The coming microbial crisis: Our antibiotic bubble is about to burst.

This month, the United Nations (UN) General Assembly will convene its second High-Level Meeting on antimicrobial resistance, urging UN member states to take decisive action against this growing threat. The US Centers for Disease Control and Prevention (CDC) has released a list of the drug-resistant bacterial and fungal infections that pose the greatest concern to public health. Yet, despite increasing warnings from infectious disease experts, the public remains largely unaware of the true scale of the problem. In a world where antibiotics still protect us from bacterial infections, we are shielded from experiencing antimicrobial resistance as an immediate threat to our daily lives.

Advancing Refugee Health Data Management: The Implementation of ICD-11 in UNRWA's Primary Care System.

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was one of the earliest healthcare systems globally to implement the International Classification of Diseases, Eleventh Revision (ICD-11) across its 140 clinics serving 5.9 million Palestine refugees. This paper discusses the integration of ICD-11 into UNRWA's cloud-based electronic medical record (EMR) system, identifying both the barriers and facilitators involved and analyzing trends in clinical documentation and healthcare utilization. The key challenges included data privacy provisions, integration into a coordinated care model, complex classification schema for primary care settings, frequent staff turnover, and limited data analysis capabilities. Conversely, facilitators included physician-tailored training and on-site support, system compatibility, a multidisciplinary team approach, policy support from UNRWA and the World Health Organization (WHO), and leadership commitment and effective change management. Medical officers (MOs) using ICD-11 reported greater satisfaction with the system's capabilities in managing and visualizing health information. This article contributes to the discourse on health data management in complex humanitarian settings, offering insights into the benefits and challenges of implementing advanced classification systems like ICD-11. Future research should explore longitudinal impacts and further integration with global health systems, ensuring that the advancements in classification continue to support the overarching goal of health equity and access in vulnerable and hard-to-reach populations.

Leveraging Technology to Support Aging in Place: Opportunities, Challenges and Recommendations.

The aging population presents pressing societal challenges, emphasizing the importance of aging in the right place to support older individuals' quality of life. Technology can play a crucial role in facilitating aging in place by enabling multiple factors such as remote healthcare monitoring, social connectivity and access to essential services. However, several challenges must be addressed to ensure widespread adoption and effective usage of technology among older adults. From integrating digital literacy into the United Nations' Sustainable Development Goals (United Nations n.d.) to promoting co-creation and fostering intergenerational dialogue, multiple solutions can be envisioned. This commentary emphasizes these opportunities, discusses these issues and provides a set of recommendations.

Perspectives of the role of ICRP and the system of protection in meeting the United Nations sustainable development goals.

Established in 2015 the United Nations (UN) sustainable development goals (SDGs) were agreed with the aim to balance the need to address social and ethical obligations such as ending poverty and other deprivations, while tackling climate change and the other planetary boundaries. In 2018 the International Commission on Radiological Protection (ICRP) initiated a review and revision of the System of Radiological Protection which will lay the foundation for Radiation Protection standards, regulations, guidance and practice worldwide for the next 40 years. Recognising the importance of the UN SDG's the ICRP has started to consider what the role of the revised system of protection should be in enabling delivery. On the 15 May 2024 the Society for Radiological Protection and World Nuclear Association ran a workshop exploring the intersection of the System of Radiological Protection and the SDG's. The outputs of the workshop are summarised in this paper showing the views from a variety of practitioners working across the radiation protection sectors on the key factors to be considered in the revision of the system of radiological protection to enable delivery of the UN SDG's.

Scientists' call to action: Microbes, planetary health, and the Sustainable Development Goals.

Microorganisms, including bacteria, archaea, viruses, fungi, and protists, are essential to life on Earth and the functioning of the biosphere. Here, we discuss the key roles of microorganisms in achieving the United Nations Sustainable Development Goals (SDGs), highlighting recent and emerging advances in microbial research and technology that can facilitate our transition toward a sustainable future. Given the central role of microorganisms in the biochemical processing of elements, synthesizing new materials, supporting human health, and facilitating life in managed and natural landscapes, microbial research and technologies are directly or indirectly relevant for achieving each of the SDGs. More importantly, the ubiquitous and global role of microbes means that they present new opportunities for synergistically accelerating progress toward multiple sustainability goals. By effectively managing microbial health, we can achieve solutions that address multiple sustainability targets ranging from climate and human health to food and energy production. Emerging international policy frameworks should reflect the vital importance of microorganisms in achieving a sustainable future.

COP 28 Policy Perspectives: Achieving Environmental Sustainability through FDI, Technological Innovation Index, Trade Openness, Energy Consumption, and Economic Development in N-11 Emerging Economies.

