Contributors’ takes all over the 2025 meant a lot to PEAH scope and aims. Find out here the relevant links whereby health access gaps and challenges worldwide are tackled from an equity based multidisciplinary One Health perspective

By Daniele Dionisio

PEAH – Policies for Equitable Access to Health

 2025: A Year in Review Through PEAH Contributors’ Takes

PEAH engages, under One Health perspective, with the best options for use of trade and government rules related to public health first and foremost in the resource-limited settings. In so doing, while aligning with World Health Organization’s definition of Health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, PEAH is aware that the health of people is closely connected to the health of animals and our shared environment 

Link HERE

Just at the beginning of a new year, I wish to pay homage to the many top thinkers, either stakeholders or academics, who contributed articles all over the 2025. My deepest gratitude goes to each of them as boosting voices in the One Health arena towards climate, ecosystems safeguarding and more inclusive, equitable directions for care, treatments, health technologies access for all. As invaluable food for thought, their insightful reflections meant a lot to PEAH scope and aims, while adding to debate worldwide how to equitably address health priority challenges from a One Health view encompassing the policies, strategies and practices of all involved actors.

Find out below the relevant links:

Conflict, Decolonization, and the Collapse of Health Systems: Reflections from Sudan  by Khlood Fathi 

Beyond Obesity Pills: Ethical Imperatives for a World of Excess, Hunger, and Ecological Breakdown  by Juan Garay 

The Global Polycrisis: Reframing Learning through One Health & Wellbeing for a Sustainable Earth  by George R. Lueddeke 

Toward a Healthier Planet and Humanity: Industrial Animal Agriculture, Glyphosate Risk, Slaughter Suffering, and the Case for a Global Plant-Based Dietary Transition  by Juan Garay 

COP30 Confirms the Near‑Irreversible Path to Human Self‑Destruction and Ecocide  by Juan Garay 

Legal Literacy: The Missing Pillar In Universal Health Coverage  by Sylvia Penelao Hamata 

Allostatic Load in the age of AI   by Brian Johnston 

Inequity in Antenatal Care Quality in Low- and Middle-Income Countries  by Hadiza Magaji Mahmoud 

The Role of Traditional Birth Attendants in Improving Maternal Health Outcomes in LMICs  by Yvonne Akukwe 

Knowledge and Utilisation of Malaria Prevention Strategy among Pregnant Women in Some Selected Primary Health Centres in Maiduguri, Borno State, Nigeria  by Samuel, Gabriel; Abdullahi, Mohammed Ibn; Danladi, Samuel Sam; Jonah, Japhet Haruna; Tweneboah, Emmanuel; Musa, Ahmed

Knowledge, Attitudes, and Practices of AI-Assisted Diagnostics Among Students of Master of Public Health in Ahmadu Bello University, Zaria, Nigeria  by Samuel, D., Jonah, J., Samuel, G., Amos, I., Eche, R.., Makinta, A., & Musa, H

Rethinking Global Health Metrics Beyond the Frontier: A Response to the GBD 2023 Mortality Report  by Juan Garay 

Beyond Green Complacency: WISE, SHEM and the Case for Radical Sharing  by Juan Garay 

Pitch for a UN General Assembly Special Session on Climate Change  by David Patterson 

India’s Demographic Wake-Up Call  by Veena S Rao 

Eliminating Dog Mediated Human Rabies from India by 2030: a Pipe Dream  by M K Sudarshan and Tanushree Mondal 

Storytelling to Combat Vaccine Hesitancy in Africa: Building Trust Through Narrative  by Kirubel Workiye Gebretsadik 

The Inequity Risks of AI When the Global Good Is Not the Goal  by Juan Garay 

Keeping Up the Quest for Sustainable Health Equity: Fifth Anniversary of SHEM  by Juan Garay 

Way Forward: Building a Resilient Healthcare System in Nepal  by Damodar Adhikari 

Toward Global Instability and Autocracy? A Critical Examination of the Trump Regime’s Global Impact  by George Lueddeke 

Breaking the Silence: Confronting Postpartum Depression and the Urgent Need for Mental Health Checks in Maternal Care  by Youmna Abdelnabi 

Climate Change and Health Disasters/Risks in Nepal  by Damodar Adhikari 

Valuing Medicines in Different Health Systems  by Andy Gray and Christiane Fischer 

Seville 2025: 5% for War, 0.25% for Life?  by Juan Garay 

Stethoscopes on Hold: Exploring the Employment Crisis Among New Doctors in the Kurdistan Region of Iraq  by Goran Abdulla Sabir Zangana 

Polio Eradication in Pakistan by 2050: Innovations, Gaps, and the Forgotten Human Factor  by Muhammad Noman

Stick by Stick, Big Tobacco Is Killing Africa’s Future: A Continental Call to Conscience  by Peter Unekwu-Ojo F.

Mental Health in Crisis Zones: A Personal Look at Hidden Wounds  by Rasha Almashhra 

The Pandemic Treaty’s Failure to Confront Profit-Driven Injustice in Global Health  by Juan Garay

Advancing Societal Understanding and Care for Our Worl: Regional Project Proposals  by George Lueddeke 

White Coats, Empty Pockets: The Silent Exploitation of Ethiopian Doctors  by Melaku Kebede 

Cultural Influences on Health of Migrant Women  by Sevil Hakimi 

Refugee Women’s Healthcare Accessibility: What We Should Know  by Sevil Hakimi 

BOOK REVIEW: MY JOURNEY WITH COMMUNITY MEDICINE – A MEMOIR  by Tanushree Mondal 

The Dilemmas of Localization for Climate Action: The Struggles of Local NGOs in Accessing Global Platforms in Countries Like South Sudan  by David Odukanga 

The Nexus Between Climate Change, Security Impact on Public Health, and WASH in South Sudan  by David Odukanga 

Tools for Healing: A Journey Through the Centuries from the Etruscan-Roman Era to the Robot. Testimonies from Tuscan Museums  by Esther Diana 

Rabies in India: Current Scenario and Prospects of Elimination  by Tanushree Mondal and M.K. Sudarshan 

Universities in the Early Decades of the Third Millennium: Saving the World from Itself? – and 1 HOPE-TDR Regional Project Proposals  by George Lueddeke 

