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Top 40 Most Popular Case Studies of 2021

Two cases about Hertz claimed top spots in 2021's Top 40 Most Popular Case Studies

Two cases on the uses of debt and equity at Hertz claimed top spots in the CRDT’s (Case Research and Development Team) 2021 top 40 review of cases.

Hertz (A) took the top spot. The case details the financial structure of the rental car company through the end of 2019. Hertz (B), which ranked third in CRDT’s list, describes the company’s struggles during the early part of the COVID pandemic and its eventual need to enter Chapter 11 bankruptcy. 

The success of the Hertz cases was unprecedented for the top 40 list. Usually, cases take a number of years to gain popularity, but the Hertz cases claimed top spots in their first year of release. Hertz (A) also became the first ‘cooked’ case to top the annual review, as all of the other winners had been web-based ‘raw’ cases.

Besides introducing students to the complicated financing required to maintain an enormous fleet of cars, the Hertz cases also expanded the diversity of case protagonists. Kathyrn Marinello was the CEO of Hertz during this period and the CFO, Jamere Jackson is black.

Sandwiched between the two Hertz cases, Coffee 2016, a perennial best seller, finished second. “Glory, Glory, Man United!” a case about an English football team’s IPO made a surprise move to number four.  Cases on search fund boards, the future of malls,  Norway’s Sovereign Wealth fund, Prodigy Finance, the Mayo Clinic, and Cadbury rounded out the top ten.

Other year-end data for 2021 showed:

• Online “raw” case usage remained steady as compared to 2020 with over 35K users from 170 countries and all 50 U.S. states interacting with 196 cases.
• Fifty four percent of raw case users came from outside the U.S..
• The Yale School of Management (SOM) case study directory pages received over 160K page views from 177 countries with approximately a third originating in India followed by the U.S. and the Philippines.
• Twenty-six of the cases in the list are raw cases.
• A third of the cases feature a woman protagonist.
• Orders for Yale SOM case studies increased by almost 50% compared to 2020.
• The top 40 cases were supervised by 19 different Yale SOM faculty members, several supervising multiple cases.

CRDT compiled the Top 40 list by combining data from its case store, Google Analytics, and other measures of interest and adoption.

All of this year’s Top 40 cases are available for purchase from the Yale Management Media store .

And the Top 40 cases studies of 2021 are:

1.   Hertz Global Holdings (A): Uses of Debt and Equity

2.   Coffee 2016

3.   Hertz Global Holdings (B): Uses of Debt and Equity 2020

4.   Glory, Glory Man United!

5.   Search Fund Company Boards: How CEOs Can Build Boards to Help Them Thrive

6.   The Future of Malls: Was Decline Inevitable?

7.   Strategy for Norway's Pension Fund Global

8.   Prodigy Finance

9.   Design at Mayo

10. Cadbury

11. City Hospital Emergency Room

13. Volkswagen

14. Marina Bay Sands

15. Shake Shack IPO

16. Mastercard

17. Netflix

18. Ant Financial

19. AXA: Creating the New CR Metrics

20. IBM Corporate Service Corps

21. Business Leadership in South Africa's 1994 Reforms

22. Alternative Meat Industry

23. Children's Premier

24. Khalil Tawil and Umi (A)

25. Palm Oil 2016

26. Teach For All: Designing a Global Network

27. What's Next? Search Fund Entrepreneurs Reflect on Life After Exit

28. Searching for a Search Fund Structure: A Student Takes a Tour of Various Options

30. Project Sammaan

31. Commonfund ESG

32. Polaroid

33. Connecticut Green Bank 2018: After the Raid

34. FieldFresh Foods

35. The Alibaba Group

36. 360 State Street: Real Options

37. Herman Miller

38. AgBiome

39. Nathan Cummings Foundation

40. Toyota 2010

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To solve big issues like climate change, we need to reframe our problems

Reframing our problems could help yield new solutions to major issues like climate change and gender inequality. Image:  Unsplash / @pinewatt

.chakra .wef-1c7l3mo{-webkit-transition:all 0.15s ease-out;transition:all 0.15s ease-out;cursor:pointer;-webkit-text-decoration:none;text-decoration:none;outline:none;color:inherit;}.chakra .wef-1c7l3mo:hover,.chakra .wef-1c7l3mo[data-hover]{-webkit-text-decoration:underline;text-decoration:underline;}.chakra .wef-1c7l3mo:focus,.chakra .wef-1c7l3mo[data-focus]{box-shadow:0 0 0 3px rgba(168,203,251,0.5);} Thomas Wedell-Wedellsborg

Jonathan wichmann.

.chakra .wef-9dduvl{margin-top:16px;margin-bottom:16px;line-height:1.388;font-size:1.25rem;}@media screen and (min-width:56.5rem){.chakra .wef-9dduvl{font-size:1.125rem;}} Explore and monitor how .chakra .wef-15eoq1r{margin-top:16px;margin-bottom:16px;line-height:1.388;font-size:1.25rem;color:#F7DB5E;}@media screen and (min-width:56.5rem){.chakra .wef-15eoq1r{font-size:1.125rem;}} Behavioural Sciences is affecting economies, industries and global issues

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Stay up to date:, behavioural sciences.

• Reframing social and global problems could yield viable solutions to major issues such as climate change and gender inequality.
• Being able to identify patterns in how people tend to frame problems underpins this approach.
• Three such patterns include framing problems to avoid change, to blame individuals instead of the system, and to bypass "messy" realities.

Imagine you own an office building and your tenants are complaining that the elevator is way too slow. What do you do?

Faced with this problem, most people instinctively jump into solution mode. How can we make the elevator faster? Can we upgrade the motor? Tweak the algorithm? Do we need to buy a new elevator?

The speed of the elevator might be the wrong problem to focus on, however. Talk to an experienced landlord and they might offer you a more elegant solution: put up mirrors next to the elevator so people don’t notice the wait. Gazing lovingly at your own reflection tends to have that effect.

The mirror doesn’t make the elevator faster. It solves a different problem – that the wait is annoying.

Solve the right problem

The slow elevator story highlights an important truth, in that the way we frame a problem often determines which solutions we come up with. By shifting the way we see a problem, we can sometimes find better solutions.

Problem framing is of paramount importance when it comes to tackling the many hard challenges our societies face. And yet, we’re not terribly good at it. In a survey of 106 corporate leaders, 87% said their people waste significant resources solving the wrong problems. When we go to the doctor, we know very well that identifying the right problem is key. Too often, we fail to apply the same thinking to social and global problems.

Problem framing is of paramount importance when it comes to tackling the many hard challenges our societies face.

Three common patterns

So, how do we get better at it? One starting point is to recognise that there are often patterns in the way we frame problems. Get better at recognising those patterns, and you can dramatically improve your ability to solve the right problems. Here are three typical patterns:

1. We prefer framings that allow us to avoid change

People tend to frame problems so they don’t have to change their own behaviour. When the lack of women leading companies first became a prominent concern decades ago, it was often framed as a pipeline problem. Many corporate leaders simply assumed that, once there were enough women in junior positions, the C-suite would follow.

That framing allowed companies to carry on as usual for about a generation until time eventually proved the pipeline theory wrong , or at best radically incomplete. The gender balance among senior executives would surely be better by now if companies had not spent a few decades ignoring other explanations for the skewed ratio.

People tend to frame problems so they don’t have to change their own behaviour.

2. We blame individuals and ignore the system

Another pattern is that we tend to frame problems at the level of the individual, overlooking systemic factors.

Climate change is an obvious example. Research shows the majority of your carbon footprint is determined by your socioeconomic status and the shared emissions of the area in which you live. There’s only so much you can do to change this, unless you are willing to engage in a very radical lifestyle change such as living off the grid. In popular culture, however, climate change is mostly framed as an individual choice, for example choosing to fly less or at least buy a carbon offset if you do fly.

Framing climate change as an individual responsibility is not a bad thing. If enough people change, it makes a real difference, at least over time. Research has also suggested that individual action can build momentum for systemic change.

But the framing can also distract us from focusing on systemic issues, including what companies do (or don’t do) to address climate change. Some companies may be using this strategically. For example, it's a little-known fact that oil company BP popularised the idea of a “carbon footprint” as part of a mid-2000s advertising campaign .

Framing can distract us from focusing on systemic issues, including what companies do (or don’t do) to address climate change.

3. We want magic bullets, not messy reality

Most of our social and global problems are multi-causal. The problem-solving scholar Russell L. Ackoff memorably used the term “ messes ” to describe real-world problems. But people often dislike complexity, preferring neat stories with a single, easily-identifiable villain.

Take the case of gun deaths in the US. Advocates for gun ownership often use the “mental health” argument that guns don’t kill people, people do. On the other hand, people who dislike guns often see it as an access problem and call for a ban on all guns. Arguably, both of these framings are as simplistic as they are infeasible.

Contrast this with the approach described by the economist Paul Krugman in a recent New York Times column . He uses the car industry to reframe the gun debate. We fight automobile accidents through a broad suite of different interventions, which allows us to keep using our cars but in a safer way.

This approach calls for a portfolio of reasonable regulations that recognises the political fact that many Americans want to keep their guns. This is a far stretch from the binary "access-or-mental-health" framing and, in our opinion, much more likely to create results.

Problem framing is a critical skill and one that can make a big difference to our shared problems.

How to escape a horrible boss

Problem framing is a critical skill and one that can make a big difference to our shared problems. But that’s not the only reason to get better at it - framing can also be useful in our personal lives.

The creativity scholar Robert Sternberg once told the story of an executive who loved his job but hated his boss. The executive’s contempt for his boss was so strong that he decided to contact a headhunter who said that finding a similar job elsewhere should be easy. The same evening, however, the executive spoke to his wife, who happened to be an expert on reframing.

This led to a better approach. In Sternberg’s words: “He returned to the headhunter and gave the headhunter his boss’s name. The headhunter found a new job for the executive’s boss, which the boss—having no idea of what was going on—accepted. The executive then got his boss’s job.”

It seems we could all do with a little bit of reframing.

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The views expressed in this article are those of the author alone and not the World Economic Forum.

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Top 10 International Business Negotiation Case Studies

International business negotiation case studies offer insights to business negotiators who face challenges in the realm of cross-cultural business negotiation..

By PON Staff — on March 26th, 2024 / International Negotiation

If you engage in international negotiation , you can improve your odds of success by learning from these 10 well-known international business negotiation case studies:

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• Apple’s Apology in China

When Apple CEO Timothy D. Cook apologized to Apple customers in China for problems arising from Apple’s warranty policy, he promised to rectify the issue. In a negotiation research study, Professor William W. Maddux of INSEAD and his colleagues compared reactions to apologies in the United States and in Japan. They discovered that in “collectivist cultures” such as China and Japan, apologies can be particularly effective in repairing broken trust, regardless of whether the person apologizing is to blame. This may be especially true in a cross-cultural business negotiation such as this one.

• Bangladesh Factory-Safety Agreements

In this negotiation case study, an eight-story factory collapsed in Bangladesh, killing an estimated 1,129 people, most of whom were low-wage garment workers manufacturing goods for foreign retailers. Following the tragedy, companies that outsourced their garment production faced public pressure to improve conditions for foreign workers. Labor unions focused their efforts on persuading Swedish “cheap chic” giant H&M to take the lead on safety improvements. This negotiation case study highlights the pros and cons of all-inclusive, diffuse agreements versus targeted, specific agreements.

• The Microsoft-Nokia Deal

Microsoft made the surprising announcement that it was purchasing Finnish mobile handset maker Nokia for $7.2 billion, a merger aimed at building Microsoft’s mobile and smartphone offerings. The merger faced even more complexity after the ink dried on the contract—namely, the challenges of integrating employees from different cultures. International business negotiation case studies such as this one underscore the difficulties that companies face when attempting to negotiate two different identities.

• The Cyprus Crisis

With the economy of the tiny Mediterranean island nation Cyprus near collapse, the International Monetary Fund (IMF), European Central Bank (ECB), and the European Commission teamed up to offer a 10-billion-euro bailout package contingent on Cyprus provisioning a substantial amount of the money through a one-time tax on ordinary Cypriot bank depositors. The move proved extremely unpopular in Cyprus and protests resulted. The nation’s president was left scrambling for a backup plan. The lesson from international business negotiation case studies such as this? Sometimes the best deal you can get may be better than no deal at all.

• Dissent in the European Union

The European Union (EU) held a summit to address the coordination of economic activities and policies among EU member states. German resistance to such a global deal was strong, and pessimism about a unified EU banking system ran high as a result of the EU financial crisis. The conflict reflects the difficulty of forging  multiparty agreements  during times of stress and crisis.

• North and South Korea Talks Collapse

Negotiations between North Korea and South Korea were supposed to begin in Seoul aimed at lessening tensions between the divided nations. It would have been the highest government dialogue between the two nations in years. Just before negotiations were due to start, however, North Korea complained that it was insulted that the lead negotiator from the South wasn’t higher in status. The conflict escalated, and North Korea ultimately withdrew from the talks. The case highlights the importance of pride and power perceptions in international negotiations.

• Canceled Talks for the U.S. and Russia

Then-U.S. president Barack Obama canceled a scheduled summit with Russian President Vladimir Putin, citing a lack of progress on a variety of negotiations. The announcement came on the heels of Russia’s decision to grant temporary asylum to former National Security Agency contractor Edward Snowden, who made confidential data on American surveillance programs public. From international business negotiation case studies such as this, we can learn strategic reasons for  breaking off ties , if only temporarily, with a counterpart.

• The East China Sea Dispute

In recent years, several nations, including China and Japan, have laid claim to a chain of islands in the East China Sea. China’s creation of an “air defense” zone over the islands led to an international dispute with Japan. International negotiators seeking to resolve complex disputes may gain valuable advice from this negotiation case study, which involves issues of international law as well as perceptions of relative strength or weakness in negotiations.

• An International Deal with Syria

When then-U.S. Secretary of State John Kerry and his Russian counterpart, Sergey Lavrov, announced a deal to prevent the United States from entering the Syrian War, it was contingent on Syrian President Bashar al-Assad’s promise to dismantle his nation’s chemical weapons. Like other real-life negotiation case studies, this one highlights the value of expanding our focus in negotiation.

• A Nuclear Deal with Iran

When the United States and five other world powers announced an interim agreement to temporarily freeze Iran’s nuclear program, the six-month accord, which eventually led to a full-scale agreement in 2015, was designed to give international negotiators time to negotiate a more comprehensive pact that would remove the threat of Iran producing nuclear weapons. As Iranian President Hassan Rouhani insisted that Iran had a sovereign right to enrich uranium, the United States rejected Iran’s claim to having a “right to enrich” but agreed to allow Iran to continue to enrich at a low level, a concession that allowed a deal to emerge.

What international business negotiation case studies in the news have you learned from in recent years?

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Seven case studies in carbon and climate

Every part of the mosaic of Earth's surface — ocean and land, Arctic and tropics, forest and grassland — absorbs and releases carbon in a different way. Wild-card events such as massive wildfires and drought complicate the global picture even more. To better predict future climate, we need to understand how Earth's ecosystems will change as the climate warms and how extreme events will shape and interact with the future environment. Here are seven pressing concerns.

The Far North is warming twice as fast as the rest of Earth, on average. With a 5-year Arctic airborne observing campaign just wrapping up and a 10-year campaign just starting that will integrate airborne, satellite and surface measurements, NASA is using unprecedented resources to discover how the drastic changes in Arctic carbon are likely to influence our climatic future.