Despite remarkable success in attracting foreign direct investment (FDI) to achieve maximum economic growth, the Next-11 emerging economies grappling with an undesirable situation of environmental degradation have become a hot topic at COP28. Researchers have long focused on this connection, emphasizing the urgent need for international and national environmentalists to promote sustainable development (SD) in these rapidly growing economies under the United Nations (UN) Framework Convention on Climate Change action plans. As a result, this study examines the role of FDI in the N-11 emerging economies, focusing on energy usage and technological innovation within the theoretical framework of the Halo-Haven hypothesis, covering the period from 1990 to 2022. We utilize ARDL, FMOLS, and DOLS techniques to analyze both short-term dynamics and long-term equilibrium relationships, effectively managing heterogeneity, time dynamics, and cross-sectional dependence issues to produce comprehensive results. The long-term analysis supports the haven hypothesis, demonstrating an affirmative relationship between FDI, economic growth, and carbon emissions, whereas energy usage is negatively associated with carbon emissions. Furthermore, the D-H test established a reciprocal causal relationship between variables such as FDI, economic growth, trade openness, and environmental pollution. However, we found a one-way causal correspondence in the usage of green energy, the technological innovation index, and carbon emissions. Given the mixed findings, policymakers should focus on attracting FDI to the green energy sector while reinforcing regulations and implementing stringent oversight for FDI in energy-intensive industries. This approach will ensure that such investments adhere to high environmental standards, thereby benefiting future generations.

Towards Establishing Quality Standards on Human Rights for Services in Dementia Care.

BACKGROUND: People with dementia often experience violations of fundamental human rights and impeded access to healthcare. This study aims to investigate the views of experts regarding the use of the United Nations Convention on the Rights of People with Disabilities (CRPD) principles as quality standards for human rights-based care. METHODS: A single-round Delphi e-consultation with 15 dementia experts was designed to evaluate each CRPD principle and collect feedback on their views about the application of the CRPD principles in dementia care. RESULTS: The CRPD principles were fully endorsed as quality standards; however, several experts commented on the complexities of the use of CRPD principles in relation to information disclosure, capacity assessment, stakeholders' involvement in decision-making, respecting needs and preferences, holistic approaches in care practice, and protection against abuse, neglect and discrimination. CONCLUSIONS: These findings indicate the CRPD quality standards were fully applicable for people with dementia although some clarification around interpretation could assist in their use. Future research should elaborate on further points of support and guidance for dementia care providing examples of good practice from across the globe, and develop a concordant, human rights-based scheme for the implementation and evaluation of dementia services. IMPLICATIONS FOR PRACTICE: This study suggests that the CRPD can serve as a benchmark for human rights-based practices in dementia services globally that could enhance nursing care practice. Nursing staff are encouraged to consider human rights in relation to the complexities associated with people with dementia, their caregivers, and other services involved in their care.

Hope amidst neglect: Mycetoma Research Center, University of Khartoum. A holistic management approach to achieve the United Nations' Sustainable Development Goals.

Mycetoma is a debilitating neglected tropical disease that affects individuals worldwide, particularly in regions where there is poverty and limited health care access. The Mycetoma Research Center (MRC), based in Khartoum, Sudan, provides a sustainable, holistic approach to patient care as the only World Health Organization collaborating center for mycetoma. We describe MRC activities that align with the United Nations' Sustainable Development Goals to control mycetoma in Sudan and globally.

Measuring breastfeeding prevalence using demographic and health surveys.

BACKGROUND: This study aims to investigate the measurement of breastfeeding prevalence indicators using Demographic and Health Surveys (DHS) data, focusing on early initiation, exclusive breastfeeding, and continued breastfeeding indicators as reported by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) and on the discrepancies arising from small changes in their definition. METHODS: Two hundred sixty DHS samples from 78 countries were analyzed to re-calculate usual indicators reported by WHO and UNICEF: early initiation of breastfeeding (EIB), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding between 1 and 2 years (CBF12 and CBF24). Additionally, alternative estimates of the same indicators, slightly changing their definition, were calculated to test their robustness. RESULTS: The WHO and UNICEF indicators for early initiation (EIB) primarily capture cases where breastfeeding is initiated "immediately" after birth, omitting those initiated within 0 or 1 hour. This discrepancy leads to substantial underestimation of levels in some regions, particularly South Asia, and in trends. Furthermore, sizable discrepancies between exclusive breastfeeding (EBF) indicators arise from the inclusion or exclusion of plain water in the definition, with significant variations across regions, especially in West and Middle Africa. However, continued breastfeeding indicators showed consistency across definitions, proving them robust for international comparisons and time trend estimations. CONCLUSION: This study highlights the importance of understanding how breastfeeding indicators are defined and calculated using DHS data. Researchers should be cautious when using WHO and UNICEF indicators for early initiation and exclusive breastfeeding, as they may underestimate prevalence due to their narrow definition. Continued breastfeeding indicators, on the other hand, are less affected by small changes in definitions and provide reliable measures for cross-country comparisons and trend analyses. These findings underscore the need for standardized robust definitions and transparent reporting of breastfeeding indicators in global health assessments.