Examining the U.N. Sustainable Development Goals (SDGs) Using a One Health Approach: Profiling Cambodia, Laos, Thailand, and Viet Nam  by Laura H. Kahn 

Framing Health and Well-Being: a Positive Confrontation Between Life and Social Sciences as a Trigger/Engine for Public Health Challenges  by Tomas Mainil 

Navigating a New Era: Africa’s Health Systems after USAID Funding and the Road Ahead  by Kirubel Workiye Gebretsadik 

”Cultivating an Active Care for the World and With Those With Whom We Share It”  by George Lueddeke 

Food Security – Back to Basics  by Philip J Gover 

The Sustainable Wellbeing Equity Index: An Ethical Reference to Wellbeing while Respecting Other Lives  by Juan Garay

 

The contributions highlighted above add to PEAH internal posts published in the year. Find the links below:

Interview: Clare Hanbury, CEO and Founder CHILDREN FOR HEALTH  by Daniele Dionisio

INTERVIEW: Sebastian Kevany  by Daniele Dionisio

2024: A Year in Review Through PEAH Contributors’ Takes  by Daniele Dionisio 

 

In the meantime, our weekly column PEAH News Flash has been serving as a one year-long point of reference for PEAH contents, while turning the spotlight on the latest challenges by trade and governments rules to the equitable access to health in resource-limited settings.

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Dustbin-lid jellyfish (Rhizostoma pulmo)

News Flash 646

Weekly Snapshot of Public Health Challenges

 

Stronger together: milestones that mattered in 2025

2025: A Brutal Year for Global Health

Rescued from Fire: the World in 2025

2025 in review: resilience tested as aid cuts run deep

Reflections on 2025 and the year ahead!

What We Know—and Don’t Know—About the Trump Administration’s Global Health Agreements

Registration: EB TODAY meetings in January

One Health for all: Implementing international frameworks with local communities

Protecting ​Children’s Health: Ensuring Vaccine ​Access Through Strong State Policies

Assessing the quality of antimalarial drugs in Equatorial Guinea: a follow-up study

Medical Product Alert N°7/2025: Falsified IBRANCE (palbociclib)

The global macroeconomic burden of diabetes mellitus

Rethinking and transforming health systems for dementia care in low- and middle-income country settings

Cervical Cancer in India: Early Marriage, Poor Screening and Gender Inequality Fuel a Preventable Killer

International core ethical principles for medical research put to the test: the newly revised Declaration of Helsinki

HRR798. WE NEED COURAGE TO PUT AN END TO THIS MADNESS; THAT IS WHAT POLITICAL AWARENESS (AND BEYOND) MEANS. (Jaime Breilh)

Green Horizons: Mobilizing Climate Capital to Support Safe Routes for Green-Skilled Displaced People

What makes people welcome or reject refugees? What research in Germany reveals

Women in Global Health 10 Years

The Fight Against Femicide: Victories and Setbacks in 2025

Sexual abuse and blood theft: What I found at a camp for Sudanese displaced from El Fasher

From sex differences to sex inequalities in life expectancy: A cross-country observational benchmarking analysis

People’s Health Dispatch Bulletin #111: People’s Health Movement turns 25

Conflict, Decolonization, and the Collapse of Health Systems: Reflections from Sudan  by Khlood Fathi

In Kenya, Smallholder Farmers Push Back Against Corporate Control of Agriculture

Crop loss deepens food insecurity across Africa

The Iodine blog: End-of-Year reflections: Protecting progress and renewing commitment

Conservation Impact Millionaires: Oliver Dauret

From Crisis to Control: How Delhi Can Build Resilient Systems for Air Pollution

UNEA-7 reaffirms Rio principles, advances global environmental action

 

 

 

 

IN A NUTSHELL
Author's Note 
This piece examines the impact of armed conflict on Sudan’s health system using the WHO health system building blocks framework, with reflections on global health equity and decolonization

By Khlood Fathi

MD | Public Health & Preventive Medicine Resident

Sudan 

Conflict, Decolonization, and the Collapse of Health Systems

Reflections from Sudan

 

We live in an era marked by an increasing number of armed conflicts, disproportionately affecting countries in the Global South. While calls for the “decolonization of global health” have grown louder in academic and policy spaces, these calls often remain rhetorical rather than transformative. Too often, conflict is framed as an inevitable characteristic of previously colonized, resource-rich countries, obscuring the political and economic forces that sustain instability. The “resource curse,” exemplified by countries such as the Democratic Republic of Congo, continues to shape global health inequities. Sudan is no exception.

Sudan, the third-largest country in Africa and rich in natural resources, including gold, has a long history of political instability. In April 2023, a devastating armed conflict erupted in the capital, Khartoum, and rapidly spread to multiple states. The consequences have been catastrophic: Sudan is now facing one of the largest humanitarian crises in recent history, with over 10 million internally displaced people and more than half of the population in need of humanitarian assistance. Among the most severely affected sectors is the health system, which has experienced widespread destruction and institutional disintegration, including the effective collapse of the Ministry of Health.

This article examines the impact of the conflict on Sudan’s health system using the World Health Organization’s six health system building blocks: service delivery, health workforce, health information systems, medical products and technologies, financing, and leadership and governance.

Service delivery has been profoundly disrupted. Health facilities, particularly hospitals, have been attacked, looted, or rendered nonfunctional. Insecurity has prevented both healthcare providers and patients from accessing services. The destruction of infrastructure in the capital—historically the logistical and administrative hub of the country—led to the loss of drug warehouses and vaccine stocks, resulting in severe shortages of both curative and preventive services. As supply routes were diverted away from conflict zones, delivery times for essential health commodities increased substantially.

The health workforce has also been heavily affected. Large-scale displacement included healthcare workers, many of whom fled to safer states or left the country altogether in search of security and economic stability, accelerating an already critical brain drain. While some displaced health professionals were absorbed into state-level health systems, often without formal integration or training, the relocation of highly skilled personnel from the capital paradoxically contributed to capacity-building in some peripheral states through informal mentorship and technical support.

Health information systems, a cornerstone of effective public health response, proved highly vulnerable to conflict. Attacks on telecommunications infrastructure caused prolonged nationwide internet outages, severely disrupting routine reporting to central digital platforms. These challenges were compounded by electricity shortages, destruction or theft of hardware, and the displacement of trained data personnel, resulting in major gaps in health surveillance and decision-making.

