Health policy competencies in regional organizations: a retrospective analysis for 76 regional organizations from 1945 to 2015.

BACKGROUND: Health policy competencies of regional organizations include mandates to create regional health laws and policies, as well as authorities that allow member states to undertake collective actions in the health field. The examination of the health policy competencies of regional organizations is essential, as it constitutes an important prerequisite for regional organizations to govern regional health. This study aims to map the development trajectory of health policy competencies in regional organizations worldwide and investigate their potential correlates. This will contribute to the enhanced promotion of both existing and new regional health cooperation. METHODS: This retrospective analysis utilized the health policy competencies of the 76 regional organizations worldwide from 1945 to 2015, as investigated in the Regional Organizations Competencies Database. By aggregating member state data from various sources such as the IHME Global Burden of Disease 2019, the World Bank, and the World Trade Organization, we extracted the mean values and coefficients of variation for the covariates in regional organization characteristics, socioeconomic and demographic factors, health status and health-system capacity. The correlation between changes in the health policy scope of regional organizations and independent variables was analyzed using Poisson pseudo-likelihood regression with multiple levels of fixed effects. RESULTS: From 1945 to 2015, the number of regional organizations with health policy competencies experienced a slow growth stage before 1991 and an explosive growth stage post-1991. By 2015, 48 out of the 71 existing regional organizations had developed their health policy competencies, yet 26 (54.2%) of these organizations possessed only 1-2 health policy competencies. An enhancement in the health policy scope of a regional organization correlated with its founding year, a greater number of policy fields, higher under-five mortality, and larger disparities in trade and healthcare access and quality indexes among member states. In contrast, larger disparities in population, under-five mortality and health worker density among member states, along with more hospital beds per capita, were negatively correlated with the expansion of a regional organization's health policy scope. CONCLUSION: Since 1991, there has been a surge of interest in health among regional organizations, although health remains a secondary priority for them. The health policy competencies of regional organizations are pivotal for promoting social equity within regional communities. Its establishment is also closely linked to the level and disparities among member states in aspects such as trade, population, child mortality rates, and health system capacity.

Major depressive disease research in BRICS: A bibliometric analysis of publications from 2003 to 2022.

Major depressive disorder (MDD) seriously threatens human health. BRICS, known as an acronym for "Brazil, Russia, India, China, and South Africa," were also actively carrying out researches on MDD. This study aimed to conduct a bibliometric study of research on MDD conducted by the BRICS. By searching in the Web of Science and using the software Vosviewer and Citespace as analysis tools, this study analyzed the cooperation network at the country, institution, author-specific levels, the research hotspots and trends from BRICS between 2003-2022. A total of 10,911 articles were finally included. Our findings showed that researches on MDD from BRICS rapidly increased during the past two decades. China and India have shown explosive growth, while South Africa has the largest average "Usage Count" and "Time Cited". The current cooperation partners of the BRICS were mainly high-income countries and other developing countries with similar cultures, languages, and geographical locations. Institutions in high-income countries served as the main bridges for BRICS cooperation, while at the author level, some core authors in the BRICS countries serve as centers. China showed a flexible model in domestic partnership, but institutions and authors in the other four countries have gathered to cooperate within the group. BRICS research on MDD mainly focused on cognitive science, brain science, epidemiology, and disease mechanisms. The keywords"gut microbiota", "network analysis," "machine learning" and "sleep quality" showed explosive growth and might become research hotspots in the near future. This bibliometric analysis provided a science knowledge graph and references for other researchers.

The priority areas and possible pathways for health cooperation in BRICS countries.

As one of the largest alliances of middle-income countries, the BRICS, known as an acronym for five countries including "Brazil, Russia, India, China, and South Africa", represents half of the global population. The health cooperation among BRICS countries will benefit their populations and other middle- and low-income countries. This study aims to summarize the current status of health cooperation in BRICS countries and identify opportunities to strengthen BRICS participation in global health governance. A literature review was conducted to analyze the status, progress, and challenges of BRICS' health cooperation. Content analysis was used to review the 2011-2021 annual joint declarations of the BRICS Health Ministers Meetings. The priority health areas were identified through segmental frequency analysis. Our research suggested that communicable diseases, access to medicine, and universal health coverage appeared most frequently in the content of declarations, indicating the possible top health priorities among BRICS' health collaboration. These priority areas align with the primary health challenges of each country, including the threats of double burden of diseases, as well as the need for improving health systems and access to medicines. Respective external cooperation, inter-BRICS health cooperation, and unified external cooperation are the main forms of health cooperation among BRICS countries. However, challenges such as the lack of a unified image and precise position, lack of practical impact, and weak discourse power have impeded the impact of BRICS on health governance. This study suggests that the BRICS countries should recognize their positioning, improve their unified image, and establish cooperative entities; at the same time, they should increase their practical strength, promote non-governmental cooperation, and expand the cooperation space through the "BRICS Plus" mechanism with countries with similar interests to join.

