2024: A Year in Review Through PEAH Contributors’ Takes

Contributors’ takes all over the 2024 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

 2024: 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

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 2024. 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 (including, though not limited to, climate safeguarding, fair access to care, medicines and food, protection of disadvantaged/discriminated people and cultural diversity) from a view encompassing the policies, strategies and practices of all involved actors.

Find out below the relevant links:


Navigating the Labyrinth: Addressing the Structural Challenges for IMGs in the UK Healthcare System
  by G. Zangana, C. Flores, A. Elseraty, T. Wardani 

1 HOPE-TDR in a Nutshell  by George Lueddeke 

A Comprehensive Approach to Polio Eradication in Pakistan  by Muhammad Noman 

Ethical Equity Redistribution/Contribution to Global Good  by Juan Garay 

WHO and Immigrant Health Workers: A Social Justice Perspective  by Raymond Saner 

Enough is Enough, and More is Too Much: Between Basic Dignity and Excess/Hoarding Thresholds  by Juan Garay 

Geography of Global Injustice: State of the Burden of Global Health Inequity in 2023  by Juan Garay 

Committing Gainhopes Towards Low-Income Pregnant Women In Ethiopia  by Liele Netsanet 

The Price of Global Injustice in Loss of Human Life  by Juan Garay

USA Election 2024 ‘Take Time to Think – It is the Source of Power’  by George Lueddeke 

Identifying International Sustainable Health Models  by Juan Garay 

The Power of AI for Health Inequalities  by Brian Johnston 

A Dangerous Moment for America and the World  by George Lueddeke 

GER-Rwanda 2022-2024 Activity Report  by Innocent Musore 

You Can Ask for What You Need from Aged Care Services Videos  by Nikolaus Rittinghausen 

‘‘One Size Does Not Fit All’’ Podcast by The Centre for Cultural Diversity in Ageing  by Biljana Grbevska 

Reducing the Burden of Disease: A Prospective Link between Health Promotion and Preventive Medicine  by Shahzad Mahmood

Homo Interitans: Countries that Escape, So Far, the Human Bio-Suicidal Trend  by Juan Garay 

Proposal Highlight: Providing Sexual and Reproductive Health System for Marginalized Women in Northern Amhara Region, Ethiopia  by Liele Netsanet 

Empowering Women in Bugesera District for Climate Resilience, Rwanda  by Innocent Musore 

Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions  by Juan Garay 

Health and Financing  by Francisco Becerra-Posada 

Re-Orientation to Sustain Life on Earth: a PDF by George Lueddeke

Creating Aspirations in Aspiration District Yadgir, a Pre-Industrial Pocket of India  by Veena S Rao 

Betting on SDGs in a Disequal World  by George Lueddeke 

ARE YOU NOT ADDICTED TO CANNABIS? PROVE IT  by Nejat Hassen, Dr. Mohita Chadha, Dr. Michael Chaiton, Dr. Sumedha Kushwaha

Inadequate Access to Essential Medicines in Poor Countries by Christiane Fischer 

Impact of the Pandemic on Health Inequalities: How COVID-19 Exacerbated Existing Disparities  by Nicolas Castillo

Holistic Systemic Change to Care for All Life on Earth  by George Lueddeke 

Unmasking Gender Inequities in Health: Research Findings & A Roadmap to Gender-Equitable UHC  by Philip J Gover 

Stroke Awareness and Africa  by Kirubel Workiye Gebretsadik 

Restoring Broken Human Deal  by Juan Garay 

Impact of Digital Health on the Management of Infectious Diseases: Lessons Learned during the COVID-19 Pandemic  by Nicolas Castillo 

Empowering Gray House Communities Towards Vaccination Efforts: Navigating Fake Vaccination, Mobilizing Influencers, and Cultivating Trust  by Muhammad Noman 

Immunization Programs and Health Services  by Francisco Becerra-Posada 

Bridging the Gap: Elevating Preventive Healthcare in Pakistan’s Health Agenda  by Muhammad Noman 

Wavering Sexuality During Covid Pandemic  by Subhash Hira and Rajiv Hira 

Ethiopia: How Persistent Unemployment and Low Motivation Affect Health Workers and the Healthcare System  by Melaku Kebede 

Lessons From Ecuador: A One Health Perspective  by Laura H. Kahn 

Polio Eradication Strategies and Challenges: Navigating Hidden Risks  by Muhammad Noman 

WHO and Health & Environment: Need to Rethink Role of Civil Society  by Raymond Saner 

The Pandemic as Tipping Point, Revisited  by Ted Schrecker 

Neglected Tropical Diseases: Lessons for Future Pandemics and Global Health Preparedness  by Kirubel Workiye Gebretsadik 

 

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

PEAH’s Way of Championing the Worst Off  by Daniele Dionisio

FOCUS ON: Universities in the Early Decades of the Third Millennium: Saving the World from Itself?  by Daniele Dionisio

Interview to Ms. Gloria Nirere, Menstrual Health Training Lead in Uganda  by Daniele Dionisio 

INTERVIEW: Liele Netsanet, Gainhopes organization, Ethiopia  by Daniele Dionisio

Interview: Joan Kembabazi, Gufasha Girls Foundation, Uganda  by Daniele Dionisio 

2023: 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.

 

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* Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. Former director of the Infectious Disease Division at the Pistoia City Hospital (Italy), Dionisio is Head of the research project  PEAH – Policies for Equitable Access to Health. He may be reached at: danieledionisio1@gmail.com  

 

News Flash 602: Weekly Snapshot of Public Health Challenges

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

Vulcano island, Italy

News Flash 602

Weekly Snapshot of Public Health Challenges

 

The Year 2024: Hopes & Despairs

What’s shaping aid policy in 2025

If US Pulls Out of WHO, Will Other Member States Step Up?

WHO Bulletin: The ethics of research into health and climate change: call for papers

Webinar registration: Challenging the idea of “substandard and falsified medical products “: what role for WHO in facilitating geographically diversified medical manufacturing? Jan 21, 2025

Meeting registration: NCDA/UNIGE access to medicines, diagnostics and medical devices Jan 23, 2025

Join us for the online launch of the G-FINDER 2024 Neglected Disease R&D Report Thursday 30 JAN 2025, 13:00-14:30 GMT

What justifies public engagement in health financing decisions?

The Revised Declaration of Helsinki—Considerations for the Future of Artificial Intelligence in Health and Medical Research

AI chatbot deployed to target drug resistance

Bridging the Digital Divide in Health Care: A New Framework for Equity

5 years after UK aid merger, 60% of development adviser jobs are empty

Navigating the Labyrinth: Addressing the Structural Challenges for IMGs in the UK Healthcare System  by G. Zangana, C. Flores, A. Elseraty, T. Wardani 

New EU rules for health technology assessments become effective

Medicine availability and affordability for paediatric cancers, China

Fragmented markets for older antibiotics and child formulations, Denmark, Norway, Sweden

Prices, availability, and affordability of adult medicines in 54 low-income and middle-income countries: evidence based on a secondary analysis

Drug Price Negotiation Requires Oversight To Protect Older Americans

Monitoring essential medicines access—unfinished business

Pakistan’s New Commitment to End Hepatitis Needs a People-Centered Approach

Improving Primary Healthcare in Pakistan – Transformation of an Underutilized Resource to Become a Beacon of Hope for Women and Children

People’s Health Dispatch Bulletin #92: AMR and medical genocide as weapons of imperialist war

Australia violated rights of asylum seekers held in Nauru, UN watchdog says

To succeed, Kenya should learn from other social health insurance reforms

HRR753. WHO KILLED CLASS IN ECONOMICS? INEQUALITY WAS TRADITIONALLY THE CENTRAL CONCERN OF ECONOMISTS –UNTIL IT WAS NOT

150 Nobel and World Food Prize winners call for food security ‘moonshot’

Food Security – Back to Basics  by Philip J Gover 

Solving climate change requires changing our food systems

Addressing Climate Change by Changing Our Food Systems

Health is the new Global Plastics Treaty Battleground

Earth records hottest ever year in 2024 and crosses key 1.5C threshold

 

 

 

Food Security – Back to Basics

IN A NUTSHELL
Author's Note
Addressing the challenges of food security requires a multifaceted approach, encompassing sustainable agricultural practices, technological innovation, policy interventions, and shifts in consumer behavior. This will require a concerted effort from governments, international organizations, civil society, and individuals to create a more sustainable and equitable food system that meets the needs of current and future generations

 

By Philip J Gover BA MA MPH

Public Health Consultant, Cooperation Works

Food Security – Back to Basics

 

  1. Definition of Food Security

Food security is a complex and multifaceted concept that extends beyond simply having enough food to eat. It encompasses the availability, accessibility, utilization, and stability of nutritious food for all people at all times.

  • Availability: This refers to the physical presence of sufficient quantities and qualities of food in a given area. It is influenced by factors such as agricultural production, food imports/exports, food aid, and the efficiency of food supply chains. Climate change significantly impacts food availability. For example, rising temperatures can lead to reduced crop yields, while increased frequency and severity of extreme weather events, such as droughts, floods, and heatwaves, can devastate crops and livestock, impacting food production and availability (Wheeler & von Braun, 2013).
  • Access: Access to food depends on an individual’s or household’s ability to obtain appropriate foods for a nutritious diet. This is influenced by economic factors such as income and purchasing power, as well as physical and social factors such as access to markets, transportation, and cultural norms. Poverty, income inequality, and discrimination can severely limit access to food, even when it is physically available. For instance, low-income households may not be able to afford nutritious foods, while marginalized communities may face barriers to accessing markets and obtaining affordable, healthy food options. This can be further exacerbated by limited access to transportation, particularly in rural areas, making it difficult to reach markets and obtain fresh, nutritious food (Sen, 1981).
  • Utilization: This dimension encompasses how the human body effectively uses the nutrients from consumed food. It includes factors such as food safety, hygiene, and the presence of underlying health conditions that may impair nutrient absorption. For example, poor sanitation and inadequate access to clean water can increase the risk of foodborne illnesses, such as diarrhea, which can lead to malnutrition, dehydration, and hindered growth and development. Moreover, underlying health conditions such as HIV/AIDS and chronic diseases can impair nutrient absorption and increase vulnerability to malnutrition (Pinstrup-Andersen, 2009).
  • Stability: This refers to the consistent availability of adequate food over time. Disruptions to food security can be caused by economic shocks, such as price fluctuations and market instability, as well as by climate variability, natural disasters, and political instability (Tendall et al., 2015). For example, economic downturns can lead to job losses and income insecurity, reducing people’s ability to purchase food. Similarly, armed conflicts, political instability, and natural disasters can disrupt food production, distribution, and access, leading to widespread food insecurity and displacement of populations.

