Climate change and public health in Germany - An introduction to the German status report on climate change and health 2023.

Global warming of 1.5°C and even 2°C is likely to be exceeded during the 21st century. Climate change poses a worldwide threat and has direct and indirect effects on infectious diseases, on non-communicable diseases and on mental health. Not all people are equally able to protect themselves against the impacts of climate change; particularly populations that are vulnerable due to individual factors (children, older persons, those immunocompromised or with pre-existing conditions), social factors (the socially disadvantaged), or living and working conditions (e. g. people who work outdoors) are subject to an increased risk. Concepts such as One Health or Planetary Health provide a framework to frame both climate change itself and adaptation strategies or sets of actions for environmental human and animal health. Knowledge of climate change impacts has grown in recent years, and mitigation and adaptation strategies have been developed.

[Four years after the Ebola crisis : Challenges, experiences, and implications in the German public health context]. / Vier Jahre nach der Ebolakrise : Herausforderungen, Erfahrungen und Schlussfolgerungen für den Öffentlichen Gesundheitsdienst in Deutschland.

The Ebola virus disease outbreak in West Africa in 2014/2015 was by far the biggest, most prolonged, and geographically most widespread outbreak of this disease since the discovery of the Ebola virus in 1976. Although no cases of Ebola virus disease were confirmed in Germany, a number of crisis management activities were initiated.Based on a combination of local, national, and international lessons learned, literature research, and a large number of discussions among German colleagues as well as German and foreign colleagues, the experiences of selected German public health actors as well as implications for health protection activities in Germany are presented.On the one hand, preparedness for managing unusual high consequence health events-caused by rare, highly pathogenic biological agents-including the provision of adequate material and personnel resources remains important in Germany. On the other hand, more German engagement in global health is necessary, because the dividing line between global health and local health is increasingly disappearing.

[The Ebola virus disease outbreak in West Africa in 2014/2015: important data and political events]. / Der Ebolafieberausbruch in Westafrika 2014/2015: Wichtige Daten und politische Ereignisse.

In 2014/2015 West Africa suffered an Ebola virus disease (EVD) outbreak of unprecedented unknown severity. The outbreak affected mostly Liberia, Sierra Leone and Guinea, and for the first time spread to major cities, some of which have international airports. Worldwide, 28,652 cases were registered, 11,325 of which were fatal. A few cases were confirmed outside the main outbreak countries. Three EVD patients and one person with a needle-stick injury were evacuated to Germany and treated or kept under observation there. One of the patients died.In this article, the course of the outbreak and the international response are addressed. Epidemiological data and important political developments in connection with the EVD outbreak are summarized.The outbreak started in December 2013 in Guinea. It reached its peak from September to December 2014. On 8 August 2014, the World Health Organization (WHO) declared a public health emergency of international concern (PHEIC). The General Assembly of the United Nations (UN) established on 19 September 2014 the UN Mission for Ebola Emergency Response (UNMEER). On the same day, the German government pledged more financial aid and other support, such as the establishment of an air bridge, the construction of treatment centres and training.Up until April 2016, there were repeated local outbreaks. On 29 March 2016 WHO declared that the PHEIC had ended. On 28 April 2016 the outbreak was finally over.

[Incident-crisis-disaster. Conceptualizing unusual biological incidents]. / Lage ­ Krise ­ Katastrophe. Eine Konzeptualisierung biologischer Gefahrenlagen.

Unusual biological threats demand adequate preparedness efforts, as demonstrated, for example, by the Ebola virus disease outbreak in West Africa in 2014/2015 and pandemic influenza in 2009/2010. In Germany, responsibilities for such efforts are located in different governmental authorities and differ from state to state. As a result, there are many different preparedness approaches using divergent core terminology.In this article a common definition for the term "unusual biological incident" is proposed. To do so, a literature review as well as semi-structured expert interviews with representatives of central actors in Germany were conducted. The understanding of "unusual biological incident" was not consistent among experts; four approaches to qualify a biological incident as "unusual" were identified. These were merged in a comprehensive system-oriented approach that focuses on the health system's resilience and on shortages of knowledge and material resources during incidents.Based on this approach, we suggest a stage model for the categorization of biological threats as "incident," "crisis," "severe crisis," or "disaster." The need for central coordination is a defining characteristic to qualify a biological incident as "unusual." Based on the identified shortages, the necessary response strategies can be derived.

Germany's expanding role in global health.

Germany has become a visible actor in global health in the past 10 years. In this Series paper, we describe how this development complements a broad change in perspective in German foreign policy. Catalysts for this shift have been strong governmental leadership, opportunities through G7 and G20 presidencies, and Germany's involvement in managing the Ebola virus disease outbreak. German global health engagement has four main characteristics that are congruent with the health agenda of the Sustainable Development Goals; it is rooted in human rights, multilateralism, the Bismarck model of social protection, and a link between development and investment on the basis of its own development trajectory after World War 2. The combination of momentum and specific characteristics makes Germany well equipped to become a leader in global health, yet the country needs to accept additional financial responsibility for global health, expand its domestic global health competencies, reduce fragmentation of global health policy making, and solve major incoherencies in its policies both nationally and internationally.

Some personal notes on role plays as an excellent teaching tool : commentary on "using and developing role plays in teaching aimed at preparing for social responsibility".

Role plays are extremely valuable tools to address different aspects of teaching social responsibility, because they allow students to "live through" complex ethical decision making dilemmas. While role plays are getting high marks from students because their entertainment value is high, their educational value depends on their closeness to students' work experience and the skills of the teacher in helping students comprehend the lessons they are meant to convey.

Unfinished business: efforts to define dual-use research of bioterrorism concern.

Biotechnological research poses a special security problem because of the duality between beneficial use and misuse. In order to find a balance between regulating potentially dangerous research and assuring scientific advancement, a number of assessments have tried to define which types of research are especially open to misuse and should therefore be considered dual-use research of special concern requiring rigorous oversight. So far, there has been no common understanding of what such activities are. Here we present a review of 27 assessments focusing on biological dual-use issues published between 1997 and 2008. Dual-use research activities identified by these assessments as being of special concern were compiled and compared. Moreover, from these 27 assessments, the primary research publications explicitly identified as examples of concerning research activities were extracted and analyzed. We extracted a core list of 11 activities of special concern and show that this list does not match with the reasons why primary research publications were identified as being of special concern. Additionally, we note that the 11 activities identified are not easily conducted or replicated, and therefore the likelihood of their being used in a high-tech mass casualty bioterrorism event should be reevaluated.

Biosecurity policies at international life science journals.

The prospect of bioterrorism has raised concerns about the potential abuse of scientific information for malign purposes and the pressure on scientific publishers to prevent the publication of "recipes" for weapons of mass destruction. Here we present the results of a survey of 28 major life science journals--20 English-language international journals and 3 Chinese and 5 Russian journals--with regard to their biosecurity policies and procedures. The survey addressed the extent to which life science journals have implemented biosecurity procedures in recent years, how authors and reviewers are advised about these procedures and the underlying concerns, and what the practical experiences have been. Few of the English-language publishers and none of the Russian and Chinese publishers surveyed implement formal biosecurity policies or inform their authors and reviewers about potentially sensitive issues in this area.