A framework for identifying opportunities for multisectoral action for drowning prevention in health and sustainable development agendas: a multimethod approach.

INTRODUCTION: The 2023 World Health Assembly resolution 76.18 committed the World Health Organization to the coordination of drowning prevention efforts, including those of United Nations (UN) agencies. Here, we aim to map drowning prevention linkages across UN Agency agendas, make recommendations to guide global strategies and inform the development of the Global Alliance and a Global Strategy for drowning prevention. METHODS: We applied a qualitative multimethod approach, including document review, key informant interviews, an interagency workshop and international conference panel discussion, to refine data and create our recommendations. We developed a framework to identify intersections between health and sustainable development agendas and applied it to map intersections and opportunities for the integration of drowning prevention across relevant UN Agency agendas. RESULTS: Our framework categorised intersections for drowning prevention in UN Agendas according to potential for (a) shared understandings of problems and solutions, (b) shared capacities, guidelines and resources and (c) shared governance and strategic pathways, noting that some factors overlap. We present our Position, Add, Reach and Reframe approach to outlining opportunities for the integration of drowning prevention in health and sustainable development agendas. Our results emphasise the importance of establishing approaches to the Global Alliance and Global Strategy that ensure high-level political advocacy is converted into solutions for affected communities. We recommend using research to inform effective action, building capacity and best practices, and promoting evaluation frameworks to incentivise and verify progress. CONCLUSION: Our study identifies opportunities to expand drowning prevention efforts and to build Member State capacity to reduce drowning risk through evidence-informed measures that address vulnerabilities, exposures, hazards and build population-level resilience to drowning. Our framework for identifying opportunities for integration of drowning prevention across a multisectoral set of agendas offers a research and policy toolkit that may prove useful for other policy areas.

Finding common development paths in voluntary national reviews reporting on sustainable development goals using aspect-based sentiment analysis.

Voluntary National Reviews (VNRs) provide a platform for participating countries to share their experiences, failures, and successes in achieving the United Nations (UN) Sustainable Development Goals (SDGs). The objective of this study is to gain a deeper understanding of the narrative elements, particularly the sentiment, in VNRs in order to more effectively assess and support global SDG progress. A total of 232 VNRs from 166 countries are analyzed using Aspect-Based Sentiment Analysis (ABSA) to extract each country's sentiment toward the 17 SDGs. The sentiment scores are then compared to the corresponding official UN SDG scores, and countries are grouped by their sentiment toward all 17 SDGs to identify potential common development pathways. The analysis uncovers a notable positive correlation between the reported sentiment and official SDG scores for SDG 2 (zero hunger) and SDG 11 (sustainable cities and communities), and a negative correlation for SDG 5 (gender equality). Conversely, this relationship is not significant for the majority of SDGs, suggesting that VNR narratives may not directly reflect actual progress. A t-distributed stochastic neighbor embedding (t-SNE) approach indicates a consistent sentiment score among developed countries. In contrast, there are greater differences in reporting sentiment among Emerging Markets, Frontier Markets, and Least Developed Countries (LDCs), where there is greater dispersion (especially among LDCs) and sentiment in reporting on SDG progress that appears to have changed from one reporting year to another. These findings highlight the need to interpret VNRs in the context of each country's unique situation and challenges specific to each country.

The SABER School Feeding policy tool: a 10-year analysis of its use by countries in developing policies for their national school meals programs.

Since its launch in 2011, 59 governments have used the World Bank's Systems Approach for Better Education Results (SABER) policy tool to design their national school-based health and nutrition programs. This tool guides governments to self-evaluate their education system policies against international benchmarks and identify actionable priorities to strengthen national programs. Thirty-two of the 49 countries in sub-Saharan Africa (65%) have undertaken a SABER review, and globally the approach has been adopted by 68% of the world's low-income countries and 54% of lower-middle-income countries. Analysis of 51 comparable SABER School Feeding surveys suggests that countries with longer established national school meals frameworks tend also to be more advanced in other policy areas, and vice versa. The SABER reviews consistently identify, perhaps predictably, that the weakest policy areas relate to program design, implementation and fiscal space. This analysis also found that the tool had an additional value in tracking the evolution of policies when implemented over several time points, and showed that policy areas become more advanced as national programs mature. These benefits of the tool are particularly relevant to the 98 countries that co-created the global School Meals Coalition in 2021. The Coalition member countries have the specific goal of enhancing coverage and support for the well-being of schoolchildren and adolescents affected by the school closures during the COVID-19 pandemic. The SABER tool has the demonstrated potential to implement, accelerate and track changes in school meals policy and, since it has been previously used by 74% (31/42) of low- and lower-middle-income countries in sub-Saharan Africa, is an already accepted element of the political economies of those countries and so has the potential to be deployed rapidly.