Wildfires have become common in the North. Because firefighting is so difficult in remote areas, many of these fires burn unchecked for months, throwing huge plumes of carbon into the atmosphere. A recent report found a nearly 10-fold increase in the number of large fires in the Arctic region over the last 50 years, and the total area burned by fires is increasing annually.

Organic carbon from plant and animal remains is preserved for millennia in frozen Arctic soil, too cold to decompose. Arctic soils known as permafrost contain more carbon than there is in Earth's atmosphere today. As the frozen landscape continues to thaw, the likelihood increases that not only fires but decomposition will create Arctic atmospheric emissions rivaling those of fossil fuels. The chemical form these emissions take — carbon dioxide or methane — will make a big difference in how much greenhouse warming they create.

Initial results from NASA's Carbon in Arctic Reservoirs Vulnerability Experiment (CARVE) airborne campaign have allayed concerns that large bursts of methane, a more potent greenhouse gas, are already being released from thawing Arctic soils. CARVE principal investigator Charles Miller of NASA's Jet Propulsion Laboratory (JPL), Pasadena, California, is looking forward to NASA's ABoVE field campaign (Arctic Boreal Vulnerability Experiment) to gain more insight. "CARVE just scratched the surface, compared to what ABoVE will do," Miller said.

Methane is the Billy the Kid of carbon-containing greenhouse gases: it does a lot of damage in a short life. There's much less of it in Earth's atmosphere than there is carbon dioxide, but molecule for molecule, it causes far more greenhouse warming than CO 2 does over its average 10-year life span in the atmosphere.

Methane is produced by bacteria that decompose organic material in damp places with little or no oxygen, such as freshwater marshes and the stomachs of cows. Currently, over half of atmospheric methane comes from human-related sources, such as livestock, rice farming, landfills and leaks of natural gas. Natural sources include termites and wetlands. Because of increasing human sources, the atmospheric concentration of methane has doubled in the last 200 years to a level not seen on our planet for 650,000 years.

Locating and measuring human emissions of methane are significant challenges. NASA's Carbon Monitoring System is funding several projects testing new technologies and techniques to improve our ability to monitor the colorless gas and help decision makers pinpoint sources of emissions. One project, led by Daniel Jacob of Harvard University, used satellite observations of methane to infer emissions over North America. The research found that human methane emissions in eastern Texas were 50 to 100 percent higher than previous estimates. "This study shows the potential of satellite observations to assess how methane emissions are changing," said Kevin Bowman, a JPL research scientist who was a coauthor of the study.

Tropical forests

Tropical forests are carbon storage heavyweights. The Amazon in South America alone absorbs a quarter of all carbon dioxide that ends up on land. Forests in Asia and Africa also do their part in "breathing in" as much carbon dioxide as possible and using it to grow.

However, there is evidence that tropical forests may be reaching some kind of limit to growth. While growth rates in temperate and boreal forests continue to increase, trees in the Amazon have been growing more slowly in recent years. They've also been dying sooner. That's partly because the forest was stressed by two severe droughts in 2005 and 2010 — so severe that the Amazon emitted more carbon overall than it absorbed during those years, due to increased fires and reduced growth. Those unprecedented droughts may have been only a foretaste of what is ahead, because models predict that droughts will increase in frequency and severity in the future.

In the past 40-50 years, the greatest threat to tropical rainforests has been not climate but humans, and here the news from the Amazon is better. Brazil has reduced Amazon deforestation in its territory by 60 to 70 percent since 2004, despite troubling increases in the last three years. According to Doug Morton, a scientist at NASA's Goddard Space Flight Center in Greenbelt, Maryland, further reductions may not make a marked difference in the global carbon budget. "No one wants to abandon efforts to preserve and protect the tropical forests," he said. "But doing that with the expectation that [it] is a meaningful way to address global greenhouse gas emissions has become less defensible."

In the last few years, Brazil's progress has left Indonesia the distinction of being the nation with the highest deforestation rate and also with the largest overall area of forest cleared in the world. Although Indonesia's forests are only a quarter to a fifth the extent of the Amazon, fires there emit massive amounts of carbon, because about half of the Indonesian forests grow on carbon-rich peat. A recent study estimated that this fall, daily greenhouse gas emissions from recent Indonesian fires regularly surpassed daily emissions from the entire United States.

Wildfires are natural and necessary for some forest ecosystems, keeping them healthy by fertilizing soil, clearing ground for young plants, and allowing species to germinate and reproduce. Like the carbon cycle itself, fires are being pushed out of their normal roles by climate change. Shorter winters and higher temperatures during the other seasons lead to drier vegetation and soils. Globally, fire seasons are almost 20 percent longer today, on average, than they were 35 years ago.

Currently, wildfires are estimated to spew 2 to 4 billion tons of carbon into the atmosphere each year on average — about half as much as is emitted by fossil fuel burning. Large as that number is, it's just the beginning of the impact of fires on the carbon cycle. As a burned forest regrows, decades will pass before it reaches its former levels of carbon absorption. If the area is cleared for agriculture, the croplands will never absorb as much carbon as the forest did.

As atmospheric carbon dioxide continues to increase and global temperatures warm, climate models show the threat of wildfires increasing throughout this century. In Earth's more arid regions like the U.S. West, rising temperatures will continue to dry out vegetation so fires start and burn more easily. In Arctic and boreal ecosystems, intense wildfires are burning not just the trees, but also the carbon-rich soil itself, accelerating the thaw of permafrost, and dumping even more carbon dioxide and methane into the atmosphere.

North American forests

With decades of Landsat satellite imagery at their fingertips, researchers can track changes to North American forests since the mid-1980s. A warming climate is making its presence known.

Through the North American Forest Dynamics project, and a dataset based on Landsat imagery released this earlier this month, researchers can track where tree cover is disappearing through logging, wildfires, windstorms, insect outbreaks, drought, mountaintop mining, and people clearing land for development and agriculture. Equally, they can see where forests are growing back over past logging projects, abandoned croplands and other previously disturbed areas.

"One takeaway from the project is how active U.S. forests are, and how young American forests are," said Jeff Masek of Goddard, one of the project’s principal investigators along with researchers from the University of Maryland and the U.S. Forest Service. In the Southeast, fast-growing tree farms illustrate a human influence on the forest life cycle. In the West, however, much of the forest disturbance is directly or indirectly tied to climate. Wildfires stretched across more acres in Alaska this year than they have in any other year in the satellite record. Insects and drought have turned green forests brown in the Rocky Mountains. In the Southwest, pinyon-juniper forests have died back due to drought.

Scientists are studying North American forests and the carbon they store with other remote sensing instruments. With radars and lidars, which measure height of vegetation from satellite or airborne platforms, they can calculate how much biomass — the total amount of plant material, like trunks, stems and leaves — these forests contain. Then, models looking at how fast forests are growing or shrinking can calculate carbon uptake and release into the atmosphere. An instrument planned to fly on the International Space Station (ISS), called the Global Ecosystem Dynamics Investigation (GEDI) lidar, will measure tree height from orbit, and a second ISS mission called the Ecosystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) will monitor how forests are using water, an indicator of their carbon uptake during growth. Two other upcoming radar satellite missions (the NASA-ISRO SAR radar, or NISAR, and the European Space Agency’s BIOMASS radar) will provide even more complementary, comprehensive information on vegetation.

Ocean carbon absorption

When carbon-dioxide-rich air meets seawater containing less carbon dioxide, the greenhouse gas diffuses from the atmosphere into the ocean as irresistibly as a ball rolls downhill. Today, about a quarter of human-produced carbon dioxide emissions get absorbed into the ocean. Once the carbon is in the water, it can stay there for hundreds of years.

Warm, CO 2 -rich surface water flows in ocean currents to colder parts of the globe, releasing its heat along the way. In the polar regions, the now-cool water sinks several miles deep, carrying its carbon burden to the depths. Eventually, that same water wells up far away and returns carbon to the surface; but the entire trip is thought to take about a thousand years. In other words, water upwelling today dates from the Middle Ages – long before fossil fuel emissions.

That's good for the atmosphere, but the ocean pays a heavy price for absorbing so much carbon: acidification. Carbon dioxide reacts chemically with seawater to make the water more acidic. This fundamental change threatens many marine creatures. The chain of chemical reactions ends up reducing the amount of a particular form of carbon — the carbonate ion — that these organisms need to make shells and skeletons. Dubbed the “other carbon dioxide problem,” ocean acidification has potential impacts on millions of people who depend on the ocean for food and resources.

Phytoplankton

Microscopic, aquatic plants called phytoplankton are another way that ocean ecosystems absorb carbon dioxide emissions. Phytoplankton float with currents, consuming carbon dioxide as they grow. They are at the base of the ocean's food chain, eaten by tiny animals called zooplankton that are then consumed by larger species. When phytoplankton and zooplankton die, they may sink to the ocean floor, taking the carbon stored in their bodies with them.

Satellite instruments like the Moderate resolution Imaging Spectroradiometer (MODIS) on NASA's Terra and Aqua let us observe ocean color, which researchers can use to estimate abundance — more green equals more phytoplankton. But not all phytoplankton are equal. Some bigger species, like diatoms, need more nutrients in the surface waters. The bigger species also are generally heavier so more readily sink to the ocean floor.

As ocean currents change, however, the layers of surface water that have the right mix of sunlight, temperature and nutrients for phytoplankton to thrive are changing as well. “In the Northern Hemisphere, there’s a declining trend in phytoplankton,” said Cecile Rousseaux, an oceanographer with the Global Modeling and Assimilation Office at Goddard. She used models to determine that the decline at the highest latitudes was due to a decrease in abundance of diatoms. One future mission, the Pre-Aerosol, Clouds, and ocean Ecosystem (PACE) satellite, will use instruments designed to see shades of color in the ocean — and through that, allow scientists to better quantify different phytoplankton species.

In the Arctic, however, phytoplankton may be increasing due to climate change. The NASA-sponsored Impacts of Climate on the Eco-Systems and Chemistry of the Arctic Pacific Environment (ICESCAPE) expedition on a U.S. Coast Guard icebreaker in 2010 and 2011 found unprecedented phytoplankton blooms under about three feet (a meter) of sea ice off Alaska. Scientists think this unusually thin ice allows sunlight to filter down to the water, catalyzing plant blooms where they had never been observed before.

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Rising inequality affecting more than two-thirds of the globe, but it’s not inevitable: new UN report

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Inequality is growing for more than 70 per cent of the global population, exacerbating the risks of divisions and hampering economic and social development. But the rise is far from inevitable and can be tackled at a national and international level, says a flagship study released by the UN on Tuesday.

The World Social Report 2020, published by the UN Department of Economic and Social Affairs (DESA), shows that income inequality has increased in most developed countries, and some middle-income countries - including China, which has the world’s fastest growing economy.

The challenges are underscored by UN chief António Guterres in the foreword, in which he states that the world is confronting “the harsh realities of a deeply unequal global landscape”, in which economic woes, inequalities and job insecurity have led to mass protests in both developed and developing countries.

 “Income disparities and a lack of opportunities”, he writes, “are creating a vicious cycle of inequality, frustration and discontent across generations.”

‘The one per cent’ winners take (almost) all

The study shows that the richest one per cent of the population are the big winners in the changing global economy, increasing their share of income between 1990 and 2015, while at the other end of the scale, the bottom 40 per cent earned less than a quarter of income in all countries surveyed.

One of the consequences of inequality within societies, notes the report, is slower economic growth. In unequal societies, with wide disparities in areas such as health care and education, people are more likely to remain trapped in poverty, across several generations.

Between countries, the difference in average incomes is reducing, with China and other Asian nations driving growth in the global economy. Nevertheless, there are still stark differences between the richest and poorest countries and regions: the average income in North America, for example, is 16 times higher than that of people in Sub-Saharan Africa.

Four global forces affecting inequality

The report looks at the impact that four powerful global forces, or megatrends, are having on inequality around the world: technological innovation, climate change, urbanization and international migration.

Whilst technological innovation can support economic growth, offering new possibilities in fields such as health care, education, communication and productivity, there is also evidence to show that it can lead to increased wage inequality, and displace workers.

Rapid advances in areas such as biology and genetics, as well as robotics and artificial intelligence, are transforming societies at pace. New technology has the potential to eliminate entire categories of jobs but, equally, may generate entirely new jobs and innovations.

For now, however, highly skilled workers are reaping the benefits of the so-called “fourth industrial revolution”, whilst low-skilled and middle-skilled workers engaged in routine manual and cognitive tasks, are seeing their opportunities shrink.

Opportunities in a crisis

As the UN’s 2020 report on the global economy showed last Thursday, the climate crisis is having a negative impact on quality of life, and vulnerable populations are bearing the brunt of environmental degradation and extreme weather events. Climate change, according to the World Social Report, is making the world’s poorest countries even poorer, and could reverse progress made in reducing inequality among countries.

If action to tackle the climate crisis progresses as hoped, there will be job losses in carbon-intensive sectors, such as the coal industry, but the “greening” of the global economy could result in overall net employment gains, with the creation of many new jobs worldwide.

For the first time in history, more people live in urban than rural areas, a trend that is expected to continue over the coming years. Although cities drive economic growth, they are more unequal than rural areas, with the extremely wealthy living alongside the very poor.

The scale of inequality varies widely from city to city, even within a single country: as they grow and develop, some cities have become more unequal whilst, in others, inequality has declined.

Migration a ‘powerful symbol of global inequality’

The fourth megatrend, international migration, is described as both a “powerful symbol of global inequality”, and “a force for equality under the right conditions”.

Migration within countries, notes the report, tends to increase once countries begin to develop and industrialize, and more inhabitants of middle-income countries than low-income countries migrate abroad.

International migration is seen, generally, as benefiting both migrants, their countries of origin (as money is sent home) and their host countries.

In some cases, where migrants compete for low-skilled work, wages may be pushed down, increasing inequality but, if they offer skills that are in short supply, or take on work that others are not willing to do, they can have a positive effect on unemployment.

Harness the megatrends for a better world

Despite a clear widening of the gap between the haves and have-nots worldwide, the report points out that this situation can be reversed. Although the megatrends have the potential to continue divisions in society, they can also, as the Secretary-General says in his foreword, “be harnessed for a more equitable and sustainable world”. Both national governments and international organizations have a role to play in levelling the playing field and creating a fairer world for all.

Reducing inequality should, says the report, play a central role in policy-making. This means ensuring that the potential of new technology is used to reduce poverty and create jobs; that vulnerable people grow more resilient to the effects of climate change; cities are more inclusive; and migration takes place in a safe, orderly and regular manner.

Three strategies for making countries more egalitarian are suggested in the report: the promotion of equal access to opportunities (through, for example, universal access to education); fiscal policies that include measures for social policies, such as unemployment and disability benefits; and legislation that tackles prejudice and discrimination, whilst promoting greater participation of disadvantaged groups.

While action at a national level is crucial, the report declares that “concerted, coordinated and multilateral action” is needed to tackle major challenges affecting inequality within and among countries.

The report’s authors conclude that, given the importance of international cooperation, multilateral institutions such as the UN should be strengthened and action to create a fairer world must be urgently accelerated.

The UN’s 2030 Agenda for Sustainable Development , which provides the blueprint for a better future for people and the planet, recognizes that major challenges require internationally coordinated solutions, and contains concrete and specific targets to reduce inequality, based on income.

