The rapid acceleration of global warming has led to an increased burden of high temperature-related diseases(HTDs),highlighting the need for advanced evidence-based management strategies.We have developed a conceptual...The rapid acceleration of global warming has led to an increased burden of high temperature-related diseases(HTDs),highlighting the need for advanced evidence-based management strategies.We have developed a conceptual framework aimed at alleviating the global burden of HTDs,grounded in the One Health concept.This framework refines the impact pathway and establishes systematic data-driven models to inform the adoption of evidence-based decision-making,tailored to distinct contexts.We collected extensive national-level data from authoritative public databases for the years 2010–2019.The burdens of five categories of disease causes–cardiovascular diseases,infectious respiratory diseases,injuries,metabolic diseases,and non-infectious respiratory diseases–were designated as intermediate outcome variables.The cumulative burden of these five categories,referred to as the total HTD burden,was the final outcome variable.We evaluated the predictive performance of eight models and subsequently introduced twelve intervention measures,allowing us to explore optimal decision-making strategies and assess their corresponding contributions.Our model selection results demonstrated the superior performance of the Graph Neural Network(GNN)model across various metrics.Utilizing simulations driven by the GNN model,we identified a set of optimal intervention strategies for reducing disease burden,specifically tailored to the seven major regions:East Asia and Pacific,Europe and Central Asia,Latin America and the Caribbean,Middle East and North Africa,North America,South Asia,and Sub-Saharan Africa.Sectoral mitigation and adaptation measures,acting upon our categories of Infrastructure&Community,Ecosystem Resilience,and Health System Capacity,exhibited particularly strong performance for various regions and diseases.Seven out of twelve interventions were included in the optimal intervention package for each region,including raising low-carbon energy use,increasing energy intensity,improving livestock feed,expanding basic health care delivery coverage,enhancing health financing,addressing air pollution,and improving road infrastructure.The outcome of this study is a global decision-making tool,offering a systematic methodology for policymakers to develop targeted intervention strategies to address the increasingly severe challenge of HTDs in the context of global warming.展开更多
Background:A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, ani...Background:A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed.Methods:We describe five steps towards a global One Health index (GOHI), including (i) framework formulation;(ii) indicator selection;(iii) database building;(iv) weight determination;and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators.Results:The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8–65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible.Conclusions:GOHI—subject to rigorous validation—would represent the world’s first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.展开更多
Background One Health approach is crucial to tackling complex global public health threats at the interface of humans, animals, and the environment. As outlined in the One Health Joint Plan of Action, the internationa...Background One Health approach is crucial to tackling complex global public health threats at the interface of humans, animals, and the environment. As outlined in the One Health Joint Plan of Action, the international One Health community includes stakeholders from different sectors. Supported by the Bill & Melinda Gates Foundation, an academic community for One Health action has been proposed with the aim of promoting the understanding and real-world implementation of One Health approach and contribution towards the Sustainable Development Goals for a healthy planet.Main text The proposed academic community would contribute to generating high-quality scientific evidence, distilling local experiences as well as fostering an interconnected One Health culture and mindset, among various stakeholders on different levels and in all sectors. The major scope of the community covers One Health governance, zoonotic diseases, food security, antimicrobial resistance, and climate change along with the research agenda to be developed. The academic community will be supported by two committees, including a strategic consultancy committee and a scientific steering committee, composed of influential scientists selected from the One Health information database. A workplan containing activities under six objectives is proposed to provide research support, strengthen local capacity, and enhance global participation.Conclusions The proposed academic community for One Health action is a crucial step towards enhancing communication, coordination, collaboration, and capacity building for the implementation of One Health. By bringing eminent global experts together, the academic community possesses the potential to generate scientific evidence and provide advice to local governments and international organizations, enabling the pursuit of common goals, collaborative policies, and solutions to misaligned interests.展开更多
