Iman Nuwayhid

Introduction: There is limited research on public health-related networks in the Eastern Mediterranean Region (EMR) and Arab world, where vulnerabilities are multiple, interconnected and the need for effective collaborative action is urgent. This study aimed at gaining a deeper understanding of the experiences of current and former public health-related networks in the EMR/Arab world, identifying the factors that facilitated or hindered their functioning, and providing guidance on best practices that can inform the design of sustainable and resilient regional networks. Methods: We identified nine regional public health-related networks in the EMR/Arab world. A desk review of these networks was conducted followed by key informant interviews with 16 current or former members of these networks. Inductive thematic analysis was performed on the data generated from these semi-structured interviews. Results: Analysis showed that networks exist primarily to build connections among individuals and institutions in the region. Successful networks are marked by strong institutionalization of capacity-building initiatives and rapid mobilization into public health crises. However, networks often struggle or fail due to lack of sustained, flexible financing and fragmented governance, including dependence on individual leaders. Key recommendations from participants included institutionalizing leadership, diversifying financing, enhancing regular communication, strategic planning, and investing in new leaders. Informants widely agreed that robust, sustainable networks are vital to advancing public health in the region. Conclusion: To foster resilient and sustainable public health networks across the region, future initiatives should focus on demonstrating value, building trust, and strengthening institutional frameworks. Networks should learn from each other’s experiences. The literature on regional networks has mostly emphasized activities and achievements but offered limited critical analysis of underlying enabling and constraining conditions.

Climate hazards, intensified by climate change, impact health, with conflict displaced populations being especially vulnerable. However, there is limited systematic synthesis of evidence on this topic. We conducted a scoping review which aimed to synthesise evidence on the health impacts of climate hazards on displaced populations and identify related mediators and pre-existing stressors. 27 studies conducted in 18 countries met our eligibility criteria and included diverse hazard exposures (including flooding, extreme heat and droughts) and health outcomes (such as infectious illnesses, heat-related illnesses, mental health conditions, and gender-based violence). Our findings suggest that conflict displaced populations experience substantial health vulnerabilities due to climate hazards which are mediated by environmental, infrastructural, socioeconomic and behavioural factors, and exacerbated by precarious built environments and fragile social and economic displacement settings. Further research is urgently needed to better quantify health risks and identify effective multisectoral interventions to better protect displaced populations from climate hazards.

The systematic destruction of academic infrastructure, termed scholasticide, has been normalised across the Eastern Mediterranean Region (EMR) over more than two decades. The doctrine has operated through two coexisting modalities: the targeted assassination of individual scholars and the physical destruction of institutions, escalating in scale from selective killings and partial looting to the dismantling of entire academic systems. Drawing on evidence from several EMR countries, we describe a causal cascade through which acute military strikes and chronic structural exclusion, including sanctions, platform over-compliance, and visa barriers, produce generational health workforce depletion, disrupt core public health functions, and cause population-level health harms. We argue that academic institutions constitute a distinct, upstream structural determinant of population health whose destruction is an attack on health systems, not merely on education. We propose five categories of action, implemented through standing regional and international mechanisms, to protect academic infrastructure across the EMR whenever and wherever it is attacked.

Purpose of Review: Pesticide exposure is an urgent environmental health issue in the Global South, where structural inequalities, weak regulation, and the export of banned chemicals from the Global North create disproportionate risks for marginalized populations. While environmental justice (EJ) frameworks are increasingly applied in environmental health research, their integration in pesticide research and interventions in the Global South has not been reviewed. This scoping review maps how EJ is conceptualized and operationalized in studies on pesticides in the Global South, identifying justice dimensions, methodological approaches, and interventions. Recent Findings: Fifty-four peer-reviewed and grey literature sources (1995 to 2024, English language) were reviewed using a five-dimensional EJ framework: distributive, procedural, recognition, capabilities-based, and epistemic justice. Distributive justice dominated, procedural and recognition justice were inconsistently addressed, and capabilities-based and epistemic justice were rarely applied. EJ applications varied regionally: Central and South American studies had a pluralistic approach to EJ. Sub-Saharan African (SSA) research emphasized acute exposure disparities but lacked epistemic justice. Southeast Asia focused on gender and caste-based inequities, and the Middle East and North African (MENA) region was notably under-represented, highlighting a significant geographic gap. Interventions included pesticide bans, litigation, advocacy, user training, and household adaptations, yet most reinforced individual responsibility rather than addressing structural drivers of pesticide use. Additional gaps include limited gender-specific analyses, scarce epidemiological evidence, and co-production of knowledge with affected communities. Summary: Pesticide-related EJ scholarship in the Global South remains uneven, with major regional, methodological, and epistemological gaps. Advancing EJ requires rights-based, community-led, gender-sensitive and epistemically inclusive approaches, strengthened regulations, and a global ban on prohibited pesticides.

