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454 results for “redasadki”
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RT @endmalaria: The MOU signed between RBM Partnership to End Malaria and The Geneva Learning Foundation will put #CommunityHealthWorkers a…
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Really proud to be helping community of committed health professionals meet, connect, and learn from each other about the effects of climate on health. #climate #health #CommunityHealthWorkers #communityhealth https://t.co/Uo342HbQVQ
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RT @DigitalScholarX: Watch the Teach to Reach 9 session on Female Genital Schistosomiasis (FGS) #EndNTDs #women #Africa https://t.co/kpcEk0…
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Share this thread with colleagues #TropMed23 #EndNTDs #Ghana
https://t.co/TPVJcte6xJ -
“It was one of the ways that we had equitable access to opportunity and learning with this approach.” #TropMed23 #EndNTDs #Ghana
Do you care about neglected needs of women’s health? Learn more about #FGS https://t.co/WgVmNUcb0C
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“One thing that kept us to come back with our local solutions, apart from the motivation and the commitment that we had, was an action plan development that each and every one of us had to submit.” #TropMed23 #EndNTDs #Ghana
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“It has also increased our motivation level and we want to do more online courses.” #TropMed23 #EndNTDs #Ghana
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“We were also able to disseminate information across a wider coverage than if we had an in-person training.” #TropMed23 #EndNTDs #Ghana
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“We have now become dissemination ambassadors on #FGS and after every activity that we did, we had people coming to us for recordings on the sessions that we had.” #TropMed23 #EndNTDs #Ghana
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“Finally 198 healthcare professionals were able to complete the workshop successfully.” #TropMed23 #EndNTDs #Ghana
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“It was great when we saw a link shared by the Geneva Learning Foundation that showed over 1,500 healthcare professionals who were eager and interested in learning the course.” #TropMed23 #EndNTDs #Ghana
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“The second phase of the project, which was called the Impact Accelerator, helped bring alive action plans with local solutions.” #TropMed23 #EndNTDs #Ghana
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“Participants were trained on improving the prevention, diagnosis and treatment of #FGS.” #TropMed23 #EndNTDs #Ghana
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“More than 300 healthcare professionals across all levels of health system in sub-Saharan Africa participated.” #TropMed23 #EndNTDs #Ghana
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“Research is ongoing, but it's important for us to know that knowledge gap is across many African countries and it is time for us all to join to end this menace.” #TropMed23 #EndNTDs #Ghana
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“All levels of health system need improved knowledge from specialists in obstetrics and gynaecology through to community health workers and laboratory workers.” #TropMed23 #EndNTDs #Ghana
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“Having heard all the signs and symptoms that are shared, diagnosis is sometimes very difficult because the symptoms mimic other sexually transmitted infections.” #TropMed23 #EndNTDs #Ghana
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“And when left untreated, the person is likely to come down with complications such as infertility and face stigma and discrimination in society.” #TropMed23 #EndNTDs #Ghana
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“And later the person starts coming down with symptoms such as blood urination, pain in the genital area.” #TropMed23 #EndNTDs #Ghana
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“And when an unhealthy individual steps into that water, the parasite penetrates through the skin and then travels into the internal organs of the woman or girl.” #TropMed23 #EndNTDs #Ghana
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“If we do not get the knowledge and do not do something about it, we might end up having a lot of people ending up with complications.” #TropMed23 #EndNTDs #Ghana
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“I'm sure some of us might be thinking it could be rape, it could be sexually transmitted disease, and that is why it's so important for us to talk about female genital schistosomiasis.” #TropMed23 #EndNTDs #Ghana
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“This girl loves to swim. After swimming with her new friends, she came back home having symptoms of lower abdominal pain, discharge, and a little bit of blood from the genitals that lasted for several months.” #TropMed23 #EndNTDs #Ghana
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It brings great pride to announce the commencement of our second Impact Accelerator. This programme is dedicated to supporting health workers who are striving to bring positive change within their health facilities and districts. More info: https://t.co/GeIXKNkmBu #EndNTDs
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How can governments protect and promote mental health and well-being across sectors?
For decades, global health policy has approached mental illness primarily as a clinical challenge, a condition to be managed within the walls of hospitals and clinics by medical professionals. This biomedical focus, while essential, has often obscured the broader context in which mental health is shaped. A new publication from the World Health Organization, Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors, marks a significant shift in normative standards. It posits that mental health is not merely a health outcome but a structural one, determined as much by the fiscal policy, urban planning, and labor laws of governments as by psychiatric care.
A technical framework for cross-sectoral governance
The guidance emerges against a backdrop of escalating costs. The global economic burden of mental health conditions is projected to reach US$6 trillion by 2030. In response, the WHO outlines a “whole-of-government” approach, moving beyond general advocacy to provide specific policy directives for ministries that have historically operated independently of mental health considerations.
The document details an eight-step implementation cycle, requiring high-level political dialogue, rigorous situational analysis, and the drafting of sector-specific policies. It assigns distinct responsibilities to key government sectors:
- Finance and Treasury: The guidance suggests that fiscal policies – including tax rates and welfare allocations – must be evaluated for their impact on health equity, rather than viewing mental health funding solely as a healthcare expenditure.