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Case Studies of Global Governance for Health Research

• First Online: 14 November 2019

Cite this chapter

• Kiarash Aramesh 4  

Part of the book series: Advancing Global Bioethics ((AGBIO,volume 15))

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This chapter is specified to a number of case studies to portray the challenges of Global Health Governance and Global Governance for Health Research in the real-world through historical cases. The fourth chapter begins with a broader scope. In the first case, Zika pandemic, it shows how Global Health Governance uses previous experiences to deal with newly-emerged pandemics. Research integrity in Iran discusses how local practices on research integrity are important at the global scale and should be addressed by Global Governance for Health Research. HIV/AIDS Research in LMICs describes a paradigm case of exploitation in research that contributed to a significant shift in the history of clinical research. Sending Biological Specimens Abroad discusses bio-piracy as a topic within Global Governance for Health Research. Also, it shows how international collaborations may be seen by the weaker sides. Research on Pre-Implantation Human Embryo portrays how different religious and seculars perspectives collectively take part in shaping the ethical grounds for Global Governance for Health Research. The final case study in this chapter, Traditional Medicines, Science-Pseudoscience Debate, and Biopiracy, addresses the globalized aspects of science-pseudoscience debate and Biopiracy by discussing traditional medicines as a paradigm example. By exploring such spectrum of real-world cases, the fourth chapter portrays the existing need of Global Health Governance and Global Governance for Health Research to a comprehensive ethical framework. It also shows how particular challenges or ethical principles are more relevant to each case.

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Hazel J Markwell, and Barry F Brown, “Catholic Bioethics,” 189.

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Aramesh, K. (2019). Case Studies of Global Governance for Health Research. In: An Ethical Framework for Global Governance for Health Research. Advancing Global Bioethics, vol 15. Springer, Cham. https://doi.org/10.1007/978-3-030-31132-2_4

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Volume 11 Supplement 2

Global health research case studies: lessons from partnerships addressing health inequities

• Introduction
• Open access
• Published: 08 November 2011
• Zoë Boutilier 1 ,
• Ibrahim Daibes 1 &
• Erica Di Ruggiero 2  

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Inspiration for compiling this collection of case studies comes from the Global Health Research Initiative’s (GHRI) commitment to conceptualizing and supporting global health research as a practice with increasingly discernable core characteristics. Through an exploration of these characteristics, the collection highlights practical, relevant and transferable lessons for consideration by researchers, their research-user partners, and donors working to address health inequities through global health research partnerships. The value of global health research partnerships is illustrated through the achievements of the collaborations featured in this collection.

The ten case studies included in this collection do not describe individual research projects. Instead, they each provide an in-depth account of a defined program of research that acts as a platform for theoretically linked research projects. The programs are an integrated blend of knowledge generation, capacity building, and knowledge translation activities that have evolved towards increasing complexity and sophistication. In particular, attention to capacity building and knowledge translation increases as the programs mature over time. The programs of research are animated by a core alliance of individuals whose international partnerships are rooted in mutual trust and the articulation of a common goal: health equity.

The cases presented in this collection are concerned with health inequities experienced by certain population groups. For example, the two cases set in South Asia (Haddad et al., Mumtaz et al.) are both concerned with the persistent health inequities that are experienced by lower-caste women belonging to marginalized indigenous groups. Another disadvantaged population group highlighted twice in this collection is people living with HIV/AIDS in rural Sub-Saharan Africa (Kipp et al., Sodhi et al.). A third group, Ecuadorians with limited resources who are vulnerable to environmental degradation and to acute pesticide poisoning, is also highlighted twice in this collection (Spiegel et al., Cole et al.). All of these groups face persistent social and health inequities that have “both historical roots and present day causes” (Cole et al.).

This collection features partnerships that include Canadian researchers. This is in part not accidental given that these cases were compiled by Canada’s Global Health Research Initiative (GHRI), a partnership between five Canadian government agencies that are responsible for health, health research and international development (the International Development Research Centre, the Canadian Institutes of Health Research, Health Canada, the Canadian International Development Agency, and the Public Health Agency of Canada). Over the past ten years, GHRI has sought to understand the characteristics of effective global health research and to create an environment that is conducive to its successful conduct. While the programs described in this collection are not all directly supported by GHRI, they share characteristics that are common to the programs of research supported by GHRI. We emphasize these characteristics here because we believe that they are core to the practice of global health research. The practice of global health research as described in these case studies and as supported by GHRI is characterized by:

1) long-term and sustainable North-South partnerships;

2) interdisciplinary responses to complex issues;

3) participatory action research that grounds the research in its context; and

4) research with a policy or practice impact orientation.

In this introductory essay we elaborate on each of these characteristics. We also take this opportunity to highlight some of the commendable achievements of the partnerships. At the same time, we do not neglect to expand on the challenges that face global health research partnerships, nor fail to recognize the systemic barriers that too often confine researchers, research-users, and donors.

Long-term, sustainable North-South partnerships

The complexity of health issues addressed by global health research programs necessitates long-term visions and timelines. On average, the partnerships described herein have been in existence for just short of a decade; in two cases the partnership has been in existence for almost a decade and a half (Haddad et al., Kipp et al.). This commitment to long-term, North-South partnerships is significant given that political, institutional, and professional priorities tend to change with time. Literature on North-South partnerships is often pessimistic about the prospects for partnership sustainability, with repeated references to pervasive power imbalances in agenda-setting, in funding sources, and in allegiance to methodologies and scientific traditions [ 1 – 3 ]. These and other issues present an ongoing challenge to attempts to establish and maintain long-term North-South research partnerships. Despite these challenges, the case studies in this collection demonstrate that partnerships of this kind can not only be sustained, but can thrive.

The sustainability of these partnerships might be a product – or a cause – of a continued evolution in sophistication and approach. In the case of Delisle et al., the process of exploring the initial research questions and assumptions led to new ones that needed to be tested. The generation of scientific knowledge, often the initial impetus for the partnership, was enhanced over time by an increasing investment in capacity building and knowledge translation activities. In the words of Haddad et al., “The initial focus on survey-based research and data analysis gradually transformed in the direction of understanding local governance, political analysis, marginalization, gender and empowerment” [ 4 ]. In most of the cases, the overall program of research systematically emerged from its component parts. For example, Cole et al. describe their progression through three distinctly-funded projects (‘EcoHealth II’ funded from 2005 to 2008, ‘Healthy Horticulture’ funded from 2007 to 2010, and ‘Social Capital and Accountability’ funded from 2008 to 2011). Each project was designed to build on the last; not just in terms of the scientific knowledge generated, but also in terms of the human capacity developed and the impact on policy and practice. Similarly, Spiegel et al. describe the phases that made up their Ecuador EcoHealth program: a nationally-accredited ‘train-the-trainers’ Master’s program led to the establishment of other Masters programs and eventually to the launch of an innovative doctoral program. The evolution of the research program seems to reflect an evolving understanding of the problem, a greater appreciation for nuances and context, and the consolidation of the numerous relationships that must be in place for the purposes of credibility.

Another key similarity that links these longstanding, multi-stage, and evolving programs of research is their success in attracting funds from different sources over time. This may seem obvious, given that many of these partnerships have been in existence for almost a decade and given that donors generally do not commit to ten year timelines. It is instructive nonetheless to observe that these programs of research were sufficiently multi-faceted and compelling to be supported by a series of different donors, each with unique (albeit sometimes overlapping) mandates. The research program of Yassi et al. is one good example, having received at various times support from sources including (but not limited to) the Canadian Institutes of Health Research (CIHR), the Canada Research Chairs program, the Canada Foundation for Innovation (CFI), the International Development Research Centre (IDRC), the Canadian International Development Agency (CIDA) and Health Canada (HC). Likewise, the program of Ridde et al. received funding from IDRC (through its Research for Health Equity program), from GHRI (through its Africa Health Systems Initiative program), and from CIHR (through its New Investigators program). It is apparent, therefore, that long-term partnerships have the ability to supersede and outlast their current funding arrangements when they have a coherent and compelling motivation that both keeps them together during periods of financial uncertainty, and renders them fundable across a spectrum of donors.

Interdisciplinary responses to complex issues

The majority of the research partnerships featured in this supplement are, or strive to be, interdisciplinary both in their composition and in their approach to problem solving. We see, for example, partnerships that join development economists with physicians (Haddad et al.), biostatisticians with nurses (Kipp et al.), and infectious disease biologists with occupational health professionals (Yassi et al.). We also see partnerships that embrace qualitative and quantitative researchers, researchers and decision-makers, established and junior researchers, and academics and activists. Adding yet another layer of complexity, most of the partnerships featured here involve members from far-flung geographic regions and different cultural backgrounds. Spiegel et al. sum up all of these dimensions, when they explain that “knowledge sharing has fundamentally taken place within the dynamic of difference…three or more cultures, half a dozen disciplines, distinct paradigms, (and) three languages…” [ 5 ]. If the partnerships described in this supplement are representative of the wider field of global health research, it is clear that an interdisciplinary perspective is indeed a core characteristic of global health research.

Interdisciplinary approaches are characterized by the engagement of researchers from different disciplines in understanding and engaging in all components of a study and in sharing their different viewpoints regarding results and interpretations [ 6 ]. Interdisciplinary approaches are therefore considered more likely to lead to learning that goes beyond “additive” learning [ 7 ] and more likely to produce solutions that will have traction in the messiness of the real world. This view is reflected in some of the cases of this collection. Haddad et al. explain a process whereby the strengths of the two team leaders became mutually complementary, and then were further enhanced by the addition of different disciplines to the team, such that “the project became a crucible of intense learning, sending a strong message to the Canadian team that the narrow boundaries of economics had to be transcended to understand social systems with diverse caste and religious identities” [ 4 ].

Why is global health research a practice that causes its participants to strive to break down silos on so many fronts? Upon close reading, these articles suggest that at least part of the motivation lies in matching the means to the problem and to the end. In other words, research teams must be interdisciplinary in order to process and tackle the complex nature of global health issues, and their necessarily multi-faceted solutions. This is an era in which the inter-related socio-economic determinants of health are recognized but imperfectly understood [ 8 , 9 ]. Indeed, global health has been described as a ‘composite’ field; one that comprises biological, clinical and social health and is complemented by other disciplines such as engineering and political science [ 10 ]. Per force, the problems faced by global health partnerships are profoundly complex. Now more than ever, global health research requires the bridging of traditional divisions between disciplines in order to innovatively protect and promote health for all people [ 10 , 11 ].

While the bridging of disciplines is a fine theoretical ideal, how possible is this in the everyday reality of global health research programs? Both the literature and the experiences of these teams suggest that there are common impediments as well as key facilitating factors. At least one impediment stems from the possibly incompatible core values of different epistemological traditions. The depth of difference between traditions can often be appreciated in the downstream difficulty of reconciling different research methodologies. Beliefs and values about what constitutes sound research are often grounded in epistemologies and expressed in methodological approaches [ 12 , 13 ]. As explained by Ridde et al.:

“The challenges involved in the partnership …were more of an interdisciplinary nature than about North-South differences…the focus was on complementarity of theoretical and methodological approaches. For example, anthropologists most often use a very inductive process in conducting their research, whereas researchers in evaluation and public health generally organize their data using an analytical framework.” [ 14 ]

It follows then that in addition to linguistic bilingualism, global health research partnerships often strive for “methodological bilingualism”; a bilingualism that requires a minimum competency from all team members in each of the research methods [ 15 ]. Otherwise, researchers from various traditions find themselves at worse talking mutually incomprehensible methodological languages; and at best, producing ‘parallel’ results that fail to be integrated.

Participatory action research

The case studies in this collection present a variety of experiences with participatory action research. Participatory action research involves a commitment to both study a system and to collaborate with members of that system to bring about desired change [ 16 ]. It demands the active collaboration of all stakeholders, leading ideally to a blurring of traditional roles defining “researcher” and “researched” and to an equal partnership between researchers and community stakeholders [ 17 ]. Theoretically, participatory action research involves all potential users of the research in the formulation, conduct, and application of the research and the research occurs in phased cycles (problem diagnosis, action planning, taking action, evaluating the actions, incorporating lessons, repeat) [ 18 , 19 ].

The phased-cycle nature of participatory action research is demonstrated in a number of the case studies. Cole et al. describe their decade-long program of research as a series of “iterative cycles of mixed methods research around particular questions, actions relevant to stakeholders, new proposal formulation and implementation followed by evaluation of impacts” [ 20 ]. A number of the partnerships initially worked together on fairly straightforward epidemiological surveys; and gradually moved towards a participatory action research orientation. This is exemplified by Spiegel et al., who describe moving from research for inquiry’s sake to impact-oriented investigation while maintaining rigor in methods. Similarly, Deslisle et al. reflect on the evolution of their program of research, in which “progress is being made in the type of research, impacts and partnership” [ 21 ]. All of this suggests that an enhanced degree of maturity is important for successful participatory action research. Maturity (in terms of the relationship between the primary research collaborators, the relationship between the researchers and the community stakeholders, and a nuanced understanding of the setting) and a willingness to invest in a phased-cycle of action and reflection are factors that privilege the uptake and the likely success of participatory action research.

It can be inferred from the case studies of this collection that a commitment to the ideals of participatory action research is often difficult to apply. The very complex confluence of sociocultural factors that contributed to the existing health inequities will not instantly dissipate in the face of even the best-designed action research intervention. As Cole et al. explain,

“Our research-action process sought to address (the underlying causes of health inequities)… but was constrained by them. During EcoSalud II interventions, vertical approaches to community leadership excluded broader social participation and limited some community members’ access…” [ 20 ].

A look at the relevant literature reveals some healthy skepticism about another fundamental tenet of participatory action research: the requirement of equal partnerships between researchers and community stakeholders. It has been pointed out that many action research projects, described as participatory, actually use differing levels of collaboration at distinct stages of the research. For example, community stakeholders may be more involved in diagnosing the problem and in taking action, but less involved in the analysis and writing of the findings [ 22 ]. Some argue that “dragging” participants through all of the research process is unjustified, as long as said participants help define the research questions and then eventually help to interpret the findings [ 18 ]. When the concept of community stakeholders is widened to include not just a single geographically defined human settlement, but also other groups of people such as health practitioners and policy makers, the challenges to full and equal stakeholder participation become ever greater.

Research with a policy or practice impact orientation

Scholarly publishing is recognized as a measure of excellence in research. Global health research is certainly no exception. However, our experience in global health research reinforced by the case studies presented herein indicates that publishing alone is not sufficient. Taking action on modifiable determinants that affect health and health equity, and converting new knowledge into improved policies and programs are fundamental components of global health research. That is why, throughout this collection, the reader will notice the authors continually referring to the impact orientation of their work. As expressed by Delisle et al.; “The global health field owes it to itself to not only generate new knowledge and information but also to contribute to a population’s well-being” [ 21 ].

Through their storytelling the authors demonstrate the difficult and often capricious nature of knowledge translation. As such, the authors confirm known wisdom about the non-formulaic nature of policymaking and the sheer volume of factors that can influence the uptake of knowledge gleaned from research [ 23 – 26 ]. While each case study offers program-specific introspection about the factors governing policy and practice influence, overall the collection illuminates no pattern or best practice. In the world of policy and practice change, “outright success in terms of achieving specific, hoped-for change is rare, and the work that does influence policy is often unique and rarely repeated…” [ 27 ].

In this collection, only a few of the case studies describe situations in which the research provoked a traceable influence on policy at the national level. In their case study, Delisle et al. point to the influence of their research on policy and on practice at a national level in two countries.