Recognizing the evolving understanding of food security, two additional dimensions have been proposed:

  • Agency: This dimension emphasizes the importance of individual and community empowerment in shaping food systems. It recognizes that food security is not merely about receiving food, but also about having the power to make informed choices about food production, distribution, and consumption. This includes the right to participate in decision-making processes that affect food systems, access to information and resources that support sustainable food practices, and the ability to control their own food systems (Clapp et al., 2021). For example, empowering smallholder farmers through access to markets, technology, and training can enhance their agency and contribute to more sustainable and equitable food systems.
  • Sustainability: This dimension focuses on the long-term viability of food systems, ensuring that they can meet the needs of current and future generations without compromising ecological, economic, or social foundations. It emphasizes the need for food systems that are environmentally sustainable, socially equitable, and economically viable. This includes ensuring the sustainable use of natural resources, minimizing environmental impacts, and promoting social equity throughout the food supply chain (Béné, 2019).

Understanding these interconnected dimensions is crucial for developing comprehensive strategies to achieve food security for all. It is important to note that these dimensions are not mutually exclusive and often interact in complex ways. For example, improving agricultural productivity (availability) without addressing poverty and inequality (access) may not lead to improved food security outcomes for all members of society.

  1. Importance of Sustainable Agricultural Practices 

Sustainable agricultural practices are crucial for ensuring long-term food security while safeguarding environmental resources and promoting social equity. They aim to meet the present food needs of humanity without compromising the ability of future generations to meet their own needs. This necessitates a shift from conventional, often resource-intensive agricultural practices towards more sustainable approaches that prioritize environmental stewardship, social justice, and economic viability.

Key principles of sustainable agriculture include: 

  • Soil Health Management: Healthy soils are the foundation of sustainable agriculture. Practices such as conservation tillage, cover cropping, and crop rotation are essential for maintaining and improving soil health. Conservation tillage, which minimizes soil disturbance, reduces soil erosion, enhances water infiltration, and improves soil organic matter content (Lal, 2004). Cover crops, such as legumes and grasses, planted between main crops, help to suppress weeds, prevent soil erosion, and improve soil fertility by adding organic matter and fixing nitrogen. Crop rotation, the practice of planting different crops in the same field in successive seasons, helps to break disease and pest cycles, improve soil structure, and maintain soil fertility.
  • Efficient Water Use: With agriculture accounting for a significant portion of global freshwater withdrawals, improving water use efficiency is critical. Techniques such as drip irrigation, which delivers water directly to plant roots, and deficit irrigation, which involves withholding water during specific growth stages, can significantly reduce water consumption while maintaining or even increasing crop yields (Postel et al., 2001). Drip irrigation, for example, can reduce water use by up to 60% compared to flood irrigation while increasing crop yields by 20-90% (Postel et al., 2001). Water harvesting techniques, such as rainwater harvesting and the construction of small dams, can also improve water availability in regions with limited rainfall.
  • Biodiversity Conservation: Maintaining and enhancing biodiversity in agricultural landscapes is crucial for ecosystem services such as pollination, pest control, and nutrient cycling. Practices such as intercropping, the cultivation of multiple crops simultaneously on the same land, can increase biodiversity and provide natural pest control. Agroforestry, the integration of trees with crops or livestock, can enhance soil fertility, improve water infiltration, and provide shade for crops. Maintaining hedgerows and other natural features on farms can provide habitat for beneficial insects and pollinators, contributing to a more balanced and resilient agroecosystem. A meta-analysis by Tschumi et al. (2015) found that increasing on-farm plant diversity can enhance pest control and pollination services by 16% and 50%, respectively, reducing the need for chemical inputs.
  • Integrated Pest Management (IPM): IPM combines biological, cultural, physical, and chemical control methods to manage pests and diseases while minimizing environmental risks. This approach emphasizes the use of natural enemies, such as predatory insects and beneficial microorganisms, to control pests. Cultural practices, such as crop rotation and the use of pest-resistant varieties, can also help to reduce pest populations. Physical controls, such as the use of row covers and barriers, can prevent pests from reaching crops. Chemical controls, such as the use of pesticides, should be used as a last resort and only when necessary, and should be applied in a targeted and responsible manner. Studies have shown that IPM can reduce pesticide use by up to 50% without compromising crop yields (Pretty & Bharucha, 2015).
  • Climate-Smart Agriculture: Climate-smart agriculture practices aim to increase agricultural productivity and incomes, adapt and build resilience to climate change, and reduce and/or remove greenhouse gas emissions where possible (FAO, 2013). These practices include the use of drought-resistant crop varieties, improved water management, and the use of cover crops to sequester carbon. For example, the development and adoption of drought-resistant crop varieties can help farmers maintain yields in the face of increasingly unpredictable weather patterns. Improved water management practices, such as rainwater harvesting and efficient irrigation techniques, can help to reduce water consumption and minimize the impact of drought. The use of cover crops can help to improve soil health, reduce erosion, and sequester carbon dioxide, mitigating the impacts of climate change.

The benefits of sustainable agriculture extend beyond environmental considerations. By reducing reliance on external inputs, such as synthetic fertilizers and pesticides, and diversifying income streams through agrotourism, value-added product development, and other non-farm activities, sustainable agriculture can improve farm profitability and resilience to market shocks. Furthermore, by promoting fair labor practices, community engagement, and the preservation of traditional farming knowledge, sustainable agriculture can contribute to rural development and social equity. 

  1. Challenges in Global Food Systems 

Global food systems face a multitude of interconnected challenges that threaten food security and sustainable development. These challenges are exacerbated by climate change, resource depletion, economic inequalities, and geopolitical factors, creating a complex and interconnected web of issues that require multifaceted solutions.

  • Climate Change: Climate change poses a significant and growing threat to global food security. Rising global temperatures, altered precipitation patterns, and increased frequency and severity of extreme weather events (droughts, floods, heatwaves) are impacting crop yields, livestock productivity, and the availability of water resources.
    • Impacts on Crop Production: Changes in temperature and precipitation patterns can directly impact crop yields. For example, prolonged periods of drought can lead to crop failure, while excessive rainfall can cause flooding and soil erosion, damaging crops and reducing yields. Increased temperatures can accelerate crop maturation, leading to reduced yields and lower nutritional quality. Moreover, climate change can increase the incidence and severity of pests and diseases, further impacting crop production.
    • Impacts on Livestock Production: Climate change can significantly impact livestock production. Rising temperatures can increase heat stress in animals, leading to reduced productivity, increased mortality rates, and decreased milk and meat production. Changes in rainfall patterns can affect the availability and quality of forage, impacting livestock feed and nutrition.
    • Impacts on Aquatic Ecosystems: Rising sea levels, ocean acidification, and changes in ocean currents can disrupt marine ecosystems, impacting fish stocks and other aquatic resources. This can have significant implications for food security, particularly for coastal communities that rely heavily on fisheries for their livelihoods and food sources. 
  • Resource Depletion: Soil degradation, water scarcity, and biodiversity loss are major challenges facing global food systems. Intensive agricultural practices, such as excessive use of fertilizers and pesticides, contribute to soil erosion, nutrient depletion, and water pollution. Overexploitation of water resources for irrigation threatens agricultural productivity and can lead to water scarcity and conflicts. Deforestation and habitat destruction are leading to significant biodiversity loss, impacting pollinators, natural predators, and other essential components of healthy ecosystems.
  • Biodiversity Loss: The loss of biodiversity in agricultural landscapes has significant implications for food security. Biodiversity plays a crucial role in maintaining ecosystem services such as pollination, pest control, and nutrient cycling. The decline of pollinators, such as bees and butterflies, due to habitat loss, pesticide use, and climate change, can significantly impact the production of many fruits, vegetables, and other crops. Similarly, the loss of natural predators can lead to increased pest outbreaks, requiring greater reliance on chemical pesticides, which can have negative environmental and human health impacts.
  • Economic Inequalities: Poverty and income inequality remain major drivers of food insecurity, limiting access to nutritious food for millions of people. Even when food is available, economic constraints can prevent individuals and households from acquiring sufficient quantities of nutritious food. This can lead to undernutrition, micronutrient deficiencies, and a higher risk of diet-related non-communicable diseases. Furthermore, economic inequalities can exacerbate the impacts of other challenges, such as climate change and resource depletion, as marginalized communities are often more vulnerable to the negative consequences of these challenges.
  • Food Waste and Loss: A significant portion of food produced for human consumption is lost or wasted throughout the food supply chain, from production and harvesting to transportation, storage, and consumption. Food waste and loss not only represent a significant economic loss but also contribute to environmental degradation, as food waste in landfills generates methane, a potent greenhouse gas. Reducing food waste and loss is crucial for improving food security and mitigating climate change.
  • Geopolitical Factors: International trade policies, conflicts, and geopolitical instability can significantly disrupt food production, distribution, and access. Trade restrictions, export bans, and armed conflicts can disrupt food supply chains, limit access to essential agricultural inputs, and displace populations, leading to food shortages and increased vulnerability to food insecurity.