- Interior and Justice: It recommends a shift in the role of police and prisons, advocating for the retraining of first responders to manage crises through de-escalation rather than coercion, and establishing independent mechanisms to report abuse.
- Education and Employment: The framework calls for schools to embed social-emotional learning into standard curricula and for labor ministries to enforce standards that mitigate psychosocial risks in the workplace, such as precarious contracts and unsafe working conditions.
This approach frames mental health as a shared liability across the state apparatus, requiring coordinated action to address the social and structural determinants such as poverty, discrimination, and violence that drive poor mental health outcomes.
The challenge of implementation in resource-constrained settings
While the normative framework is clear, the practical pathway to implementation remains complex, particularly in low- and middle-income countries (LMICs). The current development finance landscape is characterized by shrinking budgets and a fracturing of global health funding. Governments in LMICs face the dual challenge of executing complex, multi-sectoral strategies while managing severe fiscal constraints.
One critical question for policymakers is operational: How can a Ministry of Health in a resource-constrained setting effectively engage other sectors – such as finance or justice – to adopt these recommendations without significant new external funding? Moving from high-level policy documents to localized action requires a mechanism that can bridge the gap between statutory intent and the reality of service delivery.
So what are the options to do more with less?
Peer learning as a mechanism for structural change
The Geneva Learning Foundation (TGLF) offers an operational model that addresses this implementation gap by utilizing the existing capacity of the health and social workforce. Rather than relying on traditional, resource-intensive capacity-building or technical assistance models, TGLF employs a “learning-to-action” methodology rooted in structured peer interaction. This approach connects thousands of frontline professionals – ranging from district administrators to social workers – into a structured digital network to learn from and support each other in actual implementation.
This model could support this WHO guidance in three specific ways:
- Generating actionable local data: In contexts where central data is scarce, the network functions as a distributed sensor. In a recent deployment in Nigeria, working with NPHCDA and UNICEF, 4,300 health workers generated over 400 root cause analyses within weeks. By identifying specific local barriers to service delivery the network produced the granular evidence needed to inform the cross-sectoral policies advocated by the WHO, and turn them into practice.
- Facilitating cross-sectoral integration: The WHO guidance necessitates collaboration between siloed professionals. TGLF’s model creates a forum where professionals from different sectors can share experience as they work to drive change, each in their own context. A school nurse can analyze crisis response strategies alongside a social worker from a different district, fostering the “collective intelligence” required to implement complex, multi-agency directives right down to the community level.
- Improving cost-efficiency: By digitizing the peer-learning process and utilizing peer accountability rather than external consultants, the model achieves a cost reduction of approximately 90 percent compared to conventional implementation methods. This efficiency could allow governments to begin operationalizing the WHO guidelines immediately using existing payroll structures, rather than waiting for external grants.
By validating local knowledge and structuring peer accountability, this innovative model provides a practical means to transform the WHO’s technical guidance into sustained administrative action. It demonstrates that the capacity to reform mental health governance lies not only in new financial instruments but in the structured coordination of the workforce already present on the ground.
Image: Crossing Into Clarity, The Geneva Learning Foundation Collection © 2025. A corridor built from carved, interlocking forms – half letters, half symbols – evokes the dense, overlapping pressures that shape mental health across societies. As the viewer steps through this textured passage, the individual ahead emerges into a space of light and openness, suggesting the possibility of coherence after complexity. The piece reflects a core truth of whole-of-government mental health action: when fragmented systems align, even imperfectly, they create pathways that help people move from burden toward balance, and from confusion toward care.
Reference
Michelle Funk, Dévora Kestel, Natalie Drew Bold, Celline Cole, Maria Francesca Moro, 2025. Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors. World Health Organization, Geneva, Switzerland. https://www.who.int/publications/i/item/9789240114388
#governmentSectors #implementationScience #lmics #mentalHealth #peerLearning #genevaLearningFoundation #wellBeing #workforce
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How can governments protect and promote mental health and well-being across sectors?
For decades, global health policy has approached mental illness primarily as a clinical challenge, a condition to be managed within the walls of hospitals and clinics by medical professionals. This biomedical focus, while essential, has often obscured the broader context in which mental health is shaped. A new publication from the World Health Organization, Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors, marks a significant shift in normative standards. It posits that mental health is not merely a health outcome but a structural one, determined as much by the fiscal policy, urban planning, and labor laws of governments as by psychiatric care.
A technical framework for cross-sectoral governance
The guidance emerges against a backdrop of escalating costs. The global economic burden of mental health conditions is projected to reach US$6 trillion by 2030. In response, the WHO outlines a “whole-of-government” approach, moving beyond general advocacy to provide specific policy directives for ministries that have historically operated independently of mental health considerations.
The document details an eight-step implementation cycle, requiring high-level political dialogue, rigorous situational analysis, and the drafting of sector-specific policies. It assigns distinct responsibilities to key government sectors:
- Finance and Treasury: The guidance suggests that fiscal policies – including tax rates and welfare allocations – must be evaluated for their impact on health equity, rather than viewing mental health funding solely as a healthcare expenditure.
- Interior and Justice: It recommends a shift in the role of police and prisons, advocating for the retraining of first responders to manage crises through de-escalation rather than coercion, and establishing independent mechanisms to report abuse.