A proposal on Kuroko leadership: An element of Japan’s global health competency extracted from the experiences of international health cooperation / 国際保健医療

  In the increasingly globalized world, developing global health competency (GHC) education by determining the required core elements for undergraduates is on the rise. A growing number of people from different backgrounds have migrated to Japan. To accommodate their various healthcare needs, potential GHC elements that facilitate Japanese GHC education should be identified. This paper aims to extract some of the key GHC elements required for students in medical and healthcare fields based on the abundant experience of Japan’s international health cooperation and to make recommendations for GHC education in Japan and worldwide.  To date, Japan’s international health cooperation has cultivated a variety of competencies to realize its mission of reducing global health disparities. Japanese GHC elements are the bases of core concepts in healthcare and share commonalities with GHC elements in global communities: Cultural competency, “Go to the People”, respect for diversity, transdisciplinary collaboration, capacity building, independence, people/patient-centered healthcare, and empowerment.   Comprehensive preparation of these elements is found among kabuki kurokos (black robes), people dressed in all black who assist kabuki actors onstage during performances. The black worn by the kurokos means “nothingness”; they should be invisible on stage, so as not to interfere with the performance. Kurokos understand the culture (values, behaviors, etc.) of the lead actors, manage and coordinate stage proceedings to meet the actors’ needs, and help them achieve the best performance by collaborating with other backstage workers.   Kurokos’s empowering leadership competency is akin to the Western concept of servant-leadership, which emphasizes being a servant first and devoting oneself to enabling greater health and independence/autonomy among vulnerable people. Japanese educators can exemplify kuroko values by providing their students with GHC education. Japanese GHC elements can be integrated into worldwide GHC education. Spiritual care is also essential for inclusion in GHC education to develop students’ holistic care competency.

Perspectivas da cooperação em saúde no espaço lusófono: análise da atuação do Brasil nas relações de cooperação com países de Língua Portuguesa / Perspectives of health cooperation in Lusophone area: analysis of Brazil's role in cooperation relations with Portuguese-speaking countries

O presente artigo objetivou examinar como se dá a cooperação em saúde entre o Brasil e os países de língua oficial portuguesa, de forma tanto bilateral quanto multilateral, com destaque para as ações adotadas pela Comunidade dos Países de Língua Portuguesa. Após análise dos desafios às iniciativas de cooperação, apontaram-se os avanços já obtidos e as perspectivas que se apresentam, com vistas a concretizar o cumprimento das metas da Agenda 2030 da Organização das Nações Unidas. Também se evidenciou a necessidade de minimizar os atrasos e paralisações que ocorrem quando há mudanças administrativas; de criar um marco legal que defina como se deve dar a cooperação brasileira nos planos bilateral e multilateral, fundada nos princípios que regem o Estado em suas relações internacionais, na busca de sustentabilidade financeira e em uma melhor análise prévia dos projetos a serem desenvolvidos, com uma avaliação posterior de seus resultados; bem como a necessidade de estabelecer mecanismos de resposta a crises humanitárias. Concluiu-se que a cooperação em saúde proporciona um aprendizado recíproco e pode ser vista como uma ferramenta de aperfeiçoamento nessa área. A pesquisa adotou metodologia analítica e quantitativa, de cunho bibliográfico e documental, e se pretendeu exploratória ao apontar possíveis respostas às questões levantadas.

