In recent years, the paradigm of health research has undergone an interesting shift, moving from a traditional top-down approach to one that aims to actively engage patients, citizens, and communities as co-creators of knowledge.

This participatory model democratises science and enhances the relevance, impact, and sustainability of health research. However, the transition from aspiration to systemic change presents complex institutional, methodological and practical challenges. This workshop offers a comprehensive journey from theory to practice, structured around broad disciplinary areas rather than siloed methodologies. We will have expert presentations across global health, environmental, clinical, and translational research, as well as interactive World Café sessions, where participants will collectively explore the opportunities, barriers, ethical considerations, and institutional conditions required for meaningful participatory research. The insights generated throughout the day will inform the development of an institutional position paper, outlining shared principles, priorities, and practical recommendations for embedding participatory approaches across the health research ecosystem.

Whether you are a researcher, community advocate, patient, or policy maker, this event provides a unique platform to learn from inspiring practices, share insights and build synergies. We aim to leave participants with the understanding that health research should not only be conducted for society, but also in partnership with it.

Speakers

• Vincent Dumez, Former Co-Director, Centre of Excellence on Partnership with Patients and the Public (CEPPP); and Former Co-Director, Patient Collaboration and Partnership Directorate, Faculty of Medicine, Université de Montréal (Canada)
• Dra. Rosa Arias, Director, Science for Change
• Dr. Danielle Marie Agnello, post-doc researcher, University of Copenhagen
• Professor Sarah Lebeer, ISALA Principal Investigador, University of Antwerp

With the support of the Centre of Excellence Severo Ochoa Programme (CEX 2023-001290-S) funded by MCIN/AEI/ 10.13039/501100011033.

A study led by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the ”la Caixa” Foundation, and the University of Basel proposes a new framework to standardise this process. The method has been developed to be applicable to different types of digital health data and was tested using walking activity and gait data from 2,181 people. The study has been published in npj Digital Medicine. 

Digital devices can record health parameters at a frequency and over periods of time that would have been difficult to achieve only a few years ago. However, having more data does not necessarily mean having better information. To use these data in research or clinical practice, it is necessary to decide which parts are relevant and how they should be summarised. These decisions can influence how the results are subsequently interpreted.

There are currently no internationally accepted guidelines standardising how continuous, high-resolution digital health data should be aggregated, nor is there consensus on the terminology used to describe this process. A previous review cited in the study found, for example, that more than half of the studies using mobile devices that were analysed did not specify which data restrictions they had applied.

A three-step process

To address this problem, the research team used a structured expert consensus process, in which 16 specialists from different disciplines went through several rounds of proposals, assessment and discussion until agreement was reached. The panel included experts in sensor and algorithm development and evaluation, biomechanics, epidemiology, statistics and different clinical fields.

“The framework we propose follows three stages. First, we identify possible ways of summarising the data, taking into account their technical validity, clinical interpretability, sample size and distribution. We then statistically assess how stable the resulting measures are within the same individual and whether they can distinguish between relevant groups - for example between people with and without walking disabilities. Finally, experts compare these results with existing evidence, available international guidelines and practical considerations to select the most appropriate measures,” explains Sarah Koch, first author of the study and a researcher at the University of Basel and ISGlobal.

More than 2,000 people monitored for one week

To test how the framework works, the researchers applied it to data from the European Mobilise-D project. The analysis included 2,181 people, including participants with chronic obstructive pulmonary disease (COPD), multiple sclerosis, Parkinson’s disease, proximal femur fracture and congestive heart failure, as well as healthy controls. Participants wore a sensor for seven days that recorded their mobility in real-world conditions.

The team started with seven measures related to walking activity and gait —including step count, walking speed, stride length, cadence and walking bout duration— and assessed different ways of aggregating them. The process ultimately enabled the selection of 24 mobility indicators, aggregated at daily and weekly levels and related both to the amount and patterns of walking activity and to gait characteristics.