- Education and Employment: The framework calls for schools to embed social-emotional learning into standard curricula and for labor ministries to enforce standards that mitigate psychosocial risks in the workplace, such as precarious contracts and unsafe working conditions.
This approach frames mental health as a shared liability across the state apparatus, requiring coordinated action to address the social and structural determinants such as poverty, discrimination, and violence that drive poor mental health outcomes.
The challenge of implementation in resource-constrained settings
While the normative framework is clear, the practical pathway to implementation remains complex, particularly in low- and middle-income countries (LMICs). The current development finance landscape is characterized by shrinking budgets and a fracturing of global health funding. Governments in LMICs face the dual challenge of executing complex, multi-sectoral strategies while managing severe fiscal constraints.
One critical question for policymakers is operational: How can a Ministry of Health in a resource-constrained setting effectively engage other sectors – such as finance or justice – to adopt these recommendations without significant new external funding? Moving from high-level policy documents to localized action requires a mechanism that can bridge the gap between statutory intent and the reality of service delivery.
So what are the options to do more with less?
Peer learning as a mechanism for structural change
The Geneva Learning Foundation (TGLF) offers an operational model that addresses this implementation gap by utilizing the existing capacity of the health and social workforce. Rather than relying on traditional, resource-intensive capacity-building or technical assistance models, TGLF employs a “learning-to-action” methodology rooted in structured peer interaction. This approach connects thousands of frontline professionals – ranging from district administrators to social workers – into a structured digital network to learn from and support each other in actual implementation.
This model could support this WHO guidance in three specific ways:
- Generating actionable local data: In contexts where central data is scarce, the network functions as a distributed sensor. In a recent deployment in Nigeria, working with NPHCDA and UNICEF, 4,300 health workers generated over 400 root cause analyses within weeks. By identifying specific local barriers to service delivery the network produced the granular evidence needed to inform the cross-sectoral policies advocated by the WHO, and turn them into practice.
- Facilitating cross-sectoral integration: The WHO guidance necessitates collaboration between siloed professionals. TGLF’s model creates a forum where professionals from different sectors can share experience as they work to drive change, each in their own context. A school nurse can analyze crisis response strategies alongside a social worker from a different district, fostering the “collective intelligence” required to implement complex, multi-agency directives right down to the community level.
- Improving cost-efficiency: By digitizing the peer-learning process and utilizing peer accountability rather than external consultants, the model achieves a cost reduction of approximately 90 percent compared to conventional implementation methods. This efficiency could allow governments to begin operationalizing the WHO guidelines immediately using existing payroll structures, rather than waiting for external grants.
By validating local knowledge and structuring peer accountability, this innovative model provides a practical means to transform the WHO’s technical guidance into sustained administrative action. It demonstrates that the capacity to reform mental health governance lies not only in new financial instruments but in the structured coordination of the workforce already present on the ground.
Image: Crossing Into Clarity, The Geneva Learning Foundation Collection © 2025. A corridor built from carved, interlocking forms – half letters, half symbols – evokes the dense, overlapping pressures that shape mental health across societies. As the viewer steps through this textured passage, the individual ahead emerges into a space of light and openness, suggesting the possibility of coherence after complexity. The piece reflects a core truth of whole-of-government mental health action: when fragmented systems align, even imperfectly, they create pathways that help people move from burden toward balance, and from confusion toward care.
Reference
Michelle Funk, Dévora Kestel, Natalie Drew Bold, Celline Cole, Maria Francesca Moro, 2025. Guidance on policy and strategic actions to protect and promote mental health and well-being across government sectors. World Health Organization, Geneva, Switzerland. https://www.who.int/publications/i/item/9789240114388
#governmentSectors #implementationScience #lmics #mentalHealth #peerLearning #genevaLearningFoundation #wellBeing #workforce
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The cost of inaction: Quantifying the impact of climate change on health
This World Bank report ‘The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries’ presents new analysis of climate change impacts on health systems and outcomes in the regions that are bearing the brunt of these impacts.
Key analytical insights to quantify climate change impacts on health
The report makes three contributions to our understanding of climate-health interactions:
First, it quantifies the massive scale of climate change impacts on health, projecting 4.1-5.2 billion climate-related disease cases and 14.5-15.6 million deaths in LMICs by 2050. This represents a significant advancement over previous estimates, which the report demonstrates were substantial underestimates.
Second, it illuminates the profound economic consequences, calculating costs of $8.6-20.8 trillion by 2050 (0.7-1.3% of LMIC GDP). The report employs both Value of Statistical Life and Years of Life Lost approaches to provide a range of economic impact estimates.
Third, it reveals stark geographic inequities in impact distribution, with Sub-Saharan Africa bearing approximately 71% of cases and nearly half of deaths, while South Asia faces about 18% of cases and a quarter of deaths. This spatial analysis helps identify where interventions are most urgently needed.
Policy implications and systemic perspectives
The report’s findings point to several critical policy directions:
- The need for systemic rather than disease-specific interventions emerges as a central theme. The authors explicitly advocate for strengthening entire health systems rather than pursuing vertical disease programs.
- The economic analysis makes a compelling case for immediate action, demonstrating that the costs of inaction far exceed potential investment requirements for climate-resilient health systems.