These challenges are interconnected and often exacerbate one another. For example, climate change can exacerbate water scarcity, leading to reduced agricultural productivity and increased competition for water resources. Economic inequalities can limit access to resources and technologies needed to adapt to climate change, leaving vulnerable populations more exposed to its impacts. Addressing these challenges requires a multifaceted approach that considers the interconnectedness of these factors and recognizes the need for integrated solutions. 

  1. Role of Technology in Agriculture

    Technology plays a crucial role in addressing the challenges facing global food systems and enhancing agricultural productivity and sustainability. Advancements in technology offer the potential to increase yields, improve resource use efficiency, and enhance resilience to climate change. However, it is essential to ensure that technological advancements are developed and implemented responsibly, considering ethical, social, and environmental implications. 

  • Precision Agriculture 

Precision agriculture technologies, such as GPS guidance systems, remote sensing, and variable rate technology (VRT), enable farmers to optimize resource use and improve farm management practices. 

  • GPS Guidance Systems: These systems enable tractors and other farm machinery to operate with high accuracy, reducing overlaps and minimizing input use. For example, GPS-guided tractors can apply fertilizers and pesticides more precisely, reducing waste and environmental impact. Studies have shown that GPS-guided tractors can reduce fuel consumption by up to 6% and fertilizer use by up to 10% (Balafoutis et al., 2017). 
  • Remote Sensing: Utilizing satellites, drones, and other technologies, remote sensing provides valuable data on crop health, soil moisture levels, and pest infestations. This allows farmers to identify and address problems early, optimize resource use, and minimize yield losses. For example, remote sensing can be used to identify areas of nutrient deficiency, allowing farmers to apply fertilizer only where needed, reducing input costs and minimizing environmental impact (Mulla, 2013). 
  • Variable Rate Technology (VRT): VRT allows for the precise application of inputs such as fertilizers, pesticides, and seeds based on site-specific variations in soil fertility, topography, and crop needs. This approach can significantly reduce input use while maximizing yields. Studies have demonstrated that VRT can reduce herbicide use by up to 60% while maintaining or even increasing crop yields (Grisso et al., 2011). 
  • Biotechnology and Genetic Engineering 

Biotechnology offers significant potential for improving crop productivity and resilience. 

  • Drought-resistant crops: Genetically modified crops that can withstand water stress are crucial in regions facing increasing water scarcity. For example, drought-tolerant maize varieties developed through genetic engineering have shown yield advantages of 15-25% under drought conditions (Nuccio et al., 2018). These technologies can help ensure food security in regions vulnerable to climate change.
  • Pest-resistant varieties: Genetically engineered crops that produce their own insecticides or are resistant to specific pests can reduce reliance on chemical pesticides, benefiting both farmers and the environment. BT cotton, for example, has significantly reduced pesticide use and increased yields globally (Klümper & Qaim, 2014).
  • Biofortification: Enhancing the nutritional content of staple crops through genetic modification can help address micronutrient deficiencies. Golden Rice, enriched with beta-carotene, offers a promising solution to Vitamin A deficiency in rice-dependent populations (Potrykus, 2010).
  • Data Analytics and Artificial Intelligence 

The application of big data analytics and artificial intelligence (AI) in agriculture is revolutionizing decision-making processes:

  • Predictive analytics: By analyzing historical data on weather patterns, crop yields, and market trends, AI algorithms can predict crop yields with greater accuracy, allowing farmers to make informed decisions about planting times, crop selection, and resource allocation. Studies have shown that AI-powered predictive models can improve yield predictions by up to 30% compared to traditional methods (Liakos et al., 2018).
  • Machine learning for pest management: AI algorithms can analyze images and data to detect early signs of pest infestations or diseases, enabling timely and targeted interventions. This can significantly reduce the need for broad-spectrum pesticides, minimizing environmental impact and improving farm profitability.
  • Blockchain technology: Blockchain can enhance traceability in food supply chains, improving food safety and reducing fraud. This technology allows for the tracking of food products from farm to table, increasing transparency and accountability.
  • Robotics and Automation 

Robotics and automation are increasingly being used in various aspects of agriculture:

  • Autonomous tractors and harvesters: These technologies can operate 24/7, increasing efficiency and reducing labor costs. Studies suggest that autonomous tractors could reduce operational costs by up to 60% (Lowenberg-DeBoer et al., 2020).
  • Robotic weeding and harvesting: Precision robots can target individual plants for weeding or harvesting, reducing the need for herbicides and addressing labor shortages. Robotic weeders can reduce herbicide use by up to 90% in some crops (Fennimore et al., 2016).
  • Automated irrigation systems: These systems can optimize water use based on real-time soil moisture data and weather forecasts, potentially reducing water consumption by 30-70% compared to conventional irrigation methods (Monaghan et al., 2013). 
  1. Importance of Local Food Systems

    Local food systems, which emphasize the production, processing, and consumption of food within a defined geographical area, play a crucial role in promoting food security, enhancing community resilience, and fostering sustainable development. By shortening food supply chains, reducing reliance on long-distance transportation, and strengthening local economies, local food systems offer numerous benefits. 

  • Enhanced Food Security: Local food systems can contribute significantly to enhancing food security at the community level by increasing the resilience of communities to external shocks, such as natural disasters, economic crises, and global supply chain disruptions. During the COVID-19 pandemic, for example, many communities experienced disruptions in global food supply chains, leading to shortages of certain food items. In contrast, local food systems proved to be more resilient, as communities were able to rely on local producers for essential food supplies, ensuring continued access to food even during times of crisis (Béné, 2020).
  • Improved Nutrition and Food Quality: Local food systems often prioritize the production and consumption of fresh, seasonal produce, which can lead to improved nutrition and food quality. Shorter supply chains minimize nutrient loss during transportation and storage, ensuring that consumers have access to fresher, more flavorful, and potentially more nutritious food. Moreover, local producers often prioritize sustainable and organic farming practices, reducing exposure to harmful chemicals and enhancing the nutritional quality of locally produced food.
  • Environmental Conservation: Local food systems can contribute significantly to environmental conservation by reducing the need for long-distance transportation, which reduces greenhouse gas emissions and fossil fuel consumption associated with food production and distribution. By minimizing the distance traveled by food, local food systems can significantly reduce the carbon footprint of the food system. Furthermore, local food systems can support the preservation of agricultural land, protect biodiversity, and promote the use of sustainable agricultural practices.
  • Economic Benefits for Local Communities: Local food systems can stimulate local economies by creating jobs in food production, processing, and distribution. They can also increase the local economic multiplier effect as money circulates within the community, supporting local businesses and strengthening the local economy. By supporting small-scale farmers and local food businesses, local food systems can contribute to rural economic development and help revitalize rural communities.
  • Social and Cultural Benefits: Local food systems can contribute to the preservation of cultural food traditions, supporting the continued production and consumption of traditional varieties and local foods. They can also strengthen social connections within communities by fostering relationships between producers and consumers. Farmers’ markets, community-supported agriculture (CSA) programs, and other local food initiatives can provide opportunities for direct interaction between producers and consumers, building social capital and fostering a sense of community.

Challenges and Opportunities 

While local food systems offer numerous benefits, they also face several challenges: 

  • Seasonality and Climate Limitations: The availability of locally produced food can vary significantly throughout the year due to seasonal variations in production and climatic conditions.
  • Infrastructure Needs: Many areas lack the necessary infrastructure to support the growth of local food systems, such as processing facilities, distribution networks, and cold storage.
  • Economic Viability: Small-scale local producers may struggle to compete with larger, more efficient operations in terms of price and volume. 

Addressing these challenges requires a multi-pronged approach: 

  • Supporting local markets: Establishing and supporting farmers’ markets, community-supported agriculture (CSA) programs, and other local food markets can provide valuable outlets for local producers and connect them with consumers.
  • Investing in local food infrastructure: Investing in processing facilities, distribution networks, and cold storage can help improve the efficiency and competitiveness of local food systems.
  • Promoting agroecological practices: Encouraging the adoption of agroecological practices, such as organic farming and integrated pest management, can enhance the environmental and social sustainability of local food systems.
  • Building community partnerships: Fostering collaboration between producers, consumers, and other stakeholders, such as chefs, retailers, and policymakers, can help overcome challenges and build stronger, more resilient local food systems. 

Despite these challenges, local food systems offer significant potential for enhancing food security, promoting sustainable development, and improving the quality of life for communities around the world. 

  1. Nutrition and Health Implications

Access to nutritious food is essential for human health and well-being, impacting physical and cognitive development, disease prevention, and overall quality of life.

  • Undernutrition and Micronutrient Deficiencies 

Undernutrition, encompassing a spectrum of conditions from micronutrient deficiencies to severe acute malnutrition, remains a major public health challenge, particularly in developing countries. 

  • Stunting: Stunting, characterized by impaired growth and development, is a major consequence of chronic undernutrition in early childhood. It has long-term consequences for physical and cognitive development, impacting educational attainment, productivity, and overall health outcomes throughout the life course. Stunting can lead to reduced cognitive function, impaired physical growth, and increased susceptibility to chronic diseases later in life, such as heart disease and diabetes (Black et al., 2013).
  • Wasting: Wasting, characterized by low weight for height, indicates severe acute malnutrition and is often associated with increased mortality rates. It is a serious public health concern, particularly among children, and can have severe and long-lasting consequences for physical and cognitive development. Children who experience wasting are at increased risk of infections, weakened immune systems, and impaired cognitive development.
  • Micronutrient Deficiencies: Deficiencies in essential micronutrients, such as iron, zinc, vitamin A, and iodine, can have severe health consequences, including anemia, impaired cognitive development, and increased susceptibility to infections. Iron deficiency anemia is a widespread problem, particularly among women and children, leading to fatigue, weakness, and impaired cognitive development. Vitamin A deficiency can lead to blindness and increased susceptibility to infections. Iodine deficiency can cause goiter and impair cognitive development, particularly in children. These micronutrient deficiencies can have significant impacts on human capital and economic development.
  • Overweight and Obesity 

The global shift towards diets high in processed foods, added sugars, and unhealthy fats has contributed to a significant rise in overweight and obesity rates worldwide. Overweight and obesity increase the risk of developing chronic diseases such as cardiovascular disease, type 2 diabetes, and certain types of cancer. This “nutrition transition” poses significant challenges for public health systems and economies.