“Even when we applied the method to populations with very different mobility impairments, we obtained clinically interpretable and statistically stable indicators that can be used to compare different individuals or the same individual over time. Moreover, the framework is not designed solely to analyse mobility: its structure can be adapted to other health parameters recorded continuously over extended periods, such as heart rate or temperature,” says Judith Garcia-Aymerich, Deputy Director of ISGlobal and last author of the study.

Reference

Koch S, Buekers J, Alvarez P, Becker C, Bonci T, Carsin AE, Caulfield B, Cobo I, Del Din S, Demeyer H, Frei A, Hausdorff JM, Ionescu A, Aminian K, Klenk J, Lemos-Portela J, Marchena J, Maetzler W, Micó-Amigo E, Piraino P, Singleton D, Sverdlov O, Troosters T, Rochester L, Garcia-Aymerich J. Aggregation framework for continuous digital health measures and application to walking activity data. npj Digit. Med. (2026). https://doi.org/10.1038/s41746-026-03222-z 

During the morning, from 10 am to 2 pm, researchers and other professionals from the PRBB research centres will share their day-to-day work with the public. 

We invite you to have a great time, experience science, enter spaces that are not usually accessible to the public, discover one of the city’s iconic research facilities and talk to the people who work here.

Find out more and reserve your ticket. 

ISGlobal Activities

Green Spaces and Health. Does Urban Planning Affect Our Health?

At this station, we will explore the research we carry out on urban spaces and discover how the environment in which we live can influence our health and well-being.

• Facilitated by: Claudia Sanz and Raül Toran (ISGlobal Scientific Culture Unit)

Photographic Exhibition The Frontiers of the Climate Emergency - Perspectives on Climate Change: Barcelona and the Sahel

Part of the "Climate, Health and Migration" project, promoted by ISGlobal and the Coordinadora d’Associacions Senegaleses de Catalunya. The exhibition can be visited at a self-guided, open and accessible space for everyone.

A neglected disease with limited treatment options

Trypanosoma cruzi infection affects more than seven million people worldwide, mainly in Latin America, and is now also a public health concern in the United States, Europe and Japan. About 30–40% of infected people develop Chagas disease, with serious heart or digestive complications, yet fewer than 1% are diagnosed and treated. The only two drugs, benznidazole and nifurtimox, are given in regimens set more than 50 years ago that frequently cause side effects, and up to 31% of patients stop treatment early.

Six treatment strategies compared over three years

“TESEO is the first randomized clinical trial to evaluate benznidazole and nifurtimox head-to-head under identical conditions, with sustained follow-up to detect parasites in the blood by PCR for three years,” says Igor Almeida (UTEP), co-senior author of the study with Joaquim Gascón (ISGlobal) and Faustino Torrico (CEADES).

The phase 2b trial enrolled 450 adults at three centers in Bolivia and randomly assigned them to six groups: three benznidazole regimens (the 60-day standard, 30 days and 90 days) and three nifurtimox regimens (the 60-day standard, 30 days and 90 days). The researchers recorded drug-related adverse events and tested participants’ blood for parasite DNA by qPCR over three years.

Fewer side effects with 30 days of benznidazole

Only the 30-day benznidazole regimen significantly reduced side effects: 37% of participants had a drug-related adverse event, compared with 60% on the standard regimen, a reduction of nearly 40%. It was also easier to follow, with 83% of patients completing treatment without interruption, compared with 60%. Most side effects appeared within the first two weeks, regardless of treatment length, and almost all resolved.

Without compromising efficacy

Three years after treatment, the parasite remained undetectable in the blood of 94% of participants in the 30-day group, compared with 95% in the standard group, meeting the prespecified criterion for non-inferiority. The 30-day regimen therefore offered the best balance between benefits and harms of the six strategies tested. The nifurtimox regimens were less effective overall (81% to 90%).