Background Food systems instantiate the complex interdependencies across humans,physical environments,and other organisms.Applying One Health approaches for agri-food system transformation,which adopts integrated and ...Background Food systems instantiate the complex interdependencies across humans,physical environments,and other organisms.Applying One Health approaches for agri-food system transformation,which adopts integrated and unifying approaches to optimize the overall health of humans,animals,plants,and environments,is crucial to enhance the sustainability of food systems.This study develops a potential assessment tool,named the global One Health index-Food Security(GOHI-FS),aiming to evaluate food security performance across countries/territories from One Health perspective and identify relevant gaps that need to be improved for sustainable food systems.Methods We comprehensively reviewed existing frameworks and elements of food security.The indicator framework of GOHI-FS was conceptualized following the structure-process-outcome model and confirmed by expert advisory.Publicly available data in 2020 was collected for each indicator.The weighting strategy was determined by the Fuzzy Analytical Hierarchy Process.The data for each indicator was normalized and aggregated by weighted arithmetic mean.Linear regressions were performed to evaluate the associations of GOHI-FS with health and social-economic indicators.Results The GOHI-FS includes 5 first-level indicators,19 second-level indicators and 45 third-level indicators.There were 146 countries/territories enrolled for evaluation.The highest average score of first-level indicators was Nutrition(69.8)and the lowest was Government Support and Response(31.3).There was regional heterogeneity of GOHI-FS scores.Higher median scores with interquartile range(IQR)were shown in North America(median:76.1,IQR:75.5-76.7),followed by Europe and Central Asia(median:66.9,IQR:60.1-74.3),East Asia and the Pacific(median:60.6,IQR:55.5-68.7),Latin America and the Caribbean(median:60.2,IQR:57.8-65.0),Middle East and North Africa(median:56.6,IQR:52.0-62.8),South Asia(median:51.1,IQR:46.7-53.8),and sub-Saharan Africa(median:41.4,IQR:37.2-46.5).We also found significant associations between GOHI-FS and GDP per capita,socio-demographic index,health expenditure and life expectancy.Conclusions GOHI-FS is a potential assessment tool to understand the gaps in food security across countries/territories under the One Health concept.The pilot findings suggest notable gaps for sub-Saharan Africa in numerous aspects.Broad actions are needed globally to promote government support and response for food security.展开更多
Background Viral infectious diseases of poverty(vIDPs)remain a significant global health challenge.Despite their profound impact,the burden of these diseases is not comprehensively quantified.This study aims to analyz...Background Viral infectious diseases of poverty(vIDPs)remain a significant global health challenge.Despite their profound impact,the burden of these diseases is not comprehensively quantified.This study aims to analyze the global burden of six major vIDPs,including coronavirus disease 2019(COVID-19),HIV/AIDS,acute hepatitis,dengue,rabies,and Ebola virus disease(EVD),using data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2021(GBD 2021).Methods Following the GBD 2021 framework,we analyzed the incidence,mortality,and disability-adjusted life years(DALYs)of the six vIDPs across 204 countries and territories from 1990 to 2021.We examined the association between the Socio-Demographic Index(SDI)and the burden of vIDPs.All estimates were reported as numbers and rates per 100,000 population,calculated using the Bayesian statistical model employed by GBD 2021,with 95%uncertainty intervals(UI).Results In 2021,vIDPs caused approximately 8.7 million deaths and 259.2 million DALYs,accounting for 12.8%and 9.0%of the global all-cause totals,respectively.Globally,the burden of vIDPs varied significantly:COVID-19 caused around 7.9 million(95%UI:7.5,8.4)deaths and 212.0 million(95%UI 197.9,234.7)DALYs in 2021.Acute hepatitis had the second-highest age-standardized incidence rate,with 3411.5(95%UI:3201.8,3631.3)per 100,000 population,while HIV/AIDS had a high age-standardized prevalence rate,with 483.1(95%UI:459.0,511.4)per 100,000 population.Dengue incidence cases rose from 26.5 million(95%UI:3.9,51.9)in 1990 to 59.0 million(95%UI:15.5,106.9)in 2021.Rabies,although reduced in prevalence,continued to pose a significant mortality risk.EVD had the lowest overall burden but significant outbreak impacts.Age-standardized DALY rates for vIDPs were significantly negatively correlated with SDI:acute hepatitis(r=-0.8,P<0.0001),rabies(r=-0.7,P<0.0001),HIV/AIDS(r=-0.6,P<0.0001),COVID-19(r=-0.5,P<0.0001),dengue(r=-0.4,P<0.0001),and EVD(r=-0.2,P<0.005).Conclusions VIDPs pose major public health challenges worldwide,with significant regional,age,and gender disparities.The results underscore the need for targeted interventions and international cooperation to mitigate the burden of these diseases.Policymakers can use these findings to implement cost-effective interventions and improve health outcomes,particularly in regions with high or increasing burdens.展开更多
基金The project was supported by National Natural Science Foundation of China(No.72204160)the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(No.21410750200)Open Research Project of Key Laboratory of Parasite Pathogen and Vector Biology of National Health Commission of the People's Republic of China(No.NHCKFKT2022-16).