“We believe that, because of our work, at least partly, nutrition related chronic diseases (NRCD) are being taken into account in Benin’s 2007 – 2016 National Health Development Plan…(and)…the primary education department in Burkina Faso is now considering introducing school lunch and nutrition programs not only in rural schools but also in urban schools…” [ 21 ]

The authors’ reluctance to claim direct sole responsibility for these changes points to a reality which complicates the lives of global health researchers and their donors—the “attribution problem” [ 27 , 28 ]. The causes of change (or stasis) in policy and practice are difficult to predict ahead of time and are often just as challenging to isolate and identify after the fact. This seems particularly true of the highest levels of government, as suggested by Cole et al., who describe the effort that was required from multiple civil society actors in order to restrict the use of hazardous pesticides in Ecuador. Thus the majority of the case studies in this supplement concentrate on describing changes that occurred in practice, and often at a very local level. These local changes in practice are often more tangible and a causal link can be more accurately attributed to the given research program.

Some of the case studies in this collection describe research that resulted in little or no discernable change to date. The case study of Mumtaz et al., for example, underlines the limitations of research when it confronts the more intractable and intransigent aspects of human society. In this case, relevant - and emotionally powerful -knowledge about gender inequities was generated. However, policymakers were not ready to address the deep-rooted ramifications of this knowledge. Because knowledge translation was a stated key objective of the research, the researchers had developed direct and ongoing engagement with government policymakers, who in turn expressed appreciation of the research results and saw them as important contributions to knowledge gaps. Despite these promising acknowledgements, however, policymakers have been unable to use the research results because “it is difficult for them to address the deep-seated … inequalities” [ 29 ].

Concluding comments

It is in keeping with the nature of modern times that the practice of global health research defies tidy definition, as it grows and morphs and adapts on a continuous basis. For this reason, rather than exploring competing definitions we have preferred in this essay to deepen our understanding of global health research by examining some of the core characteristics that link ten exemplary global health partnerships. The core characteristics that we have chosen to explore (long-term partnerships, interdisciplinary approaches, participatory action research, and impact orientation) are simply those that are illustrated most vividly across the ten case studies. This is not intended to provide an exhaustive list nor a conclusive characterization of the practice of global health research. Furthermore, a listing of these four as separate characteristics risks over-simplification, since each is interwoven with the others. For example, the phased-cycle nature of participatory action research often demands long timeframes and thus long-term partnerships. Likewise, a desire to influence policy and practice requires that health researchers also understand socio-political contexts, and thus adopt interdisciplinary approaches.

In this essay we have not elaborated on the commendable achievements of this collection of partnerships. On this point, the case studies speak most eloquently for themselves. In describing long-term research programs as opposed to short-term discrete research projects, each set of authors has showcased the value and the potential of global health research partnerships.

We remain curious as to the applicability of our conceptualization of global health and global health research’s core characteristics. Does this collection of case studies represent a uniquely Canadian ‘take’ on global health research? Given that each partnership featured here is a mix of Canadian and international colleagues, and given that the partnerships have been described as egalitarian and mutually respectful, it follows that these case studies can be said to represent a ‘global’ approach to global health research. That said, it is also true that the research featured here is funded at least partially from Canadian sources, and thus might reflect the programming principles, priorities and concerns of these donors. We remain open to the idea that other collections of global health case studies, compiled using different criteria, might yield different visions about what characterises the practice of global health research.

Semantics, definitions, and core characteristics aside: at essence, this collection is a spirit-lifting demonstration that many people are incapable of living ‘life as usual’ when this requires ignoring the social injustices suffered by others. Furthermore, this collection is a demonstration that people are capable of joining forces across cultures, disciplines and sectors to forge long-term commitments to programs of research and real-world impact.

Abbreviations

Global Health Research Initiative

Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome

Canadian Institutes of Health Research

Canada Foundation for Innovation

International Development Research Centre

Canadian International Development Agency

Health Canada

nutrition related chronic disease

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Acknowledgement

The authors would like to acknowledge the contribution of the GHRI Casebook Advisory Committee, who provided valuable advice and support to this process (Susan Godt, Nadia Hamel, Thomas Kibua, and Stephen Trott). We are particularly grateful to the external reviewers who contributed their time to undertake extensive peer review of these articles. Thanks to Anna Dion and Marc Cohen, who coordinated the earliest stages of collecting the case studies and coordinating the peer review. Thanks also to Ashley Page and Manon Therien, who provided the indispensible administrative coordination that allowed this project to move forward.

This article has been published as part of BMC International Health & Human Rights Volume 11 Supplement 2, 2011: Global health research case studies: lessons from partnerships addressing health inequities. The full contents of the supplement are available online at http://www.biomedcentral.com/1472-698X/11?issue=S2 .

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Zoë Boutilier and Ibrahim Daibes serve as Program Officer and Senior Program Specialist, respectively, for the Global Health Research Initiative. Erica Di Ruggiero serves on the steering committee of the Global Health Research Initiative. The Global Health Research Initiative supported the assembly and publication of this supplement. The views expressed in this introductory article are those of the authors alone and do not represent the views of the Global Health Research Initiative (GHRI), the International Development Centre (IDRC), nor the Canadian Institutes of Health Research (CIHR).

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Boutilier, Z., Daibes, I. & Di Ruggiero, E. Global health research case studies: lessons from partnerships addressing health inequities. BMC Int Health Hum Rights 11 (Suppl 2), S2 (2011). https://doi.org/10.1186/1472-698X-11-S2-S2

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• Published: 07 July 2022

A global horizon scan of issues impacting marine and coastal biodiversity conservation

• James E. Herbert-Read   ORCID: orcid.org/0000-0003-0243-4518 1   na1 ,
• Ann Thornton   ORCID: orcid.org/0000-0002-7448-8497 2   na1 ,
• Diva J. Amon   ORCID: orcid.org/0000-0003-3044-107X 3 , 4 ,
• Silvana N. R. Birchenough   ORCID: orcid.org/0000-0001-5321-8108 5 ,
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• Maria P. Dias   ORCID: orcid.org/0000-0002-7281-4391 7 , 8 ,
• Brendan J. Godley 9 ,
• Sally A. Keith   ORCID: orcid.org/0000-0002-9634-2763 10 ,
• Emma McKinley   ORCID: orcid.org/0000-0002-8250-2842 11 ,
• Lloyd S. Peck   ORCID: orcid.org/0000-0003-3479-6791 12 ,
• Ricardo Calado 13 ,
• Omar Defeo   ORCID: orcid.org/0000-0001-8318-528X 14 ,
• Steven Degraer   ORCID: orcid.org/0000-0002-3159-5751 15 ,
• Emma L. Johnston   ORCID: orcid.org/0000-0002-2117-366X 16 ,
• Hermanni Kaartokallio 17 ,
• Peter I. Macreadie   ORCID: orcid.org/0000-0001-7362-0882 18 ,
• Anna Metaxas   ORCID: orcid.org/0000-0002-1935-6213 19 ,
• Agnes W. N. Muthumbi 20 ,
• David O. Obura   ORCID: orcid.org/0000-0003-2256-6649 21 , 22 ,
• David M. Paterson 23 ,
• Alberto R. Piola   ORCID: orcid.org/0000-0002-5003-8926 24 , 25 ,
• Anthony J. Richardson   ORCID: orcid.org/0000-0002-9289-7366 26 , 27 ,
• Irene R. Schloss   ORCID: orcid.org/0000-0002-5917-8925 28 , 29 , 30 ,
• Paul V. R. Snelgrove   ORCID: orcid.org/0000-0002-6725-0472 31 ,
• Bryce D. Stewart 32 ,
• Paul M. Thompson   ORCID: orcid.org/0000-0001-6195-3284 33 ,
• Gordon J. Watson   ORCID: orcid.org/0000-0001-8274-7658 34 ,
• Thomas A. Worthington   ORCID: orcid.org/0000-0002-8138-9075 2 ,
• Moriaki Yasuhara   ORCID: orcid.org/0000-0003-0990-1764 35 &
• William J. Sutherland 2 , 36  

Nature Ecology & Evolution volume  6 ,  pages 1262–1270 ( 2022 ) Cite this article

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The biodiversity of marine and coastal habitats is experiencing unprecedented change. While there are well-known drivers of these changes, such as overexploitation, climate change and pollution, there are also relatively unknown emerging issues that are poorly understood or recognized that have potentially positive or negative impacts on marine and coastal ecosystems. In this inaugural Marine and Coastal Horizon Scan, we brought together 30 scientists, policymakers and practitioners with transdisciplinary expertise in marine and coastal systems to identify new issues that are likely to have a significant impact on the functioning and conservation of marine and coastal biodiversity over the next 5–10 years. Based on a modified Delphi voting process, the final 15 issues presented were distilled from a list of 75 submitted by participants at the start of the process. These issues are grouped into three categories: ecosystem impacts, for example the impact of wildfires and the effect of poleward migration on equatorial biodiversity; resource exploitation, including an increase in the trade of fish swim bladders and increased exploitation of marine collagens; and new technologies, such as soft robotics and new biodegradable products. Our early identification of these issues and their potential impacts on marine and coastal biodiversity will support scientists, conservationists, resource managers and policymakers to address the challenges facing marine ecosystems.

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The fifteenth Conference of the Parties (COP) to the United Nations Convention on Biological Diversity will conclude negotiations on a global biodiversity framework in late-2022 that will aim to slow and reverse the loss of biodiversity and establish goals for positive outcomes by 2050 1 . Currently recognized drivers of declines in marine and coastal ecosystems include overexploitation of resources (for example, fishes, oil and gas), expansion of anthropogenic activities leading to cumulative impacts on the marine and coastal environment (for example, habitat loss, introduction of contaminants and pollution) and effects of climate change (for example, ocean warming, freshening and acidification). Within these broad categories, marine and coastal ecosystems face a wide range of emerging issues that are poorly recognized or understood, each having the potential to impact biodiversity. Researchers, conservation practitioners and marine resource managers must identify, understand and raise awareness of these relatively ‘unknown’ issues to catalyse further research into their underlying processes and impacts. Moreover, informing the public and policymakers of these issues can mitigate potentially negative impacts through precautionary principles before those effects become realized: horizon scans provide a platform to do this.

Horizon scans bring together experts from diverse disciplines to discuss issues that are (1) likely to have a positive or negative impact on biodiversity and conservation within the coming years and (2) not well known to the public or wider scientific community or face a substantial ‘step-change’ in their importance or application 2 . Horizon scans are an effective approach for pre-emptively identifying issues facing global conservation 3 . Indeed, marine issues previously identified through this approach include microplastics 4 , invasive lionfish 4 and electric pulse trawling 5 . To date, however, no horizon scan of this type has focused solely on issues related to marine and coastal biodiversity, although a scan on coastal shorebirds in 2012 identified potential threats to coastal ecosystems 6 . This horizon scan aims to benefit our ocean and human society by stimulating research and policy development that will underpin appropriate scientific advice on prevention, mitigation, management and conservation approaches in marine and coastal ecosystems.

We present the final 15 issues below in thematic groups identified post-scoring, rather than rank order (Fig. 1 ).

Numbers refer to the order presented in this article, rather than final ranking. Image of brine pool courtesy of the NOAA Office of Ocean Exploration and Research, Gulf of Mexico 2014. Image of biodegradable bag courtesy of Katie Dunkley.

Ecosystem impacts

Wildfire impacts on coastal and marine ecosystems.

The frequency and severity of wildfires are increasing with climate change 7 . Since 2017, there have been fires of unprecedented scale and duration in Australia, Brazil, Portugal, Russia and along the Pacific coast of North America. In addition to threatening human life and releasing stored carbon, wildfires release aerosols, particles and large volumes of materials containing soluble forms of nutrients including nitrogen, phosphorus and trace metals such as copper, lead and iron. Winds and rains can transport these materials over long distances to reach coastal and marine ecosystems. Australian wildfires, for example, triggered widespread phytoplankton blooms in the Southern Ocean 8 along with fish and invertebrate kills in estuaries 9 . Predicting the magnitude and effects of these acute inputs is difficult because they vary with the size and duration of wildfires, the burning vegetation type, rainfall patterns, riparian vegetation buffers, dispersal by aerosols and currents, seasonal timing and nutrient limitation in the recipient ecosystem. Wildfires might therefore lead to beneficial, albeit temporary, increases in primary productivity, produce no effect or have deleterious consequences, such as the mortality of benthic invertebrates, including corals, from sedimentation, coastal darkening (see below), eutrophication or algal blooms 10 .

Coastal darkening

Coastal ecosystems depend on the penetration of light for primary production by planktonic and attached algae and seagrass. However, climate change and human activities increase light attenuation through changes in dissolved materials modifying water colour and suspended particles. Increased precipitation, storms, permafrost thawing and coastal erosion have led to the ‘browning’ of freshwater ecosystems by elevated organic carbon, iron and particles, all of which are eventually discharged into the ocean 11 . Coastal eutrophication leading to algal blooms compounds this darkening by further blocking light penetration. Additionally, land-use change, dredging and bottom fishing can increase seafloor disturbance, resuspending sediments and increasing turbidity. Such changes could affect ocean chemistry, including photochemical degradation of dissolved organic carbon and generation of toxic chemicals. At moderate intensities, limited spatial scales and during heatwaves, coastal darkening may have some positive impacts such as limiting coral bleaching on shallow reefs 12 but, at high intensities and prolonged spatial and temporal extents, lower light-regimes can contribute to cumulative stressor effects thereby profoundly altering ecosystems. This darkening may result in shifts in species composition, distribution, behaviour and phenology, as well as declines in coastal habitats and their functions (for example, carbon sequestration) 13 .

Increased toxicity of metal pollution due to ocean acidification

Concerns about metal toxicity in the marine environment are increasing as we learn more about the complex interactions between metals and global climate change 14 . Despite tight regulation of polluters and remediation efforts in some countries, the high persistence of metals in contaminated sediments results in the ongoing remobilization of existing metal pollutants by storms, trawling and coastal development, augmented by continuing release of additional contaminants into coastal waters, particularly in urban and industrial areas across the globe 14 . Ocean acidification increases the bioavailability, uptake and toxicity of metals in seawater and sediments, with direct toxicity effects on some marine organisms 15 . Not all biogeochemical changes will result in increased toxicity; in pelagic and deep-sea ecosystems, where trace metals are often deficient, increasing acidity may increase bioavailability and, in shallow waters, stimulate productivity for non-calcifying phytoplankton 16 . However, increased uptake of metals in wild-caught and farmed bivalves linked to ocean acidification could also affect human health, especially given that these species provide 25% of the world’s seafood. The combined effects of ocean acidification and metals could not only increase the levels of contamination in these organisms but could also impact their populations in the future 14 .

Equatorial marine communities are becoming depauperate due to climate migration

Climate change is causing ocean warming, resulting in a poleward shift of existing thermal zones. In response, species are tracking the changing ocean environmental conditions globally, with range shifts moving five times faster than on land 17 . In mid-latitudes and higher latitudes, as some species move away from current distribution ranges, other species from warmer regions can replace them 18 . However, the hottest climatic zones already host the most thermally tolerant species, which cannot be replaced due to their geographical position. Thus, climate change reduces equatorial species richness and has caused the formerly unimodal latitudinal diversity gradient in many communities to now become bimodal. This bimodality (dip in equatorial diversity) is projected to increase within the next 100 years if carbon dioxide emissions are not reduced 19 . The ecological consequences of this decline in equatorial zones are unclear, especially when combined with impacts of increasing human extraction and pollution 20 . Nevertheless, emerging ecological communities in equatorial systems are likely to have reduced resilience and capacity to support ecosystem services and human livelihoods.