  • Diet-Related Non-Communicable Diseases (NCDs): Overweight and obesity are major risk factors for the development of NCDs, which are now the leading cause of death globally. These diseases, including heart disease, stroke, type 2 diabetes, and certain types of cancer, place a significant burden on healthcare systems and economies, impacting productivity, quality of life, and economic development.
  • Coexistence of Undernutrition and Overweight: Many countries face a “double burden” of malnutrition, with the coexistence of undernutrition, micronutrient deficiencies, and overweight/obesity within the same population. This can occur within households, with some members experiencing undernutrition while others struggle with overweight or obesity. This complex challenge requires multifaceted interventions that address both undernutrition and overnutrition simultaneously. 
  • Nutrition and Older Adults 

Older adults face unique nutritional challenges, including changes in physiological needs, reduced appetite, difficulty chewing and swallowing, and increased risk of chronic diseases. 

  • Chronic Diseases: Many older adults suffer from chronic conditions such as diabetes, cardiovascular disease, and arthritis, which can significantly impact their nutritional needs and dietary requirements.
  • Malnutrition in Older Adults: Malnutrition is a common problem among older adults, often overlooked and underdiagnosed. It can lead to muscle loss, weakened immune systems, increased risk of falls, and decreased quality of life.
  • Dietary Needs of Older Adults: Older adults require a balanced diet rich in fruits, vegetables, whole grains, and lean protein to maintain optimal health. They may also require dietary supplements to ensure adequate intake of essential nutrients. 
  • Nutrition and Prison Populations 

Prisoners are a unique population group, especially in low-income economies, that often experience extremely poor food and health outcomes due to limited access to nutritious food, inadequate healthcare, and high rates of chronic diseases (Gover & Villar 2024). 

  • Poor Diet Quality: Prison diets often lack adequate fruits, vegetables, and whole grains, while being high in processed foods, refined carbohydrates, and unhealthy fats. This can contribute to an increased risk of chronic diseases, such as obesity, diabetes, and cardiovascular disease.
  • Limited Access to Healthcare: Access to quality healthcare services is often limited in prison settings, hindering the prevention and management of chronic diseases and other health conditions.
  • Mental Health: Poor nutrition can significantly impact mental health, contributing to increased rates of depression, anxiety, and other mental health issues among prisoners. 

Addressing these nutritional challenges in prison settings is crucial for improving the health and well-being of incarcerated individuals and reducing the long-term health consequences of incarceration.

  1. Policies for Promoting Sustainable Agriculture 

Effective policies are crucial for supporting sustainable agricultural practices and creating an enabling environment for food security. Government policies can play a significant role in incentivizing sustainable farming practices, addressing market failures, and ensuring equitable access to resources and markets.

  • Subsidy Reform: Many governments provide agricultural subsidies to farmers, often aimed at increasing production and ensuring food security. However, these subsidies frequently favor large-scale, industrial agriculture, often incentivizing environmentally harmful practices such as excessive fertilizer and pesticide use, monocropping, and deforestation. Reforming agricultural subsidies to incentivize sustainable practices is crucial. This involves phasing out subsidies for environmentally harmful practices and redirecting these funds towards supporting sustainable farming practices such as organic farming, agroecology, and conservation agriculture. For example, subsidies could be provided for farmers who adopt cover cropping, implement integrated pest management, or utilize renewable energy sources.
  • Investing in Research and Development: Supporting research and development in areas such as climate-resilient crops, sustainable farming technologies, and improved nutrition is essential for addressing the challenges of food security. Public and private investments in agricultural research can lead to the development of new technologies and innovations that can enhance agricultural productivity, improve resource use efficiency, and increase resilience to climate change. This includes research on drought-resistant crop varieties, improved irrigation technologies, and the development of more efficient and environmentally friendly fertilizers and pesticides.
  • Strengthening Food Safety Regulations: Implementing and enforcing robust food safety regulations is crucial to protect public health and ensure consumer confidence in the food supply. These regulations should cover all stages of the food supply chain, from production to consumption, and should address issues such as foodborne illnesses, pesticide residues, and the use of genetically modified organisms. Strong food safety regulations can help to prevent outbreaks of foodborne illnesses, protect consumers from harmful residues, and ensure the safety and quality of food products.
  • Supporting Smallholder Farmers: Providing access to credit, training, and markets for smallholder farmers is crucial for enhancing their livelihoods and promoting sustainable agricultural practices. Smallholder farmers play a vital role in food production, particularly in developing countries, and supporting their livelihoods can contribute to improved food security and rural development. This can be achieved through programs that provide access to microcredit, agricultural extension services, and market linkages for smallholder farmers.
  • Promoting Fair Trade and Responsible Consumption: Supporting fair trade practices and encouraging consumers to make informed choices about the food they consume can promote sustainable and equitable food systems. Fair trade practices ensure that farmers receive fair prices for their products, while consumers can play a crucial role by choosing to support sustainable and ethical food producers. Consumers can also reduce their environmental impact by minimizing food waste, choosing locally produced and seasonal foods, and supporting sustainable agriculture through their purchasing decisions.
  • Land Reform and Tenure Security: Secure land tenure rights are essential for farmers to invest in long-term sustainable practices. Land reform policies can help to ensure equitable access to land and resources, particularly for smallholder farmers and marginalized communities. Secure land tenure provides farmers with the incentive to invest in soil conservation, water management, and other sustainable practices, as they are more likely to invest in improving land that they own or have secure access to.
  • Addressing Climate Change: Policies to mitigate climate change, such as reducing greenhouse gas emissions and promoting renewable energy, are crucial for creating a more sustainable and resilient food system. Climate change mitigation policies can also co-benefit agricultural production by reducing the negative impacts of climate change on crop yields and livestock productivity. For example, investing in renewable energy sources can reduce reliance on fossil fuels in agriculture, while promoting sustainable forestry practices can help to sequester carbon and mitigate climate change.

Effective policy implementation requires strong collaboration between governments, farmers, civil society organizations, and the private sector. It is crucial to ensure that policies are inclusive, equitable, and effectively address the needs of all stakeholders, including smallholder farmers, consumers, and the environment. 

  1. Case Studies on Innovative Farming Techniques

    Several innovative farming techniques have emerged to address the challenges of sustainable agriculture and food security. Here are some case studies showcasing successful implementations:

Conservation Agriculture in Uganda: Uganda has been implementing conservation agriculture practices to improve soil health and crop yields. The FAO’s analysis shows that 82% of climate-relevant public expenditures in agriculture positively stimulated the adaptive capacity of the agricultural sector. Key practices include:

    • Minimum tillage: Reducing soil disturbance through minimal or no tillage practices helps to maintain soil structure, reduce erosion, and improve soil organic matter.
    • Permanent soil cover: Maintaining continuous soil cover through the use of cover crops or crop residues helps to protect soil from erosion, improve water infiltration, and suppress weeds.
    • Crop rotation: Planting different crops in the same field in successive seasons helps to break disease and pest cycles, improve soil fertility, and maintain soil structure.
    • Results: Improved soil fertility, reduced erosion, and increased crop yields. The approach has also contributed to climate change mitigation, with projects sequestering an average of 2,980,068 tCO2-e per year between 2010 and 2030 (VOH, 2025).      

Agroforestry Systems: Integrating trees with crops or livestock offers numerous benefits.

    • Benefits: Improved soil health, increased carbon sequestration, and diversified farm income. Trees can provide shade for crops, improve soil fertility through nitrogen fixation, enhance biodiversity, and provide additional income sources through the production of timber, fruits, and other non-timber forest products.
    • Case Study: In many parts of the world, agroforestry systems have been successfully implemented. For example, in the coffee-growing regions of Latin America, shade trees are often planted in coffee plantations, providing shade for the coffee plants and improving soil fertility. This practice also enhances biodiversity by providing habitat for birds and other wildlife.

 Precision Agriculture in Developed Countries: Precision agriculture techniques use information technology to optimize resource use and improve farm management practices.

    • Key Practices:
      • GPS-guided equipment for precise application of inputs.
      • Remote sensing technologies to monitor crop health and soil conditions.
      • Variable rate technology to apply inputs based on site-specific needs.
    • Results: Reduced input use (e.g., 10% reduction in fertilizer use), improved yields, and decreased environmental impact.

Integrated Pest Management (IPM): IPM combines biological, cultural, physical, and chemical control methods to manage pests and diseases while minimizing economic, health, and environmental risks.

    • Key Practices:
      • Use of natural predators and parasites to control pests.
      • Crop rotation to disrupt pest cycles.
      • Use of physical barriers, such as row covers, to exclude pests.
      • Targeted pesticide application only when necessary and at the lowest effective dose.
    • Results: Reduced pesticide use by up to 50% without compromising crop yields (Coll, 2023).

Water-Efficient Irrigation in Water-Scarce Regions: Implementing water-saving irrigation techniques is crucial in areas facing water scarcity.

    • Key Practices:
      • Drip irrigation: Delivers water directly to plant roots, minimizing water loss through evaporation.
      • Deficit irrigation: Withholding water during specific growth stages to optimize water use.
      • Rainwater harvesting: Collecting and storing rainwater for irrigation.
    • Results: Reduced water consumption by up to 60% compared to flood irrigation while increasing crop yields (Coll, 2023).

Sustainable Rice Intensification (SRI): SRI is a methodology for increasing rice productivity while reducing water use and chemical inputs.

