The study addresses one of the main challenges in sports medicine: anticipating injuries before they occur. Although numerous artificial intelligence-based models have been developed in recent years, most have important limitations that make them difficult to apply in professional clubs. Rather than simply building a more accurate model, this work proposes a new methodological framework that addresses several of the main shortcomings identified in the scientific literature.

A new way to understand injury risk

The main innovation is to treat injury prediction as a survival analysis problem. This makes it possible to represent mathematically something practitioners already know: risk increases progressively as training or competition minutes accumulate. Unlike traditional classifiers, this behaviour is built into the model by design.

This approach is complemented by three further innovations:

• Beta Calibration, which adjusts probabilities so that they accurately reflect the observed real-world risk;
• The incorporation of decision theory, which adapts risk thresholds according to the sporting importance of each situation;
• The introduction of Rest Benefit Certainty (RBC), which allows coaching staff to define the level of certainty they want before deciding whether a player should rest.

Together, these elements turn an abstract probability into a contextualized recommendation that helps professionals assess when it is more beneficial for a player to participate or rest.

Four seasons of data from the women's first team

The study was developed using one of the most comprehensive longitudinal datasets available in elite women's football: four consecutive seasons from the FC Barcelona women's first team (2019-2023), covering 34 players, nearly 14,000 daily observations and 83 non-contact musculoskeletal injuries. The data integrate GPS information, training load, minutes played, competitions, international duty and injury duration.

A much more reliable injury-risk detection system

The results show that survival analysis-based models consistently outperform the traditional machine-learning algorithms used to date for injury prediction. In particular, these models achieved better discrimination than conventional classifiers, substantially improving the identification of high-risk situations.

Statistical calibration also corrected the tendency of the models to underestimate actual risk, making the resulting probabilities much more reliable and interpretable for the medical team.

In temporal validation on a completely new season, the system produced positive gains in player availability, suggesting that this type of model can help reduce the impact of injuries by keeping more players available throughout the season.

Cumulative fatigue, the strongest predictor

The analysis shows that the most important predictor is the distance accumulated over the previous 21 days, followed by high-speed running intensity and same-day accelerations and decelerations. This result reinforces the idea that cumulative fatigue is the main mechanism associated with non-contact injury risk.

"Unlike previous approaches, this framework makes it possible to identify, rank and calibrate the factors associated with injury risk with statistical rigour, and to quantify the contribution of cumulative fatigue. Above all, it offers a new scientific perspective on a complex phenomenon," says Juan R. González, a researcher at ISGlobal.

"The methodological challenge was twofold: to represent how risk accumulates with exposure while also contextualising the resulting probabilities so that they can be interpreted according to the relevance of each situation. Incorporating decision theory makes it possible to adapt risk thresholds to each sporting context and turn predictions into a useful tool to support professional decision-making," explains Manuel Huth, first author, from the University of Bonn.

From research to the pitch and beyond

This research provides unique insight into the factors that explain injury risk, with external load as the starting point. The athlete's digital twin integrates this with internal load - how the body responds to effort, through biomarkers, physiological indicators and molecular data - and each athlete's genetic profile: an essential tool to support the technical and medical staff, personalise each athlete's monitoring and anticipate injuries. This is the line that Barça Innovation Hub is driving together with Made of Genes.

"This kind of research brings scientific rigour to factors that, until now, we often interpreted intuitively. The real value is to better understand how load and each athlete's biology relate to injury risk," explains Gil Rodas, physician at FC Barcelona.

"Advancing in this field requires research and methodology of the highest scientific rigour, like this work. As a data and artificial intelligence platform partner, at Made of Genes we bring research onto the pitch through anticipation and performance-enhancement models that integrate, within a digital twin, each athlete's external load, internal load and genetic profile," adds Berta Canal, data scientist at Made of Genes.

The potential reaches well beyond elite football: as wearable sensors are now widely used not only by professional athletes but also in amateur sports and physically demanding occupations, the same approach could support injury prevention far beyond the football pitch.

About the study

Title: Injury prediction in elite women's football: an integrative machine learning-based decision-support framework
Journal: npj Digital Medicine (Nature Portfolio)
Publication: Online, 8 July 2026
DOI: 10.1038/s41746-026-02937-3
Data: FC Barcelona women's first team · 4 seasons (2019/20-2022/23) · 34 players · 83 non-contact injuries
Authors: Manuel Huth, Berta Canal-Simón, Eva Ferrer, Gil Rodas, Xavier Yanguas, Jan Hasenauer and Juan R. González
Institutions: ISGlobal · University of Bonn · Made of Genes · FC Barcelona Medical Department and Barça Innovation Hub · Hospital Clínic-Sant Joan de Déu · Leitat · CIBERESP · Universitat Autònoma de Barcelona

Reading time: 3 min

[This post was written by Aina Nicolàs, Camila Picchio and Anthony Armenta, from the Public Health Liver Group at ISGlobal.]

A vaccine, rapid diagnostic tests and effective treatment options exist. You’d think that viral hepatitis must be close to elimination, but it’s far from over.

The latest World Health Organization (WHO) Global Hepatitis Report has shown that viral hepatitis infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV), continue to cause over one million deaths annually. At the same time, most people living with chronic viral hepatitis remain undiagnosed or untreated, revealing a disconnect between the tools already available and better health outcomes. When we look more closely at Europe, the picture is equally striking: elimination targets remain far out of reach, with a strong gap in both diagnosis and treatment rates.

The challenge, then, is not simply whether effective medical tools exist. It is whether people can actually access, understand and navigate the services that provide them.

The challenge is not simply whether effective medical tools exist. It is whether people can actually access, understand and navigate the services that provide them.

This is particularly important for migrant communities in Europe, who may face barriers that traditional clinic-based approaches do not adequately address. These communities are disproportionately affected and account for an estimated 25% of HBV infections and 14% of HCV infections. This happens because of a complex interplay of factors, including limited availability of preventive strategies in their home countries, and substantial barriers to access and navigate their host health systems, which are further compounded by cultural and linguistic barriers.

For someone trying to access care in a new country, these barriers can be structural as well as personal: not knowing where to go for testing, struggling to understand health information in an unfamiliar language, navigating appointments and referrals, or facing stigma and misconceptions around viral hepatitis.

Early diagnosis and timely care are therefore essential to prevent serious health problems and reduce further transmission.

The consequences of being missed by the health system can be serious. A delayed diagnosis often leads to the infection being detected only after advanced liver disease has developed. This means an increased risk of cirrhosis, liver cancer, and, ultimately, death. In parallel, when people don’t know they have the infection, they may not take the precautions needed to protect others, allowing it to spread within the community unknowingly. Early diagnosis and timely care are therefore essential to prevent serious health problems and reduce further transmission.

Bringing care closer to where people live

Reaching people who are not accessing traditional health services requires us to rethink where and how care is delivered.

According to WHO, simplifying and decentralising how we deliver screening and care services is central to viral hepatitis elimination efforts. This means moving some services beyond specialised clinical settings and closer to the communities that need them, while making it easier for people to move from testing to appropriate care.

Community health workers and other community facilitators can make this possible.

In practice, their role is very tangible. These frontline public health professionals may explain why testing matters in a language and context people understand, answer questions and address stigma and misconceptions, help someone find or access a testing service, guide them through appointments or referrals, and connect them with the formal health system when further care is needed. Because they often come from, work closely with, or have established trust within the communities they serve, they can bridge cultural, linguistic and structural gaps that healthcare services may struggle to overcome on their own.

Frontline public health professionals may explain why testing matters in a language and context people understand, answer questions and address stigma and misconceptions, help someone find or access a testing service, guide them through appointments or referrals, and connect them with the formal health system when further care is needed.

This is not a new idea.

Across different health systems, community health workers have helped extend care to communities that might otherwise be missed. In Rwanda, for example, community health workers have been instrumental in strengthening primary healthcare, with their responsibilities expanding from basic health promotion to integrated community case management. Their experience shows what can happen when community-based workers are recognised as a core part of how people reach and use health services.

Despite the substantial contribution of community health workers in health systems among low- and middle-income countries, their potential to support health systems in high-income countries is immense.

In Europe, a stronger and more integrated role for community health workers could help address persistent challenges in migrant health, including unequal access to services and growing cultural and linguistic diversity. Yet their roles are not consistently embedded within formal healthcare systems. Some countries and regions–like Belgium and the United Kingdom–have taken steps to connect community health workers more closely with primary care, while elsewhere their involvement remains fragmented or dependent on individual pilot programmes and research projects.

Realising their full potential therefore requires more than simply recognising that community-based approaches work. The people delivering these services also need the knowledge, practical tools and support to carry out their roles effectively and link communities with the wider healthcare system.

Turning this approach into action through HEP-HOP

This is one of the challenges that the Health Equity Programme: Hepatitis Outreach for Migrant Populations (HEP-HOP) project aims to address.

Leaving no one behind is at the heart of HEP-HOP, an EU-funded project focused on improving access to viral hepatitis care among migrants across Europe.

Because bringing services closer to communities must involve communities themselves, a central component of the project is decentralised, point-of-care testing for viral hepatitis, delivered with the involvement of community health workers and other community facilitators, including peer navigators, social mediators and civic integration teachers.

ISGlobal and the University of Antwerp are developing a structured training curriculum to equip frontline community workers with practical skills.

These are people who are already well positioned to build trust, communicate in culturally appropriate ways and help individuals navigate services. But for this model to be effective and scalable, they also need structured preparation for the responsibilities they are being asked to take on.

That is why ISGlobal and the University of Antwerp are developing a structured training curriculum to equip frontline community workers with the practical skills needed to:

• conduct decentralised screening,
• tackle stigma and misconceptions,
• engage with migrant communities in culturally appropriate ways, and
• increase awareness of viral hepatitis among migrants in Europe.

Designed with sustainability and scalability in mind, the curriculum has undergone an expert-led revision process involving community representatives as well as global advocacy organisations, including the World Hepatitis Alliance and the Hepatitis B Foundation, alongside other researchers and experts.

The goal is to strengthen the connections between communities and the health services already available, so that people can access testing, care and treatment earlier and more easily.

Eliminating viral hepatitis will depend on making existing tools work for everyone. Trusted community support, accessible services and stronger links to care can help ensure that no one is left behind.

PROGRAMA PRELIMINAR

9.00 h – 9.20 h Entrega de documentación

9.20 h – 9.30 h Bienvenida

9.30 h – 10.40 h Riesgo de introducción de arbovirus en el Mediterráneo

10.40 h – 11.20 h Sesión de Posters (x5)

11.20 h – 11.50 h Pausa café

11.50 h – 12.50 h La próxima generación de herramientas para el control de arbovirus

12.50h – 13.50h Arbovirosis de interés emergente: la situación en España

13.50h – 14.00h Clausura

                                                INSCRÍBETE AHORA

Reading time: 3 min

[This post was jointly written by Manolis Kogevinas, Emeritus Professor at ISGlobal, an Neil Pearce, Professor of Biostatistics and Epidemiology at the London School of Hygiene and Tropical Medicine. It is based on their academic paper "Football, fossil fuels, and public health in the era of climate crisis", published in Environmental Epidemiology.]

In December 2022, millions of people watched Lionel Messi lift the World Cup wrapped in a bisht (a traditional garment) placed on him by the Emir of Qatar. The image became a global symbol, not only for its sporting value, but because it revealed something deeper: the growing fusion between the planet's most popular sport and the economic interests of major fossil fuel producers.

In the 2026 World Cup, one of the sponsors was Aramco, Saudi Arabia's state oil company, and furthermore, the 2034 World Cup will take place precisely in Saudi Arabia.

But this article is not about football. It is about how fossil fuels shape our daily lives, our cities, our climate, and ultimately, our health. Football is simply the most visible mirror of a much broader phenomenon: the ability of certain industries to influence culture and public perception through platforms of massive reach.

A link that goes far beyond sports

For decades, major oil companies and states whose wealth depends on oil and gas have invested billions in projects with global visibility. Some estimates place this annual investment at around 6 billion dollars. Sport, and especially football, is one of the most effective vehicles for this. It is no coincidence that some of Europe's most successful clubs are controlled by sovereign wealth funds from oil-producing countries, nor that state airlines or energy companies appear on jerseys, stadiums, and broadcasts. The result is a constant presence, almost invisible due to its normality, of industries responsible for a substantial share of global emissions.

It is no coincidence that some of Europe's most successful clubs are controlled by sovereign wealth funds from oil-producing countries, nor that state airlines or energy companies appear on jerseys, stadiums, and broadcasts. The result is a constant presence, almost invisible due to its normality, of industries responsible for a substantial share of global emissions.

Even the most admired managers in contemporary football, Pep Guardiola, until recently at Manchester City, and Luis Enrique at Paris Saint-Germain, work on sports projects whose excellence is sustained by capital originating from fossil fuel-based economies, through the sovereign wealth funds of the United Arab Emirates and Qatar, respectively. This is not a criticism of them, but an observation: sporting talent today coexists with financial structures that have profound implications for the climate and public health.

But reducing this strategy to a matter of image would be naive. What is at stake is the ability of these industries to maintain their social legitimacy at a time when science is unequivocal: the burning of fossil fuels is the primary driver of climate change, and climate change is already the single greatest threat to public health in the 21st century.

Public health in the era of extreme climate

Climate change is not an abstract phenomenon. Its effects on health are documented and intensify every year:

• More frequent and deadly heatwaves.
• Air pollution causing millions of premature deaths.
• Extreme events—floods, fires, droughts—that disrupt ecosystems and displace populations.
• Infectious diseases expanding into new regions.

These risks are documented in multiple reports, such as the Lancet Countdown, one of the most comprehensive evaluations on climate and health, in which ISGlobal researchers actively participate.

While the impacts of climate change increase, the industries responsible for the majority of emissions continue to find privileged spaces to project an image of modernity, dynamism, and progress.

And yet, as the impacts increase, the industries responsible for the majority of emissions continue to find privileged spaces to project an image of modernity, dynamism, and progress.

The power of normalization

This is where the link to sports, and to other cultural spheres, becomes relevant. Advertising and sponsorship do not just sell products: they shape mindsets. Associating fossil fuels with success, excitement, or sporting excellence helps maintain the idea that these industries are a natural and inevitable part of our lives.

Sportswashing is not just an ethical issue. It is a commercial determinant of health, because it indirectly influences health risks by delaying or weakening environmental protection policies.

This phenomenon has a name: sportswashing, a form of reputational laundering that uses sports to soften the public perception of activities with negative environmental impacts. But sportswashing is not just an ethical issue. It is a commercial determinant of health, because it indirectly influences health risks by delaying or weakening environmental protection policies.

An uncomfortable parallel: tobacco

History offers a clear precedent. For decades, the tobacco industry used sports to associate its products with vitality and success. The result was a significant delay in the adoption of tobacco control policies.

Today, no one would accept a cigarette brand sponsoring a major club's jersey. Yet, we continue to accept, and even celebrate, industries responsible for a climate crisis with massive health consequences occupying that very space.

Is this dependency inevitable?

A widespread idea is that sports, and by extension other cultural activities, need this type of funding to survive. But this narrative ignores something fundamental: the economic system of sports has been built on a spiral of rising expenditure, where additional revenues do not stabilize the model, but rather feed permanent inflation in salaries, transfers, and operational costs.

In other words: it is not that sports need fossil fuels; it is that the current sports model needs a constant flow of capital, wherever it comes from.

A moment for collective responsibility

The debate over the role of fossil fuels in sports is not a debate about fandom. It is not about stopping watching matches or giving up the thrill generated by the game. It is about recognizing that culture is also part of the system that determines our health.

It is not about stopping watching matches or giving up the thrill generated by the game. It is about recognizing that culture is also part of the system that determines our health.

Scientific societies have already proven that they can lead profound ethical changes, as occurred with tobacco. Today, the challenge is greater and more urgent. The question is not whether sports should divest from fossil fuels, but when and how.

Because, just as in the 20th century it became unacceptable for sports to serve as a platform to promote products that killed, in the 21st century it should be unacceptable to us that it contributes to normalizing the industry that is destabilizing the planet's climate.

Reading time: 5 min

When most people think about viruses, they think about disease. But viruses are everywhere: in oceans, soils, forests, wastewater, and on the surfaces we touch every day. In fact, there are an estimated 10³¹ viruses on the planet, of which only a tiny fraction has been identified.

This vast unknown viral diversity has been dubbed the “viral dark matter”. Thanks to recent advances in sequencing technologies, scientists are beginning to uncover the vast diversity of viruses present in soil, oceans, wildlife and other environments. One particularly fascinating study used samples from African army ants to characterise viral populations in a remote tropical forest in Gabon.  

Another remarkable study, this time focused not on forests but on cities globally, involved Xavier Rodó, ICREA researcher at ISGlobal. The study set out to map the diversity of RNA viruses across urban environments worldwide.

The hidden world of urban viruses

RNA viruses are of particular interest given their high mutation rates, which allow them to adapt quickly to new environments and hosts. Importantly, they account for two thirds of known human pathogens (HIV, influenza viruses, dengue, Ebola and SARS-CoV-2 are only some examples). Yet, few studies have looked at their diversity, especially in urban settings, where 56% of the world population now lives. 

The international MetaSUB consortium tackled this question by examining the diversity of RNA viruses in 102 cities and surrounding environments, across 31 countries. To do so, they analysed 2,922 genetic samples collected between March and July 2020, from a wide variety of urban and peri-urban environments: from handrails, benches or ticket machines in hospitals, banks and public transport stations, to nearby soils, green spaces and wastewater.

Key findings

These are some of the most noteworthy findings:

Thousands of previously unknown RNA viruses

The analysis uncovered 54,945 RNA viruses, 77% of which had not been previously reported. Two dominant classes of RNA viruses were observed across most countries, especially in environments closely associated with human activities. SARS-CoV-2 was also frequently observed, likely due to samples being collected during the pandemic.

Lower viral diversity in urban environments

Another clear finding was that viral diversity is lower in urban samples (streets, banks, subway stations) compared to those from peri-urban or natural environments, including sediment, soil or grasslands. This suggests that urbanization and human activity, whilst leaving a characteristic fingerprint, may “homogenize” viral communities. Wastewater also emerged as a major reservoir of viral populations, confirming its importance for viral monitoring.  But even in cities, the diversity remained huge- the analysis did not reach saturation, meaning that many more viruses likely remain undiscovered.   

New branches on the viral tree

The analysis also revealed evidence for two potentially new viral phyla, or major evolutionary branches, one new class and several previously unclassified groups. The study also found evidence that the emergence of double-stranded RNA genomes in the Duplornaviricote phylum may not have been a unique evolutionary event, as previously thought. Furthermore, by zooming in on a key viral enzyme (RNA-dependent RNA polymerase or RdRp), the researchers found evidence of directional selection, i.e. mutations that may provide the virus with selective advantages. Tracking these molecular signatures can help scientists understand viral evolution and adaptability, detect potentially pandemic strains, and guide vaccination strategies.

Urban viruses mostly infect bacteria

Most RNA viruses uncovered in the study are hosted by bacteria, fungi and plants, contrary to previous homocentric assumptions that RNA viruses mainly infect eukaryotes. In fact, more than half of the viruses for which a host could be identified were bacteriophages. This highlights the important ecological role these organisms play in shaping viral populations in cities and the complex eco-evolutionary dynamics that have shaped these relationships over time. Still, the researchers found over 100 viruses capable of infecting vertebrates, including families that contain well-known human pathogens such as rhinoviruses, polioviruses and enteroviruses. They also identified 166 RNA viruses associated with four major antibiotic-resistant bacteria known as ESKAPE pathogens: Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii. These viruses could eventually open the door to virus-based therapies against antibiotic-resistant bacteria. In addition, the team uncovered viruses capable of infecting human gut bacteria such as Clostridia and Bacteroidia, two major components of our microbiota.

Socioeconomic factors may influence viral abundance

By correlating viral diversity with World Development Indicators, the study also found that urban areas in less developed countries tended to show a higher burden of vertebrate-associated viruses than those in more developed settings. For example, hospital samples from Islamabad and São Paulo showed higher viral abundance than those from Baltimore and Seoul.  

A call for viral discovery and monitoring

True, as the researchers caution, the study has important limitations. For example, sampling was uneven across countries and environments, making it difficult to determine whether observed differences reflect geography or simply differences in what was sampled (e.g. public transport stations in Poland versus greenhouses in France). Much more work lies ahead to investigate in full host-virus associations and the role this viral dark matter has in ecosystems and in human health.

Studies like this one will help improve our understanding of viral hosts and evolution, strengthen environmental surveillance, and support preparedness for future outbreaks.

Even so, the study is one of the most ambitious efforts to date to map the hidden world of RNA viruses in human-associated environments and sets a new standard for viral discovery by developing a robust pipeline for viral discovery, host prediction and phylogenetic analysis. It also provides one of the most comprehensive catalogues of environmental RNA viruses assembled to date (named UPVAtlas), providing a valuable resource for future research. Studies like this one will help improve our understanding of viral hosts and evolution, strengthen environmental surveillance, and support preparedness for future outbreaks.

Air pollution is a major environmental risk factor for health and has been linked to a wide range of adverse health outcomes in adults, including cardiovascular disease and metabolic syndrome. Children are particularly vulnerable because their organs and immune systems are still developing, they breathe more air relative to their body weight, and they tend to spend more time outdoors. Metabolic syndrome refers to a cluster of risk factors, including abdominal obesity, high blood pressure, abnormal blood sugar and dyslipidaemia, that can increase the risk of type 2 diabetes and heart disease later in life.

To investigate this, researchers analysed data from 1,147 children aged 6 to 11 years from France, Greece, Lithuania, Norway, Spain, and the United Kingdom who were followed up with between 2013 and 2016 within the HELIX project. “We estimated exposure to PM_2.5 and NO₂ at home, school and during commuting, and examined its relationship with a metabolic syndrome risk score,” says Anne van Rooijen Korving, researcher at ISGlobal and first author of the study.

Using validated air pollution models based on residential, school and commuting environments, the team estimated annual exposure to both pollutants during the year prior to clinical assessment. Associations with metabolic syndrome risk were examined using multivariable regression models, and metabolic syndrome risk was calculated using a previously validated score based on waist circumference, blood pressure, blood lipids and insulin levels, following International Diabetes Federation criteria.

Stronger associations at school than at home

Air pollution was more strongly associated with metabolic syndrome risk at school than at home, suggesting that children may be particularly vulnerable in the school environment. Although pollution levels at home and at school were highly correlated (with annual PM_2.5 and NO₂ concentrations consistently exceeding World Health Organization guidelines), susceptibility appears to be greater at school. Previous research indicates that higher levels of physical activity at school increase breathing rates, which could amplify the adverse effects of pollution exposure. Conversely, no associations were found between exposure on commuting routes and metabolic syndrome risk. Similarly, no associations were observed for short-term exposure in the days or week before clinical assessment, supporting the idea that metabolic changes develop gradually over time rather than in response to acute exposure.

Potential biological mechanisms and public health implications 

Several biological mechanisms may explain these findings. Air pollution exposure has been linked to systemic inflammation, oxidative stress, and disruptions in lipid metabolism, glucose regulation and blood pressure control — all processes involved in the development of metabolic syndrome.

“Given the widespread exposure to air pollution and the long-term health consequences of metabolic syndrome, these findings have important public health implications,” says Martine Vrijheid, Director of ISGlobal's Environment and Health over the Lifecourse programme. “Our results reinforce the need to continue reducing air pollution levels to protect children’s cardiometabolic health.”


Reference

Anne van Rooijen Korving, Parisa Montazeri, Léa Maitre, Sandra Marquez, Jose Urquiza, Nuria Güil-Oumrait, Antònia Valentín, Regina Grazuleviciene, Kristine Bjerve Gützkow, Johanna Lepeule, Rosemary R.C. McEachan, Bente Oftedal, Euripides G. Stephanou, John Wright, Wen Lun Yuan, Martine Vrijheid, Childhood outdoor air pollution exposure across multiple microenvironments and metabolic syndrome: A HELIX cohort analysis, Environmental Research, Volume 305, Part 1, 2026, 124892,ISSN 0013-9351, https://doi.org/10.1016/j.envres.2026.124892

Reading time: 5 min

Sometimes a UN resolution goes unnoticed. The one on July 7 should not. It changes the playing field for more than one billion people because, from now on, neglected diseases cease to be just a health issue and also become a human rights concern.