Effects of altered nutritional content of fish due to climate change

Essential fatty acids (EFAs) are critical to maintaining human and animal health and fish consumption provides the primary source of EFAs for billions of people. In aquatic ecosystems, phytoplankton synthesize EFAs, such as docosahexaenoic acid (DHA) 21 , with pelagic fishes then consuming phytoplankton. However, concentrations of EFAs in fishes vary, with generally higher concentrations of omega-3 fatty acids in slower-growing species from colder waters 22 . Ongoing effects of climate change are impacting the production of EFAs by phytoplankton, with warming waters predicted to reduce the availability of DHA by about 10–58% by 2100 23 ; a 27.8% reduction in available DHA is associated with a 2.5 °C rise in water temperature 21 . Combined with geographical range shifts in response to environmental change affecting the abundance and distribution of fishes, this could lead to a reduction in sufficient quantities of EFAs for fishes, particularly in the tropics 24 . Changes to EFA production by phytoplankton in response to climate change, as shown for Antarctic waters 25 , could have cascading effects on the nutrient content of species further up the food web, with consequences for marine predators and human health 26 .

Resource exploitation

The untapped potential of marine collagens and their impacts on marine ecosystems.

Collagens are structural proteins increasingly used in cosmetics, pharmaceuticals, nutraceuticals and biomedical applications. Growing demand for collagen has fuelled recent efforts to find new sources that avoid religious constraints and alleviate risks associated with disease transmission from conventional bovine and porcine sources 27 . The search for alternative sources has revealed an untapped opportunity in marine organisms, such as from fisheries bycatch 28 . However, this new source may discourage efforts to reduce the capture of non-target species. Sponges and jellyfish offer a premium source of marine collagens. While the commercial-scale harvesting of sponges is unlikely to be widely sustainable, there may be some opportunity in sponge aquaculture and jellyfish harvesting, especially in areas where nuisance jellyfish species bloom regularly (for example, Mediterranean and Japan Seas). The use of sharks and other cartilaginous fish to supply marine collagens is of concern given the unprecedented pressure on these species. However, the use of coproducts derived from the fish-processing industry (for example, skin, bones and trims) offers a more sustainable approach to marine collagen production and could actively contribute to the blue bio-economy agenda and foster circularity 29 .

Impacts of expanding trade for fish swim bladders on target and non-target species

In addition to better-known luxury dried seafoods, such as shark fins, abalone and sea cucumbers, there is an increasing demand for fish swim bladders, also known as fish maw 30 . This demand may trigger an expansion of unsustainable harvests of target fish populations, with additional impacts on marine biodiversity through bycatch 30 , 31 . The fish swim-bladder trade has gained a high profile because the overexploitation of totoaba ( Totoaba macdonaldi) has driven both the target population and the vaquita ( Phocoena sinus) (which is bycaught in the Gulf of Mexico fishery) to near extinction 32 . By 2018, totoaba swim bladders were being sold for US$46,000 kg −1 . This extremely lucrative trade disrupts efforts to encourage sustainable fisheries. However, increased demand on the totoaba was itself caused by overexploitation over the last century of the closely related traditional species of choice, the Chinese bahaba ( Bahaba taipingensis) . We now risk both repeating this pattern and increasing its scale of impact, where depletion of a target species causes markets to switch to species across broader taxonomic and biogeographical ranges 31 . Not only does this cascading effect threaten other croakers and target species, such as catfish and pufferfish but maw nets set in more diverse marine habitats are likely to create bycatch of sharks, rays, turtles and other species of conservation concern.

Impacts of fishing for mesopelagic species on the biological ocean carbon pump

Growing concerns about food security have generated interest in harvesting largely unexploited mesopelagic fishes that live at depths of 200–1,000 m (ref. 33 ). Small lanternfishes (Myctophidae) dominate this potentially 10 billion ton community, exceeding the mass of all other marine fishes combined 34 and spanning millions of square kilometres of the open ocean. Mesopelagic fish are generally unsuitable for human consumption but could potentially provide fishmeal for aquaculture 34 or be used for fertilizers. Although we know little of their biology, their diel vertical migration transfers carbon, obtained by feeding in surface waters at night, to deeper waters during the day across many hundreds and even thousands of metres depth where it is released by excretion, egestion and death. This globally important carbon transport pathway contributes to the biological pump 35 and sequesters carbon to the deep sea 36 . Recent estimates put the contribution of all fishes to the biological ocean pump at 16.1% (± s.d. 13%) (ref. 37 ). The potential large-scale removal of mesopelagic fishes could disrupt a major pathway of carbon transport into the ocean depths.

Extraction of lithium from deep-sea brine pools

Global groups, such as the Deep-Ocean Stewardship Initiative, emphasize increasing concern about the ecosystem impacts from deep-sea resource extraction 38 . The demand for batteries, including for electric vehicles, will probably lead to a demand for lithium that is more than five times its current level by 2030 39 . While concentrations are relatively low in seawater, some deep-sea brines and cold seeps offer higher concentrations of lithium. Furthermore, new technologies, such as solid-state electrolyte membranes, can enrich the concentration of lithium from seawater sources by 43,000 times, increasing the energy efficiency and profitability of lithium extraction from the sea 39 . These factors could divert extraction of lithium resources away from terrestrial to marine mining, with the potential for significant impacts to localized deep-sea brine ecosystems. These brine pools probably host many endemic and genetically distinct species that are largely undiscovered or awaiting formal description. Moreover, the extremophilic species in these environments offer potential sources of marine genetic resources that could be used in new biomedical applications including pharmaceuticals, industrial agents and biomaterials 40 . These concerns point to the need to better quantify and monitor biodiversity in these extreme environments to establish baselines and aid management.

New technologies

Colocation of marine activities.

Climate change, energy needs and food security have moved to the top of global policy agendas 41 . Increasing energy needs, alongside the demands of fisheries and transport infrastructure, have led to the proposal of colocated and multifunctional structures to deliver economic benefits, optimize spatial planning and minimize the environmental impacts of marine activities 42 . These designs often bring technical, social, economic and environmental challenges. Some studies have begun to explore these multipurpose projects (for example, offshore windfarms colocated with aquaculture developments and/or Marine Protected Areas) and how to adapt these concepts to ensure they are ‘fit for purpose’, economically viable and reliable. However, environmental and ecosystem assessment, management and regulatory frameworks for colocated and multi-use structures need to be established to prevent these activities from compounding rather than mitigating the environmental impacts from climate change 43 .

Floating marine cities

In April 2019, the UN-HABITAT programme convened a meeting of scientists, architects, designers and entrepreneurs to discuss how floating cities might be a solution to urban challenges such as climate change and lack of housing associated with a rising human population ( https://unhabitat.org/roundtable-on-floating-cities-at-unhq-calls-for-innovation-to-benefit-all ). The concept of floating marine cities—hubs of floating structures placed at sea—was born in the middle of the twentieth century and updated designs now aim to translate this vision into reality 44 . Oceanic locations provide benefits from wave and tidal renewable energy and food production supported by hydroponic agriculture 45 . Modular designs also offer greater flexibility than traditional static terrestrial cities, whereby accommodation and facilities could be incorporated or removed in response to changes in population or specific events. The cost of construction in harsh offshore environments, rather than technology, currently limits the development of marine cities and potential designs will need to consider the consequences of more frequent and extreme climate events. Although the artificial hard substrates created for these floating cities could act as stepping stones, facilitating species movement in response to climate change 46 , this could also increase the spread of invasive species. Finally, the development of offshore living will raise issues in relation to governance and land ownership that must be addressed for marine cities to be viable 47 .

Trace-element contamination compounded by the global transition to green technologies

The persistent environmental impacts of metal and metalloid trace-element contamination in coastal sediments are now increasing after a long decline 48 . However, the complex sources of contamination challenge their management. The acceleration of the global transition to green technologies, including electric vehicles, will increase demand for batteries by over 10% annually in the coming years 49 . Electric vehicle batteries currently depend almost exclusively on lithium-ion chemistries, with potential trace-element emissions across their life cycle from raw material extraction to recycling or end-of-life disposal. Few jurisdictions treat lithium-ion batteries as harmful waste, enabling landfill disposal with minimal recycling 49 . Cobalt and nickel are the primary ecotoxic elements in next-generation lithium-ion batteries 50 , although there is a drive to develop a cobalt-free alternative likely to contain higher nickel content 50 . Some battery binder and electrolyte chemicals are toxic to aquatic life or form persistent organic pollutants during incomplete burning. Increasing pollution from battery production, recycling and disposal in the next decade could substantially increase the potentially toxic trace-element contamination in marine and coastal systems worldwide.

New underwater tracking systems to study non-surfacing marine animals

The use of tracking data in science and conservation has grown exponentially in recent decades. Most trajectory data collected on marine species to date, however, has been restricted to large and near-surface species, limited by the size of the devices and reliance on radio signals that do not propagate well underwater. New battery-free technology based on acoustic telemetry, named ‘underwater backscatter localization’ (UBL), may allow high-accuracy (<1 m) tracking of animals travelling at any depth and over large distances 51 . Still in the early stages of development, UBL technology has significant potential to help fill knowledge gaps in the distribution and spatial ecology of small, non-surfacing marine species, as well as the early life-history stages of many species 52 , over the next decades. However, the potential negative impacts of this methodology on the behaviour of animals are still to be determined. Ultimately, UBL may inform spatial management both in coastal and offshore regions, as well as in the high seas and address a currently biased perspective of how marine animals use ocean space, which is largely based on near-surface or aerial marine megafauna (for example, ref. 53 ).

Soft robotics for marine research

The application and utility of soft robotics in marine environments is expected to accelerate in the next decade. Soft robotics, using compliant materials inspired by living organisms, could eventually offer increased flexibility at depth because they do not face the same constraints as rigid robots that need pressurized systems to function 54 . This technology could increase our ability to monitor and map the deep sea, with both positive and negative consequences for deep-sea fauna. Soft-grab robots could facilitate collection of delicate samples for biodiversity monitoring but, without careful management, could also add pollutants and waste to these previously unexplored and poorly understood environments 55 . With advancing technology, potential deployment of swarms of small robots could collect basic environmental data to facilitate mapping of the seabed. Currently limited by power supply, energy-harvesting modules are in development that enable soft robots to ‘swallow’ organic material and convert it into power 56 , although this could result in inadvertently harvesting rare deep-sea organisms. Soft robots themselves may also be ingested by predatory species mistaking them for prey. Deployment of soft robotics will require careful monitoring of both its benefits and risks to marine biodiversity.

The effects of new biodegradable materials in the marine environment

Mounting public pressure to address marine plastic pollution has prompted the replacement of some fossil fuel-based plastics with bio-based biodegradable polymers. This consumer pressure is creating an economic incentive to adopt such products rapidly and some companies are promoting their environmental benefits without rigorous toxicity testing and/or life-cycle assessments. Materials such as polybutylene succinate (PBS), polylactic acid (PLA) or cellulose and starch-based materials may become marine litter and cause harmful effects akin to conventional plastics 57 . The long-term and large-scale effect of the use of biodegradable polymers in products (for example, clothing) and the unintended release of byproducts, such as microfibres, into the environment remain unknown. However, some natural microfibres have greater toxicity than plastic microfibres when consumed by aquatic invertebrates 58 . Jurisdictions should enact and enforce suitable regulations to require the individual assessment of all new materials intended to biodegrade in a full range of marine environmental conditions. In addition, testing should include studies on the toxicity of major transition chemicals created during the breakdown process 59 , ideally considering the different trophic levels of marine food webs.

This scan identified three categories of horizon issues: impacts on, and alterations to, ecosystems; changes to resource use and extraction; and the emergence of technologies. While some of the issues discussed, such as improved monitoring of species (underwater tracking and soft robotics) and more sustainable resource use (marine collagens), may have some positive outcomes for marine and coastal biodiversity, most identified issues are expected to have substantial negative impacts if not managed or mitigated appropriately. This imbalance highlights the considerable emerging pressures facing marine ecosystems that are often a byproduct of human activities.

Four issues identified in this scan related to ongoing large-scale (hundreds to many thousands of square kilometres) alterations to marine ecosystems (wildfires, coastal darkening, depauperate equatorial communities and altered nutritional fish content), either through the impacts of global climate change or other human activities. There are already clear impacts of climate change, for example, on stores of blue carbon (for example, ref. 60 ) and small-scale fisheries (for example, ref. 61 ) but the identification of these issues highlights the need for global action that reverses such trends. The United Nations Decade of Ocean Science for Sustainable Development (2021–2030) is now underway, aligning with other decadal policy priorities, including the Sustainable Development Goals ( https://sdgs.un.org/ ), the 2030 targets for biodiversity to be agreed in 2022, the conclusion of the ongoing negotiations on biodiversity beyond national jurisdictions (BBNJ) ( https://www.un.org/bbnj/ ), the UN Conference on Biodiversity (COP15) ( https://www.unep.org/events/conference/un-biodiversity-conference-cop-15 ) and the UN Climate Change Conference 2021 (COP26) ( https://ukcop26.org/ ). While some campaigns to allocate 30% of the ocean to Marine Protected Areas by 2030 are prominently aired 62 , the unintended future consequences of such protection and how to monitor and manage these areas, remain unclear 63 , 64 , 65 .

Another set of issues related to anticipated increases in marine resource use and extraction (swim bladders, marine collagens, lithium extraction and mesopelagic fisheries). The complex issue of mitigating the impacts on marine conservation and biodiversity of exploiting and using newly discovered resources must consider public perceptions of the ocean 66 , 67 , market forces and the sustainable blue economy 68 , 69 .

The final set of issues related to new technological advancements, with many offering more sustainable opportunities, albeit some having potentially unintended negative consequences on marine and coastal biodiversity. For example, trace-element contamination from green technologies and harmful effects of biodegradable products highlights the need to assess the step-changes in impacts from their increased use and avoid the paradox of technologies designed to mitigate the damaging effects of climate change on biodiversity themselves damaging biodiversity. Indeed, the impacts on marine and coastal biodiversity from emerging technologies currently in development (such as underwater tracking or soft robotics) need to be assessed before deployment at scale.

There are limitations to any horizon scanning process that aims to identify global issues and a different group of experts may have identified a different set of issues. By inviting participants from a range of subject backgrounds and global regions and asking them to canvass their network of colleagues and collaborators, we aimed to identify as broad a set of issues as possible. We acknowledge, however, that only about one-quarter of the participants were from non-academic organizations, which may have skewed the submitted issues and how they were voted on. However, others 3 reported no significant correlation between participants’ areas of research expertise and the top issues selected in the horizon scan conducted in 2009. Therefore, horizon scans do not necessarily simply represent issues that reflect the expertise of participants. We also sought to achieve diversity by inviting participants from 22 countries and actively seeking representatives from the global south. However, the final panel of 30 participants spanned only 11 countries, most in the global north. We were forced by the COVID-19 pandemic to hold the scan online and while we hoped that this would enable participants to engage from around the world alleviating broader global inequalities in science 63 , digital inequality was in fact enhanced during the pandemic 70 . Our experience highlights the need for other mechanisms that can promote global representation in these scans.

