Current and Emerging Issues in Global Health: An Introduction to Special Journal Collection

We are thrilled to present this special collection of articles on “Current and Emerging Issues in Global Health.” Over the last six months when the call for papers for this special collection was issued, the field of global maternal and child health (MCH) and HIV/AIDS has been agog with interest. The support from leading researchers, graduate students, pre-and-post-doctoral researchers from far and near bore testimony on the need for a curated, cutting-edge, collection of peer-reviewed articles around a common and shared theme. The International Journal of Maternal and Child Health and AIDS (IJMA) is an applied and translational global health journal; so the idea of a special collection is at the center of the journal’s global health mission and objectives.1 The collection captures three main goals for the journal. First, it presents an opportunity for innovation; second, it presents an opportunity to engage the field and community around a common theme; and finally, it is a moment of reality-check for the journal editors to support the field in evaluating the extent to which we have collectively attempted to confront the global MCH issues of our time.

The idea of a special journal collection on emerging global health issues was timely. At the beginning of 2019, the World Health Organization (WHO) released a list of 10 threats to global health for the year.2 They include: (1) air pollution and climate change, (2) non-communicable diseases, (3) threat of a global influenza pandemic, (4) fragile and vulnerable settings, such as regions affected by drought and conflict, (5) antimicrobial resistance, (6) Ebola and high-threat pathogens, (7) weak primary care, (8) vaccine hesitancy, (9) Dengue, and (10) Human immunodeficiency virus (HIV).

Each of the above global threats is real, far-reaching, and supported by overwhelming data and evidence. Few examples. Climate change, natural and human-made health stressors, influence human health and disease in multiple ways. The health effects of climate change include increased respiratory and cardiovascular disease, injuries and premature deaths related to extreme weather events, changes in the prevalence and geographical distribution of food- and water-borne illnesses and other infectious diseases, and threats to mental health.3 An American Academy of Pediatrics’ primary care research network study reported that almost 12% of caregivers had moderate or high vaccine hesitancy and that a high proportion of caregivers held inaccurate beliefs about vaccines.4 These are but a few of the real issues confronting global health.

Public health is passing through a seismic transformation. Whether at the global, national, state, and local levels, disease outbreaks, patient demographics, and health technology have changed the global health landscape in a way never imagined. Diverse health outbreaks have transformed global health. There is no doubt that shifting boundaries, ennobled by migration, have lifted the boundaries for disease outbreaks, such as Ebola, Zika virus, measles, and the pandemic flu.5 From Avian Flu, to Zika, to drug-resistant bacteria, the world faces a host of dangerous pathogens and potential epidemics.5 Consequently, public health is now center-stage at national security discourses culminating in the burgeoning field of global health security preparedness. With about 70% of the world’s countries not fully prepared for an outbreak, it is evident that we face dangerous gaps in public health systems across the globe.5

In total realization of these changing landscapes, we now have a cadre of public health professionals who found themselves engaging a changed demographics like never before. Demographic shifts and societal changes are intensifying pressures on health systems and demanding new directions in the delivery of healthcare.6 In addition, aging populations in both emerging and developed nations are driving up the demand for healthcare. Health care professionals, unlike ever known in history, now agree that the “patient is king.” The “Google-ennobled patients” come to medical visits armed with questions for their healthcare practitioners making dialogue and a meeting of the minds inevitable. Given that all information is not always accurate, evidence-informed, or simply ready for patient consumption, the healthcare professional goes the extra mile of further empowering the patient with accurate information and bursts prevalent myths and misinformation. The empowered-patient-era has led to the realization that one-size-fits-all no longer suffices. It bears testimony to the long-held aspirations for precision medicine and precision healthcare practice that addresses the needs of patients according to their individual circumstances, which is pertinent in accelerating biomedical research and improving population health and health disparities.7 The Google-ennobled patient is but one of the realities of technological incursion into healthcare presenting phenomenal opportunities but significant unanswered questions that warrant continued investigations.

The purpose of the special collection was to highlight and support emerging scientific innovations in the fields of global MCH and HIV/AIDS. The articles in the special collection lived up to this goal. They are diverse and make for a good reading touching on a wide range of contemporary topics dealing with issues that directly or indirectly influence MCH populations or people living with HIV/AIDS. Accordingly, we have high-quality articles that discuss childhood obesity and their social determinants; maternal and feto-infant survival in both developing (Nigeria, India and Malawi) and in developed (United States) settings. The role of the father during pregnancy, a concept that is increasingly gaining acceptance as an essential ingredient for favorable pregnancy outcomes, is also highlighted in this edition. Articles on HIV/AIDS report findings regarding two very important issues that determine success or failure of current efforts toward control of the HIV epidemic: stigma and HIV vaccine. The article by Aliyu et al., for example, demonstrates that stigma prevented sufficient adherence to anti-retroviral treatment among pregnant women enrolled in a prevention of mother to child transmission (PMTCT) trial in rural North Central Nigeria. A paper by Alio et al. explores factors that could influence HIV vaccine acceptance among black men and transgender persons in Western New York. Unique to this special collection is the geographical spread of the article submissions. We have articles and contributions from research groups from three continents in a single edition: Africa, Asia and North America.

Our profound gratitude goes to the editorial management and support teams in Washington, DC led by Mr. Brownmagnus U. Olivers for their diligence and indefatigable work in helping us make this special collection a reality. We thank all our authors for their painstaking commitment in addressing the multiple reviews from the guardianship of Guest Editor Dr. Salihu to assemble a profound collection of papers that will stand the test of time and challenge existing paradigms in global health policy and practice. Our ultimate hope is that papers in this collection spark new ideas for invention, improved patient care, and transformation of population health. We are grateful to reviewers for their diligence and support of this special collection. We invite you to enjoy the read. We look forward to receiving your letters and comments on the papers in this collection.