global health leader after the 2014 Ebola virus outbreak in west Africa.