- The geographic distribution of impacts highlights the need for globally coordinated responses while prioritizing support for the most vulnerable regions.
The findings suggest that transforming systems to address climate change impacts on health requires not just technical solutions but fundamental rethinking of how health systems are organized and financed in vulnerable regions.
This aligns with recent scholarship on complex adaptive systems and organizational transformation in global health.
The report’s emphasis on systemic approaches represents a significant shift in thinking about climate-health interventions. This merits unpacking on several levels:
- Inadequacy of vertical disease silos: The report challenges the traditional vertical disease management paradigm that has dominated global health programming for decades. While vertical programs have achieved notable successes in areas like HIV/AIDS or malaria control, the report argues that climate change’s multifaceted health impacts require a fundamentally different approach.
- Need for systemic intervention: Climate change simultaneously affects multiple disease pathways, nutrition status, and health infrastructure. These interactions cannot be effectively addressed through isolated disease-specific programs. Building core health system capabilities (surveillance, emergency response, primary care) creates multiplicative benefits across various climate-related health challenges. Strong health systems can better identify and respond to emerging threats, whereas vertical programs often lack this flexibility.
- Implementation implications: The report suggests this systemic approach requires: integrated planning across health system components, flexible funding mechanisms that support system-wide capabilities, enhanced coordination between different health programmes and investment in cross-cutting infrastructure and capabilities.
What about the health workforce facing impacts of climate change on health?
Between this clear-eyed assessment and effective action lies a critical implementation gap.
Interestingly, the report gives limited explicit attention to the health workforce dimension of climate-health challenges. Yet that is precisely where we need to focus attention, given that:
- Health workers based in communities are first responders to climate-related health emergencies
- Workforce capacity significantly determines a health system’s adaptive capabilities
- Climate change itself affects health worker distribution and effectiveness
Given the report’s emphasis on systemic approaches, the lack of detailed discussion about human resources for health represents a missed opportunity to explore what effective action might look like.
The Geneva Learning Foundation’s network, developed through nearly a decade of research and practice, has led us to identify a path for supporting the health workforce to strengthen preparedness and response in response to climate change impacts on health.
The network already connects over 60,000 health workers. They represent all job roles, rank, and levels of the health system.
One distinguishing feature of this network is its deep integration with existing government health systems. Over half of network participants are government employees, from community health workers to district officers to national planners.
62% of participants work in remote rural areas, 47% serve urban poor populations, and 21% operate in conflict zones.
These are not just statistics: they represent an unprecedented capability to mobilize knowledge and action where it’s most needed.
Since 2023, network participants have been sharing observations, experiences, and insights of climate change impacts on health.
The model connects different levels of health systems:
- Community-based health workers share ground-level observations
- District managers identify emerging patterns
- National planners gauge system-wide implications
- Global partners access real-time insights
When a malaria control officer in Kenya observes changing disease patterns due to altered rainfall, the network enables rapid sharing of this insight with colleagues working on water safety, nutrition, and primary care. These cross-domain connections do not need to be left to chance – they can be enabled through structured peer learning processes that transcend traditional programme, geographic, and hierarchical boundaries
This creates what organizational theorists call “embedded transformation” – where system change emerges through existing structures rather than requiring new ones.
Rather than creating new coordination mechanisms, the network enables:
- Health workers to learn directly from peers in other programs
- Rapid identification of cross-cutting challenges
- Spontaneous formation of problem-solving groups
- Systematic sharing of effective practices
Rather than replacing existing structures, TGLF’s model demonstrates how digital networks can enable health systems to:
- Maintain necessary specialization while fostering crucial connections
- Enable rapid learning and adaptation across programs
- Optimize resource use through enhanced coordination
- Build system-wide resilience through structured peer learning
Such a network enables what complexity theorists call “distributed sensing” that can provide:
- Early warning of emerging threats
- Rapid sharing of local solutions
- System-wide learning from local innovations
- Continuous adaptation to changing conditions
This has led us to posit that investment in such emergent digital networks could enable health systems to maintain necessary specialization while fostering crucial connections across domains.
This is obviously critical to respond to the systems-level complexity of climate change impacts on health.