Access to medical products and technologies, already constrained before the conflict due to longstanding international sanctions, deteriorated further. Medical equipment was destroyed or stolen, maintenance and quality assurance became nearly impossible, and supply chains were severely disrupted. The relocation of central medical stores to other states extended procurement routes, while the destruction of local pharmaceutical manufacturing facilities further undermined the availability of essential medicines.

Health financing in conflict settings is often deprioritized in favor of defense and security spending. In Sudan, resource reallocation significantly reduced public funding for health, increasing dependence on non-governmental organizations. However, insecurity and instability led many NGOs to suspend or withdraw funding, a situation exacerbated by global aid cuts and shifting donor priorities toward more stable contexts.

Finally, leadership and governance were weakened by widespread staff displacement, high turnover, and institutional fragmentation. Yet, the forced decentralization of health governance also produced unintended consequences. As state ministries of health assumed greater responsibility for managing services and resources, a form of de facto decentralization emerged, revealing both the resilience and the limitations of subnational governance in crisis settings.

 

Conclusion

Sudan’s experience illustrates how armed conflict systematically dismantles health systems, deepening existing inequities and exposing the fragility of institutions in resource-rich but politically marginalized countries. Framing such crises as local or inevitable obscures the global political and economic dynamics that sustain them. Genuine decolonization of global health requires moving beyond rhetoric toward accountability, equitable financing, and sustained investment in national systems, especially in conflict-affected settings.

 

 

 

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Conger eel (Conger conger)

News Flash 645

Weekly Snapshot of Public Health Challenges

 

Webinar registration: Rethinking Corporate Accountability in Global Health: Beyond Rankings & Voluntary Measures Dec 19, 2025

Wrapping up 2025: A tumultuous year for global public health law & policy

What Public Health Won and Lost in 2025

ODI Global in conversation with Francesca Albanese

2025: MPP’s challenging but rewarding year

Donors In A Post-Aid World December 2025 update

DNDi 2025 Year in Review

G-FINDER data portal: tracking funding for global health R&D

World leaders adopt a historic global declaration on noncommunicable diseases and mental health

Governments must take concrete actions to ensure equitable access to medical tools for noncommunicable diseases and mental health conditions

Universal Health Coverage Day 2025

Global health architecture reform must be anchored in UHC

From Law to Lives Saved: How the Maternal Newborn and Child Health Bill Can Deliver Universal Health Coverage

On Omelas, cynicism, and the hard work of reimagining Global Health

A Reflection on Lions: The New Future of Development Cooperation Coalition

How can middle-income countries successfully transition away from international health aid?

Can aid centre communities without decentring states?

EU Clinches Landmark Pharma Reform, but Industry Cites Threat to Competitiveness

The Law That Saved America’s Vaccines—And That Secretary Kennedy Is Trying To Destroy

WHO expert group’s new analysis reaffirms there is no link between vaccines and autism

UNAIDS 2025 World AIDS Day report: Overcoming disruption, transforming the AIDS response

AMR data

FDA Approves First New Gonorrhoea Treatment in Decades Amid Rising Antibiotic Resistance

Preventing Anxiety and Depression in Pregnancy: A Landmark Trial from Pakistan

Liberia Faces FGM Crisis as Lawmakers Clash Over Ban

HRR797. ACHIEVING DATA JUSTICE REQUIRES MORE THAN REDUCING THE HARM OF THE CURRENT DATA FLOW AND DATA USE SYSTEM

Calls grow for fully integrated One Health surveillance

Climate crisis driving new disease threats in Africa

‘Extreme melting’ episodes are accelerating ice loss in the Arctic

Reflection on UNPO’s First Participation at UNFCCC COP30

When Frontline Communities Lead: Lessons From Five Years of Just Climate Action

 

 

 

 

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Wide-eyed flounder (Bothus podas)

News Flash 644

Weekly Snapshot of Public Health Challenges

 

Global health architecture reform must be anchored in UHC

World malaria report 2025

Malaria’s Changing Face: A Conversation with Professor Moss on the 2025 WHO Report

CDC Committee Delays Hepatitis B Vaccine for Newborns in Critical Guidelines Shift

$1.9 Billion in Pledges to Polio Eradication by Gates and Other Donors Narrows Funding Gap

Gavi Cuts Staff and Support to WHO and UNICEF – Gives More Freedom to Countries to Decide Vaccine Priorities

New data on antimicrobials sales and use in animals in the EU

Farming pressures fuel Africa’s drug resistance crisis

Cautious Signs of Progress on Lead Exposure in Bangladesh

Call For Submissions: Second Annual Research Conference on Global Lead Exposure

The Wall Protecting Public Health from Political Interference Has Fallen

In Public Health, Non-Governmental Actors Are Rising To Meet The Moment

Five takeaways from the UN’s aid plans for 2026

The UN aid coordination agency cuts its funding appeal after Western support plunges

On the International Human Rights Day, we demand a transformation of the UN that strengthens accountability and serves peoples not budgets

Access to essential medicines for noncommunicable diseases during conflicts: The case cardiovascular diseases, diabetes and epilepsy in Northern Syria

A call to respect medical neutrality and protect healthcare in every conflict

HRR796. IT IS PERFECTLY POSSIBLE TO PROVIDE SOCIAL SECURITY TO ALL. WHY IS IT NOT DONE? AFTER ALL, SOCIAL SECURITY IS A HUMAN RIGHT

How the EU actually worked to undermine Global South debt reforms

The Patchwork Workforce: Locum Doctors in Portugal

Once more unto the REACH – Europe’s winding road away from animal testing

Sweden’s mining industry is threatening the Indigenous Sami people’s way of life

Most countries make progress towards universal health coverage, but major challenges remain, WHO–World Bank report finds

Rural women, care and agrochemicals: A Call for Action 

How can better data curb Africa’s crop loss crisis?