Displaced populations endure structural, psychological, and social vulnerabilities that impact their mental well-being. Lebanon's economic collapse, political instability, and inadequate infrastructure have exacerbated the hardships of its 1.5 million Syrian refugees. In this study, we applied the Six Dimensions of Wellness framework to explore the factors influencing the mental well-being of a sample of Syrian refugee workers in Lebanon. We conducted a cross-sectional analysis on 89 Syrian refugee agricultural workers (42 men and 47 women) recruited from 32 greenhouse farms in Lebanon's Beqaa Valley. Participants completed structured questionnaires covering the Six Dimensions of Wellness. Mental well-being was assessed using the World Health Organization five well-being index, and scores below 13 indicated poor well-being. We used descriptive statistics and logistic regression to examine associations between wellness indicators and mental well-being. We found that female workers, compared to male workers, reported a notably higher prevalence of poor mental well-being (40.4% vs. 23.89%). Participants who had experienced a work-related injury had nine times higher odds of poor mental well-being than those who had not (adjusted odds ratio (aOR) = 9.30; 95% confidence interval (CI) = 1.64-52.79). Social support was protective of mental well-being (aOR = 0.52; 95% CI = 0.28-0.97), while having difficulty accessing health information (aOR = 6.09; 95% CI = 1.61-23.06) and unmanageable work demands (aOR = 10.09; 95% CI = 2.47-41.31) were significantly linked to poor mental well-being. Although protective against poor well-being, results for age and education were not statistically significant. This study highlights the complex and multidimensional nature of mental well-being among Syrian refugee agricultural workers. Work injuries, lack of access to health information, and high work demands increase the odds of poor mental well-being, while social support offers protection. Our findings inform interventions to improve mental well-being for displaced populations.

This perspective highlights a place for Health (H) in the Water, Energy, and Water (WEF) nexus. It reviews the reference to health in the WEF nexus literature and makes the case for its inclusion into the WEF Nexus. We argue that although the nexus concept of water, energy, and food is relatively recent, it has been adopted by several UN agencies and international organizations and it will continue to draw emphasis in research, politics and communications of the scientific community. Now is the time to integrate health.

The Arab world faces numerous health challenges that mandate a competent public health workforce and strengthening public health education. To analyze university-based Master of Public Health (MPH) programs offered at Faculties of Public Health (FPH) and of Medicine (FM) in Arab countries. We searched a regional database of academic public health institutions, conducted a search of university websites, and reviewed websites of the Association of Arab Universities and World Directory of Medical Schools. A factsheet for each MPH program was emailed to deans of respective faculties for validation and completion. We examined associations between presence of such programs and population size and Human Development Index (HDI). A total of 19 FPH and 10 FM at 28 universities offer MPH programs (7 programs per 100 million population). Ten countries offer no MPH programs; the remaining 12 offer 1–5 programs each. Ten MPH programs were initiated over 45 years (1965–2009) and another 19 over 10 years (2010–2019). No correlation was observed between offering an MPH program and the country’s HDI or population size. Less than half of the programs admit students from fields outside health. FPH and FM-based programs are comparable in offering core disciplines but FPH programs offer more Social and Behavioral Sciences (83% vs. 60%). More FM-based programs provide practicum training (78% vs. 53%); 10 programs offer none. Epidemiology, alone or with Biostatistics, and Health Management and Policy are the two most frequently offered MPH concentrations. None of the MPH programs offer a concentration on public health in conflict or humanitarian crises; only one offers a certificate on the theme. Only three programs, all FPH-based, reported international accreditation. The recent increase in MPH programs in Arab countries is encouraging. Critical gaps are absence of MPH programs in 10 countries, less coverage of the social sciences, and lack of practicum experience in 10 programs. Upgrading and promoting public health education across the region to fill these gaps calls for collaboration among existing MPH programs. More in-depth analysis of the history and mission of these programs, as well as their admission criteria and curricula, is needed.

Objectives: The growing trend of for-profit organization (FPO)-funded university research is concerning because resultant potential conflicts of interest might lead to biases in methods, results, and interpretation. For public health academic programmes, receiving funds from FPOs whose products have negative health implications may be particularly problematic. Methods: A cross-sectional survey assessed attitudes and practices of public health academics towards accepting funding from FPOs. The sampling frame included universities in five world regions offering a graduate degree in public health; 166 academics responded. Descriptive, bivariate, and logistic regression analyses were conducted. Results: Over half of respondents were in favour of accepting funding from FPOs; attitudes differed by world region and gender but not by rank, contract status, % salary offset required, primary identity, or exposure to an ethics course. In the last 5 years, almost 20% of respondents had received funding from a FPO. Sixty per cent of respondents agreed that there was potential for bias in seven aspects of the research process, when funds were from FPOs. Conclusions: Globally, public health academics should increase dialogue around the potential harms of research and practice funded by FPOs.