It is not the same to demand political, financial, and medical attention for a forgotten disease as it is to denounce the violation of a fundamental right. That is the difference after July 7.

The news should have reached the speakers of each of the more than one billion affected people in the world by one or more of the 21 neglected tropical diseases (NTDs), according to the UN classification. It is a long list that includes diseases such as leishmaniasis, leprosy, lymphatic filariasis, Chagas, etc. Most of these ailments share features of exclusion, stigma, and discrimination, as well as a heavy impact on women and children.

Many of these diseases stopped being exclusively rural or tropical problems a long time ago. Chagas disease is a good example. Migratory movements and other global changes have turned it into a public health challenge also for countries like Spain, where an estimated 80,000 affected people live. In the United States, there are 300,000. Furthermore, it can be transmitted from mother to child during pregnancy, although this transmission is preventable through timely diagnosis and treatment.

A Matter of Human Rights

Since July 7, neglected diseases have become something more: they are a matter of human rights. This means that failing to properly treat these diseases will no longer be just a problem of health or political negligence, but a violation of human rights.

Since July 7, neglected diseases have been a matter of human rights. This means that failing to properly treat these diseases will no longer be just a problem of health or political negligence, but a violation of human rights.

The resolution was promoted by a group of African countries led by Malawi and had the support of dozens of organizations, among which was ISGlobal together with the Global Chagas Coalition.

In the absence of a report detailing what the inclusion of neglected diseases in Human Rights will consist of, we can anticipate an impact on strengthening the advocacy work of groups and associations of affected people. But even before knowing the practical scope of this resolution, something has already changed.

21 Diseases, One Billion People

For those who research, those who train, and those who develop therapeutic and logistical tools against neglected diseases, we are in a new era. They are not only working towards a goal of justice and equity in health, but for an officially recognized human right.

But we should not get carried away by enthusiasm. Because, honestly, who believes that states are trembling at the news right now? Do you think they are calculating the resources and millions in compensation they would have to pay to every person who has not been properly treated for a neglected disease?

It is true that, in legal terms, a public health issue is not the same as a human rights issue. These types of rights are inalienable and belong to each and every person.

In part, the UN resolution changes the names of neglected diseases: They are no longer "helminthiasis, filariasis, yaws, or onchocerciasis". Now their names are Yusuf, Amelia, Ibrahim, Wole, or Chantal.

In part, the UN resolution changes the names of neglected diseases: They are no longer "helminthiasis, filariasis, yaws, or onchocerciasis". Now their names are Yusuf, Amelia, Ibrahim, Wole, or Chantal. Addressing them is not just a public health duty but a right of Yusuf, Amelia, Ibrahim, Wole, or Chantal. A right belonging to each and every one of us.

The Worst Time for Human Rights

This is no time for high hopes. The 1948 Declaration emerged right after a world at war. Once again, we find ourselves in a world at war, with growing funding for the military sector and a fundamental cut in global health aid.

And regarding human rights, one only needs to look at what is happening in Gaza, right before our eyes, as well as in other parts of the world—north, south, east, and west. And violations of these rights are no longer even masked or concealed. At least, not yet.

We are in one of the worst moments for human rights. So, approving the inclusion of neglected diseases as part of them seems more like a poisoned gift.

We are in the "yet" phase, in one of the worst moments for human rights. Thus, the approval of neglected diseases becoming part of them seems more like a poisoned gift from a bankrupt bank choosing an unsuspecting director without informing them of the account statement.

But time passes and the weight of the dead remains. We will see a return to sanity, in that relentless pendular cycle of human beings between violence and common sense. We will read every article of the Human Rights declaration again as if it were the only border in the world.

What matters is that when that day comes, neglected diseases will already be in the articles of the Declaration, where they always belonged, with the eyes and mouths of each of the affected people, but finally cared for. For one morning, for one afternoon, that of July 7, we were not forbidden to dream. "There was evening, and there was morning—the first day."

Founded in 1996 through a joint initiative of the Ministry of Health of Mozambique and the Spanish Agency for International Development Cooperation (AECID), CISM has contributed to generating scientific evidence to improve the prevention, diagnosis and treatment of diseases such as malaria, tuberculosis, HIV and pneumonia, while also driving major advances in maternal and child health. AECID's sustained support has been instrumental in establishing the centre as a leading institution whose work has helped shape health policies both within and beyond Mozambique, positioning it as a key player in global health research.

A strategic partnership with ISGlobal

CISM's history has been closely intertwined with that of ISGlobal since its inception. Over the past three decades, the two institutions have built a strategic partnership based on strengthening scientific capacity, developing research infrastructure and jointly generating knowledge to address the health priorities of Mozambique and the African continent. Reflecting this long-term commitment, ISGlobal is a member of the Board of Trustees of the Manhiça Foundation, helping to advance the centre's mission and strategic development.

"CISM has demonstrated that research excellence can and should be led from Africa. Having accompanied its growth over the past thirty years has been a privilege and a testament to the value of scientific partnerships built on a shared vision and long-term commitment," said Quique Bassat, Director General and Scientific Director of ISGlobal.

An anniversary looking to the future

The ceremony brought together some of the key figures in this shared history. The programme included speeches by Pedro Alonso, founder of CISM and ISGlobal; Francisco Saúte, Director General of CISM; Pedro Aide, Head of CISM's Malaria Research Area; and Quique Bassat, who reflected on three decades of scientific cooperation between the two institutions. Representatives from Africa CDC, CAPRISA, AECID and the Mozambican authorities, including the President of the Republic, also took part.

Thirty years after its establishment, CISM remains a leading health research institution in Africa and an example of how long-term scientific collaboration can strengthen local capacity, consolidate research institutions and generate knowledge that improves population health.

 Read the series of posts published to mark CISM's 25th anniversary

[This text was co-written by Elsa Carbonell, field technician, and Albert Bach, postdoctoral researcher.]

Reading Time: 3 min

When you enter a park after a stressful day, what makes you feel better? The shade of the trees? The chirping of birds? The feeling of being surrounded by nature? Or the combination of freshness, nature, and calm that makes that park function as something more than just a place to pass through?

In a context of climate change, water scarcity, and urban growth, green spaces can no longer be understood merely as recreational areas or as elements with a single function. They are urban infrastructures that can simultaneously contribute to retaining water in the soil, hosting biodiversity, improving environmental comfort, and fostering the mental and emotional well-being of citizens.

The urban parks of the future will have to respond to many challenges at once. BioWater provides a baseline to think of them not as separate pieces of greenery, but as living spaces where soil, water, biodiversity, and well-being are interwoven.

With this vision in mind, the BioWater project emerged as a pilot test developed in ten urban green spaces in Barcelona. The goal has been to explore how vegetation characteristics relate to three key dimensions: soil water content, biodiversity, and the mental and emotional restoration of the people who use these spaces.

How Do Vegetation Characteristics and Soil Moisture Relate to Each Other?

The project has studied parks with different vegetation configurations: spaces dominated by herbaceous plants, shrubs, trees, and mixed combinations of vegetation. It has also incorporated various biodiversity indicators, such as birds, lichens, and hoverflies. Hoverflies are pollinating insects, often resembling small bees or wasps, which can provide information about habitat quality. Additionally, the project gathered the perception of users through surveys and participatory sessions.

The results of BioWater suggest that, in order to generate more resilient green spaces, it is necessary to better understand soil characteristics, restore it, and improve its water retention capacity.

One of the main results is that the relationship between vegetation and soil moisture is not as simple as it might seem. In the parks studied, soil moisture was primarily associated with soil characteristics (soil texture and temperature), environmental conditions such as relative humidity, and vegetation.

This is especially important in a city like Barcelona, where urban green management has been conditioned by drought. The results of BioWater suggest that, to generate more resilient green spaces, it is necessary to better understand soil characteristics, restore it, and improve its water retention capacity.

How Do Vegetation Characteristics Relate to Biodiversity?

In the case of biodiversity, the results also point to a nuanced interpretation. Spaces with a greater richness of shrubs and trees tend to feature a greater richness of birds. However, the biodiversity perceived by citizens does not depend solely on the total number of plant species. In the analyzed parks, the biodiversity perceived by citizens seems to be associated with spaces where vegetation is distributed across a greater diversity of layers and heights, and where these layers have a well-represented coverage (structural complexity of vegetation). Perceived biodiversity was also associated with a greater sense of naturalness.

How Do Vegetation Characteristics Relate to Our Well-Being?

This point is crucial: the way people perceive a green space is also part of its urban function. A park may have ecological value, but for it to be experienced as a restorative space, we must consider how people move through it, how they spend time there, and which elements foster a sense of nature.

The results on mental well-being point in this same direction:

• Mental restoration is associated with the structural complexity of vegetation, perceived naturalness, and connection to nature.
• Emotional regulation through nature—meaning the use of green spaces to calm down, reduce tension, or feel more energized—shows a more consistent relationship with total species richness.
• The length of time spent in the park seems particularly relevant to achieving calmness.

The main conclusion is that parks should not be planned by looking at a single variable. It is not just about increasing vegetation, nor just about maximizing biodiversity, nor just about creating pleasant spaces. The challenge is to integrate these dimensions.

How Should Parks Be Planned, Then?

The main conclusion is that parks should not be planned by looking at a single variable. It is not just about increasing vegetation, nor just about maximizing biodiversity, nor just about creating pleasant spaces. The challenge is to integrate these dimensions.

1. Vegetation, soil, and water must be considered together. This implies incorporating soil diagnosis into the design and maintenance of green spaces, reducing bare soil, encouraging protective organic covers, and exploring nature-based solutions for water catchment and storage.
2. More diverse, heterogeneous, and naturalized spaces must be promoted, avoiding overly homogeneous configurations and combining herbaceous, shrub, and tree layers according to the conditions and uses of each space.
3. Parks must be designed for daily use and well-being: providing shade, paths that are not just transit zones, resting spots, spaces for calm, meeting areas, and infrastructure for care and comfort, such as benches, public restrooms, lactation rooms, or spaces adapted for children, the elderly, and caregivers.

Finally, since BioWater is a pilot test, these guidelines should initially be applied in sentinel spaces or pilot actions, followed by monitoring. This would make it possible to verify which measures work best before expanding them to other areas of the city.

The urban parks of the future will have to respond to many challenges at once. BioWater provides a baseline to think of them not as separate pieces of greenery, but as living spaces where soil, water, biodiversity, and well-being are interwoven.

This study was carried out within the framework of project 24S05864-001, funded by the Barcelona City Council through the 2024 Young and Emerging Research Grant.

Climate change is increasing exposure to extreme temperatures worldwide, raising concerns about its impact on children's health. Pregnancy and the first years of life are particularly important for brain development, as the brain grows rapidly and is especially sensitive to environmental factors. Although previous studies have linked heat exposure to changes in cognition and mental health, there is not much literature about its effects on brain structure.

"We wanted to examine whether exposure to heat or cold from conception to 8.5 years of age was associated with changes in brain development during late childhood and adolescence, and to identify the periods when the brain is most vulnerable," explains Laura Granés, ISGlobal and IDIAPJGol researcher and first author of the study. 

The study included 3,251 children participating in the Generation R Study, a birth cohort in the Netherlands. “We used a high-resolution climate model that provided weekly outdoor temperature estimates during pregnancy and monthly estimates from birth to 8.5 years of age at each participant's place of residence. We then analysed brain MRI scans performed at around 10 and 14 years of age”says Granés. This allowed researchers to measure how the volume of 11 brain structures changed over time and to examine whether these changes were associated with earlier exposure to heat or cold.

Why the thalamus appears especially vulnerable

Among the brain regions studied, only the thalamus showed a consistent association with early-life heat exposure. The thalamus acts as the brain's main relay centre, processing and transmitting sensory and motor information to the cerebral cortex.

The researchers believe this region may be particularly sensitive because it develops very early in pregnancy and follows a tightly regulated developmental timeline. Its rich blood supply during foetal development may also make it more vulnerable to heat-related changes affecting the placenta or blood flow to the foetus.

A critical window: from conception to the fifth month of life

The study identified a clear period of vulnerability spanning pregnancy and the first months after birth. Compared with a reference average temperature of 12.5°C, exposure to monthly mean temperaturesof 20.5°C during this period (calculated across day and night) was associated with slower thalamic growth between 9 and 15 years of age. No similar associations were found for other brain structures or for exposure to cold temperatures.

How heat could affect brain development

Although the study was not designed to identify the biological mechanisms involved, previous research suggests several possible explanations. Heat exposure during pregnancy may alter maternal stress hormone levels, affect the placenta's ability to protect the developing foetus from these hormones, or disrupt serotonin signalling, which plays an important role in the formation of connections between the thalamus and the cerebral cortex. Heat-related inflammation and oxidative stress may also contribute, although more research is needed to confirm these mechanisms.

The researchers also found that slower thalamic growth was associated with more externalising behavioural symptoms during adolescence, including aggressive and rule-breaking behaviour. However, they did not find an association with cognitive performance. "Future studies should investigate whether early-life heat exposure contributes to neurodevelopmental disorders and whether altered thalamic development could help explain these associations," says Esmée Essers, ISGlobal researcher and study co-author.

"The children who participated in our study were born between 2002 and 2006. Since global temperatures have continued to rise, it would be valuable to conduct a new study under current conditions. In any case, our findings suggest that taking measures to reduce heat exposure during pregnancy and early infancy could play an important role in protecting children's brain development," concludes Mònica Guxens, ICREA Research Professor in ISGlobal and coordinator of the study.

Reference

Granés, L., Essers, E., Kusters, M. S. W., Petricola, S., Tiemeier, P. H., Soriano-Mas, P. C., Schwartz, P. J., & Guxens, P. M. (2026). Early life ambient temperature and brain volumes change throughout childhood. Environment International, 214(110385), 110385. https://doi.org/10.1016/j.envint.2026.110385

A study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, reveals that Plasmodium falciparum is unable to activate these heat-response mechanisms when it is in the gametocyte stage, the phase responsible for transmitting infection from humans to mosquitoes. The findings, published in PLOS Pathogens, suggest that patients with a high fever could become temporarily non-infectious: if a mosquito were to bite them during this period, it might not acquire the parasite and therefore would not transmit the disease to other people.

Malaria affects around 260 million people every year and causes roughly 600,000 deaths. P. falciparum is responsible for the most severe form of the disease and for the majority of fatal cases.

After the bite of an infected Anopheles mosquito, the parasites travel to the liver, where they multiply. They then invade red blood cells and begin a replication cycle that repeats approximately every 48 hours. During each cycle, a small proportion of the parasites transform into gametocytes, the only stage capable of infecting a mosquito and therefore essential for malaria transmission.

How and when does P. falciparum activate the thermal stress response?

Fever episodes caused by malaria usually last several hours and can reach 41°C, temperatures high enough to cause the accumulation of misfolded proteins and threaten the parasite’s survival.

To cope with this damage, the Heat Shock Response (HSR) is activated, a mechanism that protects the cell’s proteins. This response triggers the production of chaperone proteins, which act as “molecular assistants”, helping damaged proteins repair themselves and regain their structure. As in other organisms, HSR is a fundamental survival mechanism in malaria parasites. Until now, however, it was unclear under which conditions it becomes activated.

The research team developed a new protocol to expose parasites to thermal stress using a water bath instead of an incubator, allowing for more precise temperature control and the study of very short heat exposures. Using this method, they observed that just ten minutes of exposure is enough to activate the HSR.

In P. falciparum, the HSR is controlled by AP2-HS, a transcription factor that regulates the activation of genes involved in the heat response. “We found that the AP2-HS-controlled response is activated very easily. Even moderate increases in temperature, which do not threaten the parasite’s survival, are enough to trigger this protective mechanism,” explains Neus Ràfols, researcher at ISGlobal and first author of the study. These findings suggest that parasites use the HSR in a “preventive” way, which is more efficient than activating it once damage has already occurred.

The HSR is also activated following treatment with the drug DHA

When the research team treated parasites with dihydroartemisinin, or DHA (the active compound in artemisinin and its derivatives, which are the main drugs used against malaria), they also observed activation of the HSR.

These findings point to the HSR as a protective mechanism against different forms of stress that damage parasite proteins, not just thermal stress. However, parasites with truncated forms (incomplete versions) of the AP2-HS protein are more sensitive to thermal stress, although not to DHA. This may be because DHA affects many different molecules within the parasite, not only proteins.

Gametocytes at intermediate or advanced developmental stages do not activate the HSR

Unlike other stages in the parasite’s life cycle, only stage I gametocytes are able to activate the AP2-HS-dependent HSR. More developed gametocytes lose this ability. “Our findings suggest that fever could temporarily reduce the ability of a person with malaria to transmit the infection. Although the parasite appears to enhance transmission under stress conditions, mature gametocytes are particularly sensitive to high temperatures,” explains Alfred Cortés, ICREA researcher at ISGlobal and coordinator of the study.

“Future studies will need to confirm whether this effect occurs during natural infections and determine whether there is a threshold temperature above which patients become temporarily non-infectious,” concludes Cortés.

Reference

Ràfols N, Nyarko PB, Chillarón-Adán M, Tintó-Font E, Cortés A (2026) Characterisation of the thermal and non-thermal stress conditions that activate the Plasmodium falciparum AP2-HS-dependent heat-shock response. PLoS Pathog 22(7): e1014346. https://doi.org/10.1371/journal.ppat.1014346

Reading Time: 4 min

That summer in Mavrovouni refugee camp on Lesvos, Greece - one of the Aegean Sea’s fraught portals into Europe for people denied the possibility of travelling through regular routes - the temperature reached 40°C. Heat rose from the gravel, babies cried in stuffy tents, people were stuck for hours in food lines, Wi-Fi disappeared, and someone we had spent days trying to find for an interview had suddenly been transferred away.

We were trying to do something not yet done: carry out a comprehensive sexual and reproductive health analysis in a European refugee camp, not simply about the people living there, but with them leading the work. When I arrived in Lesvos, I had no idea I was entering a community of women whose faith, humour, discipline, care for one another, and refusal to give up would transform the way I saw the world.

I still remember my astonishment when, every time something went wrong, Kowthar, one of the women representing the Somali community - who would later become my sister – would serenely say, “No problem, we fix it.”

The Knowledge Was Already There

This can-do attitude carried the project. And a few years later, as our research article from the quantitative arm of the project was published last week - part of a larger participatory mixed-methods study led by Dr. Jamilah Sherally - I think about how impossible the work would have been without the 9 refugee co-researchers who represented the languages and communities living there.

I think about how impossible the work would have been without the 9 refugee co-researchers who represented the languages and communities living there. They were not there as translators or assistants, but co-producers of knowledge in a situation where they were the experts.

They were not there as translators or assistants, but co-producers of knowledge in a situation where they were the experts. After 3 weeks of discussion, training, disagreement, and 7 drafts, the household survey went from 232 questions to 119. It remained ambitious, covering maternity care, contraception, menstruation, abortion, female genital mutilation and much more.

The long discussions were not an unnecessary delay, but collective labour that made the study rigorous and honest enough to reflect women’s actual sexual and reproductive health needs in Mavrovouni. Without that process, we would have asked narrower questions and received narrower answers. For more on how the co-researchers shaped the study from design to dissemination, see How to practise what you preach: practical considerations for participatory global health research.

In a camp shaped by deprivation, uncertainty, and bureaucratic violence, our team ended up managing to interview 247 women of reproductive age, marking the first situation analysis in a European refugee camp.

When Health Is Treated as an Emergency, and Violence as Policy

The findings echoed what humanitarian sexual and reproductive health literature has long shown: emergency care is prioritised while preventive, long-term, rights-based needs disappear. Significantly, our study found that more than half of the women had experienced at least one pushback before reaching Lesbos, and 2 women reported losing a child during the sea journey. These findings cannot be separated from the European border system in which they occurred: human rights organisations have repeatedly documented violent pushbacks in Europe, while EU documents show billions of euros in support to Greece for migration and border management.

Justice Does Not Have to Wait

We could not have done this research without Kowthar and the other co-researchers; that is a methodological fact. But the project also mattered because it recognized their value in a system where asylum procedures create gaps in people’s CVs and force futures into waiting. Hiring refugee women said: your knowledge and skills count now, and your future does not begin after a government decides you can have one.

Audrey Benson and Kowthar Mohamed presenting the quantitative study at the ECTMIH congress in Hamburg, and accepting the award for best poster.

Like many others, Kowthar eventually moved on from Greece and applied for asylum in Germany. Later, Jamilah invited us to present two studies from the larger project at ECTMIH in Hamburg. Just days before we travelled, Kowthar received a rejection on her asylum application, but she came anyway. She stood in an academic space and presented evidence produced by women whose stories are so often doubted or minimised, while her own story had just been doubted by the asylum system.

Participatory Action Research taught me that while we fight for structural change, we are still responsible for smaller forms of justice already within reach: who is paid and credited, who speaks and is listened to, who gets to be believed, and who is given room to grow into a future beyond survival.

And when our poster presentation won an award, going to the stage to accept it felt complicated. We knew an award did not stop violent border policies. But if justice is only imagined at that scale, it can become so vast that people feel paralyzed by it. Participatory Action Research taught me that while we fight for structural change, we are still responsible for smaller forms of justice already within reach: who is paid and credited, who speaks and is listened to, who gets to be believed, and who is given room to grow into a future beyond survival.

The Wound Is The Place Where The Light Enters

A few weeks ago, Kowthar called me. After years of rejection, fighting and prayers, she had received asylum. We cried at the relief that there was another small piece of justice.

Kowthar should not have had to be brave in the ways she has been forced to be brave. But if she can live under the weight of rejection and still show up to study the system, name its violence, and demand better, then we can do the same. We can refuse to wait until results are published before pursuing justice, recognizing participation as an ethical and human commitment.

Even though everything may seem broken now, we can look at one another and say what Kowthar taught us to say: “We fix it.”

This event will explore all stages of the research talent journey: from attraction and selection to professional development. Participants will gain valuable insights into effective strategies and best practices for supporting research talent across its entire lifecycle.

Bringing together national and international experts, the workshop will combine keynote lectures with in-depth round-table discussions to address key challenges and opportunities and share best practices in research talent development. We expect the event to be directly relevant to our research ecosystem, and we highly encourage you to join the conversation.

The workshop is free and open to all, but registration is required. Please sign up using this form.

Agenda 

9h15 – 9h30: Welcome - Maria Feliu (Vice-rector for Doctoral Studies, Trainee Research Staff, Talent Attraction and Dissemination at the University of Barcelona)

9h30 – 10h15: Inspirational Keynote - Marta Agostinho (Executive Director, EU-LIFE)

10h15 – 11h30: Attracting Talent: What It Is and Program Opportunities

Keynote Lecture: Michele Rosa-Clot (Portfolio Owner, HR Excellence in Research, European Commission)

Round Table:

• Cristina Borrás (moderator): International Area Director at the Agency for Management of University and Research Grants (AGAUR)
• Michele Rosa-Clot: Portfolio Owner, HR Excellence in Research at the European Commission
• Gonzalo Arévalo: Senior Advisor to the Director of the Spanish State Research Agency (AEI)
• Paola Isetta: Director of Research, Innovation, and Fellowship Programmes at Fundació “la Caixa”
• Rachel Coulthard-Graf: Fellows' Skills & Career Development Lead/Scientific Ombudsperson at the European Molecular Biology Laboratory (EMBL)

11h30 – 12h00: Coffee break

12h00 – 13h15: Selecting Talent: Fair and Transparent Selection Practices

Keynote Lecture: Alexander Rushforth (Assistant Professor, Universiteit Leiden)

Round Table:

• Eva Casamitjana (moderator): Scientific Coordinator at ISGlobal
• Alexander Rushforth: Assistant Professor at Universiteit Leiden
• Michela Bertero: Strategy Director at the August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
• Emilià Pola: Executive Director at the Catalan Institution for Research and Advanced Studies (ICREA)
• Miguel Angel Benítez: Project Manager at the Basque Center for Applied Mathematics (BCAM)

13h15 – 14h15: Lunch catering

14h15 – 14h45: Inspirational Keynote - Vanessa Schubert (Mind-Body & Executive Coach)

14h45 – 15h45: Retaining Talent: Training Programs

Round Table:

• María José Merino (moderator): HR and Organisational Development coordinator at ISGlobal
• Vanessa Schubert: Mind-Body & Executive Coach
• Teresa Rosas: Academic Talent and Gender officer at the Ecological and Forestry Applications Research Centre (CREAF)
• Damjana Kastelic: Head of Training and Academic Office at the Centre for Genomic Regulation (CRG)
• Margarita Navia De Roux: Head of Strategic Development at the Catalan Institute of Nanoscience and Nanotechnology (ICN2)

15h45 – 16h00: Final remarks

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This workshop is supported with funding from our Centre of Excellence Severo Ochoa Programme, grant CEX2023-001290-S and also the grant GPE2024-001424-T, both funded by MCIN/AEI/ 10.13039/501100011033.