This article aimed to examine how health cooperation between Brazil and Portuguese-speaking countries takes place, both bilaterally and multilaterally, with emphasis on the actions taken by the Community of Portuguese-speaking Countries. After analyzing the challenges to cooperation initiatives, the advances already achieved and the prospects presented were pointed out, with a view to achieving the goals of the 2030 Agenda of the United Nations. It also highlighted the need to minimize delays and stoppages that occur when there are administrative changes; to create a legal framework that defines how Brazilian cooperation should take place at bilateral and multilateral levels, based on the principles that govern the State, in its international relations, in the search for financial sustainability and a better prior analysis of the projects to be developed, with a further evaluation of its results; as well as the need to establish mechanisms to respond to humanitarian crises. It was conclude that health cooperation provides reciprocal learning and can be seen as a tool for improvement in this area. The research adopted an analytical and quantitative methodology, of bibliographic and documentary nature, and intended to be exploratory in pointing out possible answers to the questions raised.

Sustainable implementation of international health cooperation projects while Japanese technical experts cannot go to low- and middle-income countries because of the COVID-19 pandemic travel restrictions.

Due to the COVID-19 pandemic, Japanese technical experts who have been supporting health in low-and middle- income countries (LMICs) are facing unprecedented travel restrictions. As of 11 April 2020, of 195 countries Japan has diplomatic relationship with, 181 countries have entry restrictions and 69 countries have post-entry movement restrictions (self-quarantine) for Japanese nationals or travellers from Japan. In order for technical experts to assist LMICs technically from Japan to meet the increased demand and needs in the health sector due to COVID-19, it is important to prioritize and reorganize the project activities in accordance with the local situation in particular to address three challenges i) to communicate from Japan; ii) to prioritize activities to match to the increased COVID-19 related tasks; and iii) to advocate health workers' rights and working environment.

A China - Vietnam collaboration for public health care: a preliminary study.

BACKGROUND: Vietnam has achieved significant results in terms of improving population health and sustainable development goals (SDGs). However, several public health problems remain such as high mortality deriving from non-communicable diseases (NCDs). As part of their long-standing relationship, Vietnam and China have collaborated in various health fields. The objective of this study was to examine the current situation of public health cooperation between Vietnam and China and suggest ways to deepen future co-operations. METHODS: Between March and May 2018, we conducted 14 in-depth interviews with key informants from Vietnam and China. The inclusion criteria in this study were as follows: 1) researchers who worked at research institutes or universities and were engaged in health cooperation research, 2) officers who were from government agencies or international organizations (IOs) and had been involved in, or were familiar with the health cooperation projects between China and Vietnam. The interviews were audiotaped and transcribed verbatim, and then analyzed to identify current cooperation strategies and cooperation fields, as well as to provide suggestions for future collaborations. RESULTS: Current health cooperation mechanisms between China and Vietnam include bilateral and multilateral cooperation such as ASEAN Plus Three (China, Japan and ROK), ASEAN Plus One (China), the Greater Mekong sub-region, and the Lancang-Mekong Cooperation. This health cooperation can be summarized in terms of health security, health development, and health-related innovation. The health cooperation priorities outlined by our informants consisted of unimplemented SDGs such as NCD problems and the public health system. A proposal for future health collaboration was to establish a triangular cooperation between China, IOs/non-government organizations (NGOs) and Vietnam. CONCLUSIONS: The existing cooperation between China and Vietnam in bilateral and multilateral levels has provided a good foundation for a deeper and more extensive future partnership. Key areas of future cooperation would be to achieve SDGs and solve NCD related problems, which can be accelerated through favorable cooperation and reliable partnerships. A triangular cooperation between China, Vietnam, and IOs/NGOs was considered as a suitable future mechanism.

The intentions, needs, advantages and barriers: a survey of twenty-nine countries participating in the "Belt and Road Initiative" health cooperation.

BACKGROUND: China launched the Belt and Road Initiative (BRI) aiming to develop a mutually-beneficial, sustainable trade model with partner countries. The processes of international health exchanges are key parts of how this model can be sustained into the future. This paper aims to contribute to broader understanding by exploring various intentions, needs, advantages and barriers of BRI countries and then define ways China can achieve better health cooperation. METHODS: In this study, a survey questionnaire was developed to investigate the perspectives of 60 international experts from 29 BRI countries. The survey was distributed and collected during the "Belt and Road High-level Meeting for Health Cooperation", held in Beijing in August 2017. The data were entered into EpiData 3.0 by two team members respectively and analyzed with SPSS22.0. RESULTS: Altogether 58 valid questionnaires were obtained. More than 93% of participants showed their willingness to be part of BRI health cooperation. Frist, three key areas were identified, which are broadly defined as BRI country "needs": (1) "Develop health industries"; (2) "Prevent and control infectious diseases"; and (3) "Provide health services". Second, three "advantages" of participating in BRI Health Cooperation were found: (1) "The establishment of a long-term partnership"; (2) "Quality investment and financing system"; and (3) "The convenience of cooperation". Third, two main cross-cultural "barriers" for cooperation were encountered: (1) "Cultural differences"; and (2) "Lack of communication platforms". CONCLUSION: In this study, we have identified priority fields that China can collaborate with BRI countries and show its leadership. It is suggested that successful health cooperation between China and other BRI countries should focus on maximizing present health-industry partnerships, investment and financing, as well as overcoming cultural and communication barriers.

