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Item Canada’s role in strengthening global health security during the COVID-19 pandemic(Biomed Central (Springer Nature), 2020) Chattu, Vijay Kumar; Adisesh, Anil; Yaya, SanniThe world is confronted by the current pandemic of Corona Virus Disease (COVID-19), which is a wake-up call for all nations irrespective of their development status or geographical location. Since the start of the century we have seen five big infectious outbreaks which proved that epidemics are no more regarded as historic and geographically confined threats. The Canadian government underlined that these infectious disease outbreaks are threats to global health security and disrupt societal wellbeing and development. In this context, the Public Health Agency of Canada is proactive and has shown its preparedness for outbreaks of emerging and epidemic-prone diseases, and in dealing with these pathogens. Even before the declaration of pandemic, Canada has proved its global health leadership by ensuring collective action and multisectoral coordination which still remains a serious challenge especially for low and middle- income countries with existing poor health systems. In this article we discuss how Canada is addressing the global challenges posed by the COVID-19 pandemic through its leadership and practice of global health diplomacy.Item COVID-19 Pandemic as an Excellent Opportunity for Global Health Diplomacy(Frontiers in Public Health, 2021) Taghizade, Sanaz; Chattu, Vijay Kumar; Jaafaripooyan, Ebrahim; Kevany, SebastianUndoubtedly, the COVID-19 pandemic is not the first and most frightening global pandemic, and it may not be the last. At the very least, this phenomenon has though seriously challenged the health systems of the world; it has created a new perspective on the value of national, regional, and international cooperation during crises. The post-coronavirus world could be a world of intensified nationalist rivalries on the economic revival and political influence. However, strengthening cooperation among nations at different levels will lead to the growth of health, economy, and security. The current situation is a touchstone for international actors in coordinating the efforts in similar future crises. At present, this pandemic crisis cannot be resolved except through joint international cooperation, global cohesion, and multilateralism. This perspective concludes that the pandemic could be an excellent opportunity for the scope of global health diplomacy (GHD) and how it can be applied and practiced for strengthening five global arenas, namely (1) International Cooperation and Global Solidarity, (2) Global Economy, Trade and Development, (3) Global Health Security, (4) Strengthening health systems, and (5) Addressing inequities to achieve the global health targets. GHD proves to be very useful for negotiating better policies, stronger partnerships, and achieving international cooperation in this phase with many geopolitical shifts and nationalist mindset among many nations at this stage of COVID-19 vaccine roll-outItem COVID-19 pandemic containment in the Caribbean Region: A review of case-management and public health strategies(AIMS Public Health, 2021) Umakanthan, Srikanth; Chauhan, Anuradha; Gupta, Madan Mohan; Sahu, Pradeep Kumar; Bukelo, Maryann M; Chattu, Vijay KumarCOVID-19 emerged initially from Wuhan, Hubei province, China, in late December 2019, and since then, it has spread globally to be declared a pandemic by the World Health Organization. The Caribbean region started reporting COVID-19 cases in early March 2020, triggering new regional public health crises. The initial suspects and confirmed cases across the Caribbean countries were mainly imported cases and from cruise ships. The clinical manifestations varied from fever, cough, and malaise in mild cases to acute respiratory distress syndrome (ARDS) and shock in severe cases. The Caribbean Public Health Agency has provided frequent updates on the preventive strategies and quarantine measures across the Caribbean member states. COVID-19 has had a serious impact on the Caribbean region’s health system, economy, and psychology. This review presents the Caribbean perspective of COVID-19, detailing the epidemiology, clinical manifestations, diagnosis, management, and preventive and surveillance measures. Vaccine hesitancy was found to be a major challenge that needs appropriate health education strategies to address the public. Strong leadership and regional collaboration among the Caribbean member states are necessary to provide optimal real-time data to the public and implement appropriate and effective guidelines in the island statesItem COVID-19 Vaccine, TRIPS, and Global Health Diplomacy: India’s Role at the WTO Platform(BioMed Research International, 2021) Chattu, Vijay Kumar; Singh, Bawa; Kaur, Jaspal; Jakovljevic, MihajloIn light of the devastation caused by COVID-19, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and vaccine research and development (R&D) have been occupying a prominent position in the field of global health diplomacy (GHD). Most countries, international organizations, and charitable organizations have been engaged in the R&D of COVID-19 vaccines to ensure timely affordability and accessibility to all countries. Concomitantly, the World Trade Organization (WTO) provides some provisions