文摘The rapid acceleration of global warming has led to an increased burden of high temperature-related diseases(HTDs),highlighting the need for advanced evidence-based management strategies.We have developed a conceptual framework aimed at alleviating the global burden of HTDs,grounded in the One Health concept.This framework refines the impact pathway and establishes systematic data-driven models to inform the adoption of evidence-based decision-making,tailored to distinct contexts.We collected extensive national-level data from authoritative public databases for the years 2010–2019.The burdens of five categories of disease causes–cardiovascular diseases,infectious respiratory diseases,injuries,metabolic diseases,and non-infectious respiratory diseases–were designated as intermediate outcome variables.The cumulative burden of these five categories,referred to as the total HTD burden,was the final outcome variable.We evaluated the predictive performance of eight models and subsequently introduced twelve intervention measures,allowing us to explore optimal decision-making strategies and assess their corresponding contributions.Our model selection results demonstrated the superior performance of the Graph Neural Network(GNN)model across various metrics.Utilizing simulations driven by the GNN model,we identified a set of optimal intervention strategies for reducing disease burden,specifically tailored to the seven major regions:East Asia and Pacific,Europe and Central Asia,Latin America and the Caribbean,Middle East and North Africa,North America,South Asia,and Sub-Saharan Africa.Sectoral mitigation and adaptation measures,acting upon our categories of Infrastructure&Community,Ecosystem Resilience,and Health System Capacity,exhibited particularly strong performance for various regions and diseases.Seven out of twelve interventions were included in the optimal intervention package for each region,including raising low-carbon energy use,increasing energy intensity,improving livestock feed,expanding basic health care delivery coverage,enhancing health financing,addressing air pollution,and improving road infrastructure.The outcome of this study is a global decision-making tool,offering a systematic methodology for policymakers to develop targeted intervention strategies to address the increasingly severe challenge of HTDs in the context of global warming.
基金The project was supported by China Medical Board(no.20-365)Shanghai Jiao Tong University Integrated Innovation Fund(no.2020-01).
文摘Background:A One Health approach has been increasingly mainstreamed by the international community, as it provides for holistic thinking in recognizing the close links and inter-dependence of the health of humans, animals and the environment. However, the dearth of real-world evidence has hampered application of a One Health approach in shaping policies and practice. This study proposes the development of a potential evaluation tool for One Health performance, in order to contribute to the scientific measurement of One Health approach and the identification of gaps where One Health capacity building is most urgently needed.Methods:We describe five steps towards a global One Health index (GOHI), including (i) framework formulation;(ii) indicator selection;(iii) database building;(iv) weight determination;and (v) GOHI scores calculation. A cell-like framework for GOHI is proposed, which comprises an external drivers index (EDI), an intrinsic drivers index (IDI) and a core drivers index (CDI). We construct the indicator scheme for GOHI based on this framework after multiple rounds of panel discussions with our expert advisory committee. A fuzzy analytical hierarchy process is adopted to determine the weights for each of the indicators.Results:The weighted indicator scheme of GOHI comprises three first-level indicators, 13 second-level indicators, and 57 third-level indicators. According to the pilot analysis based on the data from more than 200 countries/territories the GOHI scores overall are far from ideal (the highest score of 65.0 out of a maximum score of 100), and we found considerable variations among different countries/territories (31.8–65.0). The results from the pilot analysis are consistent with the results from a literature review, which suggests that a GOHI as a potential tool for the assessment of One Health performance might be feasible.Conclusions:GOHI—subject to rigorous validation—would represent the world’s first evaluation tool that constructs the conceptual framework from a holistic perspective of One Health. Future application of GOHI might promote a common understanding of a strong One Health approach and provide reference for promoting effective measures to strengthen One Health capacity building. With further adaptations under various scenarios, GOHI, along with its technical protocols and databases, will be updated regularly to address current technical limitations, and capture new knowledge.
文摘Background One Health approach is crucial to tackling complex global public health threats at the interface of humans, animals, and the environment. As outlined in the One Health Joint Plan of Action, the international One Health community includes stakeholders from different sectors. Supported by the Bill & Melinda Gates Foundation, an academic community for One Health action has been proposed with the aim of promoting the understanding and real-world implementation of One Health approach and contribution towards the Sustainable Development Goals for a healthy planet.Main text The proposed academic community would contribute to generating high-quality scientific evidence, distilling local experiences as well as fostering an interconnected One Health culture and mindset, among various stakeholders on different levels and in all sectors. The major scope of the community covers One Health governance, zoonotic diseases, food security, antimicrobial resistance, and climate change along with the research agenda to be developed. The academic community will be supported by two committees, including a strategic consultancy committee and a scientific steering committee, composed of influential scientists selected from the One Health information database. A workplan containing activities under six objectives is proposed to provide research support, strengthen local capacity, and enhance global participation.Conclusions The proposed academic community for One Health action is a crucial step towards enhancing communication, coordination, collaboration, and capacity building for the implementation of One Health. By bringing eminent global experts together, the academic community possesses the potential to generate scientific evidence and provide advice to local governments and international organizations, enabling the pursuit of common goals, collaborative policies, and solutions to misaligned interests.
