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Open research questions in Global Public Health Policies and Epidemiology

55 unresolved questions extracted from the limitations and future-work sections of 1,507 Global Public Health Policies and Epidemiology papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • PHEIC versus “Pandemic” The declaration of a PHEIC and the subsequent classification as a pandemic are commonly conflated in public discourse. Legally they differ. The PHEIC is explicitly regulated in Article 12 IHR (2005) and represents the highest formal alert level under international law. It activates a procedural mechanism and authorises the Director-General to issue temporary recommendations. The “pandemic declaration” by contrast has no explicit legal basis in the WHO Constitution or the IHR. It is a communicative act by which the Director-General characterises the scope and severity of global spread. It therefore lacks the procedural safeguards, defined criteria, and binding effects associated with a PHEIC. As the WHO’s Legal Counsel stated during the COVID-19 outbreak, “the IHR contain no legal definition of ‘pandemic’; it is a descriptive term used for risk communication”. 4 / 10 Björn Paulini · The Legal Mandate of the WHO in Declaring a Pandemic Absent a codified trigger, the pandemic declaration falls into the realm of soft-law normative guidance. Its authority rests on expertise and reputation rather than on treaty obligation. 3.2 Soft Law as Theoretical Frame Soft law occupies an intermediate position between political statements and binding legal instruments. It encompasses resolutions, declarations, codes of conduct, and guidelines that, although not binding, influence state conduct through legitimacy, expertise, and expectation (Burris & Lin, 2021; Quintana, 2020). The WHO’s pandemic declaration illustrates this mechanism. It creates a normative expectation of action by signalling that the global health situation has reached a qualitatively new stage requiring coordination and solidarity. The theoretical literature identifies three functions of soft law in global governance: gap-filling (issues without consensus for hard law); flexibility (adaptation to scientific and political uncertainty); norm entrepreneurship (shaping customary practice and institutional identity). Applied to the WHO, soft law enables rapid communication and mobilisation while blurring the lines of accountability. Given the enormous political and economic consequences of a pandemic declaration — affecting trade, mobility, and human rights — its non-binding character raises the question whether such authority should remain wholly discretionary. 3.3 The COVID-19 Case During COVID-19, the WHO’s decision sequence followed the IHR mechanism only up to the PHEIC phase. On 22–23 January 2020 the Emergency Committee failed to reach consensus; the Director-General therefore refrained from declaring a PHEIC.

    The Legal Mandate of the WHO in Declaring a Pandemic: Between Soft Law and Binding Obligations · 2026 · DOI

  • This review has several limitations. First, it was designed as a structured narrative review rather than a formal systematic review, and is therefore inherently more susceptible to selection bias. Second, although we applied explicit search concepts and inclusion/exclusion criteria, we prioritized policy-relevant, implementation-focused, and high-yield literature, which may have led to underrepresentation of some region-specific or disease-specific studies. Third, we did not perform a formal risk- of-bias assessment or quantitative meta-analysis. Accordingly, this manuscript should be interpreted as a policy- and implementation-oriented synthesis rather than an exhaustive evidence appraisal.

    The forgotten billion: bridging the global allergy care chasm through scalable, equity-driven strategies · 2026 · DOI

  • Application of evolutionary medicine principles to develop precision medicine interventions specifically tailored for African populations with hypertension has not been adequately developed or validated.

    From Evolutionary Medicine to Precision Medicine in the Hypertension Treatment in Africa · 2021 · DOI

  • Policy makers in both the global north as well as the global south rose to the challenge, with decidedly mixed responses as well as decidedly mixed results, as comparisons between reported case loads of, say the UK and Germany or between Brazil and the PR of China, show.

    The ethical challenges of the SARS‐CoV‐2 pandemic in the global south and the global north – same and different · 2020 · DOI

  • Although, in good governance, a series of principles and basic features related to good governance are considered as international and for all countries and governments, it should be noted that the implementation of them in different countries is different and that what needs to be done and prioritized in an specific country is a matter that needs to be studied.

    Explaining the Indicators of Good Governance in the Health System · 2018

  • By the time the Peace Accords were signed in 1996, the country's primary health care system was scarcely functioning with virtually no services available in rural indigenous areas.

    Government stewardship and primary health care in Guatemala since 1996 · 2018 · DOI

  • The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies.

    What’s in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR · 2015 · DOI

  • It finds that characteristics associated with NPI support vary widely by region, possibly because of cultural variation and prior experience, and that minority groups tend to be less supportive of NPIs when arrest is the consequence of noncompliance.

    Predicting support for non‐pharmaceutical interventions during infectious outbreaks: a four region analysis · 2014 · DOI

  • It seeks to contribute, first, to strengthening the field of LMIC health policy analysis by highlighting gaps in the literature and generating ideas for a future research agenda and, second, to thinking about the value and applicability of qualitative synthesis approaches to the health policy analysis field.