Can a human right to good mental health be justified?

Can a human right to good mental health be justified? This is an under-explored question: until recently, rights in relation to mental health have been framed and debated primarily in terms of their relevance to psychosocial disability and mental ill-health/mental distress. By contrast, in this article, I propose the basis of a normative justification for a population-wide right to good mental health, focusing in particular on individuals who do not experience mental ill-health/distress or do not have (or may never have) a psychiatric diagnosis or a psychosocial disability. The article is structured into three parts. First, I will outline the emergence of a population-wide right to good mental health in mental health discourse, led by recent reports published by the former United Nations Special Rapporteur on the Right to Health, Danius Puras. I will then go on to explore what we might understand by 'good mental health'. Finally, I will explain how a right to good mental health may be justified, drawing on insights from compassion, 'vulnerable agency', and James Wilson's account of 'a right to public health'. I then respond to feasibility and demandingness concerns about such a right, which together inform the basis of the qualified public health right to good mental health I propose.

The role of universities in accelerating the sustainable development goals in Europe.

The process of implementation of the UN Sustainable Development Goals (SDGs) which were approved by the UN General Assembly in 2015 has not been simple, being influenced by variety of social, economic, and logistical problems. It has also been negatively affected by the COVID-19 pandemic. There are to date no specific studies aimed at assessing the extent to which higher universities institutions in Europe are active in the SDGs implementation process. Departing from this research need, this paper reports on a study aimed at examining the current degree of engagement of European universities in the implementing the SDGs. By using a multi-methods approach, which entails a review of existing documents, a survey involving participants from 22 countries and case studies, the paper maps, documents and disseminates examples of what European universities are doing to implement the SDGs, the challenges they face, and the solutions being deployed to overcome them.

Premature mortality trends in 183 countries by cancer type, sex, WHO region, and World Bank income level in 2000-19: a retrospective, cross-sectional, population-based study.

BACKGROUND: Cancer is a leading cause of mortality worldwide. By 2040, over 30 million new cancers are predicted, with the greatest cancer burden in low-income countries. In 2015, the UN passed the Sustainable Development Goal 3.4 (SDG 3.4) to tackle the rising burden of non-communicable diseases, which calls for a reduction by a third in premature mortality from non-communicable diseases, including cancer, by 2030. However, there is a paucity of data on premature mortality rates by cancer type. In this study, we examine annual rates of change for cancer-specific premature mortality and classify whether countries are on track to reach SDG 3.4 targets. METHODS: This is a retrospective, cross-sectional, population-based study investigating premature mortality trends from 2000-19 using the WHO Global Health Estimates data. All cancers combined and thirteen individual cancers in 183 countries were examined by WHO region, World Bank income level, and sex. The risk of premature mortality was calculated for ages 30-69 years, independent of other competing causes of death, using standard life table methods. The primary objective was to compute average annual rate of change in premature mortality from 2000 to 2019. Secondary objectives assessed whether this annual rate of change would be sufficient to reach SDG 3.4. targets for premature mortality by 2030. FINDINGS: This study was conducted using data retrieved for the years 2000-19. Premature mortality rates decreased in 138 (75%) of 183 countries across all World Bank income levels and WHO regions, however only eight (4%) countries are likely to meet the SDG 3.4 targets for all cancers combined. Cancers where early detection strategies exist, such as breast and colorectal cancer, have higher declining premature mortality rates in high-income countries (breast cancer 48 [89%] of 54 and colorectal cancer 45 [83%]) than in low-income countries (seven [24%] of 29 and four [14%]). Cancers with primary prevention programmes, such as cervical cancer, have more countries with declining premature mortality rates (high-income countries 50 [93%] of 54 and low-income countries 26 [90%] of 29). Sex-related disparities in premature mortality rates vary across WHO regions, World Bank income groups, and by cancer type. INTERPRETATION: There is a greater reduction in premature mortality for all cancers combined and for individual cancer types in high-income countries compared with lower-middle-income and low-income countries. However, most countries will not reach the SDG 3.4 target. Cancers with early detection strategies in place, such as breast and colorectal cancers, are performing poorly in premature mortality compared with cancers with primary prevention measures, such as cervical cancer. Investments toward prevention, early detection, and treatment can potentially accelerate declines in premature mortality. FUNDING: WHO.