and enforcements regarding copyrights, patents, trademarks, geographical indications, and industrial designs. Given these safeguards, it is considered that intellectual property rights (IPRs) have become major barriers to the affordability and accessibility of vaccines/medicines/technology, particularly to the developing/least developed countries. Realizing the gravity of the pandemic impact, as well as its huge population and size, India has elevated this issue in its global health diplomacy by submitting a joint proposal with South Africa to the World Trade Organization (WTO) for a temporary waiver of IPRs to ensure timely affordability and accessibility of COVID-19 medical products to all countries. However, the issue of the temporary waive off had become a geopolitical issue. Countries that used to claim per se as strong advocates of human rights, egalitarianism, and healthy democracy have opposed this proposal. In this contrasting milieu, this paper is aimed at examining how the TRIPS has become a barrier for developing countries’ development and distribution of vaccines/technology; secondly, how India strategizes its role in the WTO in pursuant of its global health diplomacy? We conclude that the IPRs regime should not become a barrier to the accessibility/affordability of essential drugs and vaccines. To ensure access, India needs to get more engaged in GHD with all the involved global stakeholders to get strong support for their joint proposal. The developed countries that rejected/resisted the proposal can rethink their full supportItem Developing a community‑based breast cancer risk prediction tool for resource‑poor settings(Journal of Education and Health Promotion, 2019) Pillai, Divya; Shah Hossain, Shaikh; Chattu, Vijay KumarBACKGROUND: With an estimation of every two women newly diagnosed with breast cancer, one dies. It is accounted that 1 in 28 women is likely to develop breast cancer during her lifetime. Developing a risk prediction tool by assessing the prevalence of known risk factors in the community will help public health intervention. METHODOLOGY: A cross‑sectional study was conducted among 18–64‑year‑old women to gather the prevalence of known breast cancer risk factors, through a community survey (sample survey). In this multistage random number‑based cluster sampling study, the results were compiled, collated, and analyzed in rates and proportions. Statistical conclusions were made using spreadsheets (Microsoft) and the values were converted into ordinal values using modified Likert scale and median was used to estimate central values. The estimated prevalence of these known risk factors was re‑assorted for analysis and these re‑assorted data were categorized into range of values across the communities. The internal validity of the survey questionnaire was measured using Cronbach’s alpha (α). RESULTS: The analysis of 558 participants was performed for the known risk factors for breast cancer including participant’s age, age at menarche, marriage, first childbirth, menopause, family history of breast cancer and benign breast disease, history of abortion, and body mass index. Based on the estimated prevalence of these risk factors, a community‑based risk prediction tool was developed with Cronbach’s α score of medium internal validity. CONCLUSIONS: The risk assessment tool has collated most of the risk factors of breast cancer that are capable of being measured at community level. The survey findings concluded that the community under survey was bearing moderate risk for breast cancer for womenItem Diabetes and nutrition: factors affecting dietary choices(2016) Arthur, SandiItem The Emerging Role of Blockchain Technology Applications in Routine Disease Surveillance Systems to Strengthen Global Health Security(Big Data and Cognitive Computing, 2019) Chattu, Vijay Kumar; Nanda, Anjali; Chattu, Soosanna Kumary; Manzoor Kadri, Syed; Knight, W. AndyBlockchain technology has an enormous scope to revamp the healthcare system in many ways as it improves the quality of healthcare by data sharing among all the participants, selective privacy and ensuring data safety. This paper explores the basics of blockchain, its applications, quality of experience and advantages in disease surveillance over the other widely used real-time and machine learning techniques. The other real-time surveillance systems lack scalability, security, interoperability, thus making blockchain as a choice for surveillance. Blockchain o ers the capability of enhancing global health security and also can ensure the anonymity of patient data thereby aiding in healthcare research. The recent epidemics of re-emerging infections such as Ebola and Zika have raised many concerns regarding health security which resulted in strengthening the surveillance systems. We also discuss how blockchains can help in identifying the threats early and reporting them to health authorities for taking early preventive measures. Since the Global Health Security Agenda addresses global public health threats (both infectious and NCDs); strengthen the workforce and the systems; detect and respond rapidly and e ectively to the disease threats; and elevate global health security as a priority. The blockchain has enormous potential to disrupt many current practices in traditional disease surveillance and health care researchItem Equity in health care: is it achievable?