    Mapping the existing body of health policy implementation research in lower income settings: what is covered and what are the gaps? · 2014 · DOI

  • NCD control and monitoring of programme funding should occur at the country and regional levels, since insufficient data on global health financing makes comprehensive auditing of funds nearly impossible.

    Tracking global funding for the prevention and control of noncommunicable diseases · 2012 · DOI

  • The authors show how the relatively new method of respondent-driven sampling can be used successfully in an Australian setting to recruit people who inject drugs (PWID); however, as they argue, the capacity of respondent-driven sampling to produce population estimates remains unclear.

    Evolving Knowledge and Practice: Hepatitis C and Illicit Drug Use · 2010 · DOI

  • The Interinar Years During the 1914-1918 war the activities of the OIHP were virtually limited to the publication of its monthly bulletin, the form of which had been laid down in the Arrangement de Rome.

    The World Health Organization in Historical Perspective · 1981 · DOI

  • Effective approaches to global public health justice, then, cannot be limited to the introduction of international legal safeguards but need to include a project for the social redistribution of bads and reallocation of global responsibility for risk-creation and risk-management.

    COVID-19, global public health justice, and the culture of organized irresponsibility · 2024 · DOI

  • Literature on OHS in the Southern African region is scarce because it is still in its infancy and greatly underdeveloped.

    Occupational Health and Safety Legislation for the Health Sector in Southern African Development Community: The Case of Botswana and South Africa · 2023 · DOI

  • However, the impact that NGOs could have on ameliorating the effects of NCDs remains understudied and is a promising direction for future scholarly efforts.

    The sociology of global health: Inequality, disease‐related stigma, and the rise of nongovernmental organizations · 2023 · DOI

  • However, limited evidence around data elements, interoperability, and implementation leaves unanswered questions regarding the utility of indices to prioritize health equity.

    Assessment of Population‐Level Disadvantage Indices to Inform Equitable Health Policy · 2022 · DOI

  • Activities of KTPs in Africa are most often curtailed by many obstacles, but not limited to the following; lack of infrastructure, human and financial capital, high turnover among top-level policymakers, and lack of collaboration between academia and industry.

    Knowledge translation platforms to support African evidence-informed policies: challenges and progress · 2021 · DOI

  • In Zimbabwe, communities in marginalised and hard to reach areas are the most susceptible to infectious disease, because of insufficient information on symptoms, progression, and actions to take towards treatment.

    Information enclave and corona virus disease 2019 (COVID-19) pandemic in remote areas: a case of Binga district, Zimbabwe · 2021

  • Limited empirical data on the specific genetic and molecular pathways linking ancestral adaptations (salt retention, vascular reactivity) to contemporary hypertension prevalence in African individuals.

    From Evolutionary Medicine to Precision Medicine in the Hypertension Treatment in Africa · 2021 · DOI

  • The evolutionary mechanisms explaining susceptibility to hypertension in African populations remain incompletely understood, particularly regarding how ancestral selective pressures continue to influence modern disease susceptibility.

    From Evolutionary Medicine to Precision Medicine in the Hypertension Treatment in Africa · 2021 · DOI

  • Screening governance organizations in different jurisdictions vary widely in how they are constituted, how they relate to other interested organizations and actors, and what powers and authority they wield.

    Half a Century of Wilson & Jungner: Reflections on the Governance of Population Screening · 2020 · DOI

  • Conclusion Men in the community of rural Jérémie, Haiti, have limited knowledge of illness and disease, which may stem from insufficient resources being allocated to their health care.

    Haitian Men’s Health and Health Seeking Behavior · 2020 · DOI

  • Therefore, in order to improve the health of both the men and their family members in this community, novel and targeted approaches to disseminate important health information to these men should be further investigated and readily implemented.

    Haitian Men’s Health and Health Seeking Behavior · 2020 · DOI

  • This special issue on urban health in Africa responds to these questions as part of the renewed search for pathways to fill the gaps in knowledge and support evidence-based policy and action in the region.

    Research to address socio-environmental determinants of health and access to healthcare in urban(izing) Africa · 2020 · DOI

  • Tracing the pathways of cooperation in health in sub-Saharan Africa from hesitant exchanges to institutionalized dimensions from the 1920s to the early 1960s, this article addresses regional dynamics in health diplomacy which have so far been under-researched.

    Regional cooperation and health diplomacy in Africa: from intra-colonial exchanges to multilateral health institutions · 2020 · DOI

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55 open questions have been extracted from the limitations and future-work passages of 1,507 Global Public Health Policies and Epidemiology papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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