A path to cooperation between China and Mongolia towards the control of echinococcosis under the Belt and Road Initiative.

Health is the core of development. Health cooperation between countries plays a pivotal role under the Belt and Road Initiative (B&R). In 2013, China launched its B&R to improve the international cooperation of which health was an important component. As one of the neglected zoonotic diseases, echinococcosis has become a public health concern and is on top of the government agenda among neglected zoonosis in Mongolia. The transmission of the disease involves animal husbandry, and its characteristics determine the prevention and control of such diseases which requires cross-sector collaboration and comprehensive prevention and control strategies. Taking echinococcosis as an entry point and adopting a 'Mongolia-led, China-supported, and results-sharing' approach to public health cooperation will not only contribute to the advancement of Mongolia's national health coverage, but also promoting China's capacity to engage in global health. In this way, it contributes to meeting the sustainable development goals, especially goal 3, target 3.3: by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases. This paper provides an overview on how the cooperation between China and Mongolia under the context of B&R was initiated, planned and moved forward to implementation. The experience may provide a good model and inform policy and practice for other bilateral cooperations.

Latin American social medicine across borders: South-South cooperation and the making of health solidarity.

Latin American social medicine efforts are typically understood as national endeavours, involving health workers, policymakers, academics, social movements, unions, and left-wing political parties, among other domestic actors. But Latin America's social medicine trajectory has also encompassed considerable between-country solidarity, building on early twentieth century interchanges among a range of players who shared approaches for improving living and working conditions and instituting protective social policies. Since the 1960s, Cuba's country-to-country solidarity has stood out, comprising medic exchanges, training, and other forms of support for the health and social struggles of oppressed peoples throughout Latin America and around the world, recently via Misión Barrio Adentro in Venezuela. These efforts strive for social justice-oriented health cooperation based on horizontal power relations, shared political values, a commitment to social and economic redistribution, bona fide equity, and an understanding of the societal determination of health that includes, but goes well beyond, public health and medical care. With Latin America's left-wing surge now receding, this article traces the provenance, dynamics, impact, challenges, and legacy of health solidarity across Latin American borders and its prospects for continuity.

Sharing public health data and information across borders: lessons from Southeast Asia.

BACKGROUND: The importance of data and information sharing for the prevention and control of infectious diseases has long been recognised. In recent years, public health emergencies such as avian influenza, drug-resistant malaria, and Ebola have brought renewed attention to the need for effective communication channels between health authorities, particularly in regional contexts where neighbouring countries share common health threats. However, little empirical research has been conducted to date to explore the range of factors that may affect the transfer, exchange, and use of public health data and expertise across borders, especially in developing contexts. METHODS: To explore these issues, 60 interviews were conducted with domestic and international stakeholders in Cambodia and Vietnam, selected amongst those who were involved in regional public health programmes and networks. Data analysis was structured around three categories mapped across the dataset: (1) the nature of shared data and information; (2) the nature of communication channels; and (3) how information flow may be affected by the local, regional, and global system of rules and arrangements. RESULTS: There has been a great intensification in the circulation of data, information, and expertise across borders in Southeast Asia. However, findings from this study document ways in which the movement of data and information from production sites to other places can be challenging due to different standards and practices, language barriers, different national structures and rules that govern the circulation of health information inside and outside countries, imbalances in capacities and power, and sustainability of financing arrangements. CONCLUSIONS: Our study highlights the complex socio-technical nature of data and information sharing, suggesting that best practices require significant involvement of an independent third-party brokering organisation or office, which can redress imbalances between country partners at different levels in the data sharing process, create meaningful communication channels and make the most of shared information and data sets.