    • Key Practices:
      • Wider spacing of plants to allow for better root development.
      • Intermittent irrigation to optimize water use.
      • Organic fertilization to enhance soil fertility.
    • Results: Increased yields, reduced water use, and lower input costs for farmers.

Urban Farming Initiatives: Vertical farming, rooftop gardens, and other urban farming initiatives can address land scarcity and reduce food miles.

    • Key Practices:
      • Hydroponic systems: Growing plants without soil using nutrient-rich water solutions.
      • Aquaponics: Integrating aquaculture (raising aquatic animals) with hydroponics.
      • Controlled environment agriculture: Growing plants in controlled environments such as greenhouses.
    • Results: Year-round production, reduced transportation costs, and improved urban food security (Sustainable Agricultural Practices and Methods, 2024).

Participatory Plant Breeding: Involving farmers in the crop breeding process can lead to the development of varieties that are better adapted to local conditions.

    • Key Practices:
      • Farmer-led selection of superior plant varieties.
      • On-farm trials to evaluate the performance of different varieties.
      • Seed saving networks to preserve and share locally adapted varieties.
    • Results: Improved crop resilience, preservation of genetic diversity, and better adaptation to local environmental conditions. 

These case studies demonstrate that innovative farming techniques can successfully address multiple challenges in sustainable agriculture, including soil degradation, water scarcity, biodiversity loss, and climate change. However, widespread adoption of these practices often requires supportive policies, access to resources, and knowledge sharing platforms. The success of sustainable agriculture depends, indeed, not just on individual farmers, but on coordinated action by communities and supportive policy frameworks. 

  1. Future Trends in Food Security Efforts

    Addressing the complex challenges of food security requires a multifaceted approach that embraces innovation, promotes sustainable practices, and fosters global collaboration.

Emerging Technologies: 

  • Cellular Agriculture: The production of meat, dairy, and other animal products without the use of animals offers the potential to reduce the environmental impact of animal agriculture and address concerns about animal welfare. Cultured meat, produced by cultivating animal cells in bioreactors, offers a more sustainable alternative to conventional meat production, with reduced land use, greenhouse gas emissions, and environmental impact. Plant-based alternatives, such as plant-based burgers and dairy products, are increasingly popular and offer a more sustainable and ethical option for consumers.
  • Vertical Farming: Growing crops in stacked layers within controlled environments, such as skyscrapers or shipping containers, can maximize land use, reduce water consumption, and minimize the impact of pests and diseases. Vertical farming allows for year-round production, reduces reliance on pesticides, and minimizes the environmental impact of transportation. This technology can be particularly beneficial in urban areas with limited land availability.
  • Gene Editing Technologies: Tools like CRISPR-Cas9 offer the potential to develop more precise and targeted genetic modifications in crops, enabling the development of crops with enhanced nutritional value, improved drought tolerance, and increased disease resistance. Gene editing can also be used to develop crops with reduced environmental impact, such as those with increased nitrogen use efficiency or reduced reliance on pesticides. However, the ethical and societal implications of gene editing technologies must be carefully considered, and public engagement is crucial to ensure responsible development and deployment.

Shifting Consumer Behavior: 

  • Reduced Food Waste: Promoting consumer awareness of food waste and implementing strategies to minimize food waste at the household level, such as proper food storage, meal planning, and composting, is crucial. Food waste contributes significantly to environmental degradation and represents a significant economic loss.
  • Shift towards Plant-Based Diets: Encouraging a gradual shift towards more plant-based diets can have significant environmental and health benefits. Reducing meat consumption can lower greenhouse gas emissions, conserve water resources, and improve human health.
  • Supporting Sustainable Consumption Patterns: Educating consumers about the environmental and social impacts of their food choices and encouraging them to support sustainable and ethical food producers is essential. Consumers can make informed choices by selecting locally produced, organic, and fair-trade products, by minimizing food waste, and by supporting sustainable agriculture through their purchasing decisions. This includes supporting farmers’ markets, joining Community Supported Agriculture (CSA) programs, and choosing to buy from companies with strong sustainability commitments. 

Global Collaborations: 

  • International Cooperation: Strengthening international cooperation to address global food security challenges, including climate change, resource depletion, and food crises, is crucial. This can involve sharing knowledge, technology, and resources, as well as developing and implementing international agreements and policies to address global food security issues.
  • South-South Cooperation: Fostering collaboration among developing countries to share best practices, technologies, and knowledge related to sustainable agriculture and food security. South-South cooperation can provide valuable opportunities for developing countries to learn from each other and address common challenges, such as climate change adaptation and the development of resilient food systems. 

Addressing Emerging Challenges: 

  • Antimicrobial Resistance: The rise of antimicrobial resistance in foodborne pathogens poses a significant threat to public health. Addressing this challenge requires a multi-pronged approach, including responsible antibiotic use in both human and animal health, improved food safety practices, and the development of new antimicrobial agents.
  • Climate Change Adaptation: Developing and implementing climate-resilient agricultural practices is crucial for ensuring food security in a changing climate. This includes developing drought-resistant crop varieties, improving water management, and implementing sustainable land management practices.
  • Addressing Food Insecurity in Conflict Zones: Conflict and displacement can severely disrupt food systems, leading to widespread hunger and malnutrition. Addressing food insecurity in conflict zones requires humanitarian assistance, peacebuilding efforts, and the protection of civilians.
  • Improving Food and Nutrition Security in Prisons: Incarcerated individuals often experience limited access to nutritious food and adequate healthcare, contributing to increased rates of chronic diseases and poor health outcomes. Improving prison diets, providing access to healthcare services, and implementing nutrition education programs are crucial for improving the health and well-being of incarcerated individuals. 

Addressing the Limitations of Industrial Agriculture: 

Industrial agriculture, while increasing food production, has significant environmental and social drawbacks.

  • Environmental Impacts:
    • High Reliance on Chemical Inputs: Heavy reliance on synthetic fertilizers and pesticides can lead to soil degradation, water pollution, and harm to beneficial insects and pollinators.
    • Greenhouse Gas Emissions: Industrial agriculture contributes significantly to greenhouse gas emissions through the use of fossil fuels in farm machinery, the production and transportation of inputs, and the release of methane from livestock.
    • Deforestation: The expansion of agricultural land, often driven by the demand for livestock feed, contributes to deforestation and habitat loss.
    • Water Pollution: Runoff from agricultural fields can contaminate waterways with fertilizers, pesticides, and animal waste, harming aquatic ecosystems.
  • Social Impacts:
    • Rural Depopulation: Industrial agriculture has led to the displacement of smallholder farmers, contributing to rural depopulation and social inequality.
    • Worker Exploitation: Low wages and poor working conditions are common in many parts of the agricultural sector, particularly in developing countries.
    • Loss of Cultural Diversity: The dominance of industrial agriculture has led to a decline in traditional farming practices and the loss of agricultural biodiversity. 

Strengthening Local Food Systems: 

Local food systems play a crucial role in enhancing food security and building more sustainable and equitable food systems.

  • Social and Cultural Benefits: Local food systems can strengthen social connections within communities by fostering relationships between producers and consumers. Farmers’ markets, community-supported agriculture (CSA) programs, and other local food initiatives can provide opportunities for direct interaction, building social capital and fostering a sense of community. They can also contribute to the preservation of cultural food traditions, supporting the continued production and consumption of traditional varieties and local foods.
  • Economic Benefits: Local food systems can stimulate local economies by creating jobs in food production, processing, and distribution. They can also increase the local economic multiplier effect as money circulates within the community, supporting local businesses and strengthening the local economy.
  • Environmental Benefits: Local food systems can reduce the environmental impact of food production and distribution by shortening supply chains, minimizing transportation distances, and reducing reliance on long-distance transportation. They can also promote the use of sustainable agricultural practices and support the preservation of agricultural land. 

Addressing the challenges of food security requires a multifaceted approach, encompassing sustainable agricultural practices, technological innovation, policy interventions, and shifts in consumer behavior. This will require a concerted effort from governments, international organizations, civil society, and individuals to create a more sustainable and equitable food system that meets the needs of current and future generations. 

Key Takeaways
  • Food security is a complex and multifaceted challenge that requires a holistic and integrated approach.
  • Sustainable agriculture is essential for long-term food security, contributing to environmental sustainability, economic viability, and human health.
  • Climate change, resource depletion, and economic inequalities pose significant challenges to global food systems.
  • Technology plays a crucial role in improving agricultural productivity and sustainability, but it must be developed and implemented responsibly, addressing ethical considerations and ensuring equitable access.
  • Local food systems can promote food sovereignty, reduce environmental impact, and enhance community resilience.
  • Addressing the double burden of malnutrition and promoting nutrition-sensitive agriculture are critical for improving public health.
  • Effective policies are crucial for supporting sustainable agriculture practices and addressing the challenges of food insecurity.
  • Consumer choices play a vital role in shaping the future of food systems. By supporting sustainable and ethical food producers, reducing food waste, and shifting towards more plant-based diets, consumers can contribute to a more sustainable and equitable food system.

The issues discussed in this article are closely linked to other critical aspects of sustainable development, including poverty reduction, access to clean water and sanitation, climate action and responsible consumption and production. 

 

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Author Profile

Philip J. Gover is a chartered manager and public health consultant with an extensive career spanning three decades in development work. Educated at Durham University, Durham University Business School and Northumbria University, Philip has established himself as a practical source of support in community development, community enterprise and public health.  His public health focus has concentrated on prison health and older people’s health.

Throughout his career, Philip has worked across Europe, Africa, and Southeast Asia, bringing a wealth of international experience to his work. This global perspective has established a nuanced understanding of diverse healthcare systems and cultural contexts, enhancing his ability to implement effective public health strategies in various settings.

Philip’s expertise bridges academic research and practical implementation, making significant contributions to understanding and addressing complex public health challenges across multiple continents.