Synthetic chemicals in food system creating health burden of $2.2tn a year, report finds

Sri Lanka & the Global Climate Emergency: The Lessons of Cyclone Ditwah

DNDi statement on COP30: Advancing health in the climate agenda

Still Possible to Divert from Disastrous Climate Path to Sustainable, Healthy Planet, says UNEP

How Community Radio Is Powering Tanzania’s Climate Resilience

 

 

 

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Dusky grouper (Epinephelus marginatus)

News Flash 643

Weekly Snapshot of Public Health Challenges

 

The Global Polycrisis: Reframing Learning through One Health & Wellbeing for a Sustainable Earth  by George R. Lueddeke 

Why plant health matters for One Health systems 

Webinar registration: Development Banks, Biodiversity, and Food Security: Complementary, or Contradictory?

The Untapped Power of Health Taxes in Sub-Saharan Africa

Opportunities to improve public health in China

AI’s impact could worsen gaps between world’s rich and poor, a UN report says

Africa is Stuck Between Global Pathogen-Sharing Talks and Conflicting US Bilateral Agreements

HIV prevention services hit hardest by funding cuts, UNAIDS warns

WHO Calls on Africa to Protect HIV Gains Amid Funding Cuts

New prevention tools and investment in services essential in the fight against AIDS

Health Beat #36 | Aids at 44: Will HIV-negative people take anti-HIV jabs?

Hepatitis C: a continuing public health challenge in China

International seminar explores the development of treatments for dengue for populations not covered by vaccines

Brazil Approves World’s First Single-Dose Dengue Vaccine

Measles is Surging as Vaccination Coverage Dips Below 95%

A Call to Action to Train Antimicrobial Stewardship Leaders to Combat AMR Globally, Especially in Resource-Limited Settings Like Sierra Leone

How insulin pens are changing lives in South Sudan’s remote villages

Sources of insulin, oral medicines, and medical devices for diabetes for low-and middle income countries

WHO issues global guideline on the use of GLP-1 medicines in treating obesity

Beyond Obesity Pills: Ethical Imperatives for a World of Excess, Hunger, and Ecological Breakdown  by Juan Garay

HRR795. THE FOOD SYSTEM THAT HAS TRAPPED US: WAKE UP AND YELL LOUDLY!

UNPO Advisory Board Member at UN Minority Forum Highlights the “Superpower” of Minority Perspectives

New Diplomatic Effort Underway to Reduce the Costs of Menstrual Products

Bringing medical care to Egyptian and Sudanese people in Aswan

Yemen’s Worsening Food Security Crisis: Economic Collapse, Continued Insecurity, and Humanitarian Challenges

Kenyan court declares law banning seed sharing unconstitutional

Reuse and return schemes could help eliminate plastic pollution in 15 years, says report

The Climate Briefing: What happened at COP30?

COP30 Editor’s take: Why climate policy needs to move beyond consensus

Coastal regions and climate change: how better risk assessment can help protect infrastructure and livelihoods

 

 

 

 

 

 

 

IN A NUTSHELL
Author's Note 
The WHO’s recent decision to consider anti-obesity drugs as essential medicines occurs in a world marked by profound contradictions: persistent global undernutrition, widespread overconsumption, accelerating ecological degradation, and unprecedented corporate concentration in the agri-food and pharmaceutical sectors. Industrial food systems generate vast ecological harm and animal suffering while driving both obesity and hunger. 
This article analyzes the ethical, ecological, and equity implications of medicalizing obesity, drawing on global health ethics, political ecology, and the author’s earlier work on sustainable health equity, as well as the principles articulated in the Sustainable Health Equity Movement (SHEM) webinars. It argues that pharmaceuticalizing a structurally produced problem risks perpetuating an economy of excess—of calories, material throughput, wealth accumulation, and ecological destruction—while deflecting attention from the structural transformations needed to achieve equitable and sustainable global health

By Juan Garay

Co-Chair of the Sustainable Health Equity Movement (SHEM)

Professor/Researcher of Health Equity, Ethics and Metrics (Spain, Mexico, Cuba, Brazil)

Founder of Valyter Ecovillage (valyter.es)

By the same Author on PEAH: see HERE

Beyond Obesity Pills

Ethical Imperatives for a World of Excess, Hunger, and Ecological Breakdown

 

Introduction

Today, the world confronts a fundamental ethical paradox: nearly one billion people lack sufficient nutrition, while another billion experience conditions of excess, especially obesity linked to ultra-processed and animal-dense diets (FAO, 2023; WHO, 2024). These phenomena are not isolated but interconnected outcomes of global systems that prioritize economic accumulation over health, justice, and ecological balance.

The author’s earlier work on sustainable health equity emphasized that inequities emerge from structural determinants—economic concentration, ecological overshoot, precarious living conditions, and food systems designed around profit rather than well-being. The Sustainable Health Equity Movement (SHEM) further elaborates these principles, arguing that health equity can only be achieved when economic, social, and ecological inequities are addressed together, as interdependent dimensions of one crisis.

It is in this context that the WHO’s decision to incorporate anti-obesity drugs into essential medicines lists must be critically examined.

Structural Roots of Global Nutritional Inequity

Hunger amid systemic abundance

Global hunger persists primarily because of inequitable distribution, political marginalization, conflict, and poverty, not because of inadequate food production (Sen, 1981; FAO, 2023). SHEM highlights that inequity is systemic: institutions, markets, and power structures create conditions in which hunger is reproduced generation after generation.

Overconsumption as a structural outcome

In many countries, obesity is fueled by:

industrial overproduction of cheap calories

aggressive marketing of ultra-processed foods

subsidies for livestock and monocultures

socioeconomic stressors and precarity

weakened regulatory institutions

These dynamics form what Stuckler and Nestle (2012) call the corporate determinants of health, in which harmful consumption patterns are shaped—and normalized—by powerful economic interests.

Ecological destruction and animal suffering

Industrial animal agriculture contributes to:

high greenhouse gas emissions

deforestation and biodiversity loss

water contamination

antibiotic resistance

the suffering of billions of sentient beings

SHEM emphasizes that ecological degradation and health inequity are inseparable: the communities most harmed by environmental damage are typically those with the least political and economic power.

Medicalization of Obesity

Addressing symptoms while ignoring causes

Pharmaceutical treatment of obesity, though beneficial for individuals, risks reinforcing a paradigm that focuses on downstream biomedical interventions rather than upstream determinants. The author’s earlier work on sustainable health equity argues that health cannot be sustainably improved if structural drivers remain unaddressed.

