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International relations theorists and global health politics scholars largely fail to communicate with one another. We argue that drawing on insights from classic and contemporary international theory more explicitly will positively augment the study of global health politics. This paper highlights four major theoretical orientations in the international relations literature (realism, neoliberal institutionalism, constructivism, and feminism) and discusses how an understanding of these perspectives can strengthen our understanding of global health policy.

The objectives of the Global Health Security Agenda (GHSA) will require not only a "One Health" approach to counter natural disease threats against humans, animals, and the environment, but also a security focus to counter deliberate threats to human, animal, and agricultural health and to nations' economies. We have termed this merged approach "One Health Security." It will require the integration of professionals with expertise in security, law enforcement, and intelligence to join the veterinary, agricultural, environmental, and human health experts essential to One Health and the GHSA. Working across such different professions, which occasionally have conflicting aims and different professional cultures, poses multiple challenges, but a multidisciplinary and multisectoral approach is necessary to prevent disease threats; detect them as early as possible (when responses are likely to be most effective); and, in the case of deliberate threats, find who may be responsible. This article describes 2 project areas that exemplify One Health Security that were presented at a workshop in January 2014: the US government and private industry efforts to reduce vulnerabilities to foreign animal diseases, especially foot-and-mouth disease; and AniBioThreat, an EU project to counter deliberate threats to agriculture by raising awareness and implementing prevention and response policies and practices.

Eye health and vision have widespread and profound implications for many aspects of life, health, sustainable development, and the economy. Yet nowadays, many people, families, and populations continue to suffer the consequences of poor access to high-quality, affordable eye care, leading to vision impairment and blindness. In 2020, an estimated 596 million people had distance vision impairment worldwide, of whom 43 million were blind. Another 510 million people had uncorrected near vision impairment, simply because of not having reading spectacles. A large proportion of those affected (90%), live in low-income and middle-income countries (LMICs). However, encouragingly, more than 90% of people with vision impairment have a preventable or treatable cause with existing highly cost-effective interventions. Eye conditions affect all stages of life, with young children and older people being particularly affected. Crucially, women, rural populations, and ethnic minority groups are more likely to have vision impairment, and this pervasive inequality needs to be addressed. By 2050, population ageing, growth, and urbanisation might lead to an estimated 895 million people with distance vision impairment, of whom 61 million will be blind. Action to prioritise eye health is needed now. This Commission defines eye health as maximised vision, ocular health, and functional ability, thereby contributing to overall health and wellbeing, social inclusion, and quality of life. Eye health is essential to achieve many of the Sustainable Development Goals (SDGs). Poor eye health and impaired vision have a negative effect on quality of life and restrict equitable access to and achievement in education and the workplace. Vision loss has substantial financial implications for affected individuals, families, and communities. Although high-quality data for global economic estimates are scarce, particularly for LMICs, conservative assessments based on the latest prevalence figures for 2020 suggest that annual global productivity loss from vision impairment is approximately US$410·7 billion purchasing power parity. Vision impairment reduces mobility, affects mental wellbeing, exacerbates risk of dementia, increases likelihood of falls and road traffic crashes, increases the need for social care, and ultimately leads to higher mortality rates. By contrast, vision facilitates many daily life activities, enables better educational outcomes, and increases work productivity, reducing inequality. An increasing amount of evidence shows the potential for vision to advance the SDGs, by contributing towards poverty reduction, zero hunger, good health and wellbeing, quality education, gender equality, and decent work. Eye health is a global public priority, transforming lives in both poor and wealthy communities. Therefore, eye health needs to be reframed as a development as well as a health issue and given greater prominence within the global development and health agendas. Vision loss has many causes that require promotional, preventive, treatment, and rehabilitative interventions. Cataract, uncorrected refractive error, glaucoma, age-related macular degeneration, and diabetic retinopathy are responsible for most global vision impairment. Research has identified treatments to reduce or eliminate blindness from all these conditions; the priority is to deliver treatments where they are most needed. Proven