This Marine and Coastal Horizon Scan seeks to raise awareness of issues that may impact marine and coastal biodiversity conservation in the next 5–10 years. Our aim is to bring these issues to the attention of scientists, policymakers, practitioners and the wider community, either directly, through social networks or the mainstream media. Whilst it is almost impossible to determine whether issues gained prominence as a direct result of a horizon scan, some issues featured in previous scans have seen growth in reporting and awareness. Others 3 found that 71% of topics identified in the Horizon Scan in 2009 had seen an increase in their importance over the next 10 years. Issues such as microplastics and invasive lionfish had received increased research and investment from scientists, funders, managers and policymakers to understand their impacts and the horizon scans may have helped motivate this increase. Horizon scans, therefore, should primarily act as signposts, putting focus onto particular issues and providing support for researchers and practitioners to seek investment in these areas.

Whilst recognizing that marine and coastal environments are complex social-ecological systems, the role of governance, policy and litigation on all areas of marine science needs to be developed, as it is yet to be established to the same extent as in terrestrial ecosystems 71 . Indeed, tackling many of the issues presented in this scan will require an understanding of the human dimensions relating to these issues, through fields of research including but not limited to ocean literacy 72 , 73 , social justice, equity 74 and human health 75 . Importantly, however, horizon scanning has proved an efficient tool in identifying issues that have subsequently come to the forefront of public knowledge and policy decisions, while also helping to focus future research. The scale of the issues facing marine and coastal areas emphasizes the need to identify and prioritize, at an early stage, those issues specifically facing marine ecosystems, especially within this UN Decade of Ocean Science for Sustainable Development.

Identification of issues

In March 2021, we brought together a core team of 11 participants from a broad range of marine and coastal disciplines. The core team suggested names of individuals outside their subject area who were also invited to participate in the horizon scan. To ensure we included as many different subject areas as possible within marine and coastal conservation, we selected one individual from each discipline. Our panel of experts comprised 30 (37% female) marine and coastal scientists, policymakers and practitioners (27% from non-academic institutions), with cross-disciplinary expertise in ecology (including tropical, temperate, polar and deep-sea ecosystems), palaeoecology, conservation, oceanography, climate change, ecotoxicology, technology, engineering and marine social sciences (including governance, blue economy and ocean literacy). Participants were invited from 22 countries across six continents, resulting in a final panel of 30 experts from 11 countries (Europe n  = 17 (including the three organizers); North America and Caribbean n  = 4; South America n  = 3; Australasia n  = 3; Asia n  = 1; Africa n  = 2). All experts co-authored this paper.

To reduce the potential for bias in the identification of suitable issues, each participant was invited to consult their own network and required to submit two to five issues that they considered new and likely to have a positive or negative impact on marine and coastal biodiversity conservation in the next 5–10 years ( Supplementary Information text describes instructions given to participants). Each issue was described in paragraphs of ~200 words (plus references). Due to the COVID-19 pandemic, participants relied mainly on virtual meetings and online communication using email, social-media platforms, online conferences and networking events. Through these channels ~680 people were canvassed by the participants, counting all direct in-person or online discussions as individual contacts but treating social-media posts or generic emails as a single contact. This process resulted in a long list of 75 issues that were considered in the first round of scoring (see Supplementary Table 1 for the full list of initially submitted issues).

Round 1 scoring

The initial list of proposed issues was then shortened through a scoring process. We used a modified Delphi-style 76 voting process, which has been consistently applied in horizon scans since 2009 (refs. 4 , 77 ) (see Fig. 2 for the stepwise process). This process ensured that consideration and selection of issues remained repeatable, transparent and inclusive. Panel members were asked to confidentially and independently score the long list of 75 issues from 1 (low) to 1,000 (high) on the basis of the following criteria:

Whether the issue is new (with ‘new’ issues scoring higher) or is a well-known issue likely to exhibit a significant step-change in impact

Whether the issue is likely to be important and impactful over the next 5–10 years

Whether the issue specifically impacts marine and coastal biodiversity

Left and right columns show the process for the first and second rounds of scoring, respectively.

Participants were also asked whether they had heard of the issue or not.

‘Voter fatigue’ can result in issues at the end of a lengthy list not receiving the same consideration as those at the beginning 76 . We counteracted this potential bias by randomly assigning participants to one of three differently ordered long-lists of issues. Participants’ scores were converted to ranks (1–75). We had aimed to retain the top 30 issues with the highest median ranks for the second round of assessment at the workshop but kept 31 issues because two issues achieved equal median ranks. In addition, we identified one issue that had been incorrectly grouped with three others and presented this as a separate issue. The subsequent online workshop to discuss this shortlist, therefore, considered the top-ranked 32 issues (Fig. 3a ) (see Supplementary Table 2 for the full list).

a , Round 1. Each point represents an individual issue. For all issue titles, see Supplementary Table 1 . Issues in dark blue were retained for the second round. Issues that were ranked higher were generally those that participants had not heard of (Spearman rank correlation = 0.38, P  < 0.001). b , Round 2. Scores as in round 1. For titles of the second round of 32 issues, see Supplementary Table 2 . The 15 final issues (marked in red) achieved the top ranks (horizontal dashed line) and had only been heard of by 50% of participants (vertical dashed line). Red circles, squares and triangles denote issues relating to ecosystem impacts, resource exploitation and new technologies, respectively. The two grey issues marked with crosses were discounted during final discussions because participants could not identify the horizon component of these issues.

Source data

Workshop and round 2 scoring.

Before the workshop, each participant was assigned up to four of the 32 issues to research in more detail and contribute further information to the discussion. We convened a one-day workshop online in September 2021. The geographic spread of participants meant that time zones spanned 17 h. Despite these constraints, discussions remained detailed, focused, varied and lively. In addition, participants made use of the chat function on the platform to add notes, links to articles and comments to the discussion. After discussing each issue, participants re-scored the topic (1–1,000, low to high) based on novelty and the issue’s importance for, and probable impact on, marine and coastal biodiversity (3 participants out of 30 did not score all issues and therefore their scores were discounted). At the end of the selection process, scores were again converted to ranks and collated. Highest-ranked issues were then discussed by correspondence focusing on the same three criteria as outlined above, after which the top 15 horizon issues were selected (Fig. 3b ).

Reporting summary

Further information on research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

The datasets generated during and/or analysed during the current study are available from figshare https://doi.org/10.6084/m9.figshare.19703485.v1 . Source data are provided with this paper.

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Acknowledgements

This Marine and Coastal Horizon Scan was funded by Oceankind. S.N.R.B. is supported by EcoStar (DM048) and Cefas (My time). R.C. acknowledges FCT/MCTES for the financial support to CESAM (UIDP/50017/2020, UIDB/50017/2020, LA/P/0094/2020) through national funds. O.D. is supported by CSIC Uruguay and Inter-American Institute for Global Change Research. J.E.H.-R. is supported by the Whitten Lectureship in Marine Biology. S.A.K. is supported by a Natural Environment Research Council grant (NE/S00050X/1). P.I.M. is supported by an Australian Research Council Discovery Grant (DP200100575). D.M.P. is supported by the Marine Alliance for Science and Technology for Scotland (MASTS). A.R.P. is supported by the Inter-American Institute for Global Change Research. W.J.S. is funded by Arcadia. A.T. is supported by Oceankind. M.Y. is supported by the Deep Ocean Stewardship Initiative and bioDISCOVERY. We are grateful to everyone who submitted ideas to the exercise and the following who are not authors but who suggested a topic that made the final list: R. Brown (colocation of marine activities), N. Graham and C. Hicks (altered nutritional content of fish), A. Thornton (soft robotics), A. Vincent (fish swim bladders) and T. Webb (mesopelagic fisheries).

Author information

These authors contributed equally: James E. Herbert-Read, Ann Thornton.

Authors and Affiliations

Department of Zoology, University of Cambridge, Cambridge, UK

James E. Herbert-Read

Conservation Science Group, Department of Zoology, Cambridge University, Cambridge, UK

Ann Thornton, Thomas A. Worthington & William J. Sutherland

SpeSeas, D’Abadie, Trinidad and Tobago

Diva J. Amon

Marine Science Institute, University of California, Santa Barbara, CA, USA

The Centre for Environment, Fisheries and Aquaculture Science (Cefas), Lowestoft, UK

Silvana N. R. Birchenough

Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada

Isabelle M. Côté

Centre for Ecology, Evolution and Environmental Changes (cE3c), Department of Animal Biology, Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal

Maria P. Dias

BirdLife International, The David Attenborough Building, Cambridge, UK

Centre for Ecology and Conservation, University of Exeter, Penryn, UK

Brendan J. Godley

Lancaster Environment Centre, Lancaster University, Lancaster, UK

Sally A. Keith

School of Earth and Environmental Sciences, Cardiff University, Cardiff, UK

Emma McKinley

British Antarctic Survey, Natural Environment Research Council, Cambridge, UK

Lloyd S. Peck

ECOMARE, CESAM—Centre for Environmental and Marine Studies, Department of Biology, University of Aveiro, Santiago University Campus, Aveiro, Portugal

Ricardo Calado

Laboratory of Marine Sciences (UNDECIMAR), Faculty of Sciences, University of the Republic, Montevideo, Uruguay

Royal Belgian Institute of Natural Sciences, Operational Directorate Natural Environment, Marine Ecology and Management, Brussels, Belgium

Steven Degraer

School of Biological, Earth, and Environmental Sciences, University of New South Wales, Sydney, New South Wales, Australia

Emma L. Johnston

Finnish Environment Institute, Helsinki, Finland

Hermanni Kaartokallio

Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Burwood Campus, Burwood, Victoria, Australia

Peter I. Macreadie

Department of Oceanography, Dalhousie University, Halifax, Nova Scotia, Canada

Anna Metaxas

Department of Biology, University of Nairobi, Nairobi, Kenya

Agnes W. N. Muthumbi

Coastal Oceans Research and Development in the Indian Ocean, Mombasa, Kenya

David O. Obura

School of Biological Sciences, University of Queensland, St Lucia, Brisbane, Queensland, Australia

Scottish Oceans Institute, School of Biology, University of St Andrews, St Andrews, UK

David M. Paterson

Servício de Hidrografía Naval, Buenos Aires, Argentina

Alberto R. Piola

Instituto Franco-Argentino sobre Estudios de Clima y sus Impactos, CONICET/CNRS, Universidad de Buenos Aires, Buenos Aires, Argentina

School of Mathematics and Physics, The University of Queensland, St Lucia, Brisbane, Queensland, Australia

Anthony J. Richardson

Commonwealth Scientific and Industrial Research Organisation (CSIRO) Oceans and Atmosphere, Queensland Biosciences Precinct, St Lucia, Brisbane, Queensland, Australia

Instituto Antártico Argentino, Buenos Aires, Argentina

Irene R. Schloss

Centro Austral de Investigaciones Científicas (CADIC-CONICET), Ushuaia, Argentina

Universidad Nacional de Tierra del Fuego, Antártida e Islas del Atlántico Sur, Ushuaia, Argentina

Department of Ocean Sciences and Biology Department, Memorial University, St John’s, Newfoundland and Labrador, Canada

Paul V. R. Snelgrove

Department of Environment and Geography, University of York, York, UK

Bryce D. Stewart

Lighthouse Field Station, School of Biological Sciences, University of Aberdeen, Cromarty, UK

Paul M. Thompson

Institute of Marine Sciences, School of Biological Sciences, University of Portsmouth, Portsmouth, UK

Gordon J. Watson

School of Biological Sciences, Area of Ecology and Biodiversity, Swire Institute of Marine Science, Institute for Climate and Carbon Neutrality, Musketeers Foundation Institute of Data Science, and State Key Laboratory of Marine Pollution, The University of Hong Kong, Kadoorie Biological Sciences Building, Hong Kong, China

Moriaki Yasuhara

Biosecurity Research Initiative at St Catharine’s (BioRISC), St Catharine’s College, University of Cambridge, Cambridge, UK

William J. Sutherland

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J.E.H.-R. and A.T. contributed equally to the manuscript. J.E.H.-R., A.T. and W.J.S. devised, organized and led the Marine and Coastal Horizon Scan. D.J.A., S.N.R.B., I.M.C., M.P.D., B.J.G., S.A.K., E.M. and L.S.P. formed the core team and are listed alphabetically in the author list. All other authors, R.C., O.D., S.D., E.L.J., H.K., P.I.M., A.M., A.W.N.M., D.O.O., D.M.P., A.R.P., A.J.R., I.R.S., P.V.R.S., B.D.S., P.M.T., G.J.W., T.A.W. and M.Y. are listed alphabetically. All authors contributed to and participated in the process and all were involved in writing and editing the manuscript.

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Herbert-Read, J.E., Thornton, A., Amon, D.J. et al. A global horizon scan of issues impacting marine and coastal biodiversity conservation. Nat Ecol Evol 6 , 1262–1270 (2022). https://doi.org/10.1038/s41559-022-01812-0

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Issue Date : September 2022

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Global Health Research in an Unequal World: Ethics Case Studies from Africa

Gemma Aellah , Tracey Chantler , and P Wenzel Geissler .

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This book is a collection of fictionalised case studies of everyday ethical dilemmas and challenges, encountered in the process of conducting global health research in places where the effects of global, political and economic inequality are particularly evident. It is a training tool to fill the gap between research ethics guidelines, and their implementation 'on the ground'. The case studies, therefore, focus on 'relational' ethics: ethical actions and ideas that emerge through relations with others, rather than in regulations.

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• ACKNOWLEDGEMENTS
• FINDING YOUR WAY AROUND THE BOOK
• 1. RESEARCHER-PARTICIPANT RELATIONSHIPS
• 2. COMMUNITY AND FAMILY RELATIONSHIPS
• 3. INSTITUTIONAL RELATIONSHIPS
• 4. STAFF RELATIONSHIPS
• REGULATORY VERSUS RELATIONAL ETHICS
• ANTHROPOLOGY AND RELATIONAL ETHICS
• RELATIONAL ETHICS AND INEQUALITY IN AFRICA
• FACILITATOR'S NOTES
• GROUP ACTIVITY
• FURTHER READING
• REFLECTIONS ON YOUR OWN EXPERIENCE
• REFLECTION ON YOUR OWN EXPERIENCE
• REFLECTION ON YOUR OWN EXPERIENCES
• THE STORIES
• REFLECTIONS ON YOUR OWN EXPERIENCES
• THINKING ABOUT CORRUPTION MORE WIDELY
• ANTHROPOLOGY AND EBOLA WEB RESOURCES
• INDIVIDUAL USE
• CHOICE OF TRAINING MATERIALS
• TRAINING GROUND RULES
• FACILITATOR'S ROLE AND PREPARATION
• EXAMPLE: ‘HELPING HAND’
• FACILITATOR'S PREPARATION TEMPLATE
• FIRST EXPERIENCES OF PILOTING THIS TOOL IN AFRICA AND EUROPE
• ETHICS GUIDES AND TOOLKITS
• Ethics and structural violence
• A systemic perspective
• Ethical deliberation
• Conscious choices and possibilities
• THE CONTEXT OF GLOBAL HEALTH INEQUALITY
• INEQUALITY AND DISCOMFORT
• The ‘standards of care’ controversy
• The regulatory turn
• A changing ethical landscape in medical research
• WE NEED TO TALK MORE; WE NEED TO DO MORE
• ABOUT THE CONTRIBUTORS

ADDITIONAL CONTRIBUTIONS: BIRGITTE BRUUN, LUISA ENRIA, ANN H. KELLY, SHELLEY LEES, PHILISTER A. MADIEGO, FERDINANDO OKWARO, FRANCESCA RAPHAELY

ILLUSTRATIONS: JOHNSON A. ONDIEK

The authors and contributors to this book collaborated between 2005 and 2015 in the Anthropologies of African Biosciences Research Group

www ​.africanbiosciences.wordpress.com

Global Health Research in an Unequal World: Ethics Case Studies from Africa is licensed under a Creative Commons Attribution 3.0 Unported License, http://creativecommons.org/licenses/by/3.0/

Monographs, or book chapters, which are outputs of Wellcome Trust funding have been made freely available as part of the Wellcome Trust's open access policy

• Cite this Page Aellah G, Chantler T, Geissler PW. Global Health Research in an Unequal World: Ethics Case Studies from Africa. Oxfordshire (UK): CAB International; 2016.
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• Qualitative research ethics on the spot: Not only on the desktop. [Nurs Ethics. 2016] Qualitative research ethics on the spot: Not only on the desktop. Øye C, Sørensen NØ, Glasdam S. Nurs Ethics. 2016 Jun; 23(4):455-64. Epub 2015 Feb 9.
• A qualitative study on the ethics of transforming care: examining the development and implementation of Canada's first mental health strategy. [Implement Sci. 2015] A qualitative study on the ethics of transforming care: examining the development and implementation of Canada's first mental health strategy. Park MM, Lencucha R, Mattingly C, Zafran H, Kirmayer LJ. Implement Sci. 2015 Aug 19; 10:121. Epub 2015 Aug 19.
• Review Essentials of research ethics for healthcare professionals. [Nurs Health Sci. 2005] Review Essentials of research ethics for healthcare professionals. Aita M, Richer MC. Nurs Health Sci. 2005 Jun; 7(2):119-25.
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Editor’s pick: 7 case studies on environmental cooperation

We know environmental changes and dwindling resources can lead to conflicts and inflame grievances among societal groups or even states dependant on nature. But how often do we speak about the role of environment as a catalyst for cooperation? In honour of this year’s World Environment Day, we bring to you 7 case studies in which the need to share a common environment and its resources has led adversaries to – despite hostilities and even ongoing conflict, and with the help of several resolution mechanisms – work in cooperation.