(Elsevier Public Health Emergency Collection, 2020) Pooransingh, Shalini; Chattu, Vijay KumarItem An Exploratory Study of Quality of Life and Its Relationship with Academic Performance among Students in Medical and other Health Professions(Medical Sciences, 2020) Chattu, Vijay Kumar; Sahu, Pradeep Kumar; Seedial, Neela; Seecharan, Gerlisa; Seepersad, Amanda; Seunarine, Melina; Sieunarine, Shivanna; Seymour, Kahamaron; Simboo, Samantha; Singh, ArissaQuality of life (QOL) is a broader concept which represents experiences, states, appraisals, behaviors, capacities and emotional reactions to circumstances. The study aimed to evaluate the di erences in various domains of QOL among the students of five schools (medicine, dentistry, veterinary medicine, pharmacy and nursing) and an optometry unit in the Faculty of Medical Sciences, Trinidad and Tobago. Further, the study evaluated the factors (sociodemographic variables and academic performance) predictive of physical, psychological, social and environment domains of quality of life. The research tool consisted of a validated questionnaire which had two sections; (1) sociodemographics inclusive of students’ cumulative grade point average and (2) the shorter version of WHO quality of life (WHOQOL-BREF). The data were transformed into a linear scale and exported into the IBM SPSS version 24 where t-tests, one-way ANOVA and stepwise regression were performed. Of the total 535 participants, most 383 (71.6%) were females. While comparing the di erences in the domains of QOL that existed based on the schools (professions) they were enrolled, significant di erences were recorded for physical (p < 0.05), psychological (p < 0.05) social (p < 0.05) and environmental domains (p < 0.05). Though the domains of physical health, psychological health and environment showed a significant association with the academic performance of students, the social domain had no such relationship. The overall quality of life has a positive connection with the academic performance of students in medical and health professions. Therefore, universities and all stakeholders involved in health professions need to play a critical role to ensure the students in health professions maintain a high QOL. At the same time, there is a great need for extra attention for students who showed poor academic performance in the previous semester to bring them on track.Item Global epidemiology, risk factors, and histological types of ovarian cancers in Trinidad(Journal of Family Medicine and Primary, 2019) Umakanthan, Srikanth; Chattu, Vijay Kumar; Kalloo, ShereneOvarian cancer is the seventh most common cancer in women in the world and Trinidad and Tobago is ranked 18th in the world with respect to the rate of occurrence. About 68% cases are diagnosed at a late stage, resulting in low survival rates. Since there is very scanty literature available on the epidemiology of ovarian cancer in the Caribbean region, this study was undertaken to assess the most common risk factors, presenting symptoms and common histological varieties in Trinidad. Methods: A hospital‑based, cross‑sectional study was designed, and all the 23 diagnosed ovarian cancer cases registered during 2015–2017 were considered. Information on sociodemographics, presenting symptoms, and histological type of cancers were collected after getting the ethical approval. Of the total 23 cases, 17 cases were included in this study after ensuring completeness of data as detailed analysis of patient data was done using Microsoft Excel. Results: The common risk factors identified were previous pregnancies, previous surgeries, and irregularities in the menstrual cycle. The commonest histological variety was granulosa tumors and the most common associated symptoms were irregular menses and abdominal pain in premenstrual women, and abdominal distention in postmenopausal women. Conclusions: It would greatly enhance the detection rate if screening and testing for the CA‑125 gene were a mandatory practice, for any patient found with more than three risk factors. The public health authorities should identify the modifiable risk factors and implement cancer reduction and health promotion activities to reduce the mortality related to ovarian cancersItem Global health diplomacy at the intersection of trade and health in the COVID-19 era(Health Promotion Perspective, 2021) Chattu, Vijay Kumar; Pooransingh, Shalini; Allahverdipour, HamidGlobal health diplomacy has gained significant importance and undoubtedly remained high on the agendas of many nations, regional and global platforms amid the coronavirus disease 2019 (COVID-19) pandemic. Many countries have realized the importance of the health sector and the value of a healthy workforce. However, there is little control on issues related to trade that impact on human health due to the dominance of profit-oriented business lobbies. A balance, however, needs to be struck between economic profits and a healthy global population. This paper aimed to highlight the importance of building capacity in global health diplomacy, especially during the COVID-19 pandemic so that health personnel may effectively negotiate on the multisectoral stage to secure the resources they need. The recent proposal to waive off certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement for the prevention, containment and treatment of COVID-19 by India and South Africa at the World Trade Organization (WTO) presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access at the international level so that both developed and developing nations may enjoy improved health outcomes related to the COVID-19 pandemicItem Global Health Diplomacy Fingerprints on Human Security(International Journal of Preventive Medicine, 2019) Chattu, Vijay Kumar; Knight, W. Andy; Reddy, K. Srikanth; Aginam, ObijioforHuman security is a concept that challenges the traditional notion of national security by placing the ‘human’ as the central referent of security instead of the ‘state.’ It is a concept that encompasses health and well-being of people and prioritizes their fundamental freedoms and basic livelihoods by shielding them from acute socioeconomic threats, vulnerabilities and stress. The epicenter of “health security” is located at the intersection of several academic fields or disciplines which do not necessarily share a common theoretical approach. Diverse players in the “health security” domain include practitioners in such fields as security studies, foreign policy, international relations, development theory, environmental politics and the practices of the United Nations system and other multilateral bodies like the World Health Organization (WHO) and the Pan American Health Organization (PAHO). Improvements in health are not only dependent on continued commitments to enhance the availability of healthcare and to strengthen disease prevention systems; they are very much enhanced by that intersection between global security and global health. What is emerging is global health diplomacy paradigm that calls for strengthening of core capacities in the public health and foreign policy arenas aimed at advancing human security through the strengthening of global health diplomacy practices. Human security in its broadest sense embraces far more than the absence of violence and conflict. It encompasses human rights, good governance, access to education and health care, and ensuring that each individual has opportunities and devices to fulfill his or her potential. Every step in this direction is a step towards reducing poverty, achieving growth and preventing conflict. Freedom from want, freedom from fear and the freedom of future generations to inherit a natural environment – these are the interrelated building blocks of human‑ and therefore national securityItem Higher Education as a Bridge between China and Nepal: Mapping Education as Soft Power in Chinese Foreign Policy(Societies, 2021) Gauttam, Priya; Singh, Bawa; Chattu, Vijay KumarIn this globalized world, education has become an important medium to enhance people-to-people contact. The Delores report of the International Commission on Education for the 21st century highlights the enormous potential of higher education to use globalization as a resource for bridging the knowledge gap and enriching cross-cultural dialogue. As a major contributor to soft power and an important field of public diplomacy, international education can have a wealth of advantages, including the ability to generate commercial value, promote a country’s foreign policy goals and interests, and contribute to economic growth and investment. The People’s Republic of China, well-known for being the world’s most populous nation and the global economic powerhouse, prioritizes the internationalization of the country’s higher education system. China is looking to expand its higher education program and carry out its diplomatic project in South Asia. In this sense, the South Asian zone, especially Nepal, is significant for China, where its educational diplomacy is playing as a “bridge between Sino- Nepal relations.” In this review, we describe the place and priority of “Education” in China’s foreign policy; explore China’s mediums of investment in Nepal’s education sector; and highlight the importance of educational aid in Sino-Nepal relations. Chinese educational aid to Nepal takes many forms, where Nepali students and officials engage with Chinese investment to enhance their career prospects and the education system in NepalItem India’s Health Diplomacy as a Soft Power Tool towards Africa: Humanitarian and Geopolitical Analysis(Journal of Asian and African Studies, 2021) Mol, Rajani; Singh, Bawa; Chattu, Vijay Kumar; Kaur, Jaspal; Singh, BalinderIndia and Africa have been sharing a multidimensional relationship of cooperation and friendship since the ancient civilizations. The COVID-19 pandemic has brought new possibilities and opportunities for India to leverage its soft power diplomacy towards Africa. The paper’s main focus is to analyze how India has made soft power part of its foreign policy and examine India’s relationship with the African continent through health diplomacy. A literature search was done in major databases, such as Web of Science, Medicine/ PubMed, Scopus, OVID, and Google Scholar search engine to gather relevant information. Through humanitarian assistance and geopolitical influence, India had won the support and heart of Africans. Besides, India has become a global healthcare provider in the African continent through its global health diplomacy and vaccine diplomacy. India has achieved impressive gains through its soft power diplomacy and has become a compassionate and benevolent actor in the African continent.