To date, numerous studies have shown that the Mediterranean diet—rich in fruits, vegetables, legumes, fish and olive oil—is an effective shield against physical decline and the development of disorders such as depression. However, this new study goes a step further by focusing on positive psychological well-being, which encompasses dimensions such as control, autonomy, pleasure and self-realisation, and includes questions relating to independence, enjoyment of life, sense of purpose, energy levels and future outlook. The study suggests that the benefits of following a Mediterranean diet for well-being are independent of the presence of depressive symptoms or the participants’ socioeconomic status.

The study analysed data from 3,296 individuals aged between 50 and 90 years who were participating in the English Longitudinal Study of Ageing (ELSA). Dietary habits were assessed between 2018 and 2019 using an online platform, where participants reported everything they had eaten and drunk on two non-consecutive days. Psychological well-being was evaluated through questionnaires administered on up to two occasions between 2018 and 2020.

Protection against the mental health effects of COVID-19

Data collected through the ELSA cohort show that the emergence of the COVID-19 pandemic and the restrictive measures that followed had a negative emotional impact on study participants. However, the decline in emotional well-being was less pronounced among individuals with greater adherence to the Mediterranean diet, suggesting a protective effect.

“Our study is observational and, therefore, the results should be interpreted with caution, since we cannot draw causal conclusions,” says Camille Lassale, ISGlobal researcher and senior author of the study. “Nevertheless, the questionnaires administered during the pandemic allowed us to follow participants over time, which is a major strength of the study. Although the biological mechanisms underlying the relationship between the Mediterranean diet and better mental health are still being investigated, the evidence suggests that its foundational foods and components help regulate key processes such as stress responses, inflammation, gut health and brain function”, she adds.

“This study provides further evidence of the relationship between what we eat and our mental health, an emerging field of research that we hope will generate substantial new evidence in the years to come,” says Alanna Shand, research psychologist and co-author of the study.

“Although many questions remain open, there is no doubt about the need to promote healthy lifestyles, prioritising a balanced diet rich in plant-based foods and low in foods such as processed meats and sweets, particularly among older adults,” says Andrew Steptoe, researcher at University College London and first author of the study.

Reference

Steptoe A, Shand AJ, Lassale C. Adherence to the Mediterranean diet and psychological wellbeing before and during the COVID-19 pandemic: a prospective analysis of the English Longitudinal Study of Ageing. BMJ Open. 2026; 16(6): e109599. http://dx.doi.org/10.1136/bmjopen-2025-109599

This free, in-person event will bring together leading experts in chrononutrition for a full day of presentations, methodology sessions, and thought-provoking discussions, spanning epidemiology, human interventions, biological mechanisms, multi-omics, exposome science, digital health, and policy translation.

Early Career Researchers (MSc students, PhD students, and postdoctoral researchers) are especially encouraged to attend and submit an abstract. Abstracts should include the title, author(s), presenting author (name and email address), affiliations and preferred presentation format (oral or poster), be no more than 350 words, and may include one optional table or figure. Abstracts must be submitted by September 1, with results announced on September 10. 

To attend the event, please register here. Maximum number of attendees is 60.

Preliminary Agenda

Introductions (9.00-9.15h)
Opening Keynote (9.15-10.15h) — Overview of the State of Chrononutrition Science and Its Implications
Keynote Speaker: Marta Garaulet, Universidad de Murcia

Session 1: Epidemiological Evidence (10.15-11.30h) —Insights from large population studies on meal timing, fasting, and health outcomes
Chair: Kyriaki Papantoniou, Medical University of Vienna
Speakers:

• Bernard Srour, INRAE: Research for Agriculture, Food and Environment
• Marie-Pierre St-Onge, Center of Excellence for Sleep & Circadian Research, olumbia University Irving Medical Center 
• Camille Lassale, ISGlobal

Short coffee break (11.30-11.45h)

Session 2: Mechanistic Pathways (11.45-13.00h) — Circadian regulation of metabolism, hormonal rhythms, microbiome dynamics, and insights from multi-omics and exposome research
Chair: Emily Manoogian
Speakers:

• Daan Vanderveen, University of Surrey
• Frank Scheer, Harvard Medical School
• Selected talk from submitted abstracts

Lunch break (13.00-14.00h)

Session 3: Human Trials & Interventions (14.00-15.15h) — Insights from human clinical trials and chrononutritional interventions
Chair: Camille Lassale
Speakers:

• Emily Manoogian, Salk Institute for Biological Studies
• Jonas Salling, Steno Diabetes Center Copenhagen
• Selected talk from abstracts (open slot)

Poster Session (15.15-16.15h) – Early-career researchers present their work and network with senior scientists

Round-table Discussion and Consensus Building (16.15-17.30h) — Addressing methodological challenges assessing chrononutrition and harmonizing chrono-behavioural data using digital tools. Co-developing a “Research & Policy
Chairs: Kyriaki Papantoniou & Camille Lassale
Participants: All speakers

Closing Remarks 

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The nearly 100-page report translates the latest medical and climate evidence into the reality of Spain's streets and hospitals. It provides an accurate overview of the current situation, equipping healthcare professionals with practical information to address a risk that is already shaping the future of the country's healthcare system.

Created by DKV in 2008, the Observatory has established itself as a rigorous platform for reflection, connecting scientific evidence with social realities. Its aim is to raise public awareness of the links between the environment and health while providing knowledge to support decision-making by policymakers and healthcare professionals.

The report shows that heat stress has already become the leading climate-related health risk in Spain, revealing that each additional degree of temperature increases heat-related mortality by 35%. Far from being a temporary phenomenon, climate projections indicate that Spain could face up to eight heatwaves per year by 2050, accompanied by a critical increase in "tropical nights", during which temperatures remain too high for the body to recover physiologically.

This new climate reality is placing Spanish hospitals under increasing strain, with emergency medical admissions rising by as much as 42.8%. The report also highlights a profound inequality gap: postcode and income level have become major determinants of the risk of illness or death due to heat, with older people, women living alone and residents of disadvantaged neighbourhoods being the most affected.

Opening the event, Fernando Campos, CEO of DKV, placed the report within the insurer's broader corporate purpose: "At DKV, we are convinced that understanding the context in which we operate is essential to building a healthier future for people by providing the best solutions for our customers—both individuals and businesses—as well as for the healthcare system as a whole."

Campos was unequivocal about the consequences of inaction: "Episodes of extreme heat are no longer exceptional. They now shape healthcare planning, resource management and the quality of care. Ignoring them is not a responsible option, either from a social perspective or from the standpoint of efficient healthcare system management."

Dr Elizabeth Diago Navarro, ISGlobal researcher and presenter of the report's findings, emphasised that: "We already have robust scientific evidence on the impacts of extreme heat, we know which population groups are most vulnerable, and we have strategies to mitigate its consequences. What is needed now is to implement these measures comprehensively so that we can respond more effectively to the extreme heat events we are already experiencing and will continue to experience."

Following the presentation, the event featured a panel discussion moderated by Silvia Agulló, DKV's Director of Sustainability and Reputational Risk, who stressed that "we need to put in place mechanisms that enable us to anticipate the serious health problems arising from this adverse phenomenon."

The panel also included Dr Martín Reyes, Head of Cardiology at Quirónsalud, who noted that: "We are seeing an increasing number of vulnerable patients, particularly older adults, whose medication needs to be adjusted during heatwaves because their health becomes destabilised by the growing risks that extreme heat poses."

Víctor Segura, from the Spanish Red Cross Emergency Unit, also took part in the discussion. He stated: "We are gradually moving towards a culture of preparedness, although we are doing so in response to negative events such as the recent floods. We are currently focusing on community-based assistance so that, in cases of extreme need, neighbours and people close to those at risk are able to provide support. We are also promoting training and household and community emergency plans."

Download the full report using the following link.

6 minutes read

On 25 June I woke up to dozens of WhatsApp messages. I thought they were friends wishing me a happy birthday. That was not the case. The messages came from people wondering if my family and loved ones were OK. As I quickly learned, the night before, at 18:04 local time, and 38 seconds apart, two of the most powerful earthquakes recorded in Venezuela’s last hundred years had hit the country.

My family was fine. Mérida, the city where I come from, was spared the damage. Much of the country's northwestern coast was affected, though, with most of the destruction concentrated in the capital, Caracas, and the nearby port city of La Guaira.

At the time of writing, at least 1,450 people have died, including 17 Spanish nationals, while more than 3,000 have been injured. More than 46,000 people remain missing, and the death toll is expected to rise as rescue operations continue. International assistance and donations are proving essential to support the response on the ground.

Tragically Unprepared

After more than two decades of political, social and economic crisis, Venezuela was tragically unprepared to respond to a disaster of this magnitude. The reasons behind this are complex and extend far beyond the scope of this article. Nevertheless, the country's limited preparedness has been laid bare by the slow and insufficient response of the Venezuelan authorities. In the immediate aftermath of the earthquakes, survivors relied largely on volunteer groups, local fire brigades and neighbours, many of them searching through the rubble with their bare hands and little or no specialist equipment.

Large-scale rescue operations did not begin until international teams arrived around 48 hours after the earthquakes. That support has since been substantial, with more than 2,200 rescuers from 27 countries deployed to the affected areas. Their work is proving indispensable in locating survivors and will almost certainly need to continue over the coming days and weeks if further progress is to be made.

How to Help

Collection centres have been established around the world, including several in Barcelona. However, financial contributions remain the most direct and effective way to help, as shipments of supplies often face logistical bottlenecks and significant distribution challenges.

Campus Clínic Solidari, a joint initiative involving several institutions, including Hospital Clínic Barcelona and ISGlobal, is coordinating one such campaign and is in direct contact with teams deployed in Venezuela to identify priority needs and ensure that resources are allocated effectively. In addition, a list of other verified fundraising campaigns can be found on Caracas Chronicles, an independent media outlet that has specialised in covering Venezuela since 2002.

Support Venezuela. Campus Clínic Solidari campaign

Beyond Emergency Relief

Beyond emergency donations, the international scientific community also has an important role to play in supporting Venezuela's recovery. Even before the earthquakes, the country faced profound challenges in the provision of essential public services, including electricity, access to clean water, healthcare and the control of communicable diseases.

Since at least 2016, the United Nations has classified Venezuela as facing a Complex Humanitarian Emergency (CHE): a protracted crisis that has overwhelmed the state's capacity to perform its core functions. At the same time, years of economic collapse, political repression and persecution have driven a sustained exodus of scientific, technical and healthcare professionals, severely weakening the country's institutional capacity.

These structural challenges will make reconstruction considerably more difficult in the years ahead. They will also test the willingness and capacity of funding agencies, multilateral organisations and the international scientific community to support long-term solutions to the many problems that Venezuela already faced before the disaster, and which the earthquakes have now dramatically intensified.

At a time when global aid budgets face unprecedented financial pressures and uncertainty, Venezuela demonstrates just how much is at stake

Meeting that challenge will require sustained investment in both infrastructure and scientific research within Venezuela. This should include training local medical and scientific professionals, modernising epidemiological surveillance systems, and strengthening primary healthcare networks. Equally important is maintaining support for programmes already operating in the country, including those led by the Global Fund to Fight AIDS, Tuberculosis and Malaria and Médecins Sans Frontières. Continued funding will be essential to preserve recent progress in controlling infectious diseases such as malaria while minimising the disruption that the earthquakes are likely to cause to local NGOs and public institutions.

Ultimately, however, long-term recovery will also depend on the consolidation of transparent, accountable and effective public institutions capable of implementing these reforms. For that reason, supporting the conditions for a peaceful and orderly democratic transition is inseparable from supporting the country's long-term health and development. Global health institutions cannot remain indifferent to this broader context.

A stark reminder

The earthquakes are a stark reminder not only of the devastating consequences of institutional fragility and years of underinvestment, but also of the indispensable value of international solidarity. At a time when global aid budgets face unprecedented financial pressures and uncertainty, Venezuela demonstrates just how much is at stake.

International cooperation is saving lives in Venezuela today. As members of the global health and scientific community, we have a responsibility to help ensure that it continues to do so, both in the immediate response and throughout the long process of recovery that will follow.

Juan Carlos Gabaldon is a Venezuelan medical doctor and parasitologist based in Barcelona. His work mostly focuses on understanding the pathogenesis of Chagas disease. He has previously studied the epidemiology of malaria in southern Venezuela.

Tamara Iungman received the award for her thesis entitled “Urban heat islands and nature-based solutions: insights into health impacts and urban planning determinants”, supervised by Mark J Nieuwenhuijsen, Director of the Climate, Air Pollution, Nature and Urban Health Programme at ISGlobal. Her research examines the health impacts of urban heat islands (UHIs) and evaluates the effectiveness of Nature-based Solutions (NbS) in mitigating these effects across European cities.

The thesis highlights how rising temperatures intensified by the urban heat island effect represent a major health threat in urban areas, particularly in Europe, where they have been associated with increased mortality. Through the analysis of urban environments and planning strategies, Iungman demonstrated that increasing urban tree cover density can help reduce temperatures and mitigate some of the adverse health impacts associated with extreme heat. It also analysed how different urban planning models influence environmental exposures, CO₂ emissions and health outcomes.

As part of her research, Iungman evaluated Barcelona’s “Green Corridors” plan as a case study, identifying significant health benefits linked to increased exposure to green spaces. Her findings contribute to the ongoing debate on optimal urban heat mitigation strategies and underline the multiple benefits of Nature-based Solutions for healthier and more sustainable cities.

Marcos Quijal received the award for his thesis entitled “Temperature impacts on mortality at different spatial and temporal scales”, supervised by Joan Ballester Claramunt, Research Professor and coordinator of The Adaptation Group at ISGlobal, and Marc Marí-Dell'Olmo, Senior Public Health Officer at the Barcelona Public Health Agency. Quijal’s research investigated the relationship between temperature and mortality across different spatial and temporal scales, addressing the health impacts of rising temperatures in the context of climate change.

The thesis introduced new methods to account for the spatial dependence in exposure-response associations, making it possible to estimate risks in small areas more accurately. It also used temperature projections to estimate future temperature-related mortality under different climate change scenarios. 

In addition, Quijal’s research combined health data with weather forecasts to show how predicted temperatures in the coming days could translate into health impacts. His findings support the development of more effective heat–cold–health early warning systems and climate adaptation strategies (see the tool Forecaster Health).

With these recognitions, the UPF highlights the scientific excellence and societal relevance of both doctoral theses, which contribute to advancing knowledge on climate, urban planning and health, and to supporting the transition towards healthier and more resilient cities.

[This article was co-authored by Marta Pinto da Costa and Augusto Anguita-Ruiz, Junior Research Leader at ISGlobal.]

Reading time: 4 minutes

Over the past decades, a worldwide declining tendency in the age at menarche and the onset of puberty has been observed. Although genetic factors have been described as the main determinants of pubertal timing, a growing body of evidence suggest that children’s early-life environmental exposures and lifestyle may also influence this biological process. Understanding these potentially modifiable risk factors is important, as earlier pubertal timing has been linked to several adverse health outcomes, including an increased risk of metabolic disorders, cardiovascular disease, and breast and other reproductive cancers. Earlier pubertal timing therefore represents an important public health concern.

Researchers at ISGlobal and at the Insitute of Public Health of the University of Porto (Portugal) are currently exploring how children’s early-life living environments and early life nutrition may influence pubertal timing, using data from to European birth cohorts: the Portuguese population-based birth cohort Generation XXI and the Spanish INMA Project. Both cohorts have followed thousands of children from pregnancy into adolescence, collecting detailed data on health status, sociodemographic characteristics, living environments and lifestyle factors.

How Was the Study Conducted?

In the present study, the researchers focused on early-life urban environmental exposures, including air pollution, traffic, built environment and natural spaces, measured from pregnancy through early childhood. Rather than focus on a single exposure in isolation, an exposome approach was adopted, allowing the researchers to consider how multiple exposures coexist and their potential combined influence on pubertal timing. Exclusive breastfeeding duration and childhood diet quality were also considered. Pubertal timing was assessed at 9-10 years of age through clinical Tanner staging and/or parental report of the child’s pubertal status based on the Pubertal Development Scale (PDS). Girls also reported their age at menarche during later follow-ups.

Breastfeeding and Pubertal Development

Early-life nutrition seems to play a role on pubertal timing. A longer exclusive breastfeeding duration was associated with less advanced pubertal development among girls. This finding aligns with previous evidence suggesting that breastfeeding may have a potential protective role against earlier pubertal onset. In contrast, childhood diet quality was not associated with pubertal development in this study.

Traffic and Air Pollution: The Strongest Associations

Preliminary results also suggest that early-life urban environmental exposures may play a role in shaping pubertal timing. Children living in less favourable urban environments, mainly characterised by higher building and population density, heavier traffic and higher levels of air pollution, together with lower access to natural spaces, tended to show signs of more advanced pubertal development and age at menarche.

Exposure patterns related to traffic and air pollution emerged as the most consistently associated with earlier puberty-related outcomes

In particular, exposure patterns related to traffic and air pollution emerged as the most consistently associated with earlier puberty-related outcomes. Urban air pollution is a complex mixture of particles and chemicals, some of which are known to interfere with endocrine pathways involved in growth and reproductive development.

For instance, epidemiological studies suggest that Particulate Matter (PM) may influence estrogen-related signalling pathways, which may play a key role on the release of kisspeptin and subsequently trigger gonadotropin-releasing hormone secretion, a central regulator of pubertal onset.

The Potential Protective Role of Green and Blue Spaces

In addition, access to natural spaces also appeared to be relevant. Children growing up in areas with less surrounding green and blue spaces tended to show more advanced pubertal development in some analyses. Natural environments may help reduce stress and promote physical activity, both of which have been linked to hormonal regulation and child development.

Access to natural spaces also appeared to be relevant. Children growing up in areas with less surrounding green and blue spaces tended to show more advanced pubertal development in some analyses

Early childhood appears to be a sensitive period for pubertal development, since exposures occurring during pregnancy and early childhood may have later consequences for biological development. From a public health perspective, these findings represent an important step towards understanding how combinations of environmental and lifestyle factors in early life may shape pubertal timing, and suggest that improving air quality, reducing traffic-related pollution, increasing access to natural spaces, and promoting longer durations of exclusive breastfeeding may contribute to more favourable developmental outcomes for future generations.

La jornada abordará cómo las olas de calor afectan a la salud de la población, con especial atención a los colectivos más vulnerables, desde una perspectiva basada en la evidencia científica y en la respuesta del sistema sanitario y los servicios de emergencias.

Presentación del estudio “Observatorio DKV de Salud y Medioambiente. Calor extremo, salud en riesgo”
A cargo de la Dra. Elizabet Diago (ISGlobal)

Mesa redonda "Olas de calor: impacto cardiovascular y respuesta desde las emergencias"

• Dra. Silvia Agulló, directora de Sostenibilidad y Riesgos de Reputación de DKV Seguros (moderación)
• Dr. Martín Reyes, jefe del Departamento de Cardiología de Quirónsalud
• Víctor Segura, Unidad de Emergencias de Cruz Roja Española

El debate abordará el impacto del calor extremo en la salud cardiovascular y la respuesta operativa ante emergencias relacionadas con olas de calor, desde una perspectiva sanitaria y de protección civil.

Al finalizar la sesión, se ofrecerá un refrigerio.

Accede aquí a la noticia sobre el evento y al informe Calor extremo, salud en riesgo. 

A new study conducted in the Manhiça district, in southern Mozambique, has identified how social, family, and environmental conditions during the first years of life influence the utilization of child healthcare services. The research was led by the Barcelona Institute for Global Health (ISGlobal), a center supported by the ”la Caixa” Foundation, in collaboration with the Manhiça Health Research Centre (CISM), which has operated a unique, long-standing child morbidity surveillance system. 

The work, published in Environment International, is part of the study of the exposome, a conceptual framework that integrates all environmental and social exposures to which a person is subjected from the earliest stages of life. The team analysed data from 17,145 children under five years of age from the Manhiça demographic and health surveillance system and evaluated 47 factors related to the physical environment, housing conditions, socioeconomic status, and family structure. 

Hospital visits were used as a proxy indicator of morbidity, recognizing that they also reflect healthcare-seeking behaviors and differential access to care. Three complementary statistical methodologies were combined, allowing the identification of the most relevant exposures of the child exposome and the construction of multi-exposure models capable of describing their association with morbidity. Of the 47 exposures evaluated, 23 showed a significant relationship with hospital visits. 

More resources, family support, and connectivity associated with higher use of health services 

The results of the study show that children living in households with better socioeconomic conditions, higher maternal educational levels, access to electricity, and paternal presence presented higher rates of hospital visits than those from less favored backgrounds. Likewise, those residing in more urbanised areas and closer to roads attended health services more frequently, which could reflect better access to healthcare, though also exposure to risks associated with urbanisation processes. 

On the other hand, mobile phone ownership, an indicator previously linked to better prenatal care and more favorable perinatal outcomes, was also associated with a higher frequency of hospital visits across all conducted analyses. This suggests that connectivity can play an important role in access to and utilisation of health services. 

First external exposome study in a low-income country 

Until now, exposome research has been developed primarily in high-income countries, especially in Europe and the United States. Consequently, evidence from sub-Saharan Africa remains scarce, despite the high burden of social and environmental vulnerabilities that characterises the region. 

This is the first exposome study conducted in a low-income setting that examines how multiple social and environmental exposures during the first years of life jointly affect child health. “By applying a conceptual framework based on the exposome, instead of focusing on isolated risk factors, the study provides a more comprehensive understanding of the determinants of childhood morbidity in a population sparsely represented in research,” suggests Stefan Sieber, ISGlobal researcher and first author of the study. 

The authors note that, as the conceptual framework of the exposome continues to evolve, it will be necessary to conduct research in diverse geographical contexts, including currently underrepresented regions, to better understand the heterogeneity in the exposome's influence on child health. 

“Our findings are especially relevant in a global context marked by urban growth, climate change, and persistent health inequalities, particularly in access to health services,” highlights Cathryn Tonne, ISGlobal researcher and senior author of the study. 

Reference

Sieber, S., Coloma,F., Curto, A., Nunes, J, Milà, C, Cirach, M., Anguita-Ruiz, A., Cossa, H, Matsena, T., Hunguana, A., Sacoor, C., Jamisse, E., Sitoe, A., Vrijheid, M., Bassat, Q., Saute, F., Tonne, C. Early life social and environmental exposures and all-cause hospital visits among children under five in southern Mozambique. Environment International, 2026. Doi: 10.1016/j.envint.2026.110331

La Nit Europea de la Recerca a Catalunya és coordinada per un consorci format per ISGlobal, la Universitat de Girona (UdG), la Universitat de Barcelona (UB), la Universitat Autònoma de Catalunya (UAB) la Universitat de Vic-Universitat Central de Catalunya (UVIc-UCC), la Universitat de Lleida (UdL), la Universitat Rovira i Virgili (URV), Equitat.org i l’Associació Catalana de Comunicació Científica (ACCC). Totes elles s’han unit per organitzar la Nit de la Recerca en els seus respectius territoris i de manera col·laborativa. L’edició de l’any passat va aplegar més de 150 activitats, tant presencials com microxerrades en diferit, que es van recollir al canal de Youtube de l’esdeveniment.