World Bank findingTGLF model strategic fitScale of impact (4.1-5.2B cases, 14.5-15.6M deaths by 2050)TGLF’s digital network model demonstrates scalability, already connecting over 60,000 health practitioners across 137 countries. More significantly, the model’s effectiveness increases with scale – as more practitioners join, the network’s ability to identify emerging threats and disseminate effective responses improves. Network analysis shows that larger scale enables more diverse inputs and faster adaptation, suggesting this approach could help health systems respond to the massive scale of projected impacts.Economic consequences ($8.6-20.8T by 2050)TGLF’s model offers remarkable cost-effectiveness through its networked learning structure. Rather than requiring massive new investments in parallel systems, it leverages existing health system resources while enabling and accelerating both learning and action. The model demonstrates how digital infrastructure can maximize return on investment – practitioners implement solutions using existing resources, with 82% reporting ability to continue without external support. This suggests potential for significant cost savings while building system resilience.Geographic inequities (71% SSA, 18% SA)TGLF’s network already demonstrates strongest presence precisely where the World Bank identifies greatest need – 70% of participants work in Sub-Saharan Africa and South Asia. This concentration is not coincidental; the model’s digital infrastructure and peer learning approach prove particularly effective in resource-constrained settings. The network enables rapid sharing of context-appropriate solutions between regions facing similar challenges, while maintaining sensitivity to local conditions.Need for systemic interventionThe network transcends traditional program boundaries through what organizational theorists call “structured emergence” – practitioners naturally form cross-program connections based on shared challenges. When a malaria control officer observes changing disease patterns due to climate shifts, the network enables rapid sharing with colleagues in water safety, nutrition, and primary care. This organic integration emerges through peer learning rather than requiring new coordination mechanisms.Urgency of investmentTGLF’s model offers an immediately scalable approach that builds on existing health system capabilities. Rather than waiting years to develop new infrastructure, the network can rapidly expand to connect more practitioners and regions. Evidence shows 7x acceleration in implementation of new approaches compared to conventional means of technical assistance, suggesting potential for rapid, sustainable strengthening of health system resilience.Global coordination needWhile enabling global connection, the network maintains strong local grounding through its emphasis on locally-led action and contextual adaptation. Government health workers comprise over 50% of participants, creating what scholars term “embedded transformation” – change emerging through existing structures rather than imposed from outside. This enables coordinated response while respecting local health system authority.System transformationThe model demonstrates how digital networks can fundamentally transform how health systems operate without requiring complete restructuring. By enabling rapid knowledge flow across traditional boundaries, supporting emergence of new coordination patterns, and fostering system-wide learning, it shows how transformation can emerge through enhanced connection rather than structural overhaul. Analysis reveals development of new capabilities in surveillance, response, and adaptation through networked learning.Reference
Uribe, J.P., Rabie, T., 2024. The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries. The World Bank, Washington, D.C. https://doi.org/10.1596/42419
Image: The Geneva Learning Foundation Collection © 2024
Share this:
#digitalLearning #globalHealth #health #JuanPabloUribe #LMICs #networkedLearning #peerLearning #TamerRabie #TheCostOfInactionQuantifyingTheImpactOfClimateChangeOnHealth #TheGenevaLearningFoundation #WorldBank
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The cost of inaction: Quantifying the impact of climate change on health
This World Bank report ‘The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries’ presents new analysis of climate change impacts on health systems and outcomes in the regions that are bearing the brunt of these impacts.
Key analytical insights to quantify climate change impacts on health
The report makes three contributions to our understanding of climate-health interactions:
First, it quantifies the massive scale of climate change impacts on health, projecting 4.1-5.2 billion climate-related disease cases and 14.5-15.6 million deaths in LMICs by 2050. This represents a significant advancement over previous estimates, which the report demonstrates were substantial underestimates.
Second, it illuminates the profound economic consequences, calculating costs of $8.6-20.8 trillion by 2050 (0.7-1.3% of LMIC GDP). The report employs both Value of Statistical Life and Years of Life Lost approaches to provide a range of economic impact estimates.
Third, it reveals stark geographic inequities in impact distribution, with Sub-Saharan Africa bearing approximately 71% of cases and nearly half of deaths, while South Asia faces about 18% of cases and a quarter of deaths. This spatial analysis helps identify where interventions are most urgently needed.
Policy implications and systemic perspectives
The report’s findings point to several critical policy directions:
- The need for systemic rather than disease-specific interventions emerges as a central theme. The authors explicitly advocate for strengthening entire health systems rather than pursuing vertical disease programs.
- The economic analysis makes a compelling case for immediate action, demonstrating that the costs of inaction far exceed potential investment requirements for climate-resilient health systems.
- The geographic distribution of impacts highlights the need for globally coordinated responses while prioritizing support for the most vulnerable regions.
The findings suggest that transforming systems to address climate change impacts on health requires not just technical solutions but fundamental rethinking of how health systems are organized and financed in vulnerable regions.
This aligns with recent scholarship on complex adaptive systems and organizational transformation in global health.
The report’s emphasis on systemic approaches represents a significant shift in thinking about climate-health interventions. This merits unpacking on several levels:
- Inadequacy of vertical disease silos: The report challenges the traditional vertical disease management paradigm that has dominated global health programming for decades. While vertical programs have achieved notable successes in areas like HIV/AIDS or malaria control, the report argues that climate change’s multifaceted health impacts require a fundamentally different approach.
- Need for systemic intervention: Climate change simultaneously affects multiple disease pathways, nutrition status, and health infrastructure. These interactions cannot be effectively addressed through isolated disease-specific programs. Building core health system capabilities (surveillance, emergency response, primary care) creates multiplicative benefits across various climate-related health challenges. Strong health systems can better identify and respond to emerging threats, whereas vertical programs often lack this flexibility.
- Implementation implications: The report suggests this systemic approach requires: integrated planning across health system components, flexible funding mechanisms that support system-wide capabilities, enhanced coordination between different health programmes and investment in cross-cutting infrastructure and capabilities.
What about the health workforce facing impacts of climate change on health?
Between this clear-eyed assessment and effective action lies a critical implementation gap.