Research on the status and implication of the health cooperation between China and countries along " Belt and Road" / 中国卫生政策研究

Objective:To summarize and analyze the status of health cooperation achievement strategies between China and the countries along the "Belt and Road",determine the implications thereof, and provide reference for future practical cooperation between the China and those countries in the field of health. Methods : The relevant literature was retrieved from the research database from articles published in both Chinese and English during the period from 2013 to 2017, and the literature research method was used to summarize the status quo of health cooperation. Results : According to the exclusion criteria, 116 articles were selected. The analysis showed that the main research focus falls in the following seven aspects for both domestic and foreign scholars : The dissemination of Chinese medicine culture promotes international cooperation in Chinese medicine; the prevention and control of infectious diseases needs to further strengthen the construction of international mechanisms; the health services and systems requiremutual learning from international experience; health industry has broad prospects for development; health emergency cooperation encounters the problem of inadequate coordination mechanisms and language barriers; the research on health development assistance goes deep; and health professionals training focuses on training mode. Conclusions: The existing research topics were of great coverage in range and had the highest attention to Chinese medicine,yet least considered talent cultivation. The research showed that cooperation in various health departments emphasized on international experience and the joint participation of the government and civil society. However, the research on laws and regulations, international conventions and practices, and different families' cooperation requirements related with health cooperation mechanisms need to be further strengthened.

Analysis on health cooperation intentions, demands, advantages and disadvantages among "Belt and Road" countries / 中国卫生政策研究

Objective: To understand the health cooperation intentions, demands, advantages and obstacles that are being experienced by countries along the Belt and Road,and to provide reference for China to deepen health cooperation with those countries in regard. Methods : A seminar was held at the High Level Symposium to find out about the health cooperation status among the "Belt and Road" countries, whereby the theme was: "Belt and Road for Health Cooperation towards a Health Silk Road". Therefore, a survey was conducted among 217 Chinese and foreign guests who were invited to attend the seminar. 209 questionnaires were valid and the effective rate was 96. 3％ after the questionnaire analysis carried out using SPSS22. 0. Results : Research results showed that among the respondents, 91. 7％ of the surveyed foreign partners are willing to cooperate in health, while only 73. 2％ of the Chinese respondents desired the cooperation. The demands for health cooperation between both countries was mainly about health industry,medical and health services, and infectious disease prevention and control. Both China and foreign countries confirmed that cooperation convenience and long-term partnership were the advantages of health cooperation among Belt and Road countries, while differences were highlighted in preferential policies. The biggest challenge was found to be the cultural differences. Among other disadvantages are the lack of communication platforms, the pressure of laws and regulations, unstable policies, etc. Conclusions : The willingness and broad space to cooperate in health are strong and large forboth China and foreign countries,and they are intending to put much of emphasis on health institutions,medical and health services and prevention and control of infectious diseases in the future. It is hence suggested that health cooperation should make good use of existing advantages of partnership and convenience,and overcome found obstacles in orderto deepen cooperation in the health industry.

Africa Center for Disease Control and Prevention:analysis of its development strategy / 军事医学

Faced with huge demand for building public health capacity in the post-Ebola era, Africa Union has planned to establish Africa Center for Disease Control and Prevention ( Africa CDC,ACDC), with headquarters in Addis Ababa, Ethiopia, and at least 5 regional collaborating centers in each region of the continent .The strategic objectives of ACDC focus on building a continental integrated public health system and strengthening needed public health capacity .The current study analyzed the background , plans, development layout and strategy of ACDC , and provided references for China-Africa cooperation in the areas of public health and for the formulation of China global strategies of biosecurity and disease prevention and control .

Application of Health Promotion Strategy to International Health Cooperation of Japan / 国際保健医療

Health is heavily influenced by behavioral, social and environmental determinants as well as the biomedical characteristics of individuals. The World Health Organization announced the Health Promotion Charter in Ottawa, Canada in 1986 as a strategy to enable people to have control over and improve these health determinants. This is therefore essential to prevent disease and illness due to risky behavior as well as unsound social and natural environments. Whereas all developing countries have numerous health issues regarding behavior and environment, they need the Health Promotion strategy. Japan has so far implemented a lot of programs of health education and environment improvement to control over such determinants. Thus, Japan should promote and disseminate the Health Promotion project more in international health cooperation through official development assistance for developing countries.