El projecte de NitRecerCat2627 és un esdeveniment associat a l’MSCA i Citizens initiative de la Unió Europea finançat en el marc de les accions Marie Skłodowska Curie. 

Estimated reading time: 4 minutes

A smile of relief lights up Hassan Edries' face: “This is the first time I’ve told it like this, straight from the heart.” He is referring to his escape from Sudan, a story he has unfolded with a distant gaze. We are saying goodbye after an hour-long conversation at the ISGlobal office in Barcelona where he works, and he thanks me for the chance to express himself: “Nobody had ever talked to me about this before.”

Throughout our chat, he repeatedly mentions the two nights he spent sleeping rough in Port Sudan, waiting to board one of the few buses leaving for Egypt. Two nights out in the open, lying on the ground in a city where thousands of Sudanese were arriving, fleeing the violence that had just erupted in their country. No water, no food, no sockets to charge his phone.

Then came the long bus journey and the chaos at the Egyptian border, followed by two harsh years in Cairo living in fear of deportation, and another long year in Barcelona under the care of the Red Cross until he finally obtained political asylum. Nothing has been easy for him. Yet, it is the days following the outbreak of the war that seem to return to his memory over and over again. He had left behind the city of Wad Madani and the green lands of the Gezira State, where his parents grew tomatoes and other vegetables. From that moment on, everything ahead became a complete question mark—a pure struggle for immediate survival.

Fleeing Sudan

In April 2023, when one of the worst humanitarian crises in recent decades broke out in Sudan, Hassan had just begun his PhD within the framework of the MENA-Migrant Health project, led by ISGlobal and coordinated by researcher Ana Requena. He was interested in public health, a field he had trained in in the capital, Khartoum, before completing a master’s degree in infectious disease control at the University of Gezira in Wad Madani. Eman Elafef, also from Sudan, found herself in the same situation as a doctoral student on the project. She was right beside him in Port Sudan during the escape to Egypt, which Ana had coordinated from Barcelona.

In April 2023, when one of the worst humanitarian crises in recent decades broke out in Sudan, Hassan had just begun his PhD within the framework of the MENA-Migrant Health project, led by ISGlobal

After a long bus journey, they reached the Egyptian border, protected by their mission to collect health data on the migrant population for the project. They managed to enter the country and were given a SIM card, allowing them to finally call Ana, who had been very anxious for days. Hassan is well aware of his good fortune: “I’ve lost track of many of my colleagues from Darfur; I still know nothing about them.”

Hassan cannot emphasize enough how grateful he is for Ana’s dedicated support throughout these years. “She has helped us with our studies, finding a flat, whenever we’ve had health issues, with paperwork… How can you ever repay support like that?”.

The Long Wait

Hassan’s situation has gradually improved since those first tense, sad years in Egypt—far from his family and lost in bureaucratic limbos for many long months. He was able to travel to Spain following the granting, in February 2025, of the visa for which Ana had prepared the paperwork.

But the visa expired shortly after, leading to another wait, first for a residence permit and, ultimately, for political asylum, which was finally granted to him a month ago. He says that on Spanish soil, he has finally felt safe, with access to basic services.

In a few months, he will defend his doctoral thesis at the University of Barcelona, which he has dedicated to HIV and hepatitis B and C in migrant populations. Coming from a transit country crossed for decades by thousands of Eritreans, Ethiopians, and South Sudanese on their way to Libya and Egypt, he has now also become a migrant himself. Every day, he sends out fellowship applications to European countries, “especially Germany and the Netherlands.”

A Future in Suspense

Although the situation has improved in some regions of the country, with the conflict now centered in Darfur, Hassan does not plan to return to Sudan in the coming years. Not only is he unable to, but he does not wish to. The friends he has back home tell him, whenever an internet connection is possible, that the situation remains difficult: supply shortages persist, and meeting basic needs is a struggle. However, Gezira is safe again, he tells me; it has entered a reconstruction phase, and his family is beginning to return home after spending some time in Saudi Arabia.

But not all of his siblings are making the journey back. His twin brother, with whom he shares a very close bond, remains in Saudi Arabia working as an agricultural engineer. Hassan shows me his photo on his mobile phone. He looks very different from him, but Hassan assures me that in high school, nobody could tell them apart except their mother. They had even swapped identities at times! “We shared absolutely everything until we went to university: games, our bedroom, secrets. He knows everything about me, and I know everything about him.”

Hassan does not yet know what the next stage of his life will look like, but if he has to sum up what these years have taught him, it is that achieving your goals requires patience, knowing how to wait. “In the end, you achieve them, but you have to wait. Most people will help you if you respect them.”

Although in the general population the benefits of physical activity may outweigh the effects of air pollution, this interaction is still not fully understood in people with COPD. “Our aim was to assess how walking and exposure to air pollutants affect daily respiratory symptoms in people with COPD,” explains Alícia Josa Culleré, ISGlobal researcher and first author of the study.

To do so, the research team followed 105 people with COPD in Catalonia over two seven-day periods. They recorded daily walking activity, exposure to three air pollutants — fine particulate matter (PM2.5), nitrogen dioxide (NO₂) and black carbon (soot) — as well as symptom intensity, including cough, sputum production, breathlessness and wheezing.

More cough and mucus on days with high soot levels

Black carbon, also known as soot, consists of microscopic carbon particles produced by the incomplete combustion of fossil fuels (especially older diesel engines), wood and biomass (for example, in wildfires). The study found that when black carbon concentrations were high, longer walking duration was associated with increased cough and sputum production. By contrast, walking when levels of fine particulate matter (PM2.5) or nitrogen dioxide (NO₂) were high did not worsen respiratory symptoms, suggesting that walking under those conditions remains advisable for people with COPD.

“These findings may be explained by the fact that black carbon particles tend to be smaller and can penetrate more deeply into the lungs,” explains Judith Garcia Aymerich. “In addition, they often carry compounds that increase their toxicity and their impact on respiratory health.”

The lack of a similar association with PM2.5 and NO₂ may be due to several factors, including the low concentrations recorded during the study, which remained below the limits recommended by the World Health Organization (WHO). It may also be related to behavioural changes among participants on more polluted days — such as increased inhaler use or walking at lower intensity — or to the possibility that the benefits of walking offset the negative effects of PM2.5 and NO₂ exposure.

Physical activity remains a cornerstone of COPD management

The study examined the short-term effects of walking on respiratory symptoms within the same day, but did not assess the benefits of maintaining regular physical activity. Therefore, the findings do not call into question the benefits of physical activity for people with COPD. Previous studies have shown that physical activity can help open the airways and assist in clearing accumulated lung secretions, meaning that walking may help expel mucus through coughing.

“Our findings support the recommendation to walk for people with COPD, provided that busy roads are avoided where black carbon concentrations are high,” explains Judith Garcia Aymerich. “It is important to provide accessible spaces for safe walking, as well as to reduce black carbon emissions, a ‘super pollutant’ that is harmful both to respiratory health and the climate.”

Reference

Josa-Culleré, A., Koch, S., Rivas, I., Gimeno-Santos, E., Buekers, J., Delgado-Ortiz, L., Alcaraz, V., Blanco, I., Garcia-Olivé, I., Rodríguez-Chiaradía, D., Cirach, M., Valentin, A., Morawska, L., & Garcia-Aymerich, J. (2026). Effects of the interaction between walking activity and air pollution on daily respiratory symptoms in people with COPD. Thorax, thorax-2025-224411. https://doi.org/10.1136/thorax-2025-224411

Reading time: 4 minutes.

“Take my other side,” Adil told me, turning slightly before I took the photograph. “The one without cuts.”

He was sixteen, although he looked younger, one of the smaller boys living on the street in Ceuta, and like many of the boys we met that summer he had learned to carry himself with a kind of hardness. But in that moment, something shifted. The cuts were no longer only a sign of survival, or toughness. They were also something he wanted hidden, something he wanted to leave behind.

What has stayed with me since leaving Ceuta is not only what he said, but the way he moved his body before I took the picture, almost instinctively turning away from the scars. In public health, we have language for the forces that shape wounds like these: structural violence, institutional neglect, trauma, harm reduction, the social conditions that make self-harm and substance use more likely. But in that moment there was also something more intimate and more difficult to sit with: a boy trying to be seen beyond the wound, and carrying shame for scars that should have made the rest of us ashamed of the conditions that produced them.

1. An NNK basketball game in Ceuta gave the boys a chance to play together and shake off the day. 2. A packet of Lyrica (a medication widely misused in Ceuta), and a boy holding a cigarette with a bandaged hand. Substance use and self-harm often overlapped among unaccompanied minors navigating prolonged precarity, grief, and exclusion. 3. Healing and recent self-inflicted wounds on the arms of boys living on the street in Ceuta. These patterns of self-harm emerge as coping responses to chronic stress, violence, and systemic neglect. These are not marks of “ teenage rebellion,” but of survival. 4. Audrey Claire Benson in Ceuta. 5. A protest in Ceuta on June 24, marking the anniversary of the 2022 Melilla massacre. The sign reads in Arabic: “There is no illegal person. Freedom for all.” 6. The fortified border wall at Benzú, one of several barriers separating Ceuta from Morocco. Many unaccompanied minors attempt to climb these walls when they can’t swim across to reach Spanish territory.

On the Ground in One of Europe’s Most Invisible Borders

As a predoctoral epidemiologist at ISGlobal, I see borders not as abstract policy spaces, but as places where global inequalities, colonial histories, national decisions and transnational power structures become painfully visible in people’s bodies: as exhaustion, untreated wounds, hunger, anxiety, fear, substance use and self-harm.

Last summer, I went to Ceuta to understand what was happening at one of Europe’s most important and least discussed borders, a place that is Spanish territory and European territory and yet often remains politically and emotionally far away from the peninsula.

I worked with No Name Kitchen (NNK), a grassroots movement that supports people on the move across Europe’s borders. In Ceuta, we focused specifically on unaccompanied minors, most of them Moroccan boys living either in overcrowded protection centres or on the street. We organised simple activities, helped them access showers at a local mosque, distributed basic supplies, and spent a lot of time doing what sounds small but matters enormously in a context of abandonment: listening, remembering names, noticing when someone looked different, and trying to create moments where boys treated as problems could simply be children.

The Wounds that Made us Look Closer

As the health focal point, I handled first aid. Although most wounds were “normal”, it slowly became impossible for me to ignore the fresh cuts and old scars on arms and hands, often hidden beneath long sleeves despite the heat. We also noticed that these young boys were constantly under the influence of substances like hashish, pregabalin, or clonazepam.

What saddened me most was the mental state around these habits: exhaustion, rage, grief, boredom, fear, shame and a deep sense of having no agency. These were children who had crossed borders alone, many by swimming, and had arrived in Europe only to find themselves stuck in Ceuta, unable to legally move to mainland Spain. Adil was one of them. He was often under the influence when we saw him, but he was also proud to tell us that he had stopped taking pills, which he associated with cutting, and that now he was “only” smoking marijuana.

Substance use and self-harm in Ceuta should not be read as teenage rebellion, individual pathology or cultural deviance. They are coping strategies shaped by the conditions these boys are forced to live in. This matters because the way we name a problem shapes the way we respond to it. If we call these boys dangerous, we justify surveillance. If we call them disobedient, we justify punishment. If we call them broken, we risk reducing them to their wounds. But if we understand substance use and self-harm as responses to abandonment, then the question changes. It is no longer, “What is wrong with these children?” It becomes, “What have we allowed to happen around them, and what would it take to make survival not only less painful, but an act of joy and dignity?”

Why we wrote Sobrevivir al limbo

In public health, we often say that what is not counted does not count (inspired by Albert Einstein’s famous quote), and in Ceuta and Melilla the absence of data is itself part of the violence. There is almost no routine monitoring or peer-reviewed research on mental health, substance use or self-harm among unaccompanied minors in these border enclaves, yet on the ground, the pattern was visible every day.

That is why we wrote Sobrevivir al limbo, No Name Kitchen’s report on substance use and self-harm among unaccompanied minors in Ceuta. Based on daily field observation and spaces of trust, the report documents a reality that institutions should no longer be able to ignore. For me, this was personal. I delayed the start of my PhD writing it because I felt that what I witnessed could not remain invisible.

Documentation does not solve those failures on its own, but it can make denial harder. It can turn scattered observations into evidence, evidence into public responsibility, and public responsibility into pressure on the institutions that are legally and morally obliged to protect these children.

Holding the line for human rights-based public health

This reflection comes at a moment when migration discourse in Europe and across the Global North is becoming increasingly hostile, not only in the language of political debate but in the legal and administrative architecture being built around borders, returns, deterrence and control. Our standards should not become lower simply because the political debate has become more dehumanising; because once cruelty becomes normalised as policy, public health cannot pretend to remain neutral.

Pedro Sánchez’s recent regularisation measure matters, and it is important to recognise policies that expand rights rather than shrink them. But we cannot celebrate an isolated policy win while ignoring what is happening to children at Spain’s border; a society can recognise a positive policy and still demand better.

What helps is not mysterious

One of the painful things about what is happening in Ceuta is that what helps is not mysterious. We saw that when boys had access to safe spaces, sports, showers, conversation, games and trusted adults who returned day after day, there were visibly fewer crises. Connection and non-judgmental support did not erase trauma, but it interrupted it.

Spain must treat substance use and self-harm among unaccompanied minors as a public health and child protection emergency, not a police problem. That means urgent healthcare without delay, culturally adapted harm reduction, early detection of self-harm and problematic substance use, real mental health care, trained staff, safe complaint mechanisms and structured activities inside and outside the protection system.

Beyond healthcare, it requires faster regularisation before boys turn 18, stronger oversight of privately managed centres, accountability for rights violations, and European monitoring of what border policies are doing to children’s bodies and mental health. The message is simple, even if the politics are not: these boys need protection, care, safe spaces and futures.

When witnessing begins to bear fruit

I am grateful that this witnessing is beginning to bear fruit. This story was recently selected as one of the grand-prize winners of the 2026 Untold Global Health Stories Contest, organised by Global Health NOW and the Consortium of Universities for Global Health. This means that journalists will now investigate further and, I hope, help bring more attention to a reality too often absent from public debate.

My hope is that this attention does not stop at recognition, but becomes pressure, and that pressure becomes protection. Boys like Adil in Ceuta do not need to be turned into symbols of suffering; they need adults, institutions and societies willing to see them fully, beyond the wounds and beyond the behaviours that have been used to mark them as difficult, dangerous or undeserving. What we owe them is protection, care, safe spaces, futures, and the courage to insist that even at Europe’s borders, especially at Europe’s borders, human rights still apply.

Reading time: 2 minutes.

As the world gets warmer, our environment may be changing the way young people move. A mild, sunny day can make walking to school, cycling to a friend’s house, or spending time outdoors feel more appealing. But when temperatures keep rising, does warmer weather still encourage teenagers to be active, or does it eventually become a barrier?

Physical activity during adolescence is essential for physical health, mental well-being, and the development of habits that can last into adulthood

This question matters. Physical activity during adolescence is essential for physical health, mental well-being, and the development of habits that can last into adulthood. Yet many young people do not reach the recommended activity levels set by the World Health Organization. At the same time, climate change is making warmer days and heat extremes more common. Understanding how temperature affects daily movement is therefore not just a lifestyle question, but also a public health and climate adaptation one. In our study of teenagers in the Netherlands and Spain, we found that warmer days were linked to more light and moderate physical activity, such as walking and cycling, but not to more vigorous activity, such as running or intense sports.

Beyond Questionnaires: Tracking Movement with Wearable Tech

We looked at how everyday temperature exposure was related to the time adolescents spent being physically active at different intensity levels: light (like yoga and walking), moderate (like cycling), and vigorous (like playing soccer). We used data from two European cohorts: The Generation R Study in the Netherlands and the INMA Project in Spain.

Warmth may invite adolescents to move more, to walk, cycle, stroll, play casually, or be outdoors, but it does not seem to push them towards higher-intensity activity such as running, fast sports, or strenuous exercise

Instead of relying on questionnaires, we used wrist-worn motion sensors, which is wearable technology that records movement throughout the day. We also linked each teenagers’ activity data to temperature levels at their home address. Importantly, we did not only look at the temperature on the day of the activity, but we considered the temperatures of the previous days, because yesterday’s weather may still influence how much someone feels like moving today.

Warmth Encourages Light Activity…

The main finding was clear: adolescents spent more time in light and moderate physical activity on warmer days. In the Dutch cohort, a 5 ºC increase in temperature was linked to around 11 extra minutes of light activity and 5 minutes of moderate activity per day. In the Spanish cohort, the increases were even larger: around 16 minutes of light and 14 minutes of moderate activity. These may sound like small numbers, but when it comes to daily movement, small increases matter and can contribute to meaningfully healthier routines.

…But it Doesn’t Boost Vigorous Activity

But here comes the interesting part: warmer days did not lead to more vigorous activity. This is the paradox at the heart of the study. Warmth may invite adolescents to move more, to walk, cycle, stroll, play casually, or be outdoors, but it does not seem to push them towards higher-intensity activity such as running, fast sports, or strenuous exercise.

Several possible explanations

There are several possible explanations. Light and moderate activities are easier to fit into daily life and are often linked to being outside: walking to school, cycling, meeting friends, or spending time in parks and streets. These activities may feel more attractive when the weather is pleasant. Vigorous activity, on the other hand, may be more structured, such as organized sports or training sessions, which could be less dependent on the weather.

We had limited data from very hot summer days, which means we may not have captured the conditions under which heat becomes a stronger barrier. This is an important point for future research

Another possibility is more biological: as temperatures rise, higher-intensity exercise becomes less comfortable and may place more strain on the body. At some point, heat may stop being a motivator and start becoming a warning signal.

Our study did not find a clear temperature threshold where activity started to decline. One likely reason is that the temperatures observed in our data were moderate. We had limited data from very hot summer days, which means we may not have captured the conditions under which heat becomes a stronger barrier. This is an important point for future research, especially as climate change increases the frequency and intensity of heat events.

Building Climate-Adapted Environments for Healthy Teens

So, what does this mean in practice?

1. Temperature should be considered when designing strategies to promote physical activity among young people. A campaign encouraging teenagers to move more may work different in spring than during a heatwave.
2. Schools, sport clubs, and city councils need to think seriously about climate-adapted activity environments. Shade, trees, drinking water, cooler playgrounds, safe cycling routes, and access to indoor or shaded sports spaces should not be luxuries. They are part of the essential infrastructure needed to help adolescents stay active safely.

Warmer days may encourage teenagers to engage in more light and moderate physical activity, but if we want young people to remain active, healthy, and protected as the climate changes, we need to plan for the heat. Supporting active lifestyles in a warming world means creating environments where all adolescents can move comfortably and safely.

Previous studies have linked exposure to hot or cold temperatures during pregnancy to a higher risk of complications and adverse birth outcomes. However, whether ambient temperature influences development during the earliest stages of pregnancy remains unclear. The first trimester is a critical period, as the baby’s organs and the placenta begin to form; alterations during this stage have previously been associated with adverse birth outcomes and with cardiovascular and respiratory conditions later in childhood.

“To evaluate the association between ambient temperature exposure and embryonic and early fetal development, we analysed data from a Dutch birth cohort, the Generation R Next Study (2017–2021), and replicated the findings in an independent cohort established 15 years earlier, the Generation R Study (2002–2006),” explains Esmée Essers, researcher at ISGlobal and first author of the study. The researchers estimated weekly average temperatures from the beginning of pregnancy and used ultrasound scans at around 8, 10, and 12 weeks to measure crown–rump length, a standard indicator of embryonic and early fetal growth. 

Temperature exposure linked to smaller fetal size at 12 weeks, with different timing patterns for heat and cold 

Exposure to both colder and warmer ambient temperatures during the first trimester was associated with a smaller crown–rump length at 12 weeks of gestation in the Generation R Next Study cohort. The association between colder temperatures and smaller crown–rump length at 12 weeks was also observed in the independent cohort, despite differences in temperature patterns between the study periods.

The timing of exposure appeared to differ between heat and cold. Exposure to higher temperatures showed stronger associations during early pregnancy, particularly between weeks 1 and 6. In contrast, exposure to colder temperatures was associated with CRL across a longer period, from weeks 1 to 11. In both cases, no associations were detected for earlier ultrasound measurements at 8 or 10 weeks.

At 12 weeks of gestation, exposure to both colder and warmer temperatures was associated with a crown–rump length around 7–8 millimetres smaller than expected for this stage of development. The researchers also observed differences between the two cohorts regarding when temperature exposure appeared to have the strongest associations and regarding the magnitude of the observed effects. “These differences could be related to changes in climate conditions over time, differences in how populations respond or adapt to temperature exposure, or other factors that may influence vulnerability during pregnancy”, explains Essers.

How temperature may influence early development

Physiological changes during pregnancy place additional demands on the body’s ability to regulate temperature. “External exposure to heat or cold may further challenge this balance, triggering thermoregulatory responses such as changes in peripheral blood flow,” explains Mònica Guxens, ICREA Research Professor at ISGlobal and coordinator of the study. “These responses could potentially influence uterine perfusion and, in turn, affect early developmental processes. However, further research is needed to understand the biological mechanisms involved and whether these early differences have implications later in pregnancy.”

Reference
Essers, E., de Groot, J. M., Graafland, N., Gonçalves, R., Iñiguez, C., Petricola, S., Jaddoe, V., El Marroun, H., Tiemeier, H., Steegers, E., Rousian, M., Mulders, A., & Guxens, M. (2026). Associations of ambient temperature exposure with embryonic and early fetal development. International Journal of Epidemiology, 55(3). https://doi.org/10.1093/ije/dyag060

Dengue is a viral disease transmitted by Aedes mosquitoes. Transmission has been documented in more than 100 countries, and more than half of the world’s population is estimated to live in areas at risk of infection. In recent decades, dengue incidence has increased due to the geographical spread of mosquito vectors, driven in part by climate change, as well as the rise in international travel, which contributes to the global circulation of the virus. Dengue has also become one of the leading causes of fever among people travelling to endemic regions. In this context, a safe dengue vaccine is essential to protect people at risk and to inform effective public health strategies.

Limited evidence on vaccine safety in travellers

TAK-003 is the first vaccine authorised in Europe to protect against the dengue virus. However, data on its safety in people who do not live in endemic areas remains limited, particularly among certain groups such as older adults, people with pre-existing medical conditions, and those receiving additional vaccines.

“To help address this knowledge gap, we conducted a pharmacovigilance study across eight travel health centres in Catalonia,” explains Daniel Camprubí-Ferrer, first author of the study, ISGlobal researcher and member of the International Health Service at Hospital Clínic Barcelona. The study included 1,028 travellers, mostly adults, who received TAK-003 between January and December 2024. After each dose, participants were followed up to record any adverse effects.

“We also wanted to assess whether factors such as age, sex, previous dengue infection or the co-administration of other vaccines were associated with a higher risk of adverse effects, both local and systemic,” adds Camprubí.

No serious adverse events observed

The study recorded no serious adverse events following the administration of 1,851 TAK-003 doses. Although more than half of participants reported some type of adverse effect, these were mostly mild or moderate, temporary, and less frequent after the second dose. The most common symptoms were pain at the injection site, headache, fatigue and general malaise.

Women and people with previous dengue infection, more likely to experience adverse effects

The analysis found that female participants, people with a previous dengue infection, and those who received concomitant vaccines against other flaviviruses (such as the yellow fever vaccine) had a higher risk of adverse events. Among women, reactions were mainly local, whereas in the other two groups they were predominantly systemic, such as fever.

“Importantly, we did not observe increased reactogenicity in people over 60 years of age or in those with comorbidities, two groups for which evidence has so far been very limited,” explains Cesc Bertran-Cobo, ISGlobal researcher and one of the study authors. The study also found no increased likelihood of adverse events when the dengue vaccine was administered at the same time as non-flaviviral vaccines, supporting its use in pre-travel consultations.

“Our findings expand the available evidence on the safety of TAK-003 in European travellers and highlight the need to continue assessing its impact, effectiveness and long-term safety,” concludes Jose Muñoz, ISGlobal researcher and head of the International Health Service at Hospital Clínic Barcelona.

