Find out more about our research into the causes and consequences of global health problems around the world
Our academics have been studying public health challenges around the world, considering why and how they occur, their impact and how they may best be prevented or minimised in the future.
Queen Mary academics collaborated with UNFPA to publish a review of 50 Nationally Determined Contribution documents, which evaluated national climate policies with a focus on health, including sexual and reproductive health and rights (SRHR) issues, to help provide information on gaps and areas of potential improvement, and ensure climate policy better reflects SRHR.
The publication can be viewed at https://esaro.unfpa.org/en/publications/how-are-sexual-and-reproductive-health-and-rights-represented-national-climate-policy
Doreen Montag has also written an article with Emma Duus on ‘Protecting Women’s Health in a Changing Climate: The Role of Community-Based Adaptation’ in The Journal of Climate Change and Health (2022): 100120 (Preproof version)
Heather McMullen has recently co-written an article for The Conversation on her research into Birthstrike for Climate and its flaws before the campaign disbanded in 2021.
A partnership between Queen Mary academics and the UN sexual and reproductive health agency (UNFPA) has produced a scoping review, evidence brief and set of infographics showing that environmental changes have profound negative impacts on sexual and reproductive rights, and on women's and girl's bodily autonomy including climate crisis-related child marriages.
Doreen Montage and Marco Barboza Medina published an essay (in Spanish) entitled ‘‘Melancholy and Balance: A 21st Century Homeostasis’. This considers the relationships and exchanges between critical processes such as the destruction of natural resources and democracy, the circumstances and impacts of breaking the links between nature and society, and opportunities to return to the original balance. An article by Ensayo General (in Spanish) provides a summary of their arguments.
Other research led by Dr Jonathan Kennedy shows that the rise of populism across Europe has coincided with a growing mistrust of vaccines. The study, published in the European Journal of Public Health, looked at national-level data from 14 European countries. It found a highly significant positive association between the percentage of people in a country who voted for populist parties and the percentage who believe that vaccines are not important and not effective.
Populism and vaccines
Research led by Dr Jonathan Kennedy shows that the rise in populism across Europe has coincided with a growing mistrust of vaccines.
Lead author Dr Jonathan Kennedy from Queen Mary’s Global Public Health Unit said: “It seems likely that scientific populism is driven by similar feelings to political populism, for example, a profound distrust of elites and experts by disenfranchised and marginalised parts of the population.
Even where programmes objectively improve the health of targeted populations, they can be viewed with suspicion by communities that do not trust elites and experts. In the case of vaccine hesitancy, distrust is focused on public health experts and pharmaceutical companies that advocate vaccines.
Data from 14 European countries
The study, published in the European Journal of Public Health, looked at national-level data from 14 European countries. This data included the percentage of people in a country who voted for populist parties in the 2014 European Parliament elections, and the percentage of people in a country who believe that vaccines are not important, safe and/or effective, according to data from the 2015 Vaccine Confidence Project.
The analysis found a highly significant positive association between the percentage of people in a country who voted for populist parties and the percentage who believe that vaccines are not important and not effective.
Professor Sophie Harman, an expert on global health politics from Queen Mary’s School of Politics and International Relations, and who was not involved in the research, commented: “Like restrictions on reproductive rights, anti-vaccination rhetoric has long been the canary in the coal mine for populism.”
Tracing back to discredited research on MMR vaccine and autism
In the research article, Dr Kennedy writes that modern vaccine hesitancy is usually traced to Andrew Wakefield’s now discredited 1998 Lancet article, which claimed a link between the measles, mumps and rubella (MMR) vaccine and autism.
MMR vaccination rates in the UK fell from 92 per cent in 1995 to a low of 79 per cent in 2003, well below the 95 per cent rate needed to achieve herd immunity. Confirmed cases of measles in England and Wales rose from 56 in 1998 to 1370 in 2008.
Wakefield was struck off the UK medical register and the Lancet study retracted. Nevertheless, his ideas remain influential and are cited as a reason why measles cases have increased in Europe over the past few years.
Examples from European populist parties
There is additional anecdotal evidence suggesting a connection between the rise of populist politicians and political movements in Western Europe and increasing levels of vaccine hesitancy, Kennedy writes.
The most prominent example is Italy. The Five Star Movement (5SM) has raised concerns about vaccine safety and the link between MMR and autism. It is argued that these concerns caused MMR vaccination coverage to fall from 90 per cent in 2013 to 85 per cent in 2016 and resulted in an increase in measles cases from 840 in 2016 to 5000 in 2017. Despite this, the upper house of the Italian Parliament – bolstered by newly elected representatives from 5SM and League – recently passed a law to repeal legislation that makes vaccines compulsory for children enrolling in state schools.
In France, the right-wing Front National have also raised concerns about vaccine safety and laws that make childhood vaccinations mandatory.