Professionals and organizations seeking collaboration or development support can reach Philip via email at philip.gover@cooperation.works, or via LinkedIn

 

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The Sustainable Wellbeing Equity Index

IN A NUTSHELL
Author's Note
To encourage deeper reflection and action while challenging the prevailing Western-centric perspectives on development, well-being, and progress, we have developed the Sustainable Health Equity Index. This index integrates the Western emphasis on individual freedom and well-being (measured by life expectancy at birth) with the Eastern focus on the collective good. It prioritizes limiting harm to others by addressing issues such as excessive accumulation—depriving others of sufficient resources—and minimizing carbon footprints, which jeopardize the lives of future generations. The index aims to create conditions for achieving the highest feasible levels of health while balancing individual and collective responsibilities

By Juan Garay

Professor of global health equity in Spain (ENS), Mexico (UNACH) and Cuba (ELAM, UCLV and UNAH), principal researcher of FioCruz Institute, Brazil

The Sustainable Wellbeing Equity Index

An Ethical Reference to Wellbeing while Respecting Other Lives

 

Speed is irrelevant if you are going in the wrong direction

Mahatma Gandhi

 

Scene setting

Some 10,000 years ago, humanity has transitioned to settled agriculture, cultivating the land, harvesting crops, and storing food for winter. This shift enabled the conquest of Earth’s surface, the rise of cities, and the establishment of hierarchical structures rooted in the power around beliefs, knowledge, laws, and resources. Artificial boundaries were drawn on the land, dividing and fostering competition among groups of people. These 10,000 years are marked by a history of wars, competition, environmental degradation, and increasing inequality. Yet, they are also a testament to progress—expanding the boundaries of knowledge about the macro- and microcosmos, the particles and quantum mechanics of matter, the genomes that encode life, and the rapid, far-reaching dissemination of information. However, the ongoing destruction of nature and the persistence of extreme inequalities continue to threaten human life, the existence of other species, and the well-being of future generations.

From the so-called “West”—encompassing social norms, ethical values, traditional customs, belief systems (rooted in monotheism), political systems, artifacts, and technologies primarily shaped by European and Mediterranean histories—we inherit values such as individual freedom including property and capital, democracy based on majority rule, and a reliance on rationalism and logic as foundations for understanding human life. While the West has made significant contributions to human knowledge, it has also imposed religions and empires, driven large-scale fossil fuel consumption, and developed nuclear risks and weapons, resulting in greater environmental destruction than any other culture.

The intensity of wars among Western nations, coupled with their expansion through oceanic exploration and the extension of empires, religions, and trade, reached its peak during the world wars—aptly referred to by others as “European wars”—in the first half of the 20th century. The devastation was so immense that it led to the establishment of a new world order aimed at fostering peace among nations and upholding universal human rights. However, these foundations were inherently fragile, as the history of nations continued to be rooted in competition, greed, and conflict. Moreover, the commitment to human rights was never enforceable and largely remained rhetorical. The structure created to uphold these principles, the United Nations, was biased from its inception, granting disproportionate power to five nations through the veto mechanism, leaving the remaining 193 subject to decisions shaped by an oligarchic framework.

The concept of development and human well-being has been heavily influenced by Western countries, notably Europe and the United States, and their free-market principles. Success is primarily measured by the intensity of market activity (reflected in transaction volumes and gross domestic product, driven by competition), the level of education (often defined by adherence to institutional norms and concepts, frequently geared towards competitiveness), and life expectancy (extended through improved living conditions and access to healthcare, though often at the cost of extreme inequalities). Consequently, the OECD development comprises the wealthiest nations in GDP terms, and the Human Development Index (HDI) is based on years of institutional education, life expectancy, and, most influential in the final rank, GDP per capita.

As humanity entered the 20th century, indisputable evidence emerged about the trends and risks of human-induced global warming and its potential to threaten the very existence of human life on the planet, along with countless other forms of life. The primary driver of this destructive, self-destructive, and “ecocidal” trajectory was greenhouse, notably carbon, emissions resulting from the burning of fossil fuels, which were strongly linked to economic activity (measured by GDP per capita). At the same time, extreme disparities in GDP per capita were closely tied to significant inequalities in life expectancy, highlighting a stark connection between economic inequality and human well-being.

Both extreme inequalities and environmental destruction were central concerns in the “Sustainable Development Goals” outlined in the 2030 Agenda. However, among the 17 goals and 169 targets, only two specifically address the challenges of reducing inequalities and carbon emissions. Unfortunately, they lack clear, objective benchmarks to guide efforts and measure progress toward achieving sustainable equity.

In the last articles we have alerted the need of change towards the WiSe (wellbeing in sustainable equity) paradigm[i] and restore a critically broken human deal[ii], questioned the shape and trend of international cooperation[iii], updated the ethical threshold on carbon emissions[iv], the identification of countries that preserve nature[v] and those that are sustainable equity references[vi], the estimates[vii] and distribution of the burden of international inequity[viii], the setting of dignity, excess and hoarding thresholds[ix] and the redistribution dynamics towards a Humanity living in sustainable equity[x]. Based on those concepts and metrics, and the 2024 demographic estimates published by the UN Population division[xi], we are updating last year´s atlas on global health equity[xii], which shows signs of decreasing references of wellbeing in sustainable equity and increasing intra and intergenerational inequities between and within countries. In the context of exponential capacities of access and analysis to data through artificial intelligence (AI) being applied to all human life dimensions, it does seem that technology continues to focus on profits and benefit disproportionately just a few. At present, AI mainly prioritizes financial speculation and accumulation of fewer and fewer concentrating economic and media, intertwined with political and military powers, beyond the hoarding threshold which does not improve wellbeing or knowledge directed to global public goods while it undermines others´ lives in this and coming generations. Probably a wise advice from some alien observing humanity could be (paraphrasing what Mahatma Gandhi once said): “speed is not only irrelevant, but slowly suicidal, if you are going in the wrong direction”.

To encourage deeper reflection and action while challenging the prevailing Western-centric perspectives on development, well-being, and progress, we have developed the Sustainable Health Equity Index. This index integrates the Western emphasis on individual freedom and well-being (measured by life expectancy at birth) with the Eastern focus on the collective good. It prioritizes limiting harm to others by addressing issues such as excessive accumulation—depriving others of sufficient resources—and minimizing carbon footprints, which jeopardize the lives of future generations. The index aims to create conditions for achieving the highest feasible levels of health while balancing individual and collective responsibilities.

The negative impact of GDP pc, related to income and wealth, above the excess threshold

As we have analyzed recentlyix, there is a threshold of GDP and income pcy, above which, life expectancy (as the best proxy for human wellbeing) does not improve any further. We have identified such level by subnational analysis in the country of higher life expectancy in the last 40 years, Japan, where we found that the Nara prefecture has the lowest GDP pc in the country ($ 21,838 pcy) yet one of the highest life expectancies at birth (84.31). The GDP in excess of such threshold accounts to over 40% of the world´s GDP, which is not only “wasted” as useless for human wellbeing, but it is also toxic given its relation to unfair inequalities and to nature´s destruction. We estimate the toxic effect of GDP pc above the excess threshold on the burden of health inequity in the following way:

  1. Life years lost in countries living with GDP pc below the dignity threshold (deficit zone) – BhiEdeficit-: 492,557,429 yearsvii
  2. GDP pc above excess threshold –exc GDP pc-: (GDP pc – 21,838).
  3. Deficit GDP gap (GDP required to meet at least the dignity threshold) -GDP gapdefiici t– : $ 7,563,073,006,854 ix
  4. Proportion of GDP above the excess threshold which would meet the GDP deficit -% excxgap-: 044 % x.
  5. Life years lost per life time above the excess threshold, in 2023:

BhiEdeficit  x (exc GDP pc /GDP gapdefiici) x % excxgap x Life expectancy =

(GDP pc -21,838) x 0.0000371 x Life expectancy

Annex 1 displays the negative impact in life years lost due to global health inequity in deficit countries (with GDP pc < dignity threshold) by, in average, each citizen living in countries with GDP pc above the excess threshold, during his or her (average) lifetime.

The negative impact of CO2 emissions, related to other dimensions of our ecological footprint, above the ethical threshold

Recent analysis based on new UN demographic estimates for the remains of the XXIst century has revealed a threshold level of CO2 emissions per person and year. To keep global warming under 2 degrees Celsius during this century, the maximum annual average carbon dioxide emissions per person should be 1,3 tons, and to limit it to 1.5 (most likely unavoidable), just 0,3 tons. If the present uptrend in world per capita CO2 emissions were maintained global warming would exceed 8 degrees and result in 218 million excess deaths and a loss of approximately 6,500 million life years[xiii].

The relation between excess emissions and the consequence of life years lost (6.5Bn) results in some 1,46 days lost for every excess ton of carbon dioxide emitted annually, mainly to those living in low-CO2 emission countries iv.

To quantify the adverse impact of CO2 emissions surpassing this ethical threshold, we propose the following approach:

  1. CO2 emissions pcy > 2º ethical threshold –exc CO2 em pcy-: (CO2 em pcy – 1.31iv).
  2. Life years lost in the rest of the century at current trend of CO2 emissions (mostly in deficit/low CO2 emitting countries) – BhiECO2>2º-: 4,064,590,919 yearsvii
  3. Global CO2 excess emissions at current trend: – CO2 em excess-: 1,615 Tn tonnes.
  4. Life years lost per life time by CO2 emissions above the ethical threshold, in 2023:

 exc CO2 em pcy x (BhiECO2>2º/ Gl. CO2 em excess) x Life expectancy =

(CO2 em pcy-1.31) x 0.000002517 x Life expectancy

Annex 1 displays the negative impact in life years lost due to excess CO2 emissions by, in average, each citizen living in countries with CO2 emissions pc above the excess threshold, during his or her (average) lifetime.