Reference

Camprubí-Ferrer, D., Bertran-Cobo, C., Valerio, L., Saloni, M., González Nieto, I, López López, V., Garcia, D., Jurado, E., Machado, M. L., Pérez-León, D., Cuevas-Marín, S., Subirà, C., Villar-García, J., Herena García, D., Ayala Cortés, S. N., Sánchez Casado, M., Gomila-Grange, A., Flores, C., Morales Llorente, N., Górriz Hidalgo, E., Morales Martínez, R. M., Vila, F., Martín, N. & Muñoz, J. (2026). Safety of the dengue vaccine TAK-003 and factors associated with adverse events in travellers from non-endemic areas: a real-world prospective multicentre pharmacovigilance cohort study in Spain. Lancet Regional Health Europe. https://doi.org/10.1016/j.lanepe.2026.101727

Organised by ISGlobal in collaboration with FESTMIH and SEMTSI, ECTMIH 2027 will bring together researchers, healthcare professionals, policymakers, NGOs, students and global health leaders from around the world.

Under the theme “Refocusing on Global Health”, the congress will address the main challenges shaping today’s global health landscape, including:

• Health inequalities
• Climate and environmental change
• Infectious diseases and antimicrobial resistance
• Mobility, preparedness and vulnerable populations
• Artificial intelligence and digital innovation
• Health systems, equity and justice

Why attend?

• Scientific sessions and interdisciplinary discussions
• Strong participation from low- and middle-income countries
• Networking and collaboration opportunities
• Dedicated support for early-career researchers
• Co-creation-focused sessions across disciplines

ECTMIH Academy: 24 October

Just before the congress, postgraduate students and early-career researchers will take part in a day of hands-on workshops, discussions and exchange of experiences with colleagues from around the world.

More information

https://ectmih2027.eu/

Graduating in Medicine from the University of Navarra (1999) and earning his PhD from the University of Barcelona (2011), Mikel Martínez Yoldi specialised in Microbiology at Hospital Clínic. After establishing himself as an expert in high-risk viruses at INSERM in Lyon (France) between 2005 and 2009, he developed his career as a senior specialist at Clínic and associate professor at the University of Barcelona. His research focused on arboviruses, emerging viruses and infectious causes of mortality in low-income countries.

“Mikel was a committed, generous person who was deeply passionate about his work. His extensive experience, scientific rigour and warmth made him an invaluable colleague and role model for all of us who had the privilege of working alongside him. His absence will be deeply felt,” expressed his colleagues at ISGlobal.

On behalf of the entire ISGlobal team, we extend our sincerest condolences to his family, friends and loved ones during this very difficult time.

Figures are often presented as mere budget lines, but resources translate into human lives.

Meanwhile, defense budgets across Europe are expanding rapidly. The political signal is clear: preventive instruments are being scaled back while military spending accelerates. However, development cooperation has long functioned as a stabilising tool, strengthening health systems, reducing fragility, and mitigating the drivers of conflict and displacement. Weakening it could ultimately prove more costly than maintaining it.

ISGlobal's Proposal

This disruption also exposes the structural weaknesses of the previous model: an over-reliance on the annual discretion of donors, governance imbalances that limit ownership in the Global South, and fragile funding mechanisms. Therefore, simply restoring previous funding levels would not be enough.

The alternative proposed in a new series of ISGlobal publications is built on three fronts:

• Politically: health must be reaffirmed as a global public good, protected from transactional logic, and backed by a more legitimate and balanced governance.
• Scientifically: sustained investment in research, regional manufacturing, and transferable technology platforms is essential to reduce structural dependency and respond more swiftly to future crises.
• Economically: the system requires more predictable funding, innovative instruments, and stronger alignment with national plans, alongside a renewed commitment to quantitative targets.

It is not a choice between generosity and austerity. The choice is between managing interdependence through cooperation or allowing fragmentation to define the next generation of global health.

Access the full series of publications:

To delve deeper into the analysis of this impact and learn about the reform proposals, you can consult the four documents that make up this series:

• Global Analysis: Rupture, Not Transition: The Retreat of European Aid, the Human Cost of Global Health Cuts, and the Fight for a New System of International Cooperation System
• France Case Study: France: The Human and Geopolitical Cost of Cuting International Aid
• UK Case Study: A Quiet Withdrawal: How the UK Is Stepping Back from Saving Lives
• Germany Case Study: The Price of Recalibration: Germany’s Aid Cuts and the Human Cost of Retreat

The research, published in the European Journal of Public Health, is based on the Workers’ Exposure Survey (WES), carried out by the European Agency for Safety and Health at Work (EU-OSHA). This survey, the first of its kind in Europe, collects detailed information from workers on tasks, exposure circumstances, and use of protective measures to estimate probable exposure to 24 cancer risk factors. WES includes 24,402 telephone interviews conducted between 2022 and 2023 with workers from Finland, France, Germany, Hungary, Ireland and Spain. Of the participants, 3,041 worked in the health and social care sector, which represents approximately 11% of the European Union workforce.

The results show that 29.5% of workers in this sector were exposed to at least one cancer risk factor evaluated during the last working week, while 7.8% were exposed to two or more. 

Radiation, diesel engine exhaust emissions, and certain chemicals represented the main risk factors

Among the most frequent risk factors are ionising radiation (7.4%), diesel engine exhaust emissions (6.2%), and solar ultraviolet radiation (6.1%). Workers may be exposed to ionising radiation through working with machines that use x-rays or with radioisotopes; to diesel engine exhaust emissions through use of diesel-powered vehicles; or to solar ultraviolet radiation through work outdoors. Relevant exposures to chemicals such as formaldehyde (5.2%) and benzene (4.8%) were also recorded.

In terms of exposure levels, formaldehyde (2.3%) and ethylene oxide (2.0%) were the most common agents at high exposure levels. The study also identifies combined exposures, such as diesel emissions together with solar radiation, or simultaneous exposure to formaldehyde and ethylene oxide.

“The analysis also reveals gender differences: men show a higher prevalence of exposure (35.7%) compared to women (26.1%),” says Muhammad Waseem Khan, ISGlobal researcher at the time of the study and first author of the research.

Need to strengthen prevention

“Despite their relevance, risks associated with exposure to carcinogens in the health and social care sector have historically been less visible than in other economic sectors. This study highlights the need to develop prevention strategies adapted to real working conditions in this field”, highlights Michelle Turner, ISGlobal researcher and senior author of the study.

Reference

Khan, M.W., Vallbona-Vistós, M., Cavet, M., Vilahur, N., Turner, M. C. Occupational exposure to cancer risk factors among health and social care workers in Europe: results from the Workers’ Exposure Survey. European Journal of Public Health, 2026. Doi: 10.1093/eurpub/ckag056

A silent burden affecting millions

Chronic liver disease is responsible for a substantial burden of premature illness and death across Europe, with disproportionate effects among men and socially disadvantaged populations. It is now second only to ischemic heart disease as the leading cause of years of working life lost in Europe.

The Series also warns that metabolic liver disease is rapidly reshaping Europe’s liver health burden. It found that one in three people in the EU and UK are estimated to be living with metabolic dysfunction-associated steatotic liver disease (MASLD), now a leading driver of liver cancer in Europe.

Europe has the highest rates of alcohol consumption per person, the highest prevalence of heavy episodic drinking, and the lowest rates of abstention from alcohol in the world. Alcohol combines with obesity and other risk factors for liver disease to drive high rates of end-stage liver disease and liver cancer. Alcohol causes an estimated 40% of the 287,000 premature liver-related deaths in Europe every year, although the true number may be higher.

Across Europe, liver disease is already cutting into working-age health, with deaths from alcohol-related liver disease and undetected or untreated viral hepatitis often occurring decades earlier than many other chronic conditions. Hepatitis B and C account for more than 85 per cent of the nearly 57,000 annual deaths due to HIV, tuberculosis and viral hepatitis infections in the EU/EEA.

Beyond hepatology: a broader public health response

“Europe does not need another warning that liver disease is getting worse. It needs a different way of responding,” said Jeffrey V. Lazarus, Professor at the CUNY Graduate School of Public Health and Health Policy and Head of the Public Health Liver Group at ISGlobal, and Chair of the Lancet Europe Series.

“When we talk about ultraprocessed food, alcoholic drinks and generally unhealthy diets, we are essentially talking about liver disease risk. When we talk about diabetes, obesity and sedentary lifestyles, we are also talking about that same risk. We need stronger public health policies and interventions to address this disease burden,” Lazarus states. “And primary care also needs to change. It makes no sense that people are assessed for blood pressure, cholesterol and weight but not liver fibrosis,” he adds.

The Series examines chronic liver disease from four complementary angles: 1) detection and care models, 2) MASLD policy preparedness, 3) alcohol-related liver disease and MetALD, and 4) progress towards viral hepatitis elimination.

It examines metabolic, alcohol-related and viral causes of liver disease together. "By examining these causes together, these papers show why Europe needs coordinated prevention, earlier detection, care pathways and a non-judgemental approach that connect liver health with diabetes, obesity, cardiovascular disease, alcohol policy, cancer prevention and the needs of underserved communities," said Elisa Pose, co-Chair of the Series.

In a Series comment, patient advocates Jeff McIntyre, Gina Bartes and Raquel Peck warned that individuals with liver disease frequently encounter assumptions and judgment that frame disease as solely a consequence of personal choices. "The stigma from this lack of context directly influences care-seeking, engagement, and health outcomes, while also shaping policy priorities and contributing to the persistent under-recognition of liver disease," they said.

Paul Brennan, co-Chair of the Series, added, "For too long we have accepted the normalisation of how society in general and industry lobbyists have directed blame upon individuals, rather than collective government and institutional responsibility and failings. Liver disease, especially MASLD, viral hepatitis and alcohol-related liver disease, disproportionately affect those most vulnerable in society. In this series we highlight how we can incorporate evidence-based interventions around diagnostics, preparedness, pathways of care and policy development to better protect the next generations of Europeans".

Missed opportunities for prevention and early detection

The authors also warn that millions of people with chronic liver disease remain undiagnosed. Earlier identification through primary and community-based care, including testing strategies and automated non-invasive liver fibrosis assessment, could prevent progression to fibrosis, cirrhosis, liver cancer and premature death.

Key recommendations include:

• Integrating liver health into non-communicable disease and cancer prevention strategies;
• Aligning liver disease responses with diabetes, obesity, alcohol, cardiovascular disease, physical activity and nutrition policies;
• Strengthening surveillance systems and early detection;
• Improving access to treatment and harm reduction services;
• Implementing stronger alcohol policies and reducing commercial drivers of harm;
• Addressing stigma and barriers affecting underserved communities.

“Ending chronic liver disease as a public health threat in Europe is possible, but only if Europe acts before advanced disease becomes the default point of diagnosis,” concludes Lazarus.

The Series was released to coincide with the Flagship Event hosted today in Barcelona by the Global Think-tank on Steatotic Liver Disease, an initiative of ISGlobal’s Public Health Liver Group, ahead of this year's European Association for the Study of the Liver (EASL) Congress.

About the series

The Series comprises four papers and four accompanying comments. The papers focus on:

 Diagnostic innovation and models of care for chronic liver disease;

• MASLD policy preparedness in Europe;
• Alcohol-related liver disease and MetALD;
• Viral hepatitis control and elimination.

 The accompanying comments address high-priority perspectives including patient advocacy, cultural and language barriers to care, laboratory medicine and the needs of people with autoimmune and rare liver diseases.

[This post was jointly written by Denise Naniche and Elizabeth Diago, respectively Co-Director and Coordinator of the Preparedness and Response Hub at the Barcelona Institute for Global Health (ISGlobal).]

As of today, May 21^th, there have been approximately 600 suspected cases and 139 suspected deaths from the deadly Bundibugyo ebolavirus in the northeastern Ituri province in the Democratic Republic of Congo (DRC). The first reported case was a health worker who died on April 24^th; then on May 5^th the WHO was informed of a cluster of an unknown illness with high mortality in health workers, and dispatched a rapid response team. The epidemic was declared a public health emergency of international concern (PHEIC) on May 15th. Since then, the WHO and international organizations have launched emergency control activities.

The lost weeks between the first death and declaration of the PHEIC allowed the virus to spread to a wide network of contacts and across borders. While the DRC has experience managing past Ebola outbreaks, the current crisis presents unique challenges. Unlike the more common Zaire ebolavirus, there are no commonly used diagnostic tests which significantly delayed the identification of the disease, nor approved vaccines or specific therapeutic treatments for the Bundibugyo strain. Consequently, management relies on public health measures: active operational case detection based on symptoms and epidemiological links, isolation, contact tracing, and safe burial practices.

A perfect storm

If we rewind a bit, we can see elements of a perfect storm. First, the capacity to respond to and contain an outbreak depends heavily on pre-existing infrastructure. The Ituri Province has experienced decades of armed conflict, creating a prolonged humanitarian crisis that complicates healthcare delivery.

Second, this fragile health system was further strained in July 2025, by the United States administration’s elimination of its approximately $9 billion in aid funding destined for the DRC. These funds were vital for essential health services, HIV programs, and disease surveillance. Local health systems were thus forced to scale down basic operations, which likely included reducing expenditures on infection control and surveillance networks: the very tools needed to sound the alert for the initial cases in Ituri.

Finally, while public health professionals were attempting to contain the spreading Bundibugyo virus in DRC, a separate health event occurred in another part of the world. On May 2^nd, the WHO received reports of a cluster of the deadly Andes hantavirus disease among passengers on the cruise ship MV Hondius. The international response was rapid: by May 10^th, the affected individuals, primarily from Europe and North America, were evacuated and quarantined in their respective home countries. As of today’s, date, the hantavirus outbreak has resulted in 11 cases and 3 deaths, and the WHO classified the global risk to the general population as "low."

Hantavirus-Ebola: two crises, two standards

While the hantavirus cases received swift and extensive media attention across global outlets, coverage of the Ebola outbreak in the DRC appeared less visible and delayed until having reached a dramatic death toll and the WHO declaration of Public Health Emergency of International Concern. This brings us to the overarching theme of equity.

While the hantavirus cases received swift and extensive media attention across global outlets, coverage of the Ebola outbreak in the DRC appeared less visible and delayed until having reached a dramatic death toll and the WHO declaration of Public Health Emergency of International Concern

The apparent difference in media attention is not new. Global news priorities can be influenced by geographical proximity or by the origin of the populations affected, rather than by the level of public health risk. When this trend is replicated in access to resources such as vaccines, low- and middle-income countries are directly disadvantaged, as we witnessed during the Covid-19 pandemic. We need to ensure that the trend in media coverage is not mirrored by international political will and mobilization of resources for the current Bundibugyo-ebolavirus outbreak.

Putting the '100-Day Mission' to its ultimate test

The declaration of a PHEIC on May 15 activates international frameworks and specifically the 100-Day Mission which is a global initiative spearheaded by the Coalition for Epidemic Preparedness Innovations (CEPI) and endorsed by international organization, global political leaders and the private sector in 2021. The objective of this mission is to develop diagnostics, initial therapeutics, and vaccine candidates within 100 days of an outbreak declaration.

We have a responsibility to treat every outbreak as though it were occurring in our backyard

This framework was utilized for the first time during the 2024 Marburg virus outbreak in Rwanda, facilitating clinical trials for investigational vaccines for an epidemic that remained local and was rapidly contained. The current outbreak in the DRC may represent a more stringent test of the 100-day mission due to the magnitude of its spread and the absence of a specific rapid diagnostic test. As the WHO assembly convenes this month and discusses aspects of equity in the pandemic agreement and benefits sharing across the north and south, we have a responsibility to treat every outbreak as though it were occurring in our backyard, because in an interconnected world, it actually is. 

Giving migrant farm workers a voice to better understand their experiences

Climate change is intensifying exposure to heat, with heatwaves becoming increasingly frequent and severe. Heat stress can cause anything from dizziness and cramps to fainting, while also increasing the risk of workplace injuries, worsening pre-existing conditions and impairing kidney function over the long term. In Spain, a strong link has been documented between rising temperatures and workplace injuries in the agricultural sector.

“Until now, no study had examined the experiences of migrant agricultural workers dealing with heat in Spain. Our aim was to understand how they experience and cope with occupational heat stress,” explains Marlena van Selm, predoctoral researcher at ISGlobal and first author of the study.

The team interviewed 30 migrant agricultural workers —24 men and six women, mainly from sub-Saharan and North Africa— in Almería, Lleida and Huelva. The interviews were recorded, transcribed and analysed using reflexive thematic analysis.

Heat and precarious working conditions limit people’s ability to protect their health

Participants described extreme heat as a routine part of their work and reported frequent symptoms of heat stress, including dizziness, exhaustion and fainting. Conditions were particularly severe inside greenhouses, where temperatures can rise far above outdoor levels if adequate ventilation and shading measures are not in place. Although many workers tried to protect themselves by drinking water, wearing suitable clothing or taking breaks, these measures were often limited by pressure to maintain high work rates and minimise rest periods.

The study shows that the ability to prevent the effects of heat depends largely on social and economic factors. Job insecurity, irregular immigration status, language barriers and the fear of losing employment make it difficult for workers to demand better conditions or stop working during periods of extreme heat. Housing conditions also play a role. Many participants were living in poor-quality accommodation with very high indoor temperatures, making it difficult to recover from heat exposure after the working day.

Protection against heat depends more on employers than on guaranteed rights

Although Spanish legislation requires working conditions to be adapted during periods of high temperatures, interviewees pointed out that, in practice, their protection largely depends on the goodwill of employers.

“Reducing the health risks associated with heat stress requires clearer and enforceable preventive measures, as well as improvements in working conditions. It also means addressing other structural vulnerabilities, such as access to decent housing, in a context where temperatures are rising due to climate change,” concludes Ana Requena-Méndez, head of ISGlobal’s Migration Health group and coordinator of the study.

Reference

van Selm, L., Voorhis, C., Williams, S., Izuzquiza-Regalado, D., Notario-Gallego, S., Diop, S., Evangelidou, S., Briones-Vozmediano, E., & Requena-Méndez, A. (2026). Lived experiences of heat stress among migrant agricultural workers in Spain: a qualitative study. International Journal for Equity in Health, 25(1). https://doi.org/10.1186/s12939-026-02850-x

The course, held between March and April 2026, brought together 33 participants from HCM and included contributions from leaders and experts from different strategic areas of ISGlobal, IDIBAPS, the Hospital Clínic de Barcelona, Maputo Central Hospital and Mozambique’s Eduardo Mondlane University.

Barcelona and Maputo strengthen knowledge exchange and capacity building

Throughout the different sessions, delivered in Spanish and Portuguese, participants addressed topics related to research, institutional management, healthcare organisation and international collaboration. Both the organising institutions and participants gave very positive feedback on the relevance of the topics covered, the practical approach of the activities and the clarity of the course content.

The course was created with the aim of strengthening capacities in key areas of scientific and healthcare management and forms part of a broader line of collaboration between the participating institutions and Maputo Central Hospital. It also marks the beginning of a series of initiatives promoted by Campus Clínic Solidari together with ISGlobal and IDIBAPS to strengthen knowledge exchange and capacity building with healthcare institutions in Mozambique.

[Elizabet Diago is the coordinator of the Preparedness and Response Hub at the Barcelona Institute for Global Health (ISGlobal).]

Reading time: 7 minutes.

On May 10, the cruise ship MV Hondius anchored at the port of Granadilla de Abona, in Tenerife. Spain. On board were 151 people from 23 nationalities and an outbreak of the Andes virus, the strain of hantavirus capable of human-to-human transmission. The outbreak has already caused three deaths and 10 confirmed cases, while dozens of people remain under monitoring.

It is a scene nobody expected in the Canary Islands: personnel in protective suits, buses from the Military Emergency Unit (UME), staggered evacuations, and protests outside the port.

The MV Hondius crisis is not only a health emergency. It is also an urgent lesson in why pandemic preparedness matters, why international response mechanisms are indispensable and, above all, why the failure to properly fund these systems is a mistake we could pay dearly for in the near future.

Why Spain had to respond

There has been debate over whether Spain was obliged to receive the cruise ship. The answer is clear: Spain acted in compliance with the legal obligations derived from the International Health Regulations (IHR), created in 2005 in response to another international health emergency, the 2002–2004 SARS coronavirus outbreak. The World Health Organization (WHO) simply invoked them when formally requesting support to receive the vessel. The IHR are not an external imposition: they are a treaty ratified by Spain (and 195 other WHO member states) that reflects a basic principle of global health: a health emergency anywhere is a shared responsibility.

This crisis should not make us question whether welcoming the ship was the right thing to do —it was— but rather why the global system, which should have contained this outbreak much earlier, still has so many gaps

Article 13.1 of the IHR requires states to develop core capacities to respond to public health emergencies, including diagnostic laboratories, adequate isolation units, properly trained personnel and international evacuation logistics. WHO considered that the Canary Islands had these capacities. Cape Verde, the first port the ship attempted to approach, did not. This asymmetry in capacities between countries is exactly the problem the IHR were designed to correct, and we still have not solved it.

Spain’s response followed a fundamental principle, expressed by Prime Minister Sánchez in recent days: “ask for help when needed and offer it when capable.” In this sense, the operation has been exemplary. This crisis should not make us question whether welcoming the ship was the right thing to do —it was— but rather why the global system, which should have contained this outbreak much earlier, still has so many gaps. One of the most evident relates to the Pandemic Agreement.

A historic agreement stranded by political differences

In May 2025, WHO member states adopted by consensus the first global Pandemic Agreement, the result of more than three years of negotiations. Its purpose was to address the gaps and inequalities revealed during the international response to COVID-19. It was real progress. But the agreement still lacks a critical piece: Article 12, dealing with the pathogen access and benefit-sharing system (PABS), without which the text cannot be opened for signature or enter into force. Negotiations have stalled over disagreements between high-income and low- and middle-income countries regarding equitable access to vaccines and contributions from the pharmaceutical industry, extending negotiations until May 2027. Once these differences are resolved, the agreement will still require ratification by 60 countries to enter into force.

The road ahead is long and the context is not helping: Argentina announced its withdrawal from WHO in March, following the steps of the United States. Health multilateralism is not only unfinished: it is under direct attack from some of the most relevant actors, precisely when it is most needed

The road ahead is long and the context is not helping: Argentina announced its withdrawal from WHO in March, following the steps of the United States. Health multilateralism is not only unfinished: it is under direct attack from some of the most relevant actors, precisely when it is most needed.

Aid cuts threaten to turn the IHR into dead letter

The IHR and the Pandemic Agreement are only as strong as the health systems implementing them. And those systems are losing funding at an alarming speed.

The United States accounted for approximately 40% of all global development aid. The dismantling of USAID is leaving a gap that nobody has filled. On top of that, its withdrawal from WHO has resulted in the loss of nearly 15% of the organisation’s total budget, forcing it to cut almost 3,000 jobs (22% of its workforce) by mid-2025. These cuts directly affect the strengthening of health systems in developing countries: nearly 24 million people are at risk of losing access to essential health services, and more than 2,600 facilities have already suspended services in crisis areas. And it is not only the United States: the United Kingdom, France, Germany and the Netherlands have also reduced their global health cooperation budgets.

The IHR and the Pandemic Agreement are only as strong as the health systems implementing them. And those systems are losing funding at an alarming speed

What is being cut is not abstract aid. These are surveillance systems and laboratories that detect outbreaks before they reach a cruise ship. It is community health personnel identifying index cases and having the resources needed to manage them safely and effectively. These are the data systems that make coordinated responses like that of the MV Hondius possible. Without this infrastructure, the IHR become dead letter.

The lesson from Tenerife

The management of the MV Hondius crisis is still ongoing and it is too early to draw definitive lessons. But the mere fact that Spain was able to respond with laboratories, protocols, specialised personnel and international coordination demonstrates the difference that prepared systems make. That difference is precisely what the IHR and the Pandemic Agreement seek to guarantee for all countries, not only those that already have the necessary resources.

Recent studies estimate nearly a 50% probability that within the next decade we will face another health crisis comparable in scale to COVID-19. In this case, hantavirus arrived from the South Atlantic aboard a cruise ship. The next threat will come from somewhere else, under another name. We cannot control when it will appear, but we can control the investment in systems, agreements and coordination that allow us to prevent, prepare and respond together. What happened ten days ago demonstrates that a better prepared world is possible. But it cannot be built by stripping it of financial and legal resources.

