Blockchain Papers

Esteban Ortiz‐Prado, María Paz Cadena, Jorge Vasconez-Gonzalez, Juan S. Izquierdo-Condoy

Latin America and the Caribbean are a global hotspot for emerging and re-emerging infectious diseases, yet regional One Health preparedness remains uneven and incompletely operationalized. This narrative Mini Review synthesizes evidence published mainly between 2015 and 2026 on One Health preparedness for emerging infectious diseases in the region, emphasizing how environmental disruption and climate change shape zoonotic and vector-borne spillover risk. Available regional surveys suggest broad professional familiarity with the One Health concept but limited operational implementation, with environmental health frequently identified as the least-integrated domain. We argue that spillover risk—and the failure to detect and contain spillover once it occurs—should be understood as a system-level outcome shaped by ecological disruption, socioeconomic vulnerability, surveillance capacity, and governance, rather than as an isolated biological event: deforestation, agricultural and extractive expansion—including illegal mining and logging—unplanned urbanization, and climate variability generate new human–animal–vector interfaces, while fragmented governance, uneven and poorly decentralized laboratory capacity, and limited reservoir and environmental surveillance leave these interfaces unmonitored. Environmental and climatic drivers are robustly linked to spillover, although the pathways are disease-specific rather than universal, and socioeconomic vulnerability concentrates the resulting burden in Indigenous, rural, and marginalized populations. We identify priority gaps in integrated surveillance, decentralized diagnostics, genomic capacity, reservoir ecology, governance, financing, and equity, and propose an agenda for anticipatory, climate-informed, and context-sensitive preparedness.

Vivek Kumar, Navya Vyas, Myron Anthony Godinho, S. Elstin Anbu Raj · 5 authors

Abstract Background Vector-borne diseases (VBD) pose significant threats to global public health. Despite the adoption of Integrated Vector Management (IVM) in India to address this issue, its implementation encounters several obstacles that undermine its effectiveness. This review systematically examines implementation challenges and highlights key areas for improving VBD reduction in India. Methods We conducted a systematic review and meta-synthesis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Studies conducted during 2016–2025 were included in this review, as the first IVM guidelines were introduced in India in 2016. PubMed, Scopus, Embase, and Web of Science databases were included in the search. The Consolidated Framework for Implementation Research (CFIR) was used as a lens to synthesise the evidence. Methodological quality of the included studies was assessed using an appraisal tool based on the study design. Results Across the 55 studies included, 35 implementation challenges affecting IVM were identified. The most frequently reported barriers included low preventive practices and risk perception (29.1%, n = 16), insecticide resistance (25.5%, n = 14), deficits in community engagement (21.8%, n = 12), and gaps in physical and information technology infrastructure (21.8%, n = 12). System-level challenges related to health workforce capacity, inter-sectoral coordination, financing, and governance were common. Individual-level barriers included knowledge gaps, misconceptions, and limited motivation among communities, as well as training and competency gaps among implementers. Process-related challenges were prominent and included coverage and fidelity gaps, weak engagement, issues with surveillance data quality, and inadequate planning and monitoring. Conclusion IVM implementation in India reflects interconnected multi-level barriers, particularly within the outer, process and inner domains. Strengthening decentralized, real-time surveillance system with a formal feedback mechanism, alongside institutionalizing community co-design approaches, represents a key approach through theory-informed, context-sensitive implementation strategies to improve implementation fidelity and program effectiveness and accelerate towards Sustainable Development Goal (SDG) 3. Registration This review protocol was developed and registered in the Open Science Framework (OSF). Registration https://doi.org/10.17605/OSF.IO/JTCWD

Saadaq Adan Hussein, Marian Muse Osman, Mohamed Mohamoud Hassan, Mohamed Abdullahi Awale · 19 authors

INTRODUCTION: Somalia, the 44th largest country in the world by land area, struggles with a heavy burden of infectious diseases. Since 1991, populations have lacked essential health services, exacerbated by recurring infectious-disease outbreaks. Recurrent outbreaks of measles, cholera, and polio have devastated public health, generating significant morbidity and mortality. Despite improvements through new graduates, these issues remain unresolved. This study examines the impact of climate change on infectious-disease outbreaks in Somalia focusing on cholera, measles, and polio-to fill a gap in the literature by linking climate variability with outbreak dynamics and identifying weaknesses in Somalia's health system. The findings will inform targeted public-health strategies. METHOD: Following PRISMA guidelines, we undertook a narrative review of English-language literature (1990 - March 2025). Searches in PubMed, Scopus, Web of Science and Google Scholar combined terms for infectious-disease outbreaks, climate change and Somalia/Horn of Africa. Of 202 records identified, 74 met inclusion criteria. Two reviewers independently screened, extracted data and applied six-step inductive coding in NVivo 12, synthesizing findings into thematic domains. RESULTS: Four interlinked themes emerged. (1) Fragile health system: < 0.4 doctors, nurses and midwives per 10 000 population, poorly equipped facilities and patchy surveillance. (2) Control measures: routine immunization completeness ≈20%; limited oral-cholera-vaccine and WASH coverage sustain transmission. (3) Political instability and conflict: insecurity, decentralized coordination and ≥ 2.6 million IDPs hamper rapid response. (4) Impact of climate change: drought-induced water scarcity and flood-related latrine breaches create year-round face-oral exposure, while climate shocks divert resources and swell susceptibility pools. CONCLUSION: Outbreak control in Somalia now hinges on integrating climate adaptation with health-system strengthening. Climate-proofed WASH infrastructure, mobile vaccination and surveillance linked to hydro-meteorological alerts, a National Outbreak Operations Centre, and ring-fenced financing are urgent priorities. Without such measures each extreme-weather event will erase hard-won gains; with them, Somalia can break the climate-outbreak feedback loop.

Gislani Mateus Oliveira Aguilar, Luciana Freire de Carvalho, Caio Luiz Pereira Ribeiro, João Roberto Cavalcante · 8 authors

Abstract This article describes the trajectory of the city of Rio de Janeiro in facing public health emergencies between 2021 and 2024, based on three axes of action proposed by the World Health Organization (WHO): preparedness, surveillance, and response. Innovation in timely data analysis from non-conventional information sources has enabled an early detection of events, promoting reorientation in health surveillance practices. The construction of a strong institutional identity, as well as the coordination of response actions in Emergency Operations Centers, contributed to the consolidation of a culture of rapid response and networking. The integration of primary health care (PHC) and surveillance networks guaranteed a continuity of care and coordinated risk management, highlighting the importance of a decentralized health system that seeks intersectorality in responding to emergencies. The advances observed in combating the COVID-19 and dengue epidemics during this period in the city were driven by adequate investments in structure and human resources, emphasizing the importance of continuous financing and strategic planning aimed at this model of care.