Expansion of pharmaceutical dependence

Anti-obesity drugs have become a rapidly expanding global market, propelled by:

industry lobbying

medicalization of structurally produced conditions

narratives that emphasize individual responsibility

This dynamic, as some critics argue, risks entrenching long-term dependence on costly pharmacological interventions while diverting attention from prevention and systemic reform.

Ethical concerns about essential medicine designation

Key risks include:

deepening inequities when expensive treatments remain inaccessible

normalizing unhealthy dietary patterns

reinforcing economic structures that benefit from systemic overconsumption

deprioritizing ecological and social determinants of health

Ethics of Sustainable Health Equity

Interdependence of health, ecology, and economy

SHEM proposes that equitable health outcomes require equity in economic distribution and ecological impact, because health cannot be sustained in contexts of concentrated wealth and ecological overshoot.

Planetary boundaries and moral responsibility

Human health relies fundamentally on ecological stability. The crossing of planetary boundaries undermines long-term determinants of health, including food security, water access, and climate resilience (Whitmee et al., 2015; IPCC, 2021).

Redistribution as ethical and ecological necessity

Hunger and obesity represent two faces of the same structural maldistribution of:

food

economic resources

ecological capacity

SHEM emphasizes that sustainability requires reducing excess—not only in dietary intake but also in economic accumulation, resource extraction, and environmental degradation.

Pathways Beyond Pharmaceutical Dependency

Transition to plant-rich and agroecological food systems

Plant-based and agroecological systems:

improve health

reduce chronic disease

lower environmental pressure

eliminate most animal suffering

enhance food sovereignty (Willett et al., 2019)

Strengthening public-interest food governance

Effective interventions include:

regulating harmful food environments

restricting ultra-processed food marketing

fiscal measures that discourage unhealthy consumption

supporting regenerative and community-based agriculture

Reducing corporate concentration

Excessive corporate power in agriculture, food production, and pharmaceuticals undermines equity, democracy, and ecological sustainability (Clapp, 2021)

Integrating sustainable equity metrics into health governance

Inspired by the author’s earlier work and the SHEM framework, essential medicines policies should incorporate:

ecological impacts

distributive justice

structural determinants of demand

long-term sustainability of interventions

This approach helps avoid embedding unjust structures into global health policy.

Conclusion

The rise of anti-obesity medication as an essential global health intervention reflects a world shaped by structural excess and structural deprivation. While pharmacological tools may provide relief for some, they risk reinforcing the economic models and ecological trajectories that produce both hunger and obesity.

Achieving sustainable and just global health requires transforming—and not merely medicating—the conditions of excess consumption, inequality, ecological degradation, and corporate concentration. Sustainable health equity demands rebalancing human nutrition within ecological limits, reducing avoidable suffering (human and non-human), and ensuring that all people have access to nutritious, ethically produced food.

Only by addressing these systemic drivers can global health move toward a future grounded in justice, sustainability, and compassion.

References

Apovian, C. M., et al. (2023). Pharmacotherapy for obesity—new insights and challenges. New England Journal of Medicine.

Clapp, J. (2021). Food. Polity Press.

FAO. (2013). Tackling climate change through livestock.

FAO. (2023). The State of Food Security and Nutrition in the World.

IPBES. (2019). Global Assessment Report on Biodiversity and Ecosystem Services.

IPCC. (2021). Sixth Assessment Report.

Monteiro, C. et al. (2018). Ultra-processed foods and global health. Public Health Nutrition.

Mozaffarian, D., et al. (2023). Transforming the food system for health and sustainability. BMJ.

Poore, J., & Nemecek, T. (2018). Reducing food’s environmental impacts. Science.

Raworth, K. (2017). Doughnut Economics.

Safran Foer, J. (2009). Eating Animals.

SHEM – Sustainable Health Equity Movement (2020–2024).

Webinar series, International Collaborative on Sustainable Health Equity.

Documents and presentations available through participating institutions and partner seminars.

Sen, A. (1981). Poverty and Famines.

Singer, P. (2009). Animal Liberation.

Stuckler, D., & Nestle, M. (2012). Big Food and global health. PLoS Medicine.

Swinburn, B. et al. (2019). The global syndemic. Lancet Commission.

Whitmee, S., et al. (2015). Health in the Anthropocene. The Lancet.

Willett, W. et al. (2019). EAT-Lancet Report.

IN A NUTSHELL
Author's Note 
...Humanity stands at a crossroads where the choices we make—and the values that guide them—will determine whether future generations inherit a flourishing planet or a diminished one. The One Health & Wellbeing concept, the Earth Charter Principles, and ecocentrically reframed UN SDGs together offer a coherent, ethical, and scientifically grounded pathway for realigning human societies with the Earth’s life-support systems. As the 1 HOPE–TDR initiative demonstrates, transforming learning across all societal levels is not simply an educational aspiration but a civilisational imperative. By embracing interconnectedness, shared 'meaning-making' and responsibility, alongside  a renewed ethic of care for all life, humanity can begin to build a just, sustainable, and peaceful world—one in which we finally learn to live in harmony with the planet that sustains us...

By George R. Lueddeke, PhD
Global Lead, International One Health for One Planet Education & Transdisciplinary Research Initiative (1 HOPE–TDR)
United Kingdom

The Global Polycrisis

Reframing Learning through One Health & Wellbeing for a Sustainable Earth

 

A World at Breaking Point

Humanity is living through a period of profound and accelerating transformation, much of it driven by extractive, growth-driven economic models and opportunistic power structures that disregard the limits of the Earth’s life-support systems. Climate instability, biodiversity collapse, geopolitical tensions and democratic erosion, water scarcity, pollution, zoonotic spillover, widening inequalities, and rapid technological disruption are converging into a “perfect storm” of unprecedented scale. These forces are no longer isolated trends—they are mutually reinforcing symptoms of a deeper imbalance between human societies and the natural world.

At the heart of this imbalance lies an educational crisis. Our learning systems still reflect a worldview built on human supremacy, compartmentalised knowledge, and economic growth as the overriding societal priority. This worldview—grounded in human exceptionalism and uncritical technological optimism—has become dangerously misaligned with the planet’s ecological boundaries. Societies today operate without a coherent moral compass in an era defined by existential risk, continuing to function within a mindset shaped by humancentrism (“it’s all about us”), fragmentation, and persistent short-termism—echoes of the pre-Copernican belief that the Earth was the centre of the universe.