Reading time: 10 minutes.

The global average temperature has already temporarily exceeded the 1.5°C threshold above pre-industrial levels, a central limit of the Paris Agreement. Crossing this level permanently increases the risk of triggering major climate tipping points. Humanity appears to have taken stable climate conditions for granted.

Recent landmark international rulings, among which the 2025 International Court of Justice Advisory Opinion on climate change, confirm that States are legally bound to prevent foreseeable harm to the global climate system. Moreover, the Paris Agreement’s 1.5°C target has now solidified into binding international law, even as the global average temperature has already exceeded this threshold for three consecutive years.

The right to self-determination is now threatened by greenhouse gas emissions from high-emitting States. As climate change submerges islands, thaws the Arctic, and renders regions uninhabitable, it is breaking the promise of self-determination. What is needed is a decisive legal movement to drive climate action, prioritizing survival, dignity, equal rights, and a habitable planet for all.

When changes to the climate system become irreversible

The EU-funded TipESM project is generating critical data on early warning signs of climate tipping points such as the collapse of the Atlantic Meridional Overturning Circulation (AMOC) or the dieback of the Amazon rainforest, and their impacts on ecosystems, health, society, and habitability.

Extreme weather events like the 2024 Valencia floods (12% more intense due to climate change) and 2025 LA fires (36% more likely as a result of climate change) are making the reality of climate change impossible to ignore. Meanwhile, climate tipping points, irreversible shifts in the Earth system, are approaching. The AMOC, Greenland and West Antarctic ice sheets, and the Amazon rainforest are among the most concerning.

If the Amazon collapses, for example, it could add up to 0.5°C of additional warming. The AMOC may stop by century's end, with devastating effects on Europe.

If the Amazon collapses, for example, it could add up to 0.5°C of additional warming. The AMOC may stop by century's end, with devastating effects on Europe. Greenland holds enough ice for 7 metres of sea level rise. Once these systems tip, there's no going back. Cutting greenhouse gases can still reduce the future likelihood of climate extremes. However, once certain tipping points are crossed, they will trigger a new set of climate extremes that we cannot reverse, even if we later lower emissions. That's why tipping points pose a greater threat than climate change on its own.

The tipping of the Amazon rainforest

Climate change, combined with human-driven Amazon degradation (already 38% degraded and ~17% cleared), could push the forest toward partial or complete collapse, turning lush rainforest into savanna. This tipping point may occur at 2-4°C of warming, making the Paris Agreement's 1.5-2°C target a safe boundary, only if additional deforestation stays below 20%. An Amazon collapse would threaten water and food security, increase warming, drive species extinction, spread infectious diseases, and trigger mass migration and political crises. Advanced models already suggest partial dieback may begin this century, although regional dynamics remain uncertain.

No one should be expected to live under deadly heat

A fundamental question also emerges: “What legal framework exists for loss of habitability caused by climate tipping points or extreme heat?” While some low-lying island nations have relocation plans tied to sea-level rise, extreme heat, a major driver of climate-related deaths, remains dangerously under-monitored, especially in the Global South. In spring 2024, West Africa and the Sahel experienced unprecedented heatwaves, with half the continent seeing anomalies of 10°C above average. Yet we know little about the human impact.

Adaptation is feasible at 1.5°C, difficult and costly at 2°C, and beyond 3°C we hit a hard adaptation limit or a tipping point. Current pledges put us on track for 2.6-2.8°C of warming by late century.

For example, one African region recorded a full month above 30°C Wet Bulb Global Temperature (WBGT; which is considered very dangerous), with half the days exceeding 33°C WBGT (which is considered extremely dangerous). By comparison, Paris's 2003 heatwave, which caused 1,000 excess deaths, never crossed 30°C WBGT. Heat deaths in African nations remain largely uncounted.

At 3°C of warming, 1.7 billion people, mainly in West Africa, the Arabian Peninsula, Northern India, and Southeast Asia, would face at least one week per year of deadly heat stress. Impacts vary by age, health, work, acclimatization, and access to water. Having this in consideration, scientists and legal experts must work together to define vulnerability thresholds and assess survivability. No one should be expected to live under deadly heat. On the current emissions path, certain areas will exceed survivable thresholds, leading to higher mortality, illness, livestock loss, and crop failure. Better heat-health warning systems are therefore urgently needed. Adaptation is feasible at 1.5°C, difficult and costly at 2°C, and beyond 3°C we hit a hard adaptation limit or a tipping point. Current pledges put us on track for 2.6-2.8°C of warming by late century.

The right to a dignified, livable existence

As Elisa Morgera (UN Special Rapporteur on Climate Change) notes, although scientists and legal professionals operate under different standards of certainty, international law clarifies that all States have an obligation to apply the highest ambition to prevent significant environmental harm.

Tipping points have measurable impacts on all human rights, among them access to water, food, health and dignified, livable existence, which are threatened beyond precedent. States must therefore monitor these risks to develop targeted protections.

Even if we don't know exactly when tipping points will be crossed, there is enough evidence that we are heading toward irreversible, significant harm and we should act now. The precautionary principle applies. Moreover, different climate tipping points are intricately connected, meaning their impacts transcend borders and challenge traditional domestic versus extraterritorial human rights frameworks.

Breaking the addiction

A rational person slows down in the face of danger, but an addict keeps going. This powerful metaphor, used by Benjamin Schachter (from the Office of the UN High Commissioner for Human Rights) highlights our addiction to fossil fuels. The AMOC and Amazon are Earth's vital organs –if we damage them irreversibly, we head toward a "life-support planet" or a fundamentally different state of being.

And yet we are not reducing emissions. Human rights offer a framework to turn science into better policy. Even if some tipping points have already been triggered, we can still change course, provided decision-making is informed by human rights. The precautionary principle says higher risk demands greater prevention. Yet we pour money into humanitarian disasters while neglecting far more effective and economical prevention. Human rights-based measures are more sustainable. We need to break our addiction to the fossil fuel economy before large parts of the planet cease to be safely habitable.

[This article draws on discussions held during a side event on “Human Rights and Climate Tipping Points” at the 61st session of the UN Human Rights Council (March 2026), with the participation of the UN Special Rapporteur on Climate Change and Human Rights, as well as scientists and legal experts from the Climate and Planetary Change Hub at ISGlobal, the IRD France, the UK Met Office, Just Atonement Inc. and the UN Human Rights Office.]

The event was organized within the EU-funded TipESM project and the recording can be watched here:

The analysis, which compiles the main participation indicators of Catalan research institutions in the programme, highlights ISGlobal’s position within the top 10 in several key areas.

Specifically, the Institute ranks 10th in attracting European funding (net contribution), an indicator reflecting the resources directly received by the institution through Horizon Europe projects. ISGlobal also ranks 10th in the total number of coordinated projects.

Regarding overall participation in European consortia, ISGlobal ranks 11th among Catalan institutions in terms of the total number of projects in which it participates, further consolidating its strong and sustained presence within the programme.

Quique Bassat, Director General of ISGlobal, states that these results “confirm ISGlobal’s prominent role in the Catalan global health research landscape and its capacity to attract competitive European funding, as well as to lead and actively participate in international collaborative projects”.

Understanding how everyday chemicals may affect pregnancy

Endocrine disrupting chemicals (EDCs) are widely present in daily life, found in food, water, personal care products, and household environments. These substances—including phthalates, phenols, parabens, pesticides, and emerging compounds such as bisphenol S (BPS)—can enter the body through ingestion, inhalation, or skin contact.

Pregnancy represents a particularly sensitive window, as hormonal balance is essential for placental development and fetal growth. The placenta, a key endocrine organ, depends on tightly regulated angiogenic processes (that is, the formation of new blood vessels) controlled by factors such as placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1).

“Pregnant women are exposed to complex mixtures of chemicals rather than single compounds,” explains Bethany Knox, ISGlobal researcher and first author of the study. “Our goal was to better reflect real-world exposures and understand how these mixtures might influence both the placenta and fetal development.”

Different chemical mixtures show distinct effects on fetal growth

The study included 734 participants from the BiSC cohort in Barcelona, recruited between 2018 and 2021. “We analyzed exposure to more than 40 chemicals by measuring metabolites in pooled week-long urine samples collected at two stages of pregnancy: 18 and 34 weeks of gestation. This approach improves exposure assessment for non-persistent chemicals, which have short half-lives and can vary significantly over time”, explains Knox.

The research team identified distinct patterns in the associations of multiple chemical mixtures with fetal development. Exposure to mixtures of low molecular weight phthalates was consistently linked to lower birthweight in the study population, suggesting a potential adverse effect on fetal growth. In contrast, mixtures with organophosphate compounds, including pesticides and flame retardants, were associated with higher estimated fetal weight and birthweight, particularly in late pregnancy. This association may reflect dietary patterns rather than a direct effect of organophosphate exposure, as higher fruit and vegetable intake can increase exposure to these compounds while also supporting rapid fetal weight gain.

Beyond these differences in growth, the study also points to the placenta as a key intermediary. Phthalate mixtures were associated with changes in fetoplacental blood flow and with an imbalance in angiogenic biomarkers (sFlt-1/PlGF ratio), suggesting a biological pathway through which environmental exposures may influence fetal development.

Implications for public health and future research

“Our findings contribute to environmental health research by incorporating a broad panel of chemicals aligned with European regulatory priorities, including substances whose safety profiles are still under evaluation,” says Martine Vrijheid, Head of the Environment and Health over the Lifecourse Programme and coordinator of the study. 

While this study did observe deviations from normal fetal growth, they cannot be translated to an individual and this study’s population is not necessarily representative of all populations. However, the study highlights the importance of considering environmental chemical mixtures in public health research, suggesting that widespread exposures may influence fetal development through their effects on placental function at the population level.

Reference

Knox, B., Güil-Oumrait, N., Midya, V., Vespalcová, H., Dolores Gómez-Roig, M., Llurba, E., Márquez, S., García Ruiz, Z., Galmes, T., Philippat, C., Sakhi, A. K., Thomsen, C., Urquiza, J., Zanini, M. J., Dadvand, P., Gascon, M., Rivas, I., Foraster, M., Basagaña, X., Sunyer, J., Bustamante, M., Vrijheid, M. (2026). Prenatal exposure to mixtures of nonpersistent endocrine-disrupting chemicals and angiogenic biomarkers, placental function, and fetal growth. Environmental Science & Technology, 60(11), 8339–8352. https://doi.org/10.1021/acs.est.5c13234

Although the overall health burden is dominated by long-term exposure, short-term air pollution can trigger acute physiological responses, such as systemic inflammation, autonomic imbalance and increased blood clotting, that elevate mortality risk over the following days. Recent studies have shown that daily pollution levels are linked to daily short-term increases in mortality, but important limitations remain. Most research focuses only on cities, overlooking peri-urban and rural areas; and they often fail to account for regional differences in vulnerability (such as age, baseline health, socioeconomic status or environment) and air pollution toxicity. In addition, pollutants are usually analysed separately, making it difficult to understand their combined effects.

“Our study addressed these limitations by combining daily data on major air pollutants across Europe with the new mortality database from the EARLY-ADAPT project of the European Research Council (ERC), which covers the whole population in 31 countries representing over 530 million people,” explains Zhao-Yue Chen, researcher at ISGlobal and first author of the study. “This allows a more precise analysis of how short-term exposure to the major pollutants affects people differently depending on age, sex and cause of death.” The study analysed nearly 89 million deaths recorded between 2003 and 2019 across 653 European regions.

“To assess exposure to air pollution, daily levels of several pollutants were estimated across Europe using data from monitoring stations, satellites, land use and meteorological variables, and then adjusted at the regional level, giving more weight to areas where more people live,” explains Carlos Pérez García-Pando, ICREA and AXA Professor at BSC-CNS.

PM₂.₅, the most harmful pollutant

An estimated 146,500 premature deaths per year were associated with short-term exposure to overall air pollution when all pollutants are considered together. When each pollutant was analysed separately, the greatest impact was attributed to PM₂.₅ (around 79,000 deaths), followed by NO₂ (69,000), O₃ (31,000) and PM_2.5-10 (29,000). These figures cannot be simply added together; pollutants often occur simultaneously, so their effects overlap.

PM_2.5 is the most harmful pollutant because it penetrates deep into the lungs and can enter the bloodstream, causing inflammation and other rapid effects in the body. By contrast, PM_2.5-10 mainly affects the upper airways due to its larger size, while gases such as NO₂ and O₃ irritate the lungs and increase vulnerability to respiratory diseases.

Most earlier large studies focused only on fine particles (PM₂.₅) when estimating the short-term health burden of air pollution, leaving the impact of other pollutants in Europe largely unknown. This new study considers several pollutants together, providing a more complete and realistic picture of health risks. It also suggests that previous global estimates based solely on PM₂.₅ may have somewhat overestimated the burden in Europe, potentially reflecting biases from evidence derived in other regions.

Young men are more vulnerable than young women, but the pattern reverses with increasing age

Air pollution does not affect everyone in the same way. Young men showed greater vulnerability to ambient air pollutants than young women, likely due to higher exposure (outdoor work, traffic, smoking, etc.) or to the earlier appearance of comorbidities in men at young ages. However, this pattern changes with age: at older ages (especially from 85 years onwards), the highest risk is observed in women. For specific causes of death, particulate matter was more strongly associated with cardiovascular risks in women, while O₃ had a greater impact on men. These findings highlight the need for tailored protection measures, in contrast to one-size-fits-all approaches.

“Our findings are highly relevant for policymakers and public health professionals, as they support the use of epidemiological models fitted with data by sex, age and comorbidities to create a new generation of impact-based early warning systems (for example, the ERC-funded platform Forecaster.Health), which specifically target vulnerable groups,” explains Joan Ballester, researcher at ISGlobal and coordinator of the study. In a context where new daily air quality standards are being introduced across Europe, these results provide practical insights to help protect the population more effectively.

Reference

Chen, Z.-Y., Achebak, H., Petetin, H., Huang, W., Méndez Turrubiates, R. F., Beltrán, N., Peyrusse, F., Guo, Y., Pérez García-Pando, C., & Ballester, J. (2026). Short-term sex-specific, age-specific and cause-specific mortality from particulate matter, nitrogen dioxide and ozone: European-wide analysis of 653 contiguous regions. Nature Health. Doi: 10.1038/s44360-026-00124-y. Doi: 10.1038/s44360-026-00124-y.

Los encuentros mantenidos en Manhiça pusieron en valor el impacto de una colaboración sostenida en el tiempo entre instituciones científicas y financieras comprometidas con la mejora de la salud global y el fortalecimiento de capacidades locales de investigación. También se destacó el papel clave del apoyo institucional de España, incluida la contribución de la Agencia Española de Cooperación Internacional para el Desarrollo (AECID), en el crecimiento y consolidación del CISM como centro de referencia en investigación en salud en Mozambique.

“La investigación desarrollada en el CISM está alineada con estándares internacionales de excelencia y tiene un impacto directo en la mejora de la salud de las poblaciones”, destacó Quique Bassat, director general y científico de ISGlobal, quien subrayó además el valor de una colaboración construida a lo largo de los años tanto a nivel comunitario como hospitalario.

Por su parte, el director general del CISM, Francisco Saúte, recordó que la confianza y el compromiso de los socios internacionales han sido fundamentales para asegurar la continuidad y el desarrollo de la institución, incluso en contextos especialmente complejos.

Desde la Fundación “la Caixa”, Josep Maria Coronas Guinart reafirmó el compromiso de la institución con modelos de financiación sostenibles orientados a maximizar el impacto social y científico de la investigación.

Las tres instituciones coincidieron en la necesidad de seguir fortaleciendo esta colaboración estratégica a largo plazo, apostando por una investigación de excelencia con impacto directo en la salud de las poblaciones y en el desarrollo de capacidades científicas locales.

The impacts of climate change on health are already measurable and, unless adaptation and mitigation measures are implemented, they will increase in the coming decades. In Europe, between 2022 and 2024, more than 180,000 deaths associated with heat were recorded, confirming that temperature is becoming a key determinant of public health. Although cold currently causes more deaths than heat, global warming will probably reduce this difference or even reverse it, placing thermal exposure (both heat and cold) at the centre of environmental epidemiology.

However, the risk is not uniform. Due to socioeconomic disparities, climate does not affect everyone equally; environmental temperatures have a disproportionate impact on disadvantaged populations. Even in high-income regions, the consequences vary between territories and social groups – factors such as wealth distribution, housing conditions and socioeconomic structure shape vulnerability. This is the first study to evaluate data from both urban and rural areas, thereby representing the whole European population.

“We analysed daily mortality data in 32 European countries, including more than 161 million deaths between 2000 and 2019, recorded within the framework of the project EARLY-ADAPT, funded by the European Research Council (ERC),” explains Blanca Paniello-Castillo, ISGlobal researcher and first author of the study. “The aim of the research was to assess how different socioeconomic indicators modify the relationship between temperature and mortality in the European population.”

Social deprivation, a risk factor for extreme temperatures

Regions with higher levels of social deprivation are consistently more vulnerable to both heat and cold. Factors such as energy poverty, poorer housing conditions, reduced access to healthcare or lower health literacy may all contribute to increased risk.

Indicators such as the Gini index (which measures inequality in wealth distribution within a population), difficulties in keeping the home warm, and material and social deprivation are consistently associated with higher temperature-related mortality.

The study estimates temperature-attributable deaths by comparing two hypothetical scenarios: one in which all regions have the most favourable socioeconomic conditions, and another in which all are at the least favourable extreme. The difference in the number of deaths between the two scenarios exceeds 300,000 in the case of inability to keep the home warm, reaches 180,000 in relation to economic inequality, and is around 160,000 in the case of severe material and social deprivation in Europe.

Economic prosperity protects against cold, but not against heat

Regions with higher GDP per capita and longer life expectancy show lower mortality associated with cold, probably due to better insulated housing, stronger healthcare systems and lower energy poverty.

However, these same regions show higher mortality during heat. This phenomenon may be explained by intense urbanisation: dense cities and concentrated economic activity favour the “urban heat island” effect. In this climatic phenomenon, urbanised areas experience higher temperatures due to heat absorption by asphalt and the lack of vegetation, among other factors.

“Because climate change does not affect all populations equally, our results help assess and strengthen how socioeconomic factors are incorporated into adaptation policies,” explains Joan Ballester, principal investigator of the EARLY-ADAPT project and coordinator of the study. “Similar studies are needed in other regions. Although we know Europe is highly exposed to climate risks, there are still few comparable studies in the Global South,” he concludes.

Reference

Paniello-Castillo B, Chen ZY, Shartova N, Méndez Turrubiates RF, Beltrán N, Peyrusse F, et al. Socioeconomic inequality drivers of vulnerability and burden to heat- and cold-related mortality: a European-wide analysis in 654 contiguous regions. Nat Health. May, 2026. https://doi.org/10.1038/s44360-026-00106-0

The study, led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by ”la Caixa” Foundation, together with FIND (Foundation of Innovative Diagnostics, Switzerland), aimed to assess the integration of new molecular tests into current WHO-recommended diagnostic strategies.

Tuberculosis: a complex diagnosis with high mortality

Tuberculosis remains the leading cause of death among people living with HIV. Diagnosing the disease in this population is particularly challenging: symptoms are often non-specific, the disease may present outside the lungs, and many patients are unable to produce sputum, a key sample for diagnosis. In addition, the bacterial load in respiratory samples from patients with HIV is often low, reducing the likelihood of microbiological confirmation.

In response to these limitations, recent years have seen the development of alternative diagnostic approaches based on non-invasive samples such as urine and stool, with the aim of improving case detection and accelerating treatment initiation.

Intensified TB screening in hospitalised patients with HIV

The EXULTANT trial, funded by the EDCTP, is a multicentre randomised study conducted in 11 hospitals across Tanzania and Mozambique. It included 1,172 adults living with HIV admitted to hospital, regardless of whether they showed symptoms of tuberculosis. The primary objective was to assess the proportion of patients with microbiologically confirmed tuberculosis who were able to start treatment within the first 72 hours after admission. Time to diagnosis and treatment initiation, as well as mortality at eight weeks, were also evaluated.

“Participants were assigned to two groups: the intervention group received expanded screening with Xpert MTB/RIF Ultra molecular tests on sputum, urine and stool samples, along with a urine LF-LAM test,” explains Marta Cossa, researcher at CISM and first author of the study. “The control group followed the standard WHO-recommended protocol, based on symptom assessment and selective use of diagnostic tests.”

More diagnostic testing does not speed up treatment or reduce mortality

The results showed that 16.0% of patients in the expanded screening group started treatment within the first 72 hours, compared with 15.3% in the standard group, with no statistically significant difference. Likewise, no significant differences were observed in eight-week mortality between the intervention group (25.8%) and the control group (28.8%).

Overall, the expanded strategy did not increase the number of confirmed diagnoses nor shorten the time to treatment initiation. Although molecular testing of urine and stool samples identified some additional TB cases, the urine LF-LAM test detected the highest number. However, this improved diagnostic yield did not translate into earlier treatment or reduced eight-week mortality, raising questions about the test’s clinical impact and highlighting the need for further evaluation of its accuracy.

“Approximately half of the patients were able to provide sputum samples, which reinforces the role of urine and stool as alternative diagnostic samples,” explains Alberto García-Basteiro, ISGlobal researcher, consultant physician in the Preventive Medicine and Epidemiology Department at Hospital Clínic de Barcelona and principal investigator of the EXULTANT trial. “Future studies should focus on optimising diagnostic algorithms and improving the implementation of available tests in hospitalised people living with HIV,” he concludes.

Referència

Cossa, M., Ndege, R., Meggi, B., Mangu, C., Leukes, V., Sabi, I., Khosa, C., Kivuma, B., Nguenha, D., Riess, F., Fernández-Escobar, C., de la Torre-Perez, L., Manjate, P., Weisser, M., Machiana, A., Zachariah, C., Tagliani, E., Ehrlich, J., Buech, J., … Garcia-Basteiro, A. L. (2026). Expanding Xpert MTB/RIF Ultra and lateral flow urine lipoarabinomannan testing for diagnosis of tuberculosis among adults living with HIV admitted to hospitals in Tanzania and Mozambique (EXULTANT): A randomised controlled trial. The Lancet Infectious Diseases, 26 https://doi.org/10.1016/S1473-3099(26)00133-7

During pregnancy, the fetus may be exposed to invisible chemicals present in everyday products, some of which can interfere with development even before birth.

The endocrine system is a chemical messaging network in the body made up of glands, hormones, and receptors that regulate essential functions such as metabolism, sleep, growth, and reproduction.

During pregnancy, this system plays a particularly critical role. It is one of the most sensitive stages of human life, during which essential biological processes for adult life are “programmed.” The placenta itself acts as an endocrine organ, coordinating hormonal signals between mother and fetus to ensure proper fetal development, maintain a healthy pregnancy, and prepare the body for birth and breastfeeding.

In this context, environmental exposures may interfere with the developing endocrine system and disrupt this delicate biological balance.

What are endocrine disruptors?

Endocrine-disrupting chemicals are substances capable of interfering with the normal functions of the hormone system. They may imitate, block, or alter the signal of certain hormones in the body. Endocrine-disrupting chemicals are found almost everywhere in everyday products, including plastics, food packaging, cosmetics, and cleaning products. Unfortunately, the science is increasingly clear that pregnant persons and their babies are exposed to these chemicals and that their effects can last far beyond the delivery room

Why pregnancy is a particularly vulnerable period

Pregnancy is one of the most hormonally sensitive periods in human life, thus it is also one of the most vulnerable. Endocrine-disrupting chemicals have been detected in the placenta, cord blood, and amniotic fluid, showing that they can directly reach the developing fetus. After pregnancy, they can also appear in breast milk. Research has linked prenatal endocrine-disrupting chemicals exposure to a range of health effects in newborns and children such as decreased birth weight, altered growth trajectories, poorer lung function, metabolic syndrome, and even differences in brain development.