Geographical distributions of the three components of the Sustainable Wellbeing Equity Index

Life expectancy at birth

The following map shows the estimates of national average life expectancy at birth, based on the recent estimates of the UN Population Reportxi

Figure 1 : National average life expectancy at birth 2023

The map above illustrates that countries with the highest life expectancy at birth—over 83 years—include Japan (the highest, at 84.7 years), South Korea, southwestern Europe (Spain, France, Italy, and Switzerland), parts of Scandinavia (Sweden and Norway), and Australia. Conversely, countries with the lowest life expectancy at birth, below 60 years as of 2023, are Nigeria (the lowest, at 54.5 years), Chad, Lesotho, the Central African Republic, South Sudan, and Somalia, all located in sub-Saharan Africa.

Life years lost in deficit countries due to GDP pc above the excess threshold

As detailed in recent articles, there is a level of GDP per capita beyond which improvements in life expectancy and human well-being plateau, while carbon and ecological footprints become unsustainable. This excess or ‘toxic’ GDP could help bridge the income gap that keeps deficit countries below the dignity threshold, contributing to nearly 500 million life years lost. As discussed earlier, we can estimate the life years lost per capita over a lifetime in countries with GDP/income exceeding this excess threshold. For every $1,000 of GDP per capita above the excess threshold ($21,838) and over an average lifetime of 80 years (typical in high-income countries), three life years are lost in deficit countries. The map below illustrates this negative impact on individuals living in deficit countries within our generation:

Figure 2 : National average life years lost per lifetime (in deficit countries) due to excess GDP pc

The map above highlights the countries that deplete life years in deficit countries due to excess GDP per capita. These countries include those in North America, Western Europe, Japan, South Korea, Australia, New Zealand, several Arab Emirates, and Guyana. Notably, countries with a negative impact exceeding 100 life years on others over a lifetime include Norway, Switzerland, Luxembourg, Sweden, Australia, Ireland, and the United States.

Life years lost due to CO2 emissions above the ethical threshold

As recently analyzed, the ethical threshold for per capita yearly CO2 emissions, beyond which global warming is expected to exceed 2ºC above preindustrial levels—triggering negative feedback loops across all planetary boundaries—is currently 1.31 metric tons per person per year. Emissions surpassing this threshold will drive the impacts of global warming, resulting in an estimated loss of over 400 billion human life years due to premature mortality and excess deaths by the end of this century, predominantly affecting low CO2-emitting and economically deficit countriesiv.

Similar to excess GDP per capita, we can estimate life years lost per capita and over a lifetime in countries with CO2 emissions exceeding this ethical threshold. For every metric ton of CO2 emitted above the threshold (1.31) over an average lifetime of 80 years (typical in high-income countries), approximately 2 hours of life are lost—primarily in low-emitting, GDP-deficit countries. However, this is a significant underestimate, as CO2 emissions persist in the atmosphere for 300–1,000 years, extending their impact across multiple generations, potentially beyond the 21st century if humanity endures.

The map below illustrates this negative impact on others, particularly those living in low-emitting, economically deficit countries, over the coming generations within the 21st century.

Figure 3 :Life years lost per person and lifetime due to CO2 emissions > ethical threshold

As shown on the map above, the countries with the highest per capita negative impact through excess CO2 emissions over a lifetime are located on the Arabian Peninsula—led by Qatar, which contributes to the loss of 25 life years per person in future generations, primarily due to its oil-export-based economy. These are followed by Kazakhstan, the United States, Canada, and Australia, each responsible for nearly 10 life years lost.

Russia and Mongolia follow with an impact of 5–7.5 life years, along with most of Western Europe, China, and the rest of the Middle East. Slightly lower negative impacts are observed across the Americas, Northern Africa, India, Southeast Asia, and Eastern Europe. France, due to its reliance on nuclear energy (which has other impacts outside the scope of this analysis), exhibits a comparatively lower effect.

The sustainable Wellbeing Equity Index

By combining the above three factors, the following map illustrates the Sustainable Wellbeing Index, which combines the average probability of enjoying life years deducting our negative effect on others through excess GDP/income pc and excess CO2 emissions.

Figure 4 : Sustainable Wellbeing Equity Index 2023

As shown on the map—and detailed in the table in Annex 3—the countries with the highest Sustainable Wellbeing Equity (SWE) Index (indicated in dark green) are Costa Rica and Taiwan, both exceeding 80 years. They are followed by Maldives, Albania, Chile, and Portugal.

The majority of the global population resides in countries with a SWE index ranging between 52 and 78 years. In contrast, countries with the highest negative impact due to excess GDP per capita and income—key factors influencing the SWE index—such as Norway, Switzerland, Luxembourg, Ireland, the United States, and Australia, exhibit a “negative SWE index.” This means that each lifetime in these countries effectively cancels out at least one life in deficit and low-emission countries.

SWE vs HDI index

The comparison of the ranking of countries by the UN Human Development index with the one by the Sustainable Wellbeing Equity Index hereby presented are very telling:

Table 1 SWE index and ranking of top countries by the UN Human Development Index, 2023

HDI rank SWE rank SWE life years
Switzerland 1 192 -130.4
Norway 2 190 -97.9
Iceland 3 184 -35.5
Hong Kong SAR, China 4 172 14.5
Denmark 5 185 -39.9
Sweden 5 182 -22.6
Germany 7 173 13.1
Ireland 7 193 -136.3
Singapore 9 189 -57.4
Australia 10 186 -49.2
Netherlands 10 179 -8.2
Belgium 12 174 9.1
Finland 12 176 4.9
United Kingdom 15 178 2.9
New Zealand 16 170 18.0
United Arab Emirates 17 181 -11.8
Canada 18 177 4.1
Korea, Rep. 19 165 38.3
Luxembourg 20 194 -182.2
United States 20 188 -57.3

As the table above shows, the 20 countries ranked highest by the Human Development Index (where the most influential factor is GDP pc, with no limit above the excess of hoarding thresholds) have very low SWE rankings and most of them have a net negative effect on human life, that is, their negative impact on others through excess accumulation of income or excess carbon emissions is higher than their life expectancy at birth.

Conversely, as the table below shows, the countries with highest SWE index are ranked mostly in the lower third of the HDI ranking, with Costa Rica´s highest SWE ranking considered only 64th in the HDI ranking.

HDI rank SWE rank
Costa Rica 64 1
Maldives 87 2
Albania 74 3
Chile 44 4
Portugal 42 5
Greece 33 6
Panama 57 7
Cuba 85 8
Uruguay 52 9
Sri Lanka 78 10
Peru 87 11
Jordan 99 12
Colombia 91 13
Ecuador 83 14
Croatia 39 15
Cabo Verde 131 16
North Macedonia 83 17
Lebanon 109 18
Montenegro 50 19
Tunisia 101 20
Argentina 48 21

 

Conclusions

We combine the three elements detailed above to estimate the Sustainable Wellbeing Equity (SWE) Index. This index challenges the dominant Western principle of prioritizing individual human life by incorporating the broader impact each human life has on others.

The results challenge the UN Human development Index which gives the highest weighing factor to the GDP pc with those countries with levels above the excess and hoarding threshold ranking highest, while their SWE index is very low and often negative, that is, their negative effect on others cancels out their life expectancy at birth.

Future refinements of the negative effects assessed should include the negative impact of countries benefiting from their tax havens, the carbon border evaluations—considering how imports of raw materials and manufactured goods contribute to CO2 emissions shared with exporting countries—and the role of oil-producing nations, whose exports fuel emissions in importing countries.

This study is beyond the scope and capacity to estimate additional negative impacts, such as the effects of arms production and trade on war victims, the consequences of migration laws on deaths along migration routes, and even broader considerations of how human activity impacts other forms of life, moving beyond an anthropocentric perspective.

Looking forward, we should also develop ways to measure the positive impacts our lives have on others—such as contributions to global public goods, acts of care and solidarity, and efforts to protect and preserve nature—fostering a more balanced and holistic assessment of human influence.

Annex 1: Life years lost in deficit countries by excess GDP pc, per person and life time

Excess countries Life years lost in deficit countries, per person and lifetime Excess countries Life years lost in deficit countries, per person and lifetime
Bermuda -263.64 Hong Kong SAR, China -68.97
Luxembourg -257.10 Belgium -68.47
Isle of Man -227.16 Israel -63.79
Ireland -214.15 Germany -63.61
Switzerland -212.41 New Zealand -60.65
Cayman Islands -179.17 Andorra -57.21
Norway -176.73 France -53.05
Singapore -135.59 Japan -47.97
United States -127.22 Virgin Islands (U.S.) -40.17
Australia -123.16 Korea, Rep. -38.48
Denmark -119.30 Italy -37.12
Iceland -112.30 Malta -28.94
Macao SAR, China -111.40 Cyprus -27.09
Qatar -106.41 Puerto Rico -25.14
Sweden -104.19 Bahamas, The -22.78
Netherlands -86.26 Brunei Darussalam -20.41
United Arab Emirates -77.12 Spain -19.30
United Kingdom -76.01 Kuwait -15.62
Greenland -73.43 Slovenia -11.54
Finland -73.34 Bahrain -8.75
Austria -73.12 Guyana -3.88
Canada -69.22 Portugal -1.65

 

Annex 2: Life years lost (mostly in deficit countries) during the remains of the XXIst century,  by excess CO2 emissions, per person and life time

