We would like to introduce Dr Ghulam Nabi Kazi, the new Editor-in-Chief of Public Health Action (PHA), and to update you on our Editorial Plan for 2022–2025. As the Journal continues to evolve, we wanted to explain the opportunities this presents for Union members and for the scientific community as a whole.
As you know, PHA is an open-access publication of The Union, which focuses on TB, COVID-19, tobacco cessation, asthma, and other important areas of lung health. Traditionally, the mandate for PHA has followed similar lines, but we are now adapting our coverage to transcend TB and lung health and encompass the broader global health agenda. We must be cognizant of the fact that respiratory diseases cannot be tackled in isolation without addressing the social determinants that usually lie outside of the health sector. Taking the example of TB control, the need to adopt a holistic multi-sectoral approach with increased financing for TB care services, has been advocated for a long period of time, but this has rarely led to concrete practical action.
Henceforth, we will be soliciting papers that take this broader view, with the aim of publishing research that changes policy and practice. PHA will develop evidence-based solutions to address the health problems of populations, while strengthening the research capacity of countries and fostering an effective dialogue between policy makers, public health institutions, academics and health development partners. Examples of relevant topics include infection prevention control, antimicrobial resistance and disease outbreaks from Ebola to COVID-19. Aspects of non-communicable diseases of public health importance include nutrition, and the impact of environmental factors such as pollution and climate change through to planetary health.
We would like to thank the Editorial Board for their commitment and support since the Journal launched. We will continue to maintain the high ethical standards set by the Board with an adherence to intellectual integrity, combined with enhanced peer review mechanisms and increased speed and efficiency. For example, we will continue to develop the fast-track process introduced in 2021 (https://theunion.org/news/fast-track-journal-articles) and as used for the recent supplement on Antimicrobial Resistance in Nepal (https://theunion.org/PHA-preprints). One of our first tasks is to broaden the Editorial Board to ensure expert representation from all regions of the world, particularly from low- and middle-income countries (LMICs), which have fragile health systems and require further support.
When the COVID-19 pandemic struck, we learnt an important lesson: the high-income countries were equally overwhelmed (in some cases, even more overwhelmed) as the LMICs. It also taught us that the world was not prepared for a pandemic. We hoped that this would bring countries closer together in their attempts to combat the epidemic, but what we saw was increased inequality, with vaccine delivery going to the highest bidder. This clearly demonstrated that there are no simplistic solutions to global health crises.
Let us pause here and reflect on an important underlying principle of the WHO constitution that has been in effect since 1948: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” Whether or not the clause is achievable in our lifetime, it is a goal worth aiming for. Over 70 years on, however, while some sincere, committed, and vigorous efforts have been made to reach that goal – and a lot of research evidence has been generated in this regard – we find the entire process to be fraught with challenges. In 2003, Dr Gro Harlem Brundtland (a former Prime Minister of Norway and WHO Director General) remarked that "Good science is the basis of good public health, but the challenge we face is to translate the best science into public policy." Up until now, public health scientists have been grappling with ways to assess how evidence from research is applied to decision-making and identify methods for improving the presentation of research findings to facilitate their translation into policy and practice. Another top priority is reducing the 10/90 gap, which occurs when fewer than 10% of global resources allocated to health research are directed toward health in LMICs, although more than 90% of all preventable deaths occur in LMICs.
The challenges and barriers outlined above are only the tip of the iceberg, but with only 7–8 years remaining to achieve the United Nations’ Sustainable Development Goals (SDGs), particularly SDG-3 relating to universal health coverage, national governments need to be more focused in their approach. They need to evaluate their present situation using all the critical indicators and to unpack SDG-3 to determine what is required in their country’s context. We also recognise that several other SDGs are inextricably linked to health and fall within the scope of PHA. Moving further in that direction, we will encourage the submission of papers relating to virtually all the SDGs that have a bearing on health. In today’s world, no SDG can be achieved in isolation without furthering others, necessitating substantial inter-sectoral action.
Furthermore, countries cannot afford to prioritise care for COVID-19 over all other ongoing health care services – they must press forward with greater intensity and commitment than ever. The world cannot afford to miss the SDG targets in the same way as the Millennium Development Goals (MDGs). The situation warrants a much more serious approach. The challenge is to transform enthusiasm for clever ideas and noble intentions into effective strategies for SDG localisation, leading to realised transformative outcomes and changes within our economies and societies. Within the health sector, it may also be prudent to review whether to adopt horizontal or disease-specific vertical approaches while moving forward to attain our targets. Above all, it is time to work with commitment towards a globally shared vision of health based on equity and access for all towards quality health services, leaving no one behind.
We are confident that with renewed enthusiasm, and by expanding the scope of our coverage, PHA will have a greater impact in the global health arena. We have also made changes to our author guidelines to encourage a more interesting, readable style of writing to retain the interest of readers. Authors will be encouraged to make greater mention of innovation in all relevant fields, including digital technology, information technology, diagnosis and management of the leading diseases, both communicable and non-communicable. Young researchers from the LMICs will be encouraged to submit their work, especially on the use of innovative techniques for diagnosis and management of disease, as well as on the overall health system, while suggesting means for translating science into public policy.
These measures will also help in promoting capacity building in research across academic health institutions in an effort to bridge the “know-do” gap. By closely coordinating with our sister publication, the International Journal of Tuberculosis and Lung Disease (IJTLD), and other leading public health journals, we intend to convey the same basic messages in global health and resolve controversies that emerge through a mutually shared vision and a unified stand. A dialogue will also be fostered with the leading universities and health development partners.
We must not lose sight of the fact that public health is a multifaceted field and impacts us all. Above all, we are seeking to change the mindsets of policy-makers, donor agencies, development partners and academics to improve public health outcomes. PHA has an important role to play in global health and we seek the participation of all our authors, readers and supporters in making this change possible.
Thank you for your support!
Hugh Blackbourn (Publications Director) and Ghulam Nabi Kazi (Editor-in-Chief PHA)
If you would like to know more about PHA, please visit https://theunion.org/our-work/journals/public-health-action