Plastics as a major source of chemical exposure

Plastics are one of the most significant sources of endocrine-disrupting chemical exposure in daily life, and they are almost everywhere during pregnancy: food containers, water bottles, the lining of canned foods, and in personal care products that we apply to our skin. Bisphenols, like BPA and BPS, phthalates, and PFAS ("forever chemicals") are among the most studied plastic chemicals known to have endocrine disrupting effects. Heating or blending food in plastic containers accelerates the migration of these substances into food and is associated with higher levels of these chemicals in the body, as well as increased consumption of fast food or prepared food.

The “mixture effect”: understanding real-world exposure

What makes this especially complex is what scientists call ‘the mixture effect’. In real life, we are never exposed to just one endocrine-disrupting chemicals at a time, but rather, we are exposed to dozens or more simultaneously, each arriving from a different source. These chemicals enter our body via inhalation of the air, orally through consumption of food and water, and by dermal absorption when we apply products or wear synthetic fibers. Researchers have specifically studied how multiple combinations of endocrine-disrupting chemicals affect children's health, offering a more realistic picture of actual human exposure. One such analysis found that a mixture of persistent organic pollutants was associated with a greater risk of accelerated BMI gain in children. This is an important finding because rapid increase in BMI is linked to obesity, cardiovascular disease, and diabetes later in adulthood.

What is science doing to understand these risks?

Two major European-funded research projects taking place at ISGlobal and other research institutions across Europe are working to fill critical knowledge gaps:

• ATHLETE — Advancing Tools for Human Early Lifecourse Exposome Research and Translation — aims to better understand and prevent health damage from numerous environmental hazards and their mixtures, starting from the earliest stages of life during pregnancy. The project is building on data from existing exposome cohorts that cover the first 18 years of life. 
• AURORA is the Actionable European Roadmap for Early-life Health Risk Assessment of Micro- and nanoplastics. Its focus is specifically on microplastic and nanoplastic particles in the placenta, an issue of increasing concern given the ubiquity of plastics in the environment. The project investigates plastic exposures and health effects during pregnancy, in utero, and in early life and establishes a framework for plastics research in the future. Researchers have already found microplastics in the placenta and umbilical cord, underscoring the urgency of understanding their impact on reproductive health and infancy.

Together, these projects represent a significant European investment in understanding not just individual chemicals, but the full complexity of what we are all exposed to.

How to reduce exposure during pregnancy

Our health is shaped by many factors, and small steps in daily life can genuinely reduce exposure without uprooting your routine. We don’t have to change everything all at once. We can choose wisely when it's time to buy something new, or avoid daily use of products that we know can be harmful. Some practical choices that matter most during pregnancy:

• Avoid heating food in plastic containers; use glass or ceramic instead. Avoid take-away food as much as possible, or bring your own containers
• Choose glass, stainless steel, or ceramic water bottles and cookware
• Use a water filter at home instead of drinking water from plastic bottles
• Opt for fragrance-free personal care products and check labels for parabens, phthalates, and triclosan, or reduce daily use as much as possible
• Limit processed and canned foods; choose fresh, organic, and locally grown produce whenever possible.
• Ventilate your home regularly (2x per day) and clean dust thoroughly using a wet, cotton cloth as many EDCs and microplastics accumulate in indoor dust
• Choose natural fabrics when possible (cotton, linen, wool) and avoid polyester

Beyond individual choices: a collective approach

Beyond individual choices, systemic change requires collective action. Supporting stricter endocrine-disrupting chemicals regulation and choosing brands with transparent ingredient policies are all ways of supporting systemic change. How we care for pregnant persons and our children contributes to the future of everyone. Extending that care to the everyday choices we make from what we choose to put on our skin, where we source our food, or the products we purchase all matters more than we might think for our daily well being and for future generations. Reducing exposure during pregnancy is not about perfection — it’s about bringing more awareness to our daily habits and protecting the earliest stages of life.

DNA methylation involves the addition of small chemical markers (methyl groups) to DNA, which can switch genes on or off. It is part of epigenetics, a set of mechanisms that regulate gene activity without altering the DNA sequence. In the placenta, DNA methylation provides an indication of how gene activity is regulated in this organ, which is essential for fetal development.

“Later meal timing and lower meal frequency have been linked to factors such as gestational weight gain and gestational diabetes,” explains Joana Llauradó Pont, predoctoral researcher at ISGlobal and first author of the study. To explore its effects on placental epigenetics, the team conducted an epigenome-wide association study (EWAS) involving 389 women from the Barcelona Life Study (BiSC) cohort. Information on diet and chrononutrition habits was collected at week 20 of pregnancy, and placental tissue samples were obtained after delivery to analyse DNA methylation using “Illumina EPIC” technology.

“We focused on five key aspects,” adds Llauradó Pont, “the timing of the first and last meals, the duration of the overnight fast, the number of meals, and variability in meal timing.”

Dinner timing: a habit linked to epigenetic changes

The study identified changes in placental DNA methylation (hypo- or hypermethylation) mainly associated with the timing of the last meal of the day. Although this initial research did not establish an optimal dinner time, it did find that variations in this timing were linked to changes in the regulation of several genes, some involved in pregnancy-related biological processes. For instance, one plays a role in cholesterol metabolism, which is crucial for fetal development. Others are involved in the formation of blood vessels, the regulation of cell growth, and the DNA damage response. Signals were also observed in genes related to programmed cell death and the immune system.

“The timing of the last meal may act as a relevant time cue for the maternal body and, through epigenetic mechanisms, influence biological processes during pregnancy,” explains Camille Lassale, the study’s coordinator. “While a causal relationship cannot be established, these findings suggest that when food is consumed may modulate placental function and potentially have implications for fetal development.”

This study represents an initial step towards understanding how meal timing may influence placental function and opens the door to future research to clarify the specific role of eating schedules, why dinner stands out compared to other dietary habits, and which time windows may be associated with greater benefits during pregnancy.

Circadian rhythms and chrononutrition

Circadian rhythms are biological cycles of around 24 hours that regulate physiological and behavioural functions. They are controlled by internal “clocks”, such as the suprachiasmatic nucleus in the hypothalamus, which responds to light and darkness. There are also clocks in organs such as the liver and muscles, which are sensitive to signals like food intake. For this reason, meal timing influences the circadian system, and irregular eating patterns can affect health. Chrononutrition examines the relationship between diet, circadian rhythms, and health.

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The evidence is getting sharper, but our attention is drifting. The 2026 Lancet Countdown Europe Report arrives at a critical crossroads: climate impacts are hitting health systems harder than ever, yet political urgency is stalling.

For the EU, and specifically for Spain, the "health window" is narrowing. Here is what the data tells us about our path forward.

1) Heat is no longer seasonal - it’s structural;

Rising heat‑attributable mortality and the surge in extreme heat warnings are more than simple alarming statistics. Heat is already an environmental hazard for our health. It changes who can work safely outdoors, when and how people move, sleep, learn, and exercise, and how health systems plan capacity and response across the region.

Heat needs to go beyond the seasonal planning. It needs to be treated as a cross‑cutting determinant of health

Heat needs to go beyond the seasonal planning. It needs to be treated as a cross‑cutting determinant of health, embedded into urban planning, labour regulation, housing standards, and health system resilience. As such, when we work on climate adaptation and resilience, we need to incorporate health at the center of such policies, as already requested by numerous civil society organisations.

The practical question for Spain is whether heat-health plans are supported with resources and financing to the level that matches the risk, and whether they reach the people least able to self‑protect

In Spain, this is even more immediate. Spain already experiences some of Europe’s most severe heat extremes, and the exposure concentrates in vulnerable groups: older adults, infants, workers exposed to outdoor heat, and households in poor-quality housing. The practical question for Spain is whether heat-health plans are supported with resources and financing to the level that matches the risk, and whether they reach the people least able to self‑protect.

In practice this means:

• Heat-health plans that are operational, local, and evaluated, not just published.
• Enforceable occupational heat protection, e.g. schedule shifts, hydration, and appropriate shade (also for informal and seasonal workers)
• Health-protective infrastructure (housing, shading, ventilation, cooling)

2) Europe is paying twice for fossil dependence

One of the most policy-relevant findings in the report is that Europe’s fossil fuel exposure is not only a climate problem; it is also an economic fragility point that shows up in household bills, government budgets, and health outcomes. The spike in subsidies during recent energy price shocks illustrates the trap we are in: when energy systems are dependent on volatile fossil markets, governments end up spending public money to buffer citizens from those markets. That is politically understandable in the short term, but it also delays the structural fix.

One of the most policy-relevant findings in the report is that Europe’s fossil fuel exposure is not only a climate problem; it is also an economic fragility point that shows up in household bills, government budgets, and health outcomes

The report’s new indicator on solid biomass adds onto this point. Treating high‑pollution household fuels as “renewable” in practice can shift emissions categories without delivering the health benefits that we expect from clean energy. That shows up in residential air pollution and avoidable mortality, reminding us that inequalities shape this difference, making it a priority to governments to transition to cleaner energy sources in the residential sector.

At the national and the EU level, energy security, affordability, and health are now inseparable policy objectives. If subsidy regimes are needed, they should be designed to accelerate the energy transition, with investment in efficiency, heat pumps, grid upgrades, rather than locking into fossil fuels’ consumption.

If subsidy regimes are needed, they should be designed to accelerate the energy transition, with investment in efficiency, heat pumps, grid upgrades, rather than locking into fossil fuels’ consumption

Certainly Spain has had a lesser impact of ongoing conflicts that have driven energy prices up, due to the large investment in renewables earlier in the century. Fossil fuel reliance contributes to this fluctuation, and accelerating transition to clean and sustainable energy can counter this and avoid overburdening citizens and governments’ pockets alike. 

3) Attention is declining while risks are rising 

The report’s observation that climate-health engagement is stalling in key political spaces and public opinion matters because attention is an upstream determinant of action. When the health case is not consistently made, climate policy becomes easier to frame as a cost rather than a protection strategy. That framing tends to weaken ambition precisely when the benefits of action, such as cleaner air, fewer heat deaths, and lower inequalities, are most tangible.

When the health case is not consistently made, climate policy becomes easier to frame as a cost rather than a protection strategy

At EU level, climate and health must move beyond episodic messaging into institutional anchoring, through health impact assessments embedded in climate, energy, transport, and fiscal policy, tighter integration between public health and climate governance, and health metrics tracked alongside emissions in mainstream policy review cycles. As mentioned before, frameworks on climate adaptation and resilience must place the health and well-being of their populations at the centre of such policies.

Bringing health co-benefits into climate policies must also be applied at national and local levels. That is a narrative that can be adopted in municipal governments when designing cooler neighbourhoods; regional health services planning for heat seasons; and national economic policy prioritising resilience and clean energy investments, and decreasing funding for fossil fuel subsidies.

4) Europe has the evidence - now it needs the attention

The Lancet Countdown’s value is that it makes the links visible: between temperature and mortality, between energy and public budgets, between policy priorities and preventable health impacts. The strategic choice for Europe is whether to keep treating these as parallel problems or to act on them as one integrated agenda that keeps impacting one another. Spain, given its exposure to heat and its capacity for renewables-led transition, has both a strong incentive and a credible platform to lead on that integration.

Reading Time: 4 minutes.

Imagine Spencer Silver, a chemist in the 3M company laboratory in Minnesota, back in 1968. He has a special assignment: to find the strongest and most resistant adhesive possible for the aerospace industry. However, during one of the tests, he finds quite the opposite: a glue made of acrylic microspheres that peels off very easily. A setback? Well, a scientist is used to failure.

Let's fast forward a few years. 1974. Now you see Art Fry, another researcher who sings in his church choir once a week. What annoys him most is that every time he leaves small pieces of paper to mark the song pages, they disappear by the following week, and he has to start searching for every page all over again. Art Fry also works at 3M and has attended several of Spencer Silver's seminars where he uses that "useless" adhesive, but Fry finds it perfect for sticking small notes.

Art Fry believes they will work as bookmarks for his hymnal. He tries it out and sees they can be removed without tearing the pages. He meets with Silver and they brainstorm. They have something small yet big at the same time. The Post-it was born—that sticky note that has helped us so many times not to forget important tasks.

New solutions to old problems

From that Post-it idea, the ISGlobal Note-olvides initiative was also born now, in 2026, to raise awareness and funds for scientific research seeking answers to malaria and neglected diseases, as they are often called, even though they affect more than a billion people, especially in developing countries.

Fry says that research consists of finding new solutions to old problems. That’s what Hernando del Portillo must have thought, leading the malaria and neglected parasitic diseases program in the midst of a global funding crisis for medical research on these ailments.

Fry says that research consists of finding new solutions to old problems. That’s what Hernando del Portillo must have thought, leading the malaria and neglected parasitic diseases program in the midst of a global funding crisis for medical research on these ailments. “What can we do?” he asked. Immediately, Rafa Vilsanjuán and the entire ISGlobal team bet on an awareness and fundraising initiative that would reach the public.

I have been fortunate enough to collaborate on the creation of this campaign with Jorge Martínez, a highly experienced creative, who connected the concept of forgetting with humor, which is so closely linked to science. Without humor, it would be impossible to deal with failure.

But don't forget about...

Jorge remembered a phrase by the unforgettable Antonio Fraguas (Forges) that was a recurring theme in some of his cartoons: “But don’t forget about…” The first one was after the earthquake in Haiti (“But don’t forget about Haiti”) and he later used it for many other neglected causes.

And here comes the wonderful coincidence that happens when things get moving. Berta Fraguas, Forges' daughter, is a friend of Irene Losada, a doctor and researcher at ISGlobal specializing in Chagas disease, and the current director Quique Bassat. In fact, Forges drew a cartoon for Bassat’s medical school promotion. Thanks to the Forges family, we have a cover cartoon for the project.

From then on, we contacted dozens of graphic humorists from Latin America, Spain, and the United States who collaborated without hesitation. From Peridis to Nani, from Julio Rey to Eneko, among many others, each sent a drawing related to neglected diseases painted on a Post-it. We even discovered an illustrator working at ISGlobal, Alba García. All of this is collected in a wonderful little book published by the Lunwerg label (Planeta Group), available in both print and online formats. The book features short texts by scientists like María Elena Bottazzi or the director of Gavi, Sania Nishtar, and storytellers like Cuban author Leonardo Padura or the comedian and trained doctor Gran Wyoming. After a presentation at Casa del Libro in Madrid, it will continue to be presented at various fairs and events across Spain. You can buy the book in print or online. You can also contribute to this initiative to raise funds for research into malaria and neglected diseases by making a donation via Bizum to 02948.

When it matters, stick with it

By the way, you are also in time to bid online for some of the original cartoons remaining in an online auction. The proceeds will go to the research projects carried out by ISGlobal.

And I don't want to forget (I have it written down on a Post-it) to tell you something beautiful that happened to us. During the campaign's development, we managed to contact Art Fry. He is still in Minneapolis at 95 years old. He had the wonderful gesture of sending us a Post-it, not with a drawing, but with this phrase: “When it matters, stick with it”

RTS,S/AS01 is the first malaria vaccine recommended by the World Health Organization; R21/Matrix-M, based on the same antigen, was subsequently developed. Both target the CSP protein, which is present on the surface of the parasite. They have already been implemented in the vaccination programmes of many African countries, as they help prevent severe malaria cases and reduce mortality. Specifically, they are administered from five months of age in areas of sub-Saharan Africa with moderate to high transmission of Plasmodium falciparum, the most prevalent malaria parasite species on the continent.

By including fragments of the CSP protein, these vaccines induce the production of specific antibodies or immunoglobulin G (IgG), which “train” the immune system to recognise and neutralise the parasite upon subsequent exposure. Until now, protection conferred by the RTS,S vaccine has been mainly attributed to the IgG response against a specific region –epitope– of the CSP protein: the immunodominant NANP repeats, a repeating amino acid sequence (Asparagine-Alanine-Asparagine-Proline). They are immunodominant because they are the immune system’s “preferred” targets; being the most accessible and exposed, they are easily recognised by B lymphocytes, which are key for antibody production. In contrast, the C-terminal region of the protein has been less explored. This region is recognised by T lymphocytes, which contribute to the activation of B lymphocytes.

The RTS,S vaccine: a major advance, but with moderate efficacy

Although the RTS,S vaccine has represented a major milestone in malaria prevention, its efficacy is moderate and tends to wane over time. The administration of a booster dose has been shown to improve protection, but only partially, highlighting the need to further optimise the durability of immunity.

“As an ancillary study to the phase III trial of the RTS,S vaccine, we included 1,292 children from six African regions where malaria is endemic, although transmission intensity varies across countries and regions,” explains Maria Lara-Escandell, co-author of the study and ISGlobal researcher. “Unlike other studies focused on peak responses to NANP repeats, we assessed IgG levels against both NANP and Cterm, as well as against the full CSP protein, and analysed whether both the magnitude and persistence of this immune response were associated with protection against malaria.”

Focusing on a more overlooked region of the CSP protein

The study showed that the booster dose preferentially enhances Cterm-specific IgG and only modestly increases those targeting NANP. In addition, IgG against Cterm showed greater durability both after primary vaccination and following the booster dose. The persistence of these antibodies —rather than the maximum titre reached at peak response— was associated with greater protection against malaria. “Our results show that antibody durability is a stronger correlate of protection than peak magnitude,” explains Lina Sánchez, co-author of the study and ISGlobal researcher. “Furthermore, Cterm-specific IgG may be independently associated with NANP IgG with a lower risk of malaria after primary vaccination.”

The priority: sustained immunity

These findings highlight the importance of assessing antibodies against different epitopes and, in particular, their persistence over time.

“By demonstrating the preferential boosting and greater persistence of responses against Cterm, this study refines current correlates of protection and provides practical guidance for the design of CSP-based vaccines,” concludes Carlota Dobaño, head of the Malaria Immunology Group at ISGlobal and co-coordinator of the study. “These strategies should prioritise broader and more sustained humoral immunity, rather than high but transient peak responses,” adds Gemma Moncunill, also head of the Malaria Immunology Group at ISGlobal and co-coordinator of the study.

Reference

Lara-Escandell M, Sánchez L, Macià D, et al. Duration and association with protection of NANP-repeat-specific and C-terminus-specific anti-circumsporozoite protein IgG responses following RTS,S/AS01E vaccination: an observational ancillary immunological study of a phase 3 clinical trial. Lancet Infect Dis. 2026; published online April 21. https://doi.org/10.1016/S1473-3099(26)00081-2

The aim of this contest is to collect and showcase photographs that highlight the causes and effects of climate change in Barcelona and the Sahel, one of the regions of the Global South most affected by its consequences.

The photographs may depict the impact of climate change, extreme or unusual weather events (such as extreme droughts, heatwaves, and floods), the interaction between climate change and nature, or the role of humanity in relation to the climate, including migration, both in the city of Barcelona and its surroundings and in the Sahel.

No professional photography experience is required to participate. The submission deadline is 31 May.

Prizes

• Winning photograph in the category "Effects of climate change in Barcelona": fair trade product voucher worth €200
• Winning photograph in the category "Effects of climate change in the Sahel": fair trade product voucher worth €200
• Winning photograph in the "Popular vote" category: fair trade product voucher worth €100

More information

The awards ceremony will take place during the final event of the project, in November, at the Barcelona Biomedical Research Park (PRBB).

• Project website
• Competition rules

The study was led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, in collaboration with the University of Exeter and the University of Bristol and published in Clinical Epigenetics. The team found blood biomarkers associated with immunity and developmental processes in children who had been exclusively breastfed for at least three months. These markers were not present in babies who were not breastfed. However, the study did not look at whether the children had any difference in their immunity or development as a result of carrying these biomarkers.

Study co-lead Dr Doretta Caramaschi, of the University of Exeter, said: “Our findings show that babies who are exclusively breastfed carry markers in the blood related to that experience. The genes that produce these markers are related to developmental and immunity processes, but we can’t say from our study whether this affects those highly complex processes directly. “

Other research has shown separately that breastfeeding is associated with short- and long-term beneficial effects on child health.

Dr Mariona Bustamante, researcher at ISGlobal, added: “Our results are new and interesting, but we do need to interpret them with some caution. Our study is designed to be collaborative and international, however, we need to study more diverse groups to fully understand this biology.”

The research was conducted via the Pregnancy and Childhood Epigenetics (PACE) Consortium, made of 11 studies internationally, in countries including Spain, the Netherlands, Finland, France, Greece, Lithuania, Germany, South Africa and US, including a cohort of mixed ethnicity. In the UK, the study involved the Bristol-based Children of the 90s study, the Born in Bradford study and the Isle of Wight Birth Cohort Study. The analysis incorporated blood sample data from 3,421 children across these studies, aged 5 to 12 years when samples were taken.

Researchers looked at whether they were breastfed and for how long, and whether they were exclusively breastfed, and for how long. Information on breastfeeding was collected through questionnaires from birth. Blood samples were taken when the children were aged between five and 12 years old. They then measured epigenetic blood biomarkers and tested whether there was any difference related to the experience of being breastfed.

Published in Clinical Epigenetics with funding form multiple sources including the Medical Research Council, Wellcome, and Horizon 2020.

Reference
Caramaschi, D., Fernández-Barrés, S., Casey, E., Cruells, A., Czamara, D., Sharkawy, M. E., Elliott, H. R., Fore, R., Gairola, R., Gruzieva, O., Huels, A., Lahti, J., Lee, H., Magnano San Lio, R., Malmberg, A., Mansell, T., Merid, S. K., Novakovic, B., Ott, R., … Bustamante, M. (2026). Breastfeeding association with DNA methylation in the pregnancy and childhood epigenetics (PACE) consortium. Clinical Epigenetics. https://doi.org/10.1186/s13148-025-02042-4

The online training was also offered free of charge thanks to the institution’s Severo Ochoa programme, thereby reinforcing its commitment to equitable access to knowledge and its focus on lifelong learning, particularly for participants from lower-resource settings.

Innovation in content and participatory methodology

The programme in this latest edition consisted of six modules, three of them new to address emerging challenges: evaluation of research impact on society, intersectionality and gender for equity in health research, and point-of-care diagnostic testing.

These were complemented by well-established modules on health impact assessment, climate change and occupational health research methods, and health system resilience in the face of crises.

All modules featured a high level of participatory activities, promoting direct interaction between participants and faculty to apply knowledge to real-world problem-solving and connect research, public policy and practice. This approach fosters not only knowledge acquisition but also critical thinking, peer learning and the development of professional networks across regions and disciplines.

Spaces for debate on AI and health policy

In addition, open sessions on key topics were organised, including a roundtable on the impact of cuts to international aid, moderated by ISGlobal Director Quique Bassat; a practical workshop on the use of artificial intelligence in research; and a keynote lecture by Anna Roca, ICREA Research Professor at ISGlobal, on how epidemiological evidence shapes global policy priorities.

In the response to Chagas disease, women play a role that goes far beyond being mere recipients of interventions. Their active involvement in family and community care dynamics, as well as their closer contact with health services—particularly during pregnancy—places them at the centre of strategies for early detection, prevention and care. This year’s World Chagas Disease Day recognises and highlights this central role.

And it does so at a time when decisive action is more necessary than ever. Chagas disease, transmitted by kissing bugs, but also through oral, transfusional and congenital routes, affects people throughout their lives. From an often asymptomatic acute phase to chronic cardiac and digestive complications that may appear decades later. In the 21 endemic countries of mainland Latin America, 7.5 million people live with the infection and a further 100 million are at risk of contracting it, while each year around 30,000 new cases and approximately 10,000 related deaths are recorded.

This disease burden translates annually into an estimated healthcare cost of 500 million US dollars and the loss of approximately 770,000 disability-adjusted life years, whether due to premature death or lost productive years.

While significant progress has been made compared to previous decades, these figures also highlight the need to intensify efforts to achieve the regional elimination target.

Without altering the long-standing link between infection and populations living in conditions of poverty and vulnerability, migratory movements have increased the relative importance of non-vector transmission routes, such as mother-to-child transmission, allowing the disease to spread beyond the boundaries of its vectorial transmission area, breaking unprecedentedly the endemic barrier.

In this context, mother-to-child transmission represents a growing challenge, as between 2% and 8% of pregnant women transmit the parasite to their babies, resulting in 9,000 new cases annually through this route. 

