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The US National Academy of Medicine released its consensus study for the next decade entitled The Future of Nursing 2020-2030: Charting a Path To Achieve Health Equity (National Academies of Sciences, Engineering, and Medicine, 2021). This paper examines the report, its implications for nursing globally, its focus on systemic, structural, and institutional racism, and the intersection with climate change and deleterious health consequences. The National Academies of Science, Engineering, and Medicine (NASEM) has led in addressing the critical role of the nursing profession in achieving optimal population health outcomes in the US. Yet, relevance exists for nursing in other global areas. The most recent US report focuses on social determinants of health (SDoH) and explicitly addresses climate change as a looming public health threat. An analysis of the key foci of nursing's role in climate change amidst the critical role of health equity globally is explicated.

Background: Managing HIV treatment is a complex multi-dimensional task because of a combination of factors such as stigma and discrimination of some populations who frequently get infected with HIV. In addition, patient-provider encounters have become increasingly multicultural, making effective communication and provision of ethically sound care a challenge. Purpose: This article explores ethical issues that health service providers in the United States and Botswana encountered in their interaction with patients in HIV care. Research design: A descriptive qualitative design was used to collect data from health service providers and patients using focused group discussions. This article is based on responses from health service providers only. Participants and context: This article is based on 11 focused group discussions with a total sample of 71 service providers in seven US sites and one Botswana site. Ethical considerations: Ethical review boards at all the study sites reviewed the study protocol and approved it. Ethical review boards of the study's coordinating centers, Rutgers University and the University of California at San Francisco, also approved it. The study participants provided a written informed consent to participate. Findings: HIV service providers encountered ethical challenges in all the four Beauchamp and Childress' biomedical ethics of respect for patients' autonomy, beneficence, justice, and nonmaleficence. Discussion: The finding that HIV service providers encounter ethical challenges in their interaction with patients is supported by prior studies. The ethical challenges are particularly prominent in multicultural care and resource-constrained care environments. Conclusion: Provision of HIV care is fraught with ethical challenges that tend to pose different issues depending on a given care environment. It is important that strong partnerships are developed among key stakeholders in HIV care. In addition, health service providers need to be provided with resources so they can provide quality and ethically sound care. ; This work was supported by the HIV/AIDS nursing Care and Prevention, National Institutes of Health [J32 NR007081] (Portillo); Irwin Belk Distinguished Professorship, University of North Carolina Wilmington; K24DA037034 (Johnson); and the Government of Botswana Human Resources Development Council.