文摘Background Food systems instantiate the complex interdependencies across humans,physical environments,and other organisms.Applying One Health approaches for agri-food system transformation,which adopts integrated and unifying approaches to optimize the overall health of humans,animals,plants,and environments,is crucial to enhance the sustainability of food systems.This study develops a potential assessment tool,named the global One Health index-Food Security(GOHI-FS),aiming to evaluate food security performance across countries/territories from One Health perspective and identify relevant gaps that need to be improved for sustainable food systems.Methods We comprehensively reviewed existing frameworks and elements of food security.The indicator framework of GOHI-FS was conceptualized following the structure-process-outcome model and confirmed by expert advisory.Publicly available data in 2020 was collected for each indicator.The weighting strategy was determined by the Fuzzy Analytical Hierarchy Process.The data for each indicator was normalized and aggregated by weighted arithmetic mean.Linear regressions were performed to evaluate the associations of GOHI-FS with health and social-economic indicators.Results The GOHI-FS includes 5 first-level indicators,19 second-level indicators and 45 third-level indicators.There were 146 countries/territories enrolled for evaluation.The highest average score of first-level indicators was Nutrition(69.8)and the lowest was Government Support and Response(31.3).There was regional heterogeneity of GOHI-FS scores.Higher median scores with interquartile range(IQR)were shown in North America(median:76.1,IQR:75.5-76.7),followed by Europe and Central Asia(median:66.9,IQR:60.1-74.3),East Asia and the Pacific(median:60.6,IQR:55.5-68.7),Latin America and the Caribbean(median:60.2,IQR:57.8-65.0),Middle East and North Africa(median:56.6,IQR:52.0-62.8),South Asia(median:51.1,IQR:46.7-53.8),and sub-Saharan Africa(median:41.4,IQR:37.2-46.5).We also found significant associations between GOHI-FS and GDP per capita,socio-demographic index,health expenditure and life expectancy.Conclusions GOHI-FS is a potential assessment tool to understand the gaps in food security across countries/territories under the One Health concept.The pilot findings suggest notable gaps for sub-Saharan Africa in numerous aspects.Broad actions are needed globally to promote government support and response for food security.
基金National Natural Science Foundation of China(No.72204160)International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion(No.21410750200)Open Research Project of the Key Laboratory of Parasite Pathogen and Vector Biology of National Health Commission of the People’s Republic of China(No.NHCKFKT2022-16)。
文摘Background Viral infectious diseases of poverty(vIDPs)remain a significant global health challenge.Despite their profound impact,the burden of these diseases is not comprehensively quantified.This study aims to analyze the global burden of six major vIDPs,including coronavirus disease 2019(COVID-19),HIV/AIDS,acute hepatitis,dengue,rabies,and Ebola virus disease(EVD),using data from the Global Burden of Diseases,Injuries,and Risk Factors Study 2021(GBD 2021).Methods Following the GBD 2021 framework,we analyzed the incidence,mortality,and disability-adjusted life years(DALYs)of the six vIDPs across 204 countries and territories from 1990 to 2021.We examined the association between the Socio-Demographic Index(SDI)and the burden of vIDPs.All estimates were reported as numbers and rates per 100,000 population,calculated using the Bayesian statistical model employed by GBD 2021,with 95%uncertainty intervals(UI).Results In 2021,vIDPs caused approximately 8.7 million deaths and 259.2 million DALYs,accounting for 12.8%and 9.0%of the global all-cause totals,respectively.Globally,the burden of vIDPs varied significantly:COVID-19 caused around 7.9 million(95%UI:7.5,8.4)deaths and 212.0 million(95%UI 197.9,234.7)DALYs in 2021.Acute hepatitis had the second-highest age-standardized incidence rate,with 3411.5(95%UI:3201.8,3631.3)per 100,000 population,while HIV/AIDS had a high age-standardized prevalence rate,with 483.1(95%UI:459.0,511.4)per 100,000 population.Dengue incidence cases rose from 26.5 million(95%UI:3.9,51.9)in 1990 to 59.0 million(95%UI:15.5,106.9)in 2021.Rabies,although reduced in prevalence,continued to pose a significant mortality risk.EVD had the lowest overall burden but significant outbreak impacts.Age-standardized DALY rates for vIDPs were significantly negatively correlated with SDI:acute hepatitis(r=-0.8,P<0.0001),rabies(r=-0.7,P<0.0001),HIV/AIDS(r=-0.6,P<0.0001),COVID-19(r=-0.5,P<0.0001),dengue(r=-0.4,P<0.0001),and EVD(r=-0.2,P<0.005).Conclusions VIDPs pose major public health challenges worldwide,with significant regional,age,and gender disparities.The results underscore the need for targeted interventions and international cooperation to mitigate the burden of these diseases.Policymakers can use these findings to implement cost-effective interventions and improve health outcomes,particularly in regions with high or increasing burdens.