The central role of women in the fight against Chagas must not, and should not, translate into an additional burden or an exclusive responsibility placed upon them. On the contrary, it represents a strategic opportunity to strengthen more equitable, accessible and responsive health systems that recognise and respect women’s needs, decisions, and sexual and reproductive rights.

The challenge is clear: to ensure that all women of childbearing age fully exercise their right to timely diagnosis, appropriate treatment and high-quality information. This requires sustained public policies, the full integration of screening into maternal and child health programmes, and the strengthening of primary health care, ensuring services that are accessible, timely and free from discrimination.

In this context, the Pan American Health Organization, Member States and the organisations of the Global Chagas Coalition, together with a valuable group of strategic partners, are working in coordination to raise awareness across society as a whole in order to promote a collective and intersectoral response, guided by the principle of leaving no one behind. Only through shared commitment and coordinated action will it be possible to make sustained progress towards eliminating Chagas as a public health problem.

Reading time: 5 minutes.

[This excerpt is from the book “Graphic Humour Against Forgetting” (Lunwerg Editores, Grupo Planeta), which features the illustrations created for the Note-olvides campaign. Leonardo Padura and El Gran Wyoming wrote the foreword and epilogue respectively.]

The word “Chagas” was first a night and a child. A night in 2005, in Managua, Nicaragua. A 9-year-old child in his mother's arms.

His mother lays him in a casket and places beside him, one by one, the toys he had kept since he was little: stuffed animals, a small baseball, and something I cannot identify. Belongings of his history, companions for the passage, with which the pharaohs' children were also buried. His mother is a doctor and a friend. Her son had undergone emergency surgery for appendicitis, but his heart could not take it. They said he had a previous condition that went undetected. Another doctor said: “It is possible he had Chagas.” 30% of those who contract it can develop severe heart problems, among other pathologies. Occasionally, it can cause sudden death.

I have never seen a pain more silent, more invisible, than that of a mother laying toys beside her child's body

The boy used to spend weekends at a small family farm in an endemic area, inhabited by kissing bugs, the vector (triatomine) that transmits the parasite. Since that night, I tell myself that I have never seen a pain more silent, more invisible, than that of a mother laying toys beside her child's body. And I relive it in every image of war, natural disaster, or any other tragedy.

Two words that weigh like stones

Since its discovery by the Brazilian doctor who gave it its name, more than a hundred years ago, Chagas has been described in two words that weigh like stones: invisible-silent. Because its symptoms often go unnoticed until it is too late. A treacherous disease. And somewhat strange. Many other people live with the infection and are never affected. It is as if it chose its victims by some unknown chance. The insect, which inhabits rural and urban areas in 21 Latin American countries and the southern United States, usually bites at night; it defecates over the bite, introducing the infection into the body, especially if the person accidentally scratches it. Other times it infects food and drinks, as happens in some Amazonian regions.

Its symptoms often go unnoticed until it is too late. A treacherous disease. And somewhat strange. Many other people live with the infection and are never affected

In Europe, there are tens of thousands of people living with Chagas, with Spain leading the way due to migratory movements. But beyond insect transmission, it can also be contracted congenitally, through laboratory accidents, blood transfusions, or organ transplants that have not been screened.

Fortunately, there are treatments and diagnostics. They are not perfect, but they work, especially at early ages and when the infection is detected in time. However, most do not receive them.

"This girl is not going to die of Chagas on my watch"

When I started working at Doctors Without Borders (MSF), I learned more about this disease, which is the metaphor for neglect and loneliness in Latin America. And later, for me, Chagas became a woman. Another woman and mother.

I met her in Mexico, seven years ago. Her name is Elvira. Her daughter, the only girl of three siblings, was diagnosed with Chagas at eighteen, just as she was deciding what to study. The doctors who treated her lacked knowledge about the disease and told her not to make many plans for the future. The young woman did not back down and trusted her mother. So Elvira moved heaven and earth; she searched the internet until she contacted an Argentine doctor who guided her through the process. “This girl is not going to die of Chagas on my watch,” she promised herself. Today, Yaya, her daughter, is a lawyer in her thirties, healthy and infection-free after completing her treatment.

The young woman did not back down and trusted her mother. Today she is a lawyer in her thirties, healthy and infection-free after completing her treatment

I am not a doctor or a scientist, but an intruder in global health coming from communication and philology—from the world of words. But I have worked to translate the complicated words of science into a closer language. It is like searching for hidden words. For this, I have also collaborated with the Global Chagas Coalition, alongside ISGlobal. And that is why, for me, Chagas now also means “the second chance.” After more than a hundred years of patients, researchers, and clinicians fighting the disease, we know that it can be eliminated as a public health problem. And that allows us to dream of the magic of scientific work. An hypothesis is, after all, the formulation of a hope.

García Márquez, in his Nobel Prize for Literature speech, claimed the right to believe “that it is not yet too late to engage in the creation of a new utopia of life, where no one can decide for others even how they die, and where the races condemned to one hundred years of solitude have, at last and forever, a second chance on earth.”

I believe in that. And when I don’t, I read it again, to remember what is kept there, hidden, without being caught by silence or oblivion.

The agreement establishes a framework for cooperation aimed at developing joint research lines and projects in areas of shared interest, such as biomedicine and health. This includes the exchange of scientific and technological knowledge, mutual advisory activities, the creation of working groups and the preparation of specialised reports, among other initiatives.

A partnership to address global health challenges

“This collaboration strengthens the capacity of both institutions to generate excellent research with impact on global health,” said ISGlobal Director Quique Bassat. “Working together with CSIC is essential to advance the translation of scientific knowledge into solutions that address current health challenges. It is not only about sharing resources, but about building a knowledge ecosystem.”

For CSIC President Eloísa del Pino, “this agreement reflects the institution’s commitment to more collaborative, interdisciplinary health research aimed at addressing major global challenges.” She highlighted that “the partnership with ISGlobal allows us to combine capacities and accelerate the generation of knowledge with societal impact.”

R&D, knowledge translation and societal impact

Both institutions are committed to organising joint activities to promote the social impact of research, such as seminars, specialised workshops and scientific meetings; to advancing R&D studies and programmes in shared areas; and to fostering the training of researchers, contributing to a more connected and multidisciplinary research community.

CSIC is promoting this agreement through its Interdisciplinary Thematic Platform (PTI+) Global Health, which brings together nearly 170 research groups from 66 CSIC centres. This initiative promotes multidisciplinary approaches and the use of innovative technologies to advance prevention, detection and response to global health threats.

Malaria caused by Plasmodium falciparum typically triggers a pro-inflammatory immune response essential for parasite clearance, whereas helminth infections induce a predominantly anti-inflammatory response. This difference has long raised questions about how coinfections might influence disease outcomes. To address this, a team led by ISGlobal researchers Carlota Dobaño and Gemma Moncunill analysed 441 children aged 2–10 years with malaria symptoms attending hospitals in Manhiça, Mozambique. The researchers assessed malaria and helminth infections using molecular and rapid diagnostic tools, and measured a broad range of immune markers, including 30 cytokines and multiple antibody types. The study forms part of the PhD thesis of Inocência Cuamba and is the result of years of collaboration with ISGlobal’s Neglected Tropical Diseases group, led by Jose Muñoz.

“Our study goes beyond the state of the art by simultaneously measuring different immune mediators and integrating them with clinical and parasitological outcomes to provide deeper insights into the effect of concurrent STH infection on malaria disease and immunity,” says Cuamba.

Fewer parasites, distinct immune responses

Among the 74 children diagnosed with malaria, 16 were coinfected with helminths, most commonly Strongyloides stercoralis. Coinfected children had significantly lower P. falciparum parasite density and lower body temperature. They also had reduced levels of both pro-inflammatory and anti-inflammatory cytokines, suggesting an overall dampened immune activation. At the same time, antibody responses to several malaria antigens were elevated, including IgG1 and IgG3 responses that have previously been associated with protection. However, the antibody responses most strongly increased during coinfection were not always those linked to lower parasite burden, pointing to a complex immune interplay.

Overall, the results suggest that helminth infections may modulate malaria immunity in ways that reduce disease severity. Coinfection was linked to decreased parasitaemia, downregulation of inflammatory cytokines, and enhanced antibody responses, potentially contributing to milder clinical presentations. “Our findings also indicate a potential role for IgE responses in the protection linked to STH infections, although further research is needed to confirm this,” says Moncunill.

Public health implications

These findings have important implications for disease control strategies in regions where malaria and helminths overlap. “Integrated approaches combining deworming with strengthened malaria surveillance or preventive treatment may be needed to avoid a potential rise in severe malaria cases,” says Dobaño. The authors also stress the need for larger and longitudinal studies to better understand how coinfections shape immunity and to inform future public health interventions.

Reference

Cuamba I, Santano R, Grau-Pujol B et al. Helminth coinfections mitigate clinical, parasitological, and immune outcomes in Mozambican children with malaria. BMC Medicine, 2026. doi: 10.1186/s12916-026-04827-7

Reading time: 3 minuts

[This text is a collaboration between Women in Global Health (WGH) Spain and ISGlobal.]

Imagine a woman arriving at the emergency room with fatigue, nausea, and persistent pain in her jaw or back. It hasn't even crossed her mind that it could be a heart attack, because she has always heard that she would feel the classic pain in her chest or left arm. It is very likely that the medical staff won't suspect it at first either. However, she may be suffering from a heart attack.

On the occasion of Public Health Week 2026, we are shining a light on women's cardiovascular health. We cannot continue to ignore the fact that the leading cause of death in women remains under-researched, underdiagnosed, and underestimated.

Cardiovascular diseases are the leading cause of death for women worldwide (responsible for 8.6 million deaths per year), and yet they remain largely "invisible." Modern medicine was built on a male standard model and today, in the heart of 2026, women continue to pay the price of this heritage with their own lives.

The research gap: women absent from the evidence base

For decades, clinical research has been developed under an androcentric bias: men were studied and it was assumed that the results were applicable to the entire population. By not including enough women in clinical trials, much of the evidence used for the diagnosis and treatment of current diseases comes mainly from male populations. This has created a fundamental problem. We are applying medical evidence that does not adequately represent half of the population: women.

For decades, clinical research has been developed under an androcentric bias: men were studied and it was assumed that the results were applicable to the entire population

This historical exclusion has created what we know as the invisible burden of disease. It is not that women do not suffer from cardiovascular diseases; it is that science has not looked at their cardiovascular system through the same lens.

When symptoms deviate from the "classic"

The research gap translates into a dramatic reality in the doctor's office:

• Misleading symptoms: Women often present with cardiovascular symptoms that differ from the “classic” signs described in men. Instead of the characteristic chest pain, a heart attack in women can present as fatigue, nausea, jaw pain, shortness of breath, or back pain.
• Diagnostic errors: Due to these different symptoms, it is estimated that up to 50% of women are misdiagnosed or diagnosed at stages that are far too advanced.
• Misperception: A survey of 8,000 people revealed that only 34% identified cardiovascular disease as the leading cause of death in women. They wrongly believed that breast cancer was more lethal.

This lack of awareness, both in the general population and among healthcare professionals, means that symptoms can be overlooked, prevention strategies delayed, and resources allocated to other health areas considered higher priorities.

Three pillars for change

To close the gender gap and end gender inequality in research, we must transform the structure of global health—the evidence base.

1. Breaking with the standard model: We cannot apply the male model as the “only” or generalized one. We need to apply science using data that is disaggregated by sex in every clinical trial.
2. Funding with a gender perspective: Investment in women's cardiovascular health remains insufficient compared to the actual magnitude of the problem. We need resources specifically dedicated to understanding women's specific risk factors, clinical symptoms, how to diagnose them optimally, and their response to treatments.
3. Female leadership: Although women make up 70% of the healthcare workforce, we only hold 25% of leadership positions. This lack of female representation in senior research positions influences which research questions receive funding, which studies are prioritized, and how evidence is translated into public policy.

A call to action

Closing the gender gap in cardiovascular health is not just a matter of gender equity; it is an urgent public and global health necessity. To overlook the particularities of the female cardiovascular system is to ignore half of the world's population. Only by transforming the way we research, fund, and diagnose will we ensure that the leading cause of female mortality finally ceases to be an invisible burden.

Against this backdrop, the Advocacy team at the Barcelona Institute for Global Health (ISGlobal) launches The Future of Global Health, a bi-monthly newsletter offering analysis and tracking of political processes, a mapping of the global health ecosystem, and a calendar of key events.

The first edition includes two analyses. The first outlines key elements for understanding global health within the current geopolitical debate: the crisis of multilateralism, great power rivalry, health sovereignty in the Global South, and Spain’s emerging leadership. The second examines the challenges and scenarios facing WHO amid the reconfiguration of the global order.

In addition, the newsletter features recommended publications and a curated selection of analyses produced by other organizations. Upcoming editions will cover topics such as gender equality, debt swaps, and other central issues in global health.

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The research, published in BMJ Global Health, analysed data from 1,122 Colombian municipalities between 2008 and 2019. The research team combined information on different types of violence, such as kidnappings, forced displacement, disappearances, or armed attacks, with epidemiological surveillance data and mortality records. Conflict information was obtained from the National Observatory of Historical Memory, while TB morbidity and mortality data came from the National Public Health Surveillance System. Using these indicators, the team developed an index classifying municipalities according to conflict intensity in two periods: 2008–2013 and 2014–2019.

Unequal distribution of tuberculosis burden

The study shows that TB incidence varied according to the level of conflict in each territory. Throughout the analysed period, municipalities with the highest levels of violence recorded the highest TB case rates. Although at the national level TB case notifications decreased by 16% over the study period, the reduction was not uniform, and significant territorial inequalities persisted. Regarding mortality, results indicate that despite a 9% reduction nationwide, municipalities most affected by conflict continued to show the highest TB death rates.

“Our findings show how armed conflicts can indirectly affect health. Displacement and forced migration create living conditions characterised by overcrowding, poor ventilation, and housing instability, which facilitate TB transmission and disease progression. These processes interact with conditions that compromise immune function, such as food insecurity, malnutrition, HIV infection, and other comorbidities, contributing to adverse TB outcomes,” notes Salomé Valencia, predoctoral researcher at ISGlobal and lead author of the study.

Differences between population groups

The research also calculated tuberculosis rates by age and sex, finding significant differences among population groups. Children under one year showed the greatest inequalities: in municipalities with the highest conflict intensity, the likelihood of tuberculosis in this population group was 39 % higher than in those with lower conflict. Women also experienced persistent inequalities in case notifications. 

“Conflicts disproportionately affect women, children, and historically marginalised populations. Among these, indigenous communities face some of the most severe barriers. For example, on Colombia’s Pacific coast, TB case notifications among indigenous groups reached 192.1 per 100,000 inhabitants, mainly related to limited access to healthcare services due to geographic isolation and conflict-related disruptions,” points out Alberto Garcia-Basteiro, research professor at ISGlobal and senior author of the study.

Prevention strategies adapted to each territory

According to the research team, the observed inequalities in TB burden highlight the need to implement control strategies adapted to the characteristics of each territory. In particular, they emphasize the importance of incorporating conflict-sensitive approaches within surveillance, prevention, and healthcare systems to reduce inequities and strengthen public health response.

The research also proposes an analytical framework that can be applied to other conflict contexts to analyze health inequalities. This approach could help develop evidence-based policies to reduce the impact of prolonged conflicts on infectious diseases. 

The study involved researchers in epidemiology and public health, including Carlos Andrés Castañeda, Juan Camilo Gutiérrez, and Karol Cotes, from the National Institute of Health and the National University of Colombia in Bogotá.

Reference

Valencia-Aguirre, S., Castañeda, CA., Gutiérrez, JC., Cotes, K., Garcia-Basteiro, AL., Armed conflict intensity and inequalities in tuberculosis outcomes in Colombian municipalities, 2008–2019. BMJ Global Health, 2025. Doi: 10.1136/bmjgh-2025-019144

[This post was jointly written by Raül Toran and Minerva López, science communicators at the Scientific Culture Unit (UCC+i) of ISGlobal.]

What do a series about a transgender activist, a movie about a wealthy 1950s housewife, and a drama about a police officer in northern India have in common? More than it seems. Cinema and series allow us to see how inequalities intersect in people's lives and condition their opportunities, their well-being, and even their health.

Gender, origin, social class, sexual orientation, or age do not act in isolation: they combine and reinforce each other, leading to very different experiences of vulnerability or privilege

Gender, origin, social class, sexual orientation, or age do not act in isolation: they combine and reinforce each other, leading to very different experiences of vulnerability or privilege. This approach, known as intersectionality, helps us understand precisely how these inequalities cross paths.

In scientific research —and especially in the field of global health— this perspective is fundamental. Ignoring the intersection of social factors can lead to incomplete studies and interventions that do not reach those who need them most. Incorporating it, however, allows us to move towards a more rigorous, inclusive, and equitable science.

From ISGlobal's Scientific Culture and Innovation Unit, and within the framework of the European project INCLUDE, we bring together a selection of films and series that invite reflection on these issues from different perspectives.

1. Hidden Figures

This 2016 film tells the unknown story of three African-American female scientists, Katherine G. Johnson, Dorothy Vaughan, and Mary Jackson, who worked at the NASA space agency in the early sixties on the project to put the first American, John Glenn, into orbit.

Scientific knowledge is not neutral

This serves as an example of how intersectionality allows for a critical rereading of the history of science. It shows how scientific knowledge is produced within institutional contexts shaped by hierarchies of gender and racialization. The systematic exclusion of highly qualified African-American women highlights how structural racism and sexism operate together to invisibilize key scientific contributions. For contemporary research, this work invites us to question the criteria for merit, authorship, and recognition, and to reflect on how current scientific systems continue to reproduce inequalities under seemingly objective logic.

Where to watch: RTVE, YouTube, Google Play, Apple TV, Rakuten TV, and Prime Video.

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2. Rurangi

This production, awarded the International Emmy for Best Series, tells the story of Caz Davis returning to his hometown, Rurangi. It is a conservative New Zealand town with an economy based on dairy farming. Caz wants to reunite with his father, whom he hasn't seen since before his transition.

Identity, territory, and indigenous roots

Recognized in festivals such as San Francisco, Melbourne, and LesGaiCineMad, the series explores the difficulties faced by the LGTBIQA+ community when coming out in rural environments. Furthermore, it focuses on the Māori community, showing the daily challenges they face in achieving respect for their language, traditions, culture, and territory.

Where to watch: Filmin.

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3. Far from Heaven

A 2002 American film set in the 1950s in the United States. It tells the story of a wealthy woman whose seemingly perfect life begins to unravel following a marital crisis.

The silent oppression of social norms

Far from Heaven offers a critical look at how dominant social norms generate inequalities at the intersection of gender, race, class, and sexual orientation. The film demonstrates that oppression is not only manifested through direct exclusion, but also through the imposition of life models considered "acceptable," which cause silencing, suffering, and social vulnerability.

Where to watch: Movistar Plus+.

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4. Moonlight

This film, which won the Oscar for Best Picture in 2017, follows the life of Chiron, a gay African-American young man, from childhood to adulthood. It shows his process of identity construction and his relationships in a complex environment in Miami. The work addresses, among other topics, the intersection between homosexuality, racism, and social discrimination in the United States.

Surviving violence, stigma, and precariousness

Moonlight offers an intimate approach to identity construction at the intersection of racialization, masculinity, social class, and sexual dissidence. The film is especially relevant in demonstrating how structural violence, stigma, and precariousness impact mental and emotional health in a cumulative way. It invites us to think about the social determinants that shape these experiences.

Where to watch: Filmin, Amazon Video, and Apple TV.

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5. Santosh

After her husband's death, Santosh inherits his position as a police officer in a police station in a rural area of India. The station is led by Inspector Sharma. The film was the UK's candidate for the Oscar for Best International Feature Film in 2024.

Gender, caste, and institutional power structures

This work highlights how gender inequalities are reinforced by economic precariousness and deeply rooted hierarchical systems. For scientific research, it is particularly relevant as it shows how institutions —including those responsible for ensuring justice and security— can reproduce violence and exclusion, a key aspect for studies on governance, ethics, and equitable access to rights and services.

Where to watch: Filmin.

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6. Master

A 2022 thriller in which two African-American women, a professor and a freshman student, share strange experiences in a predominantly white university in New England (USA).

The hostility of seemingly neutral spaces

Master exposes in both symbolic and explicit ways the tensions that cross academic spaces when gender and race combine as axes of exclusion. The film questions the supposed neutrality of the university environment and reveals how structural racism and sexism affect the experience of students and researchers. Its contribution to the scientific debate is clear: it invites a critical review of institutional cultures, evaluation mechanisms, and the conditions of knowledge production in contemporary academic contexts.

Where to watch: Amazon Prime.

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7. Norwegian Dream

The story focuses on Robert, a Polish immigrant working in a fish factory in Norway to pay off his mother's debts. Despite the harshness of the work, he discovers he feels an attraction to Ivar, a colleague at the plant. He decides to hide his feelings for fear of rejection from his Polish coworkers. When a strike breaks out, loyalties between employees are tested, revealing aspects such as the power of desire, solidarity, and the hope for a better life.

Sexual identity in migratory contexts

This film articulates migration, the working class, sexual dissidence, and national belonging, showing how labor precariousness and migratory status condition the possibility of living one's identity openly. From an intersectional perspective, the work is especially relevant for research in occupational health, mental health, and social rights, by evidencing how structural determinants influence well-being and the support networks available to migrant populations.

Where to watch: Filmin.

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8. Ciao Bambina

This documentary short film, nominated for the 2025 Goya Awards and co-directed by Afioco Gnecco and Carolina Yuste, follows the gender change of Rafi, who began his transition ten months ago. His testosterone treatment is not being easy as no one told him about the emotional changes this process involved. Together with his friend Carolina, who has accompanied him since the beginning of his transition, he will try to reconcile with his current and former self to finally be able to swim in the sea.

Social determinants and the trans experience

The short film provides a sensitive and rarely represented look at the emotional processes associated with gender transition. By focusing on the subjective experience, it questions reductionist biomedical approaches that address transition exclusively from clinical parameters. From intersectionality, it underscores the importance of integrating psychological, social, and relational dimensions in research and healthcare for trans people, avoiding linear or simplified narratives.

Where to watch: Filmin.

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9. 20,000 Species of Bees (20.000 especies de abejas)

This film, nominated for 15 Goya Awards, was one of the great successes of Spanish cinema in 2024. It reveals the necessary story of Cocó, a trans girl in search of her identity. The protagonist achieved a great milestone by winning the Silver Bear of Berlinale at just 10 years old.

Supportive environments and well-being in trans childhood

The film offers a delicate approach to trans childhood, placing gender identity in relation to family, rural environment, and social expectations. Its relevance to the scientific community lies in how it visibilizes early identity construction processes and the importance of supportive environments. The film invites reflection on childhood, gender, and care, fundamental aspects for research in health, education, and public policy.

Where to watch: Movistar + Plus.

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10. Carmen & Lola (Carmen y Lola)

Carmen and Lola are two young Roma women. Carmen is about to get married. Lola, an independent girl who only wants to study, is pressured by her father to find a good Roma husband. One day, the two girls meet while selling at a street market. In a culture where homosexuality is a taboo and young women are destined to marry and have children, this film delves into the challenges the two young protagonists face in maintaining their relationship. This film won two Goya Awards: Best New Director (Arantxa Echevarria) and Best Supporting Actress (Carolina Yuste).

Sexual diversity in specific cultural contexts

Carmen & Lola allows for an analysis of how sexual dissidence is experienced specifically at the intersection of gender, ethnicity, social class, and cultural tradition. The film challenges homogeneous readings of the LGTBIQA+ community and highlights the need for intersectional approaches that recognize the internal diversity of communities. For research, it underscores the importance of avoiding generalizations and incorporating methodologies sensitive to cultural context.

Where to watch: Movistar + Plus.

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Towards a Science That Sees Us All

This selection demonstrates that the stories we consume are, in reality, mirrors of the structural barriers that science tries to break down. From the INCLUDE project, in which ISGlobal participates, we work to ensure that research leaves no one behind, understanding that to improve global health, we must first understand the complexity of human lives.

Would you add any other movie to this list?