Modern education systems—particularly universities—have not yet fully grasped the gravity of this historical moment. A widening gap has emerged between the complexity of cascading global challenges and society’s capacity to understand and respond to them. Increasingly, as institutions are being pushed “to replace education with indoctrination,” decision-makers recognise that transforming learning across all societal levels is essential to securing a more just, inclusive, sustainable, and peaceful future for both current and future generations.

Learning at a Crossroad: Transforming Our Worldview

Yet higher education continues to operate within an outdated paradigm that privileges disciplinary silos, credentialism, institutional competition, and market-driven logic. These traditions undermine the ecological literacy, ethical insight, and transdisciplinary collaboration essential for navigating civilisation-scale crises. If education does not evolve, societies will struggle to evolve with it. Put simply, the world cannot be “saved from itself” unless the systems that shape human understanding and decision-making are transformed.

It is in this context that this article examines the emergence and purpose of the International One Health for One Planet Education & Transdisciplinary Research Initiative (1 HOPE–TDR). Developed to bridge the widening gap between global risks and societal capacity, 1 HOPE–TDR provides a values-based, ecocentric, regionally coordinated framework for rethinking how societies learn, govern, and collaborate during an era of planetary upheaval (Fig. 1). Through the integration of One Health & Wellbeing, Earth Charter ethics, and an ecocentric reframing of the UN Sustainable Development Goals, the initiative offers foundations for a transformative shift in global learning—and ultimately, in humanity’s relationship with the Earth.

Figure 1. 1 HOPE–TDR Overview

© 2020 George R. Lueddeke
Adapted from Survival: One Health, One Planet, One Future (2020)

Evolution of an Integrated Knowledge Ecology

A vital step in this transformation is the creation of an integrated knowledge ecology—an understanding of the “interconnectedness of all things” that embraces diverse zones of knowledge extending far beyond academia. These include natural, political, economic, cultural, social, and ethical domains that shape human–Earth relations.

As Emeritus Professor Ronald Barnett (UCL Institute of Education) reminds us, universities and higher education generally carry ‘responsibility not only in sustaining any such ecology’ but also, more importantly, to strengthen it. By attending to all ecological zones, universities and all other education / research system providers  can realise their full potential as institutions with an active concern for the whole Earth — even the universe — and ensure that they remain “constantly adaptable to new circumstances as the world moves forward.

Rethinking the Human–Earth Relationship

It is within this expanded context that 1 HOPE–TDR has taken shape. Recognising that systems-level challenges require systems-level solutions, the initiative brings together the life, natural, physical, and social sciences (including ethics), the humanities, and global policy frameworks to catalyse a shift toward ecocentric, integrated learning and leadership.

As shown in Figure 2, the initiative is built on Barnett’s ecological zones framework and is supported by three mutually reinforcing pillars:

1. The One Health & Wellbeing (OHWB) concept
2. The Earth Charter principles
3. A reframed ecocentric reorientation of the UN Sustainable Development Goals

Figure 2. 1 HOPE–TDR Conceptual Building Blocks

The One Health & Wellbeing Concept

The OHWB concept offers a scientific and holistic understanding of how human health is inseparable from the wellbeing of non-human animals, plants, ecosystems, and planetary processes. It exposes the illusion that human prosperity can be achieved independently of nature. OHWB demonstrates that:

• the climate emergency is fundamentally a health and wellbeing emergency (all life).
• biodiversity loss threatens food systems, water quality, and economic stability.
• ecosystem degradation accelerates the emergence of infectious diseases.

Beyond its scientific grounding, OHWB invites a new ecological consciousness—one that recognises interdependence as the organising logic of life on Earth and underscores the urgent need for a new global all-life narrative.

The Earth Charter — Turning Conscience into Action

The Earth Charter complements this scientific foundation with a moral and ethical framework for building a just, sustainable, and peaceful world. Its four pillars—respect for the community of life, ecological integrity, social and economic justice, and peace—offer a much-needed ethical compass for a fractured world. They remind us that sustainability is fundamentally an ethical project requiring responsibility, compassion across species, and cultures grounded in reciprocity and care.

Reframing the UN Sustainable Development Goals Ecocentrically

Although the SDGs remain largely humancentric in structure, they provide a crucial platform for shifting toward an ecocentric worldview that recognises the interdependence of people, other species, and the Earth’s systems. None of the goals can be realised unless the planet’s life-support systems are stabilised.

Ecocentrism does not diminish human development; rather, it recognises that development is impossible if ecosystems collapse. Reframing the SDGs in this way aligns them with:

• the scientific reality of planetary boundaries, and
• the ethical commitments of the Earth Charter.

Together, OHWB, the Earth Charter, and ecocentrically-reframed SDGs form the triad that underpins 1 HOPE–TDR—providing the philosophical, ethical, and operational foundations for rethinking learning systems worldwide.

The One Health & Wellbeing Mandate for Systemic Transformation

By embedding these three core building blocks across policy, education, governance, decision-making, and practice, societies can begin to realign human activity with the wellbeing of the Earth and all interconnected life-support systems.

Drawing on foundational works such Survival: One Health, One Planet, One Future  including the Ten Propositions for Global Sustainability (Box), and Universities in the Early Decades of the Third Millennium: Saving the World from Itself? ,the integrated conceptual framework offers a coherent pathway for navigating converging existential risks. These elements strengthen the global sustainability narrative by connecting ethical responsibility, systems thinking, and transdisciplinary research with a shared commitment to safeguarding both present and future generations.

The future is not predetermined. It is shaped by the values we teach, the knowledge we cultivate, and the courage with which we act. If humanity is to “save the world from itself,” learning must lead the way.

Box: Ten Propositions for Global Sustainability

WHAT IF?

1. We recognised the Earth as a living community whose health and wellbeing underpin humanity’s future.
2. We shifted from a humancentric to an ecocentric worldview, aligning human development with the planet’s life-support systems.
3. Education at all levels prioritised ecological literacy, ethics, and systems thinking as the foundations for sustainable societies.
4. Universities became ecological, civic, and globally responsible institutions — serving future generations as well as present communities.
5. Governments adopted integrated One Health & Wellbeing approaches across all departments, policies, and ministries.
6. Economies were reoriented toward regeneration, circularity, and long-term planetary wellbeing rather than short-term profit.
7. Youth and future generations held a central role in shaping governance, innovation, and societal priorities.
8. Science and Indigenous Knowledge informed one another to guide decisions that respected Earth’s limits and cultural diversity.
9. Global collaboration replaced competition — connecting nations, disciplines, civil society, and business in service to a sustainable Earth.
10. We adopted a shared ethic of care — towards each other, other species, and the planet — anchored in the OWB and Earth Charter values and principles.