Interestingly, the report gives limited explicit attention to the health workforce dimension of climate-health challenges. Yet that is precisely where we need to focus attention, given that:
- Health workers based in communities are first responders to climate-related health emergencies
- Workforce capacity significantly determines a health system’s adaptive capabilities
- Climate change itself affects health worker distribution and effectiveness
Given the report’s emphasis on systemic approaches, the lack of detailed discussion about human resources for health represents a missed opportunity to explore what effective action might look like.
The Geneva Learning Foundation’s network, developed through nearly a decade of research and practice, has led us to identify a path for supporting the health workforce to strengthen preparedness and response in response to climate change impacts on health.
The network already connects over 60,000 health workers. They represent all job roles, rank, and levels of the health system.
One distinguishing feature of this network is its deep integration with existing government health systems. Over half of network participants are government employees, from community health workers to district officers to national planners.
62% of participants work in remote rural areas, 47% serve urban poor populations, and 21% operate in conflict zones.
These are not just statistics: they represent an unprecedented capability to mobilize knowledge and action where it’s most needed.
Since 2023, network participants have been sharing observations, experiences, and insights of climate change impacts on health.
The model connects different levels of health systems:
- Community-based health workers share ground-level observations
- District managers identify emerging patterns
- National planners gauge system-wide implications
- Global partners access real-time insights
When a malaria control officer in Kenya observes changing disease patterns due to altered rainfall, the network enables rapid sharing of this insight with colleagues working on water safety, nutrition, and primary care. These cross-domain connections do not need to be left to chance – they can be enabled through structured peer learning processes that transcend traditional programme, geographic, and hierarchical boundaries
This creates what organizational theorists call “embedded transformation” – where system change emerges through existing structures rather than requiring new ones.
Rather than creating new coordination mechanisms, the network enables:
- Health workers to learn directly from peers in other programs
- Rapid identification of cross-cutting challenges
- Spontaneous formation of problem-solving groups
- Systematic sharing of effective practices
Rather than replacing existing structures, TGLF’s model demonstrates how digital networks can enable health systems to:
- Maintain necessary specialization while fostering crucial connections
- Enable rapid learning and adaptation across programs
- Optimize resource use through enhanced coordination
- Build system-wide resilience through structured peer learning
Such a network enables what complexity theorists call “distributed sensing” that can provide:
- Early warning of emerging threats
- Rapid sharing of local solutions
- System-wide learning from local innovations
- Continuous adaptation to changing conditions
This has led us to posit that investment in such emergent digital networks could enable health systems to maintain necessary specialization while fostering crucial connections across domains.
This is obviously critical to respond to the systems-level complexity of climate change impacts on health.
World Bank findingTGLF model strategic fitScale of impact (4.1-5.2B cases, 14.5-15.6M deaths by 2050)TGLF’s digital network model demonstrates scalability, already connecting over 60,000 health practitioners across 137 countries. More significantly, the model’s effectiveness increases with scale – as more practitioners join, the network’s ability to identify emerging threats and disseminate effective responses improves. Network analysis shows that larger scale enables more diverse inputs and faster adaptation, suggesting this approach could help health systems respond to the massive scale of projected impacts.Economic consequences ($8.6-20.8T by 2050)TGLF’s model offers remarkable cost-effectiveness through its networked learning structure. Rather than requiring massive new investments in parallel systems, it leverages existing health system resources while enabling and accelerating both learning and action. The model demonstrates how digital infrastructure can maximize return on investment – practitioners implement solutions using existing resources, with 82% reporting ability to continue without external support. This suggests potential for significant cost savings while building system resilience.Geographic inequities (71% SSA, 18% SA)TGLF’s network already demonstrates strongest presence precisely where the World Bank identifies greatest need – 70% of participants work in Sub-Saharan Africa and South Asia. This concentration is not coincidental; the model’s digital infrastructure and peer learning approach prove particularly effective in resource-constrained settings. The network enables rapid sharing of context-appropriate solutions between regions facing similar challenges, while maintaining sensitivity to local conditions.Need for systemic interventionThe network transcends traditional program boundaries through what organizational theorists call “structured emergence” – practitioners naturally form cross-program connections based on shared challenges. When a malaria control officer observes changing disease patterns due to climate shifts, the network enables rapid sharing with colleagues in water safety, nutrition, and primary care. This organic integration emerges through peer learning rather than requiring new coordination mechanisms.Urgency of investmentTGLF’s model offers an immediately scalable approach that builds on existing health system capabilities. Rather than waiting years to develop new infrastructure, the network can rapidly expand to connect more practitioners and regions. Evidence shows 7x acceleration in implementation of new approaches compared to conventional means of technical assistance, suggesting potential for rapid, sustainable strengthening of health system resilience.Global coordination needWhile enabling global connection, the network maintains strong local grounding through its emphasis on locally-led action and contextual adaptation. Government health workers comprise over 50% of participants, creating what scholars term “embedded transformation” – change emerging through existing structures rather than imposed from outside. This enables coordinated response while respecting local health system authority.System transformationThe model demonstrates how digital networks can fundamentally transform how health systems operate without requiring complete restructuring. By enabling rapid knowledge flow across traditional boundaries, supporting emergence of new coordination patterns, and fostering system-wide learning, it shows how transformation can emerge through enhanced connection rather than structural overhaul. Analysis reveals development of new capabilities in surveillance, response, and adaptation through networked learning.Reference
Uribe, J.P., Rabie, T., 2024. The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries. The World Bank, Washington, D.C. https://doi.org/10.1596/42419
Image: The Geneva Learning Foundation Collection © 2024
Share this:
#digitalLearning #globalHealth #health #JuanPabloUribe #LMICs #networkedLearning #peerLearning #TamerRabie #TheCostOfInactionQuantifyingTheImpactOfClimateChangeOnHealth #TheGenevaLearningFoundation #WorldBank
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The crisis in scientific publishing: from AI fraud to epistemic injustice
There is a crisis in scientific publishing. Science is haunted. In early 2024, one major publisher retracted hundreds of scientific papers. Most were not the work of hurried researchers, but of ghosts: digital phantoms generated by artificial intelligence. Featuring nonsensical diagrams and fabricated data, they had sailed through the gates of peer review.