eye care interventions, such as cataract surgery and spectacle provision, are among the most cost-effective in all of health care. Greater financial investment is needed so that millions of people living with unnecessary vision impairment and blindness can benefit from these interventions. Lessons from the past three decades give hope that this challenge can be met. Between 1990 and 2020, the age-standardised global prevalence of blindness fell by 28·5%. Since the 1990s, prevalence of major infectious causes of blindness—onchocerciasis and trachoma—have declined substantially. Hope remains that by 2030, the transmission of onchocerciasis will be interrupted, and trachoma will be eliminated as a public health problem in every country worldwide. However, the ageing population has led to a higher crude prevalence of age-related causes of blindness, and thus an increased total number of people with blindness in some regions. Despite this progress, business as usual will not keep pace with the demographic trends of an ageing global population or address the inequities that persist in each country. New threats to eye health are emerging, including the worldwide increase in diabetic retinopathy, high myopia, retinopathy of prematurity, and chronic eye diseases of ageing such as glaucoma and age-related macular degeneration. With the projected increase in such conditions and their associated vision loss over the coming decades, urgent action is needed to develop innovative treatments and deliver services at a greater scale than previously achieved. Good eye health at the community and national level has been marginalised as a luxury available to only wealthy or urban areas. Eye health needs to be urgently brought into the mainstream of national health and development policy, planning, financing, and action. The challenge is to develop and deliver comprehensive eye health services (promotion, prevention, treatment, rehabilitation) that address the full range of eye conditions within the context of universal health coverage. Accessing services should not bring the risk of falling into poverty and services should be of high quality, as envisaged by the WHO framework for health-care quality: effective, safe, people-centred, timely, equitable, integrated, and efficient. To this framework we add the need for services to be environmentally sustainable. Universal health coverage is not universal without eye care. Multiple obstacles need to be overcome to achieve universal coverage for eye health. Important issues include complex barriers to availability and access to quality services, cost, major shortages and maldistribution of well-trained personnel, and lack of suitable, well maintained equipment and consumables. These issues are particularly widespread in LMICs, but also occur in underserved communities in high-income countries. Strong partnerships need to be formed with natural allies working in areas affected by eye health, such as non-communicable diseases, neglected tropical diseases, healthy ageing, children's services, education, disability, and rehabilitation. The eye health sector has traditionally focused on treatment and rehabilitation, and underused health promotion and prevention strategies to lessen the impact of eye disease and reduce inequality. Solving these problems will depend on solutions established from high quality evidence that can guide more effective implementation at scale. Evidence-based approaches will need to address existing deficiencies in the supply and demand. Strategic investments in discovery research, harnessing new findings from diverse fields, and implementation research to guide effective scale up are needed globally. Encouragingly, developments in telemedicine, mobile health, artificial intelligence, and distance learning could potentially enable eye care professionals to deliver higher quality care that is more plentiful, equitable, and cost-effective. This Commission did a Grand Challenges in Global Eye Health prioritisation exercise to highlight key areas for concerted research and action. This exercise has identified a broad set of challenges spanning the fields of epidemiology, health systems, diagnostics, therapeutics, and implementation. The most compelling of these issues, picked from among 3400 suggestions proposed by 336 people from 118 countries, can help to frame the future research agenda for global eye health. In this Commission, we harness lessons learned from over two decades, present the growing evidence for the life-transforming impact of eye care, and provide a thorough understanding of rapid developments in the field. This report was created through a broad consultation involving experts within and outside the eye care sector to help inform governments and other stakeholders about the path forward for eye health beyond 2020, to further the SDGs (including universal health coverage), and work towards a world without avoidable vision loss. The next few years are a crucial time for the global eye health community and its partners in health care, government, and other sectors to consider the successes and challenges encountered in the past two decades, and at the same time to chart a way forward for the upcoming decades. Moving forward requires building on the strong foundation laid by WHO and partners in VISION 2020 with renewed impetus to ultimately deliver high quality universal eye health care for all.