(© 2020 *Adapted from Lueddeke, G. R. (2020). Survival: One Health, One Planet, One Future.)

Building a Global Architecture for Learning Transformation

Informed by years of foundational development and driven by the imperative to optimise global sustainability, 1 HOPE–TDR advances several essential shifts:

• from human-centred health to the wellbeing of all species and ecosystems;
• from individualism to learning with, from, and for one another;
• from fragmented knowledge to integrative, transdisciplinary learning;
• from passive knowledge transmission to collaborative knowledge creation;
• from institution-centred models to deeper community engagement;
• from vested interests and power dynamics to altruism, compassion, and truth.

Anchored in these principles, 1 HOPE–TDR is establishing continental and regional steering committees and sub-regional coordinating groups to lead major regionally owned grant proposals under a shared theme:
One Health & Wellbeing for the Earth: Learning for Sustainability.

These committees engage multidisciplinary and multisector stakeholders, with strong emphasis on youth and marginalised communities. Dedicated secretariats—currently the University of Education, Winneba (Africa); the Institute of Hygiene and Tropical Medicine, NOVA University Lisbon (Europe); and the Institute for Advanced Studies, Federal University of Rio de Janeiro (Latin America and the Caribbean [LAC])—provide coherence and regional leadership. Plans are underway to extend initiatives to India, Southeast Asia, Oceania, and the Middle East.

Why Learning Must Be Reframed for a Sustainable Future

This wave of coordinated regional developments may represent one of the more significant global shifts now emerging in sustainability efforts. Increasingly, leaders recognise that learning is the master key—the mechanism through which worldviews evolve, values transform, institutions adapt, and societies discover new pathways forward. Learning is not confined to classrooms; it occurs in communities, governments, civil society, workplaces, homes, and rapidly expanding digital environments.

Concluding Comments

Humanity stands at a crossroads where the choices we make—and the values that guide them—will determine whether future generations inherit a flourishing planet or a diminished one. The One Health & Wellbeing concept, the Earth Charter Principles, and ecocentrically reframed UN SDGs together offer a coherent, ethical, and scientifically grounded pathway for realigning human societies with the Earth’s life-support systems. As the 1 HOPE–TDR initiative demonstrates, transforming learning across all societal levels is not simply an educational aspiration but a civilisational imperative. By embracing interconnectedness, shared ‘meaning-making’ and responsibility, alongside  a renewed ethic of care for all life, humanity can begin to build a just, sustainable, and peaceful world—one in which we finally learn to live in harmony with the planet that sustains us.

 

About the Author

George Lueddeke, PhD is Global Lead of the 1 HOPE–TDR initiative, advancing ecocentric-focused One Health & Wellbeing education and transdisciplinary research - rising above discipline silos. A recognised education developer, adviser, and author  across higher and medical education, population health, sustainability, and learning transformation, he writes and speaks widely on global risks and systemic solutions. He champions a just, sustainable, and peaceful future for all life on the planet. (Brief Bio)

 

 

 

 

 

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Tompot blenny (Parablennius gattorugine)

News Flash 642

Weekly Snapshot of Public Health Challenges

 

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Toward a Healthier Planet and Humanity: Industrial Animal Agriculture, Glyphosate Risk, Slaughter Suffering, and the Case for a Global Plant-Based Dietary Transition   by Juan Garay

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IN A NUTSHELL
Author's Note 
Industrial animal agriculture—driven by high-input, chemically intensive, and GMO-based feed systems—has become one of the most powerful contributors to climate change, biodiversity collapse, and global health burdens (Poore & Nemecek, 2018; Crippa et al., 2018). It also causes the mass suffering and slaughter of trillions of land and aquatic animals each year (Aleksandrowicz et al., 2016). Growing concerns over glyphosate exposure, especially its potential interactions with milk proteins such as casein, highlight additional risks embedded within current dietary patterns (Bouvard et al., 2015; WHO, 2015).

Plant-based diets, in contrast, consistently demonstrate strong benefits for human health, climate mitigation, and social equity (Willett et al., 2019; Tilman & Clark, 2014). 

Drawing on epidemiological research, environmental modeling, animal welfare evidence, and the ethical frameworks advanced by the Sustainable Health Equity Movement (SHEM, 2024), this manuscript reviews the scientific, ethical, and political case for reducing animal-based foods in favor of more plant-centered systems. It also integrates SHEM analyses of excess mortality arising from excess production, trade, and consumption—fueled by inequitable income and wealth structures and heavily reinforced by the global animal-based food industry

By Juan Garay

Co-Chair of the Sustainable Health Equity Movement (SHEM)

Professor/Researcher of Health Equity, Ethics and Metrics (Spain, Mexico, Cuba, Brazil)

Founder of Valyter Ecovillage (valyter.es)

By the same Author on PEAH: see HERE

 Toward a Healthier Planet and Humanity: Industrial Animal Agriculture, Glyphosate Risk, Slaughter Suffering, and the Case for a Global Plant-Based Dietary Transition 

Health, Ecology, Equity, and the Sustainable Health Equity Movement (SHEM)

 

 

Introduction

Modern animal agriculture operates on a scale without historical precedent. Tens of billions of terrestrial animals and vast, uncounted populations of aquatic animals are raised and slaughtered annually, often in systems that compromise basic welfare and expose workers, communities, and consumers to environmental and health risks (Aleksandrowicz et al., 2016; Poore & Nemecek, 2018). These systems rely heavily on genetically modified feed crops, herbicides such as glyphosate, and extensive water and land use (Bouvard et al., 2015; Clark et al., 2019).

Beyond ecological and health concerns, today’s food system is deeply linked to global inequity. As highlighted by SHEM (2024), excess production, trade, and consumption—driven by concentrated income and wealth—create avoidable morbidity and mortality, with industrial animal agriculture playing a central role in these unjust patterns. Corporate political influence from meat, dairy, feed, and agrochemical sectors further entrenches a system that prioritizes profit over planetary and human well-being (Dagevos & Voordouw, 2013).