Excess CO2 emission countries Life years lost in deficit countries, per person and lifetime Excess CO2 emission countries Life years lost in deficit countries, per person and lifetime
Qatar -25.93 Croatia -2.05
United Arab Emirates -17.63 Lebanon -2.03
Bahrain -17.17 Hong Kong SAR, China -2.03
Kuwait -16.92 Barbados -2.01
Brunei Darussalam -14.79 Switzerland -1.97
Trinidad and Tobago -13.45 Argentina -1.94
Saudi Arabia -11.52 Portugal -1.94
Oman -10.00 Guyana -1.85
Australia -9.94 Liechtenstein -1.79
United States -9.37 Mexico -1.74
Canada -9.26 Algeria -1.71
Kazakhstan -8.16 Iraq -1.68
Korea, Rep. -7.51 Sweden -1.64
Luxembourg -7.34 Thailand -1.61
Palau -6.48 Romania -1.58
Russian Federation -6.40 Montenegro -1.55
Mongolia -6.11 North Macedonia -1.53
Turkmenistan -5.90 Nauru -1.52
Iceland -5.86 Azerbaijan -1.51
Greenland -5.55 Latvia -1.47
Czech Republic -5.54 Ukraine -1.41
Singapore -5.50 Vietnam -1.40
Japan -5.26 Uzbekistan -1.34
Malaysia -4.81 Maldives -1.34
Libya -4.76 Marshall Islands -1.33
Germany -4.69 Malta -1.27
Poland -4.62 Mauritius -1.25
Ireland -4.56 Georgia -1.05
Belgium -4.52 Lao PDR -1.04
Aruba -4.50 Tunisia -1.02
China -4.50 Panama -0.94
Norway -4.46 Equatorial Guinea -0.93
Estonia -4.42 Botswana -0.90
Iran, Islamic Rep. -4.35 Grenada -0.89
Turks and Caicos Islands -4.26 Venezuela, RB -0.86
Netherlands -4.13 Indonesia -0.80
Bermuda -4.00 St. Lucia -0.80
Austria -3.94 Uruguay -0.65
Finland -3.69 Ecuador -0.65
Bulgaria -3.59 Armenia -0.63
Israel -3.48 Gabon -0.62
New Zealand -3.47 Egypt, Arab Rep. -0.62
Antigua and Barbuda -3.42 Brazil -0.59
Slovenia -3.30 Jamaica -0.59
Bosnia and Herzegovina -3.22 St. Vincent and the Grenadines -0.59
Slovak Republic -3.20 Dominican Republic -0.49
Italy -3.19 Dominica -0.47
Greece -3.13 Jordan -0.46
Serbia -3.12 India -0.41
Belarus -3.12 Colombia -0.39
South Africa -3.10 Korea, Dem. People’s Rep. -0.39
Seychelles -3.04 Cuba -0.35
Cyprus -3.03 Morocco -0.32
Suriname -2.85 Peru -0.30
Spain -2.78 Belize -0.28
Denmark -2.56 Albania -0.28
Turkey -2.52 Tonga -0.27
Bahamas, The -2.48 Bolivia -0.25
British Virgin Islands -2.46 Moldova -0.19
Andorra -2.39 Costa Rica -0.13
United Kingdom -2.38 Macao SAR, China -0.12
France -2.36 Namibia -0.11
Lithuania -2.15 Kyrgyz Republic -0.05
St. Kitts and Nevis -2.11 Lesotho -0.01
Chile -2.09 Bhutan 0.00
Hungary -2.08

 

Annex 3: Sustainable Wellbeing Equity Index by national averages

Country Sustainable wellbeing equity index Country Sustainable wellbeing equity index
Costa Rica 80.67 Pakistan 67.65
Maldives 79.70 Malawi 67.35
Albania 79.33 Fiji 67.32
Chile 79.08 Ethiopia 67.32
Portugal 78.77 Namibia 67.27
Greece 78.73 Saudi Arabia 67.21
Panama 78.66 Micronesia, Fed. Sts. 67.20
Cuba 77.73 Tuvalu 67.10
Uruguay 77.49 Tanzania 67.00
Sri Lanka 77.48 Myanmar 66.89
Peru 77.44 Comoros 66.78
Jordan 77.35 Slovenia 66.77
Colombia 77.33 Russian Federation 66.76
Ecuador 76.74 Kiribati 66.47
Croatia 76.53 Zambia 66.35
Cabo Verde 76.06 Sudan 66.33
North Macedonia 75.86 Kazakhstan 66.24
Lebanon 75.78 Papua New Guinea 66.13
Montenegro 75.54 Afghanistan 66.03
Tunisia 75.49 Djibouti 65.99
Argentina 75.45 Gambia, The 65.86
Brazil 75.25 Congo, Rep. 65.77
Slovak Republic 75.14 Mongolia 65.63
Armenia 75.05 Marshall Islands 65.61
Morocco 75.00 Ghana 65.50
Hungary 74.95 West Bank and Gaza 65.17
Nicaragua 74.95 Haiti 64.94
Thailand 74.80 Angola 64.62
Estonia 74.73 Libya 64.58
Latvia 74.72 Guyana 64.46
Bangladesh 74.67 Turkmenistan 64.18
Turkey 74.64 Eswatini 64.12
Bosnia and Herzegovina 74.63 Guinea-Bissau 64.08
Algeria 74.55 Cameroon 63.70
Romania 74.36 Burundi 63.65
Grenada 74.31 Kenya 63.65
Czech Republic 74.29 Madagascar 63.63
Antigua and Barbuda 74.18 Mozambique 63.61
Barbados 74.17 South Africa 63.04
Poland 74.02 Zimbabwe 62.77
Lithuania 73.87 Equatorial Guinea 62.77
Paraguay 73.84 Togo 62.74
Turks and Caicos Islands 73.75 Liberia 62.16
Mauritius 73.67 Cote d’Ivoire 61.94
Serbia 73.65 Congo, Dem. Rep. 61.90
China 73.45 Sierra Leone 61.79
Georgia 73.45 Spain 61.60
Mexico 73.33 Niger 61.18
Iran, Islamic Rep. 73.30 Burkina Faso 61.09
Belize 73.28 Benin 60.77
Dominican Republic 73.23 Guinea 60.74
Vietnam 73.19 Nauru 60.59
Bhutan 72.97 Mali 60.44
Azerbaijan 72.92 Trinidad and Tobago 60.04
Honduras 72.88 Somalia 58.82
Tonga 72.63 Central African Republic 57.41
Guatemala 72.60 Lesotho 57.37
Syrian Arab Republic 72.12 Bahrain 55.37
El Salvador 72.10 Chad 55.07
Bulgaria 72.05 Nigeria 54.46
Ukraine 72.01 Malta 53.09
St. Lucia 71.89 Cyprus 51.53
Aruba 71.85 Bahamas, The 49.30
Malaysia 71.84 Kuwait 47.86
Tajikistan 71.79 Italy 43.41
Samoa 71.70 Brunei Darussalam 40.13
Kyrgyz Republic 71.63 Korea, Rep. 38.34
India 71.59 Virgin Islands (U.S.) 35.31
Vanuatu 71.48 Japan 31.48
Belarus 71.32 France 27.92
Uzbekistan 71.04 Andorra 24.44
Egypt, Arab Rep. 71.02 New Zealand 17.97
Moldova 71.01 Israel 15.14
Jamaica 70.89 Hong Kong SAR, China 14.51
Suriname 70.78 Germany 13.07
Cambodia 70.67 Belgium 9.12
Dominica 70.66 Austria 4.90
St. Vincent and the Grenadines 70.64 Finland 4.88
Iraq 70.64 Canada 4.15
Solomon Islands 70.53 United Kingdom 2.90
Nepal 70.35 Netherlands -8.24
Indonesia 70.34 Greenland -8.93
St. Kitts and Nevis 70.04 United Arab Emirates -11.85
Oman 70.03 Sweden -22.57
Philippines 69.83 Macao SAR, China -28.44
Seychelles 69.82 Iceland -35.46
Sao Tome and Principe 69.72 Denmark -39.93
Yemen, Rep. 69.30 Australia -49.18
Senegal 68.68 Qatar -49.97
Mauritania 68.48 United States -57.29
Bolivia 68.33 Singapore -57.35
Botswana 68.27 Norway -97.88
Uganda 68.25 Cayman Islands -98.81
Lao PDR 67.92 Switzerland -130.43
Rwanda 67.79 Ireland -136.30
Gabon 67.72 Luxembourg -182.20
Timor-Leste 67.69 Bermuda -185.33

 

References

[i] https://www.peah.it/2023/12/12800/

[ii] https://www.peah.it/2024/04/13164/

[iii] https://www.peah.it/2023/03/a-renewed-iinternational-cooperation-partnerhip-framework-in-the-xxist-century/

[iv] https://www.peah.it/2024/07/13556/

[v] https://www.peah.it/2024/09/13667/

[vi] https://www.peah.it/2024/10/identifying-international-sustainable-health-models/

[vii] https://www.peah.it/2024/11/the-price-of-global-injustice-in-loss-of-human-life/

[viii] https://www.peah.it/2024/11/14003/

[ix] https://www.peah.it/2024/11/enough-is-enough-and-more-is-too-much-between-basic-dignity-and-excess-hoarding-thresholds/

[x] https://www.peah.it/2024/12/14117/

[xi] https://www.un.org/development/desa/pd/world-population-prospects-2024

[xii] https://www.interacademies.org/news/unveils-global-health-equity-atlas

[xiii] https://www.peah.it/2018/07/5498/

 

By the same Author on PEAH

Ethical Equity Redistribution/Contribution to Global Good
 
Enough is Enough, and More is Too Much: Between Basic Dignity and Excess/Hoarding Thresholds

Geography of Global Injustice: State of the Burden of Global Health Inequity in 2023

The Price of Global Injustice in Loss of Human Life

Identifying International Sustainable Health Models 

Homo Interitans: Countries that Escape, So Far, the Human Bio-Suicidal Trend

Human Ethical Threshold of CO2 Emissions and Projected Life Lost by Excess Emissions

 Restoring Broken Human Deal

   Towards a WISE – Wellbeing in Sustainable Equity – New Paradigm for Humanity

  A Renewed International Cooperation/Partnership Framework in the XXIst Century

 COVID-19 IN THE CONTEXT OF GLOBAL HEALTH EQUITY

 Global Health Inequity 1960-2020 Health and Climate Change: a Third World War with No Guns

 Understanding, Measuring and Acting on Health Equity