This spectre of AI-driven fraud is not only a new technological threat. It is also a symptom of a pre-existing disease. For years, organized networks have profited from inserting fake papers into the scholarly record. It seems that scientific publishing’s peer review process, intended to seek truth, cannot even tell the real from the fake.
These failures are not just academic embarrassments. In fields like global health, where knowledge means the difference between life and death, we can no longer afford to ignore them. Indeed, the crisis in scientific journals is not, at its heart, a crisis in publishing. It is a crisis of knowledge—of what we value, who we trust, and how we come to know. That makes it a crisis of education.
Crisis in scientific publishing: The knowledge we ignore
Consider what Toby Green has called the “dark side of the moon.” He is referring to the vast body of knowledge produced by established experts in international organizations. Volumes of high-quality reports and analyses come from organizations large and small. They contain immense expertise. Often, not only do they qualify as science. They may be more likely to shape policy and practice than most academic outputs. Yet this “grey literature” is rarely incorporated into the scholarly record. This is why Green is actively implementing projects to find, collect, and index such materials.
If the formal knowledge of some of the world’s leading experts is being left in the dark, what hope is there for the practical wisdom of a frontline nurse?
In the rigid hierarchy of evidence that governs global health, a randomized controlled trial sits at the pinnacle. At the very bottom, dismissed as mere “anecdotes,” lies the lived experience of practitioners. A nurse in a rural clinic who discovers a better way to dress a wound in a humid environment has generated life-saving knowledge that could be useful elsewhere. A community health worker who develops a sophisticated method for building trust with vaccine-hesitant parents has solved a problem in context. Yet, in our current culture, their insights are not data. Their experience is not evidence.
To dismiss such knowledge is an act of willful ignorance. Science, at its best, is a process of disciplined curiosity. Its fundamental purpose is to reduce ignorance and expand our understanding of the world. To willfully ignore entire categories of human experience and expertise is therefore a betrayal of the scientific ethos itself. It is an active choice to remain in the dark.
Crisis in scientific publishing: the architecture of exclusion
This devaluation of practical knowledge is not an accident. It is a feature of a system designed to exclude. The modern ideal of science began with a radically open mission. As the scholar John Willinsky has meticulously documented in his history of Western European science, the creation of scientific journals in the 17th century was intended to create a public commons of knowledge, accelerating progress for the benefit of humanity. The principle was one of access. How was this mission corrupted?
The architecture of modern science was built on a colonial foundation. Its violence was not only physical but also scientific and intellectual. Frantz Fanon, the Martinican psychiatrist who became a theorist of decolonization in the crucible of Algeria’s war of independence, described colonization’s deepest work as the effort to “empty the mind of the colonized.” This is a systematic process of convincing people that our own histories, cultures, and ways of knowing are worthless.
Generations later, the Māori scholar Linda Tuhiwai Smith detailed how this was put into practice. She showed that Western research methodologies themselves were often not neutral tools of discovery but instruments of empire. The acts of observing, classifying, extracting, and analyzing were used to control populations and invalidate their knowledge systems, replacing them with a single, supposedly universal, European model of truth.
This worldview pretends to be a neutral, “view from nowhere,” a concept also critiqued powerfully by the white American feminist philosopher Donna Haraway. She argued that all knowledge is situated—shaped by the position and perspective of the knower. You see the landscape differently from the mountain top than you do from the valley. A complete map requires both perspectives.
Echoing this, her philosophical and geographical sister Sandra Harding argued that by excluding the perspectives of marginalized people, dominant science becomes “weakly objective.” It is blind to its own biases and assumptions.
Crisis in scientific publishing: Fear of knowledge
A common and deeply felt fear among scientists is that embracing diverse forms of knowledge will lead to a dangerous relativism, where objective truth dissolves and “anything goes.”
Harding’s work shows this fear to be misplaced. She argues that the “view from nowhere” provides not a stronger, but a more brittle and fragile grasp of the truth. A truly “strong objectivity,” she contended, is achieved by intentionally seeking out multiple, situated perspectives. This does not mean that all views are equally valid. It means that by examining a problem from many standpoints, we can triangulate a more robust and reliable understanding of reality. We can identify the biases and blind spots inherent in any single view, including our own.
This process is the antidote to the willful ignorance mentioned earlier. It strengthens our grasp of objective truth by making it more complete and more honest.