This manuscript synthesizes scientific evidence on slaughter and suffering, glyphosate and casein risk hypotheses, health impacts of animal-based diets, and environmental and equity benefits of plant-based transitions.

Methods

This narrative review draws from:

Peer-reviewed epidemiological and toxicological studies (Sinha et al., 2009; Bouvard et al., 2015)

Meta-analyses on diet and mortality (Willett et al., 2019; Hallström et al., 2015)

Animal welfare and slaughter research (Aleksandrowicz et al., 2016)

Environmental and climate modeling (Clark et al., 2019; Poore & Nemecek, 2018)

Policy reports and investigative journalism (Crippa et al., 2018)

SHEM frameworks and sustainable-health equity analyses, including work linking excess mortality to inequitable production and consumption systems (SHEM, 2024).

The review also incorporates perspectives from climate governance debates (e.g., COP30) and sustainability scholarship.

Results

The Scale of Slaughter and Suffering

Industrial animal agriculture kills approximately 83 billion land animals each year, primarily chickens, pigs, and cattle (Aleksandrowicz et al., 2016). Aquatic slaughter exceeds even this scale: hundreds of billions of fish are killed annually, many without legitimate stunning—via methods such as ice-slurry immersion or CO₂ asphyxiation—prolonging suffering (Aleksandrowicz et al., 2016).

In dairy systems, the routine early separation and culling of male calves, treated as production by-products, represents a major and often overlooked animal welfare issue.

These realities demonstrate profound ethical concerns and reinforce the need for systemic dietary change.

Glyphosate, Casein, and Possible Synergistic Carcinogenicity

Glyphosate is widely used on herbicide-tolerant feed crops. Although regulatory bodies have established “acceptable daily intake” thresholds, scientific debate continues (Bouvard et al., 2015; WHO, 2015). Some animal and in vitro studies show that glyphosate formulations can induce proliferative or toxic responses in mammalian cells (Bouvard et al., 2015).

A theoretical—but currently under-studied—concern is the potential interaction between glyphosate and casein (milk protein), possibly enhancing carcinogenic processes. While human evidence remains limited, the plausibility identified in mechanistic studies warrants precaution and further epidemiological research.

Human Health and Chronic Disease

Large substitution meta-analyses show:

Replacing red and processed meats with legumes, whole grains, or nuts significantly reduces all-cause mortality and cardiometabolic disease (Sinha et al., 2009; Willett et al., 2019).

Cohort evidence indicates ~10% lower all-cause mortality among individuals adhering more strongly to plant-based diets (Hallström et al., 2015).

Vegetarian and vegan diets are associated with ~29% lower cardiovascular disease incidence and ~32% lower ischemic heart disease mortality (Tilman & Clark, 2014).

Evidence on dairy and cancer remains mixed, especially for hormonally sensitive cancers, and is further complicated by feed-related chemical exposures (e.g., glyphosate) (Bouvard et al., 2015).

Environmental and Emissions Impacts

Studies show that:

Switching to a vegan diet can reduce individual food-related GHG emissions by ≈46% (Clark et al., 2019).

Vegetarian and vegan diets routinely reduce emissions by one-third to one-half compared to high-animal-product diets (Poore & Nemecek, 2018).

Diet–climate–health co-benefits suggest mortality reductions of 6–10% if plant-based transitions were adopted at population scale (Willett et al., 2019; Tilman & Clark, 2014).

Equity, Excess Mortality, and Structural Drivers

SHEM (2024) emphasizes that modern societies suffer from excess mortality driven by:

Excess production

Excess trade and distribution of harmful commodities

Excess consumption

And deeply unequal income and wealth structures.

 

Industrial animal agriculture exemplifies these dynamics:

It generates environmental burdens borne disproportionately by poorer regions (Aleksandrowicz et al., 2016; Crippa et al., 2018).

It consumes land, water, and subsidies that could nourish many more people through plant-based systems (Tilman & Clark, 2014).

It reinforces inequitable global trade patterns and diet-related disease inequalities (SHEM, 2024).

Reducing animal-based diets therefore becomes not only a health and environmental strategy but also a key equity intervention.

Discussion

The findings support a multi-dimensional critique of industrial animal agriculture:

1. Widespread Suffering: Trillions of animals endure poor welfare and painful slaughter methods (Aleksandrowicz et al., 2016).
2. Chemical Risk: Glyphosate-heavy feed systems and the potential interactions between glyphosate and casein demand precaution and further research (Bouvard et al., 2015).
3. Human Health Benefits: Strong, consistent evidence shows that shifting toward plant-based diets reduces mortality and chronic disease (Willett et al., 2019; Hallström et al., 2015).
4. Climate & Ecosystem Recovery: Dietary change is among the most powerful levers for lowering emissions and protecting biodiversity (Clark et al., 2019; Poore & Nemecek, 2018).
5. Equity & Excess Mortality: SHEM’s analyses reveal how current animal-based food systems fuel avoidable deaths through inequitable production and consumption (SHEM, 2024).
6. Structural Barriers: Protein-industry lobbying and concentrated corporate power resist meaningful transformation (Dagevos & Voordouw, 2013).

The convergence of scientific, ethical, ecological, and equity evidence makes dietary transition an urgent moral responsibility.

Conclusion

Industrial animal agriculture causes profound and interconnected harms: ecological degradation, chemical exposure risks, chronic disease burdens, and the suffering of countless animals. Evidence around glyphosate—especially in combination with casein—adds further concern for long-term human health (Bouvard et al., 2015).

Plant-based dietary transitions offer a proven pathway toward lower emissions, reduced mortality, healthier ecosystems, and more equitable distribution of resources (Willett et al., 2019; Tilman & Clark, 2014). From a global equity viewpoint, reshaping diets aligns with the ethical principles advanced by SHEM, addressing excess mortality rooted in excess production, consumption, and wealth inequality (SHEM, 2024).

Transforming food systems is not merely advisable—it is essential. Integrating plant-based dietary goals into national guidelines, climate negotiations, and global health governance represents a practical and moral imperative for the decades ahead.

 

References

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