And in Greece, the left-wing SYRIZA government proposed that parents should be able to opt out of vaccinating their children.
While UKIP has not expressed similar concerns, a poll conducted by Mori showed UKIP voters were almost five times more likely than the general population to believe that MMR was unsafe.
The United States, Donald Trump and Andrew Wakefield
Further afield in the US, Donald Trump has met well-known anti-vaccination campaigners, including Wakefield, and expressed sympathy with their ideas. For example, in 2014 he tweeted: ‘Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes – AUTISM. Many such cases!’
Dr Kennedy adds: “Vaccine hesitancy will be difficult to resolve unless its underlying causes of populism – an iniquitous economic system and unrepresentative political system – are addressed.”
Watch Jon talk about his findings in this Economist documentary.
A new study by global public health researchers, published in the journal Health Policy and Planning, has looked at the impact of economic crises on health workers. The lead author of the study, Giuliano Russo, suggests that governments need to be careful not to harm health workers by choosing the wrong policy response during an economic crisis. Austerity measures need to be avoided at all costs, and incentives offered to health labour markets to respond to the increased demand for care during a downturn.
Dr Jessica Potter has co-written an article for The Conversation on Russia's invasion of Ukraine threatening the fight against tuberculosis.
In recent years, conflicts in Ethiopia, Syria, Afghanistan and Yemen have caused huge suffering. They have devastated the health and wellbeing of local populations and led to countless unnecessary deaths. Russia’s invasion of Ukraine is showing the world, yet again, the abhorrent consequences of war.
As well as the direct casualties of these conflicts, yet more people will suffer illness and death due to disrupted health systems and lack of access to clean water, food, medicines or simply warmth and shelter. In these desperate conditions, control of infectious diseases breaks down. One such infectious disease is tuberculosis (TB).
More difficult to treat are multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), which affect half a million people per year. MDR-TB is a major global public health challenge and a leading cause of death from antimicrobial resistance.
The effect of TB and MDR-TB is not only physical but socioeconomic. Being ill with MDR-TB, seeking care, and being hospitalised are associated with out-of-pocket costs and lost income that can be catastrophic.
Previous decades have seen an epidemic of MDR-TB in Russia and former Soviet countries, including Ukraine. Drug resistance thrives on fractured health systems and sporadic medicine supply. Such conditions plagued these states following the breakdown of the Soviet Union, and are exacerbated by war.
The invasion of Ukraine is an impending disaster for TB control across the entire region and potentially beyond. War anywhere lays the foundations for outbreaks and epidemics of infectious diseases from cholera in Yemen, to polio in Syria, and measles in Afghanistan. Indeed, both world wars caused a profound increase in TB deaths.
Wars lead to conditions that are the perfect breeding ground for TB, including food insecurity and overcrowding in poorly ventilated spaces. This is the dire situation currently facing many people in bomb shelters across Ukraine. Wars ravage healthcare infrastructure, decimate immunisation programmes, and limit access to quality care. This means unwell people often have late diagnoses, resulting in worse complications and a greater chance of onward transmission.
Over 3 million people have fled Ukraine following Russia’s recent invasion. This follows extensive recent migrations from Syria, Afghanistan and Ethiopia, all of which have high MDR-TB prevalence. Such displacement is going to challenge public health responses.
These challenges come on the backdrop of the COVID pandemic, during which TB notification rates plummeted. This was not because TB suddenly went away. It was due to disruptions in access to TB diagnosis and treatment.
Estimating the pandemic’s true impact on TB infections, disease, and death is complex. However, the World Health Organization has suggested that the pandemic has set back efforts to end TB by more than a decade.
The war in Ukraine will only make eliminating TB harder. Investment is key because for every dollar we spend on TB prevention and care, we get 43 back.
Professor Vicky Bird has been awarded a £7 million grant by the National Institute for Health and Care Research to co-direct a new Global Health Research Centre with partners across Latin America. The Centre will work with communities to develop innovative, low-cost solutions to improve healthcare for non-communicable diseases, with a key focus on indigenous populations.
The grant will enable Queen Mary researchers and their partners, including co-director Carlos Gomez Restrepo (Javeriana University, Colombia) and colleagues from universities in Bolivia and Guatemala, to investigate the best ways to manage long-term conditions, developing community-based interventions to change factors and behaviours linked to the development of long-term non-communicable diseases. The Centre will develop the skills of local researchers and clinicians, and will host a PhD and master’s programme to provide formal training for students in all three countries.
Non-communicable diseases such as mental health conditions, cardiovascular and respiratory diseases, and diabetes are responsible for 8 in 10 premature deaths, with the greatest burden in low- and middle-income countries. In Latin America long-term non-communicable diseases are a leading cause of disability and poor quality of life, and there is a lack of community-based care to help people manage long-term conditions, with most available care currently limited to hospital-settings.
Find out more about Global Public Health research and news