Can change be paved by good intentions?
Today, the need for a change in research culture is widely acknowledged. The world’s largest research funders publish reports calling for more diversity and inclusion. Yet we observe paralysis rather than progress. The individuals who sit on the decision-making committees of such institutions will almost certainly not fund a project with a primary investigator whose work is not validated by the existing system of prestigious but exclusive journals. Elite global scholars leading the vital movement to “decolonize global health” first established their legitimacy by adhering to conventional norms, then began using the master’s tools to have their critiques of the system heard. Such contradictions illustrate how deeply the exclusionary norms are embedded.
Since top-down change is caught in such contradictions, a meaningful path forward may be to change the culture of science from the ground up. The core challenge is to correct for epistemic injustice: the wrong done to someone in their capacity as a knower. This injustice takes several insidious forms.
The most obvious is testimonial injustice. Imagine the scene. A senior male doctor from a famous university presents a finding and is met with nods of assent. His words carry the weight of evidence. A young female nurse from a rural clinic presents the exact same finding based on her direct experience. Her knowledge is dismissed as a “story” or an “anecdote.” She is not heard because of who she is. Her credibility is unjustly discounted.
Even deeper is hermeneutical injustice. This is the wrong of not even having the shared language to make your experience understood by the dominant culture. The community health worker who builds trust with hesitant parents may have a brilliant system, but if they cannot articulate it in the formal jargon of “implementation science,” their knowledge remains invisible. They are wronged not because they are disbelieved. They are wronged because the system lacks the concepts to even recognize their wisdom as knowledge in the first place.
Projects like Toby Green’s grey literature repository or initiatives like Rogue Scholar, pioneered by Martin Fenner, that assign a permanent Digital Object Identifier (DOI) to science that was not previously in the scholarly record, are practical interventions. But this not a technological problem. It is an educational one. Changing a culture that perpetuates these injustices is the primary work. Within this larger project, new tools can serve as tactics of resistance. As such, they can be used to support acts of epistemic defiance, for example by creating a formal, citable record of knowledge that exists outside the traditional gates. Yet they remain tools, not the solution.
The science of knowing
You cannot fix a broken culture by patching its systems. You must change its DNA. The crisis haunting science is not ultimately about publishing, fraud, or peer review. It is a crisis of education—not of schooling, but of how we come to know. If physics is the science of matter, education is the science of all sciences. It provides the architecture of assumptions and values that shapes how every other field discovers and validates truth.
A new philosophy of education is needed, one that includes these three principles:
- It must recognize that the most durable knowledge comes from praxis—the cycle of acting in the world and reflecting on the consequences.
- It must be built on collaborative intelligence, understanding that the most difficult problems can only be solved by weaving together many perspectives.
- It must pursue strong objectivity, not by erasing human perspective, but by intentionally seeking it out to create a more complete and honest picture of reality.
To change science, we must change how scientists are taught to see the world. We must educate for humility, for critical self-awareness, and for the ability to listen. This is the work of creating a science that is not haunted by its failures but is directly contributes to a more just and truthful account of our world.
References
- Boghossian, P., 2007. Fear of knowledge: Against relativism and constructivism. Clarendon Press.
- Couch, L., 2021. Wellcome Diversity, equity and inclusion strategy [WWW Document]. Wellcome. URL https://wellcome.org/what-we-do/diversity-and-inclusion/strategy (accessed 11.8.22).
- Fanon, F. (1963). The wretched of the earth. Grove Press.
- Fenner, M., 2023. The Rogue Scholar: An Archive for Scholarly blogs. Upstream. https://doi.org/10.54900/bj4g7p2-2f0fn9b
- Gitau, E., Khisa, A., Vicente-Crespo, M., Sengor, D., Otoigo, L., Ndong, C., Simiyu, A., 2023. African Research Culture – Opinion Research. African Population and Health Research Center, Nairobi, Kenya. https://aphrc.org/project/african-research-culture-opinion-research/
- Green, T., 2022. Wait! What? There’s stuff missing from the scholarly record? Med Writ 31, 44–48. https://doi.org/10.56012/ajel9043
- Haraway, D. (1988). Situated knowledges: The science question in feminism and the privilege of partial perspective. Feminist Studies, 14(3), 575–599. https://doi.org/10.2307/3178066
- Harding, S. (1991). Whose science? Whose knowledge? Thinking from women’s lives. Cornell University Press.
- Smith, L. T. (2012). Decolonizing methodologies: Research and indigenous peoples (2nd ed.). Zed Books.
- The Social Investment Consultancy, The Better Org, Cole, N., Cole, L., 2022. Evaluation of Wellcome Anti-Racism Programme Final Evaluation Report – Public. Wellcome, London. https://cms.wellcome.org/sites/default/files/2022-08/Evaluation-of-Wellcome-Anti-Racism-Programme-Final-Evaluation-Report-2022.pdf
- Wellcome Trust, 2020. What researchers think about the culture they work in. Wellcome, London. https://wellcome.org/reports/what-researchers-think-about-research-culture
- Willinsky, J., 2006. The access principle: The case for open access to research and scholarship. MIT press Cambridge, MA.
Image: The Geneva Learning Foundation Collection © 2025
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