Turkey-Armenia: Water Cooperation Despite Tensions

Armenia and Turkey have been sharing the water of the Arpacay River – which forms the border between them – equitably, despite their lack of bilateral diplomatic relations. Before Armenia became independent in 1991, the former USSR had signed a number of treaties with Turkey over the Arpacay (or Akhourian) River. Although relations between Turkey and Armenia have been at an impasse since the 1990s, both countries have continued to implement the old treaties brokered before the collapse of the USSR and share the Arpacay River equitably to this day. 

DISCOVER THE CASE STUDY

Jordan and Israel: Tensions and Water Cooperation in the Middle-East

The rivers of the Jordan system all have a transboundary nature, a configuration which requires cooperation amongst all co-riparians to achieve sustainable water management. Yet the tensions which have prevailed between Israel and its Arab neighbours since 1948 have limited cooperation until today and at times escalated to war. However, one country, Jordan, distanced itself from the other Arab countries in the region and signed a peace agreement with Israel in which cooperation over water played an important role.

Transnational Conflict and Cooperation in the Lake Chad Basin

Since the beginning of the 2000s, growing claims of an urgent need to protect and restore Lake Chad have led the riparian states and the Lake Chad Basin Commission to engage in a number of joint water management initiatives with the support of a number of international organisations. These include a major project to transfer the waters of the Congo Basin (Oubangui) to Lake Chad in order to replenish the lake – the “Transaqua” project and a sustainable development programme for Lake Chad, which was launched in 2009. The Lake Chad Water Charter adopted in 2012 seeks to define water management and wetland management objectives based on shared concerns.

EU Influence on the Euphrates-Tigris Conflict

From the 1960s to the 1990s, tensions among the co-riparian states of the Euphrates-Tigris Basin hampered cooperation over the rivers. Since 1999, when Turkey was granted the status of candidate country for membership to the EU, the country started transposing and implementing the EU body of legislation, including the EU Water Framework Directive (WFD). The renewed cooperation which was observed among the three co-riparians in the 2000s reflects the influence of the WFD.

Lower Mekong Basin: Challenges and opportunities for early cooperation

To promote peace, regional cooperation, and development in the Lower Mekong Basin, the United Nations (UN) encouraged the creation of an intergovernmental agency for joint water management. In 1957, the Mekong Committee was created. After an initial period of enthusiasm, momentum began to subside during the 1970s. Nevertheless, the Mekong’s early institutional architecture provided a forum for dialogue that was sustained even in times of regional hostilities. It also laid the groundwork for contemporary Mekong governance in times of rapid development.

Transboundary Water Disagreements between South Africa and Namibia

Following the independence of Namibia in 1990, a number of water-related disagreements have emerged between the Orange River riparians South Africa and Namibia. These revolve around the demarcation of a common border, water allocation and water pricing, and the Lesotho Highlands Water Project (LHWP). Existing water scarcity in the lower Orange River Basin is likely to be further aggravated by the impacts of climate change. Despite the conflict potential harboured by existing disagreements, the basin’s high level of institutionalised cooperation and the possibilities for intra- and inter-basin water transfers could help alleviate water stress and resolve bilateral disagreement over shared water resources.

Iraq-Iran: from Water Dispute to War

The Shatt al-Arab River forms the boundaries between Iran and Iraq before flowing into the Persian Gulf. Due to its strategic importance for both Iraq and Iran, for centuries both countries have defended their sovereignty rights over the river. The Shatt al-Arab dispute was an important cause which led to the outbreak of the 1980-1988 war between Iraq and Iran. In recent years – and particularly since the beginning of the war in Syria –, relations between Iraq and Iran have majorly improved. This has been reflected on the Shatt-al Arab issue. In 2014, Iraq and Iran’s Prime Minister met to discuss how to delimit the river in a mutually acceptable way and to put an end to the status quo. Water-protection aspects took also a major space in the talks. Today both countries have restored bilateral diplomatic relations and reached agreements on a mutually satisfying delimitation of the river. They are also jointly working towards the protection of the river. 

130+ case studies on environment, conflict and cooperation

The Factbook is a knowledge platform that provides an overview of environmental conflict and cooperation from around the world. It does so by offering a select number of case studies that reflect instances of conflict, resolution and peacebuilding processes that are related to environmental change.

The Factbook seeks to help policy-makers, experts, researchers and any interested members of the public to better understand and compare the drivers behind environmental conflict and cooperation. The ultimate goal of this project is to contribute to the prevention and sustainable transformation of such conflicts using lessons learned from earlier (non-) interventions.

                Discover the ECC Factbook

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Lessons from the field: case studies in global implementation science

In the context of low- and middle-income countries (LMICs), there is a need for practical examples of how to conduct implementation research. To address this gap, Fogarty's Center for Global Health Studies(CGHS) in collaboration with partner NIH Institutes and Centers and key external organizations has curated a collection of global implementation science case studies, published in Implementation Science Communications . CGHS designed this cohesive collection to specifically include implementation science cases focused on global health and conducted in LMICs, spanning a range of regions and disease areas.

Fogarty will be launching the collection at the Consortium of Universities for Global Health (CUGH) annual meeting in March 2024.

The specific aims of this collection are to: (1) demonstrate the rigorous application of implementation science in the context of global health; (2) highlight the use and adaptation of frameworks, implementation strategies, research designs, and measures for LMIC settings; and (3) assess the utility and impact of implementation science in these settings.

Access the collection on BioMed Central: Lessons from the field: case studies in global implementation science

The collection also highlights the utility of case studies as a dissemination strategy and the value of detailed case studies as a teaching tool for implementation science researchers, as well as reinforces the need for “thick" (i.e., context rich) descriptions of implementation studies. The project is guided by a steering committee chaired by Dr. Rohit Ramaswamy at the University of North Carolina and made up of 14 implementation science experts with broad expertise. 

Steering Committee

• Rohit Ramaswamy, University of North Carolina Chapel Hill
• Gila Neta, National Cancer Institute, NIH
• Greg Aarons, University of California San Diego
• Theresa Betancourt, Boston College
• Ross Brownson, Washington University in St. Louis
• David Chambers, National Cancer Institute, NIH
• Chris Gordon, National Institute of Mental Health, NIH
• Usman Hamdani, HDR Foundation Pakistan
• Linda Kupfer, Fogarty International Center, NIH
• Sonia Lee, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
• Andrea Horvath Marques, National Institute of Mental Health, NIH
• Suzy Pollard, National Institute of Mental Health, NIH
• Kenny Sherr, University of Washington
• Sharon Straus, University of Toronto
• Bryan Weiner, University of Washington 

Rachel Sturke, Ph.D., MPH, MIA Deputy Director and Senior Scientist Center for Global Health Studies Fogarty Division of International Science Policy, Planning and Evaluation Email: [email protected]

Blythe Beecroft, M.S. Global Health Research and Policy Analyst (Contractor) Center for Global Health Studies Fogarty Division of International Science Policy, Planning and Evaluation Email: [email protected]

Updated February 23, 2024

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Case Studies

Eradicating smallpox ..

A massive global effort spearheaded by the World Health Organization eradicated smallpox in 1977 and inspired the creation of the Expanded Programme on Immunization, which continues today.

Preventing HIV and sexually transmitted infections in Thailand .

In Thailand, the government's "100 percent condom program" targeting commercial sex workers and other high-risk groups helped prevent the spread of HIV relatively early in the course of the epidemic. Thailand had 80 percent fewer new cases of HIV in 2001 than in 1991 and has averted nearly 200,000 new cases.

Controlling tuberculosis in China .

To address the problem of tuberculosis (TB) patients' early dropout from treatment, a national TB program in China implemented the directly observed treatment, short-course (DOTS) approach in which a health worker "watches" patients with TB daily for six months as they take their antibiotic treatment. The program helped reduce TB prevalence by 40 percent between 1990 and 2000 and dramatically improved the cure rate in half of China's provinces.

Reducing child mortality through vitamin A in Nepal .

Capitalizing on the discovery that vitamin A supplementation could save child lives, the government of Nepal began the National Vitamin A Program in 1995 that has averted nearly 200,000 child deaths.

Eliminating polio in Latin America and the Caribbean .

Beginning in 1985, a regionwide polio elimination effort led by the Pan American Health Organization immunized almost every young child in Latin America and the Caribbean, eliminating polio as a threat to public health in the Western Hemisphere in 1991.

Saving mothers' lives in Sri Lanka .

Despite relatively low national income and health spending, Sri Lanka's commitment to providing a range of "safe motherhood" services has led to a decline in maternal mortality from 486 deaths per 100,000 live births to 24 deaths per 100,000 live births over four decades.

Controlling onchocerciasis in sub-Saharan Africa .

A multipartner international effort begun in 1974 dramatically reduced the incidence and impact of the blinding parasitic disease and increased the potential for economic development in large areas of rural west Africa. Transmission has been virtually halted in west Africa today, and 18 million children born in the 20-country area are now free of the threat of river blindness.

Preventing diarrheal deaths in Egypt .

Using modern communication methods, a national diarrheal control program in Egypt increased the awareness and use of life-saving oral rehydration therapy, helping reduce infant diarrheal deaths by 82 percent between 1982 and 1987.

Improving the health of the poor in Mexico .

Since 1997, Mexico's Progresa (now known as "Oportunidades") has provided a comprehensive package of education, health, and nutrition interventions to rural families through a conditional cash grants program, resulting in lowered rates of illness and malnutrition and increased school enrollment.

Controlling trachoma in Morocco .

Since 1997, the incidence in Morocco of trachoma, the leading preventable cause of blindness, has been cut by more than 90 percent among children under 10 through a combined strategy of surgery, antibiotics, face washing, and environmental changes.

Reducing guinea worm in Asia and sub-Saharan Africa .

A multipartner eradication effort focused on behavior change reduced prevalence of guinea worm by 99 percent in 20 endemic African and Asian countries. Since the start of the campaign in 1986, the number of cases has fallen from 3.5 million to less than 35,000 in 2003.

Controlling Chagas disease in the southern cone of South America .

Through surveillance, environmental vector control, and house spraying, a regional initiative launched in 1991 has decreased the incidence of Chagas disease by 94 percent in seven countries in the southern cone of Latin America. Disease transmission has now been halted in Uruguay, Chile, and large parts of Brazil and Paraguay.

Reducing fertility in Bangladesh .

In Bangladesh, strong leadership of the family planning program, a sustained outreach strategy, and a focus on access to services increased contraceptive prevalence from 3 to 54 percent (and correspondingly decreased fertility from 7 to 3.4 children per woman) over two decades, far in excess of what would have been predicted based on changes in economic and social conditions alone.

Curbing tobacco use in Poland .

Starting in the early 1990s, the transition to a market economy and a more open society paved the way for health advocates to implement strong tobacco controls in Poland, a country that had the highest rate of tobacco consumption in the world. A combination of health education and stringent tobacco control legislation has averted 10,000 deaths a year, has led to a 30 percent reduction in the incidence of lung cancer among men aged 20 to 44, and has helped boost the life expectancy of men by four years.

Preventing iodine deficiency disease in China .

China's introduction of iodized salt in 1995 reduced the incidence of goiter among children, from 20 to 9 percent, and created a sustainable system of private provision of fortified salt.

Preventing neural tube defects in Chile .

Eliminating measles in southern africa ..

Measles vaccination campaigns in seven African countries nearly eliminated measles as a cause of childhood death in southern Africa and helped reduce the number of measles cases from 60,000 in 1996 to just 117 cases four years later.

Preventing dental caries in Jamaica .

Between 1987 and 1995 Jamaica's National Salt Fluoridation Program demonstrated up to an 87 percent decrease in dental caries in schoolchildren and has been regarded as a model for micronutrient interventions.

Treating cataracts in India .

Preventing hib disease in chile and the gambia ..

A national Hib vaccination program in Chile reduced prevalence of Hib disease by 90 percent in the early 1990s. In 1997, The Gambia introduced Hib vaccines into its national immunization program and has virtually eliminated the disease from the country.

Ideas to action: independent research for global prosperity

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Top 20 Current Global Issues We Must Address

What are the most pressing issues in the world today? What will demand the most attention in the next 5, 10, and 20+ years? In this article, which frequently refers to the World Economic Forum’s 17th Edition of the Global Risks Report, we’ll highlight 20 current global issues we must address, including issues related to climate change, COVID-19, social rights, and more. While it’s hardly a comprehensive discussion, it’s a solid introduction to the kinds of concerns facing our world today.

#1. Poverty

In fall 2022, the World Bank will update the International Poverty Line from $1.90 to $2.15. This means anyone living on less than $2.15 is in “extreme poverty.” Why the change? Increases in the costs of food, clothing, and shelter between 2011-2017 make the “real value of $2.15 in 2017 prices equal to $1.90 in 2011 prices. As for the World Bank’s goal to reduce extreme poverty to 3% or less by 2030, the pandemic has made it even harder. Extreme poverty isn’t the only poverty we have to contend with. 62% of the global population lives on less than $10/day. While there’s been progress over the years, the end of poverty is still far off.

Learn more about tackling poverty with an online course: Poverty & Population: How Demographics Shape Policy (Columbia University)

#2. Climate change

The IPCC released its sixth report in 2022. In its summary for policy-makers, the report’s authors outlined a series of near-term, mid-term, and long-term risks. If global warming reaches 1.5°C in the near term (2021-2040), it would cause “unavoidable increases in multiple climate hazards,” as well as “multiple risks to ecosystems and humans.” In the long term, climate change will present major health issues, premature deaths, risks to cities and settlements , and other dangers. Mitigation is desperately needed – and fast. Because of climate change ’s connection to other issues on this list, it’s one of the most serious challenges facing humanity.