COVID-19 has exposed profound governance challenges that demand more diverse and creative approaches to global health governance moving forward. This article works towards such a pluralization of the field by foregrounding the vital role played by heterodox actors during the pandemic. Heterodox global health actors are backgrounded actors who improve health in different parts of the world, but who remain politically marginalized – and epistemically invisibilized – because they depart in crucial respects from the liberal orthodoxy pervading the field of global health governance. The article analytically foregrounds those heterodox actors through an architectural inversion – a relational approach to the study of global health governance that builds upon recent methodological insights from postcolonial studies, infrastructure studies, and science and technology studies. The article then harnesses that methodological approach to empirically investigate the COVID-19 activities of three different heterodox actors: rebel groups providing public health in the borderlands of Myanmar, a women's vigilante movement stitching face masks in the Czech Republic, and a maverick scientific platform for the international sharing of viral sequence data. Performing that architectural inversion begins to loosen the dominance of the liberal episteme within the practice and study of global health governance. It further visibilizes how that field is continually co-produced by the background activities of many such heterodox actors. It also lays conceptual foundations for a more heterodox future research agenda on global health governance – and arguably global governance more broadly – in response to the numerous unresolved challenges revealed by COVID-19.

AbstractThis article opens up the blackbox through which evidence is selected and assessed in the making of guidelines and recommendations in global governance, through an exploration of "methods regimes." Methods regimes are a special kind of sociomaterial arrangement, which govern the production and validation of knowledge, by establishing a clear hierachy between alternative forms of research designs. When such regimes become inscribed in processes of global governance, they shape and control what knowledge is deemed valid and thus relevant for policy. We shed light that through a mode of operation that relies on a discourse of procedurality, a dispersed but powerful network of epistemic operators, and a dense web of infrastructures, methods regimes constitute and police the making of "policy-relevant knowledge" in global governance. Through an examination of the case of "GRADE" (Grading of Recommendations, Assessment, Development, and Evaluation), a standardized system that evaluates and grades the quality of evidence in global health, we show that its dominance has worked to the effect of empowering a new cast of methodologists, seen as more objective and portable across domains, sidelining certain forms of evidence that do not conform with its own methodological criteria of scientificity, and "clinicalizing" research in medicine and beyond.

The discourse on the infodemic constructs the combination of the pandemic and disinformation as a new source of insecurity on a global scale. How can we make sense – analytically and politically– of this newly politicized nexus of public health, information management, and global security? This article proposes approaching the phenomenon of the infodemic as an intersecting securitization of information disorder and health governance. Specifically, it argues that there are two distinct frames of security mobilized in the context of infodemic governance: information as a disease and information as a weapon. Drawing on literatures on global health and the emerging research on disinformation, the paper situates the two framings of the infodemic in broader discourses on the medicalization of security, and securitization of information disorder, respectively. The article critically reflects on each framing and offers some preliminary thoughts on how to approach the entanglements of health, security, and information disorder in contemporary global politics.

Do global health institutions keep up with globalization forces? We contend that they seriously lag behind. While medical knowledge becomes more and more refined in showing how diseases spread globally, the political order meant to address this problem is barely global. It is global in terms of the promises it makes in declarations and even legally binding instruments (institutional foreground). But many entrenched political practices of interaction do not keep these promises (institutional background). We explain this with the dominance of a traditional diplomatic 'feel of the game' in which often narrowly defined national interests, positioning battles among states, and a subordination of global health under considerations of international security and economics prevail. Based on this diagnosis, we discuss three scenarios for the further evolution of the global health order: (1) the persistence of current institutions, (2) revisions of the institutional foreground and persistence of the background, and (3) a qualitative break that makes amendments to both. While the COVID-19 crisis provides openings for the third and, even more so, the second one, the current upheavals in the liberal constellation of orders makes the first scenario the most likely one.

This portfolio analysis aims to give an overview of Germany's financial contribution to global health in the period 2002-13 in order to inform the continued development of health strategies and future allocations of official development assistance (ODA) for health, and to ensure transparency to the general public. The main source of data used in the analysis was the Creditor Reporting System (CRS) Aid Activity Database, which is the most comprehensive dataset available for ODA.

In 1948, with the creation of the World Health Organization (WHO), the Right to Health gained a little more global prominence, since the very purpose of the international entity is to guarantee the highest level of health for all human beings, advocating that the state of physical and mental well-being does not only consist in the absence of diseases or illnesses, but mainly when a set of values and principles are established and available to all individuals, anywhere on the planet (WHO | The Right to Health, 2012).
Health in this new millennium must be seen as a global problem. The globalization of health is a good for which we must work in an explicit and programmed way, as it becomes a desirable social purpose, either for its intrinsic value or as a symbol of the predominance of human values over other interests (Oliveira & Cutolo, 2018). In a global context with rapid changes in the disease patterns, the best understanding of the Health context is to consider the broad spectrum of the ecosystem containing the social, economic determinants of health and the diversity of institutional agents, given the considerable change in the global health scenario in recent years (Kickbusch & Berger, 2010). The conception that health should be seen from a comprehensive and plural perspective brings other aspects closer to its effectiveness.

Speakman, E. M., McKee, M., & Coker, R. (2017). Role of the European Union in global health - Author's reply. Lancet Global Health, 5(8), e757. https://doi.org/10.1016/S2214-109X%2817%2930213-9

This paper studies evidence-based aid allocations in global health with the aim to identify lessons learned for Germany as a donor for bilateral and multilateral aid programmes. At the same time, it contributes to the conceptualisation of evidence-based aid by defining two types of evidence, practical and scientific, where the former makes use of discretionary information to support the financing of aid projects, while the latter relies on the evidence from rigorous (scientific) research. This desk-study combined with interviews shows that practical evidence is commonly used in health aid allocations, while scientific evidence is used mainly at The Global Fund and is included in World Health Organization guidelines for health policies worldwide. Furthermore, benefits of and barriers to scientific evidence-based allocation are discussed, while recommendations are provided with the aim of developing a scientific, evidence-based aid approach for a bilateral donor in health aid.