Learn more about climate change with an online course: Science and Engineering of Climate Change (EDHEC Business School)

#3. Food insecurity

According to the 2022 Global Report on Food Crises , which is produced by the Global Network against Food Crises, the number of people in crisis or worse is the highest it’s been in the six years since the report has existed. Close to 193 million people were experiencing acute food insecurity in 2021, which is an increase of almost 40 million since 2020. This represents a staggering 80% increase since 2016. Causes include “economic shocks,” like an increase in global food prices. Domestic food price inflation in low-income countries also rose a lot. “Weather-related disasters” are also a big driver. For 15.7 million people in 15 countries, it was the primary driver of acute food insecurity.

Learn more about food insecurity with an online course: Feeding the World (University of Pennsylvania)

#4. Refugee rights

According to UNHCR, the war in Ukraine sparked the fastest-growing refugee crisis since WWII. Almost 6 million (as of May 10, 2022) people have fled. The UNCHR’s Refugee Brief , which compiles the week’s biggest refugee stories, has recently described situations in places like Somalia, where thousands of people were displaced due to severe drought. Between January and mid-April, more than 36,000 refugees from Nigeria, Mali, and Burkina Faso arrived in Niger. These are only a few examples of the refugee crises, which endangers already marginalized groups – like women and children – and puts them at an increased risk of trafficking , violence, and death.

Learn more about refugee rights with an online course: Refugees in the 21st Century (University of London)

#5. COVID-19

The WHO declared COVID-19 a pandemic in March 2022. It will continue to be a major issue for the world. The WEF’s Global Risks Report 2022 discusses COVID’s effects at length , including major economic recovery disparities and social erosion. According to a January 2022 article from NPR , there are also issues with vaccinations as many countries continue to have trouble getting doses. Distribution, vaccine hesitancy, healthcare systems, and other problems also factor into low vaccination rates. While we may never know the exact impact, the WHO estimates that between 1 January 2020 and 31 December 2021, there were around 14.9 million excess deaths linked to COVID-19.

Learn more about the impact of COVID-19 with an online course: Life After COVID-19: Get Ready for our Post-Pandemic Future (Institute for the Future)

#6. Future pandemic preparation and response

COVID-19 taught the world the importance of prepardeness. In a Harvard blog , Dr. Tedros Adhanom Ghebreyesus, director-general of the WHO, outlined the lessons the world should take to heart. The first: science has to guide policy. The politicization of the pandemic led to a lot of unnecessary damage. Another lesson is that science must pair with equity or it can actually make inequalities worse. This is obvious when looking at how low-income countries struggled to get the vaccines while wealthier countries stocked up. More resilient healthcare systems are also a must, as well as more coherent, global plans on how to respond. The world must also invest in research on contagious diseases, zoonotic diseases, the effectiveness of outbreak responses, and more.

Learn more about future pandemic response with an online course: Pandemic preparedness, prevention, and response (Politecnico di Milano)

#7. Healthcare

The healthcare industry has experienced major shifts due to the COVID-19 pandemic. According to the World Economic Forum, there’s been new investments and innovations, especially from the technology and telehealth sectors. In 2021, $44 billion was spent on health innovation. The world will be seeing the effects of these innovations for years to come, though equity will no doubt be a major issue. In places like the United States, the pandemic also reaffirmed how broken healthcare systems can be. In an MIT News blog , Andrea Campbell, a professor of political science, says the pandemic revealed a “dire need” for investments in public-health infrastructure, as well as a need to expand healthcare access and insurance coverage.

Learn more about health inequity issues with an online course: Addressing Racial Health Inequity in Healthcare (University of Michigan)

#8. Mental health

Globally, almost 1 billion people have some form of mental disorder. The pandemic made the world’s mental health worse. According to a scientific brief from the WHO , there’s been a 25% increase in anxiety and depression worldwide. Causes include social isolation, fear of sickness, grief, and financial anxieties. Health workers were also severely impacted, as well as young women and girls. The brief also highlights how the pandemic disrupted many mental health services, including services for substance abuse. Countries need to ensure access to mental health services as part of their COVID-19 recovery plans and beyond. It’s an economic decision, as well. The Lancet states that anxiety and depression alone cost the global economy around $1 trillion a year.

Learn more about mental health with an online course: The Science of Well-Being (Yale University)

#9. Disability rights

According to the WHO , over 1 billion people have some form of disability. Half can’t afford healthcare. They’re also more likely to live in poverty than those without a disability, have poorer health outcomes, and have less access to work and education opportunities. Human Rights Watch lists other discriminations disabled people face, such as an increased risk of violence. There’s been progress regarding disability rights, but many countries lack strong protections. The world still has a long way to go to ensure equality for those with disabilities.

Learn more about disability rights with an online courses: Disability Awareness and Support (University of Pittsburgh)

#10. LGBTQ+ rights

Members of the LGBTQ+ community face discrimination in many forms. According to Amnesty International , discrimination can target sexual orientation, gender identity, gender expression, and sex characteristics. Even in more progressive countries like the United States, people face violence and discrimination. According to the Human Rights Campaign, more than 300 anti-LGBTQ+ bills were proposed in 2022. At least a dozen states are considering legislation that forbids schools from discussing or using a curriculum that covers sexual orientation and gender identity. Considering the United States’ influence in the world, this attack on LGBTQ+ rights will likely have consequences that need to be addressed.

Learn more about LGBTQ+ issues with an online courses .

#11. Reproductive justice

Reproductive justice – which encompasses more than just abortion rights – is threatened by legislation, lack of funding, lack of education, and restricted healthcare access. In most places, wealth is a big determinant of whether a person can access reproductive services. It’s better in some places than others, but as we’ve seen with other issues on this list, even “progressive” countries like the United States are experiencing major shifts. In June 2022, the Supreme Court is expected to overrule Roe v. Wade , a milestone court case that protected a pregnant woman’s right to abortion. The impact would be immediate and will likely influence other countries.

Learn more about reproductive justice and women’s rights: International Women’s Health and Human Rights (Stanford University)

#12. Children’s rights

Children are a very vulnerable group. In 2019, around 5.2 million children under five from mostly preventable and treatable causes. 2.4 million were newborns under 28 days old. Leading causes include preterm birth complications, pneumonia, and malaria. According to UNICEF, the climate crisis also represents a severe threat to kids. Around 1 billion kids live in “extremely high-risk countries” that are hit by the worst effects of climate change. 920 kids have trouble accessing clean water and 600 million are exposed to vector-borne diseases like malaria. Child labor also remains an issue. At the beginning of 2020, around 160 million were forced into labor while COVID-19 put 9 million more kids at risk. That’s almost 1 in 10 children globally. Almost half are in dangerous environments. As is often the case, the other issues on this list – climate change, poverty, COVID, gender equality, etc – factor into children’s rights.

Learn more about children’s rights: Children’s Human Rights – An Interdisciplinary Introduction (University of Geneva)

#13. Gender equality

Global gender equality has gradually improved over the years, but data from the 2021 Global Gender Report shows that the end of the global gender gap is still 135 years away. The pandemic played a huge role in reversing positive trends as women were hit harder financially. According to Oxfam , women experienced a 5% job loss while men experienced 3.9%. That means women lost about $800 million in 2020. This is a low estimate since it doesn’t count the informal economy, which includes millions of women. Women are also more likely to live in poverty, more affected by gender-based violence, and more affected by climate change.

Learn more about gender equality: Gender Analytics: Gender Equity through Inclusive Design (University of Toronto)

#14. Cybersecurity

The WEF’s Global Risks Report 2022 (page 9) listed cybersecurity vulnerabilities as a concern. The reason is rapid digitalization, which was triggered in part by COVID-19. Many “advanced economies” are now at a higher risk for cyberattacks. GRPS respondents identified cybersecurity failure as a critical short-term risk. In 2020, malware and ransomware attacks went up by 358% and 435%. There are a few reasons for this, including better (and easier) attack methods and poor governance. Cyberattacks have a swath of serious consequences and erode public trust. As countries become more dependent on digitalization, their cybersecurity needs to keep up.

Learn more about cybersecurity: IBM Cybersecurity Analyst Professional Certificate (IBM)

#15. Disinformation

Rapid digitalization comes with many issues, including the lightning-fast spread of disinformation. The WEF report describes deepfakes, an accessible AI technology, and its potential to sway elections and other political outcomes. Disinformation doesn’t need to be sophisticated to be successful, however. Through social media posts and videos, twelve anti-vax activists were responsible for almost ⅔ of all anti-vaccine content on platforms like Facebook and Twitter. Their content flooded the internet with the type of harmful, fear-mongering disinformation that played a significant role in vaccine hesitancy and political radicalization. Because disinformation travels faster online than the truth, it’s a global issue that should be addressed.

Learn more about tackling disinformation: Communicating Trustworthy Information in the Digital World (University of Rotterdam)

#16. Freedom of the press

According to the Varieties of Democracy Institute (as reported in The Economist ), about 85% of people live in a country where press freedom has gone down in the past 5 years. After peaking at .65 in the early 2000s and 2011, the global average dropped to .49 in 2021. Major countries like China, India, Russia, Brazil, and Turkey saw significant declines. Journalists and news organizations face threats like violence, imprisonment, lack of funding, and coordinated online attacks and harassment. A free press is essential to a functioning democracy. Without press freedom, all human rights are at risk.

Learn more about freedom of expression: Human Rights for Open Societies (Utrecht University)

#17. Debt crises

In the WEF Global Risks Report (page 7), respondents named debt crises as one of the most pressing issues over the next decade, though respondents believe they will become most serious in just 3-5 years. COVID-19 is a big reason why. Government stimulus was necessary, but many countries are now left with debt burdens. For corporate and public finances in large economies, debt burdens can lead to defaults, bankruptcies, insolvency, and more. This is a far-reaching issue as it affects budgets for areas like healthcare and green energy.

Learn more about the debt: Finance for everyone – Debt (McMaster University)

#18. Corruption

Corruption encompasses a host of actions such as bribery, election manipulation, fraud, and state capture. The World Bank Group names corruption as a barrier to ending extreme poverty and “boosting shared prosperity” for the poorest populations. When it comes to addressing poverty, climate change, healthcare, gender equality, and more, corruption gets in the way. Because corruption is a global problem, global solutions are necessary. Reform, better accountability systems, and open processes will all help.

Learn more about tackling corruption: What is Corruption: Anti-Corruption and Compliance (University of Pennsylvania)

#19. Authoritarianism

According to Freedom House, global democracy is eroding. That includes countries with long-established democracies. In their 2022 report, the organization reveals that global freedom has been declining for the past 16 years. 60 countries faced declines in the last year. Only 25 saw improvements. Only 20% of the global population lives in Free countries. China, Russia, and other authoritarian countries have gained more power in the international system, while countries with established democracies – like the United States – are losing their freedoms. What can be done? Freedom House says success “requires a bold, sustained response that establishes support for democracy and countering authoritarianism.” Governments and citizens engage and stand for democracy.

Learn more about tackling authoritarianism: Citizenship and the Rule of Law (University of London)

#20. Global cooperation

Addressing the issues in this article is not an easy task. True progress is only possible through global cooperation, a fact which is woven through the WEF report. Everything from addressing cybersecurity threats to humanitarian emergencies to protecting democracy depends on strong cooperation between countries. As the report says in its preface: “Restoring trust and fostering cooperation within and between countries will be crucial to addressing these challenges and preventing the world from drifting further apart.” The challenges threatening global cooperation are just as clear as the need, however, which makes it one of the most serious issues of the day.

Learn more about global cooperation: Global Diplomacy: the United Nations in the World

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About the author, emmaline soken-huberty.

Emmaline Soken-Huberty is a freelance writer based in Portland, Oregon. She started to become interested in human rights while attending college, eventually getting a concentration in human rights and humanitarianism. LGBTQ+ rights, women’s rights, and climate change are of special concern to her. In her spare time, she can be found reading or enjoying Oregon’s natural beauty with her husband and dog.

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Global Issues And Problems Case Study Example

Type of paper: Case Study

Topic: Government , Theater , Politics , Actors , Charity , Economics , World , Body

Published: 03/30/2020

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The world, today, is facing several issues and problems that pose a threat to the wellbeing of humanity. It is important for all humanity come together to find a solution to these global problems facing us. The gap between poverty and the wealth continue to rise between countries, and it is important to act early or risk an increase in poverty level throughout the world. The other issue facing us is protection of our environment as we seek better economic prosperity for developed and developing countries. Several other issues affecting us include global pandemics, drugs trafficking that pose major problems to governments throughout the world. It is important for the public, private and civil societies bring their resources together to help solve these global issues. Several actors have come together to help in solving or trying to look for a solution to solve these issues. Examples of these actors include: - Government Actors- these are sovereign governments involved in humanitarian projects and other missions aimed at solving these global issues. The major important players in this sector are the United States government and the Swiss government which are the leading contributors to humanitarian aid in the world. The U.S. government is important in this mission because it has the necessary resources that can be useful in solving these issues. Through the USAID, the U.S. government can coordinate several humanitarian programs across the world. They also have an active army that can be deployed in times of crisis. The Swiss government on the other side has the Swiss Agency for Development and Cooperation (SDC) which is a body involved with offering humanitarian aid to save lives and alleviate suffering across the world. - Non-Governmental Organizations- these are non-profit international bodies that are not part of any government. The main aim of these non-governmental players is to help in solving these global issues. The main bodies involved with humanitarian aid in the world are the International Red Cross and Red Crescent Societies (IRCRCS) and the NGO Branch of the UN secretariat. The IRCRCS is a body that manages events between the 188 National Red Cross and Red Crescent Societies within the Program. The presence of IRCRCS is wide making it an ideal organization to help solve these global issues. The NGO Branch of the UN secretariat which is the United Nations Department of Economic and Social Affairs (DESA) is the major player within the UN Secretariat for NGOs in advice-giving status with the Economic and Social Council (ECOSOC) and NGOs in quest of status. - Private Businesses- these are international businesses with a huge market presence across the world that are involved in charity or humanitarian services. Examples of businesses that have been involved with humanitarian courses include the Apple Company in the U.S. and Samsung in South Korea. Apple is one of the most profitable businesses in the world and through the years it has been involved with charity work as well as funding of NGOs and government initiatives meant for humanitarian causes. Samsung, on the other hand, is an equally big company with a large market presence throughout the world. Samsung has also been involved with charity programs and funding for humanitarian activities through various bodies. These two organizations have vast economic resources that they are able to offer to other organizations to help in solving these global issues and problems. The main reason I chose these actors is the fact that they not only have the necessary resources, but they have also been involved in activities meant to solve these global issues. If only they could pull their resources together and forge a common front towards alleviating these global problems then, we can be sure of success.

Bibliography

Bouchet‐Saulnier, F. (2006) The Practical Guide to Humanitarian Law, Rowman and Littlefield Lamy, Steven L., John Scott Masker, John Baylis, Steve Smith, and Patricia Owens. 2014. Introduction to global politics. Rischard, Jean-francois. 2007. High Noon 20 Global Problems, 20 Years to Solve Them. New York: Basic Books. http://public.eblib.com/EBLPublic/PublicView.do?ptiID=952685.

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