“The improved safety profile of the shorter benznidazole regimen, combined with once-daily dosing, has the potential to substantially increase the proportion of patients who complete treatment,” says Gascón. The 30-day course also uses a quarter of the drug: “We can treat four patients with the same amount of drug we previously used for one,” adds Torrico.

Larger phase 3 trials are needed to confirm these results before the 30-day regimen can be incorporated into treatment guidelines. People currently receiving treatment for Chagas disease should continue the regimen prescribed by their doctor.

Reference

Alonso-Vega C, Pinto Rocha JJ, Rojas Delgadillo LG, García Ruiloba W, Palacios López A, Pinto Rocha LV, Méndez Bartolomé S, González VR, Laserna M, Ribeiro I, Pinazo MJ, Thomas MC, López MC, Losada Galván I, Ortiz L, Schijman AG, Urbina JA, Sanz Bravo S, Gascón J, Torrico F, Almeida IC. Efficacy and safety of alternative benznidazole and nifurtimox regimens for adults with chronic Trypanosoma cruzi infection (TESEO): an open-label, randomised, non-inferiority phase 2b trial. Lancet Infect Dis 2026; published online September 22. https://doi.org/10.1016/S1473-3099(26)00436-6.

The study analysed data from 1,409,084 births at term —defined as births occurring between 37 and 40 weeks of gestation— in Spain recorded by the Spanish National Statistics Institute (INE) between 2010 and 2018 and estimated exposure during pregnancy to nitrogen dioxide (NO₂) and fine particulate matter (PM₂.₅). The levels of these pollutants were calculated using models that combined pollution monitoring data with satellite information, meteorological data and characteristics of the surrounding environment. 

Low birth weight was defined as a birth weight below 2,500 grams. Among all the births analysed, 4.6% involved low birth weight. The percentage was higher among babies born to mothers with primary education (5.3%) than among those whose mothers had secondary (4.9%) or tertiary education (4.3%).

Higher risk associated with pollution and lower educational attainment

The results show an association between greater exposure to PM₂.₅ during pregnancy and an increased risk of low birth weight. Specifically, for every increase of 10 micrograms per cubic metre (µg/m³) in PM₂.₅ exposure, the odds of low birth weight increased by 6%. In the case of NO₂, an increase of 10 µg/m³ was associated with a 1% increase in the odds of low birth weight. The associations were more pronounced and precise among babies born to mothers with primary education, with 18.3% and 4.6% higher odds of low birth weight per 10 µg/m³ increase in PM2.5 and NO2, respectively, highlighting differences in vulnerability according to maternal educational attainment. 

Educational attainment showed a stronger association with the outcome. Compared with babies born to mothers with tertiary education, those whose mothers had secondary education had 32% higher odds of low birth weight, while among babies born to mothers with primary education, the odds were 76% higher.

“This greater vulnerability could reflect an accumulation of stressors, including nutritional deficiencies and more limited access to antenatal care, together with poorer maternal health and greater chronic stress, which could limit the ability to cope with the harmful effects of pollution,” says Stefan Sieber, ISGlobal researcher and first author of the study. 

Thousands of potentially preventable cases

The research team used statistical models to estimate how many cases of low birth weight could have been prevented under different hypothetical scenarios for reducing pollution. If exposure to PM₂.₅ had been limited during pregnancy to 10 µg/m³, the limit set by European legislation, there couldhave been 662 fewer cases between 2010 and 2018. With a limit of 5 µg/m³, corresponding to the World Health Organization (WHO) air quality guideline, the estimated reduction would have been 2,032 cases. For NO₂, limiting exposure to 20 µg/m³ (European legislation) was associated with an estimated reduction of 432 cases, while a limit of 10 µg/m³ (WHO guideline) was associated with an estimated reduction of 938 cases. 

The benefits of reducing pollution were clearer and greater among babies born to mothers with primary compared to higher education, consistent with the stronger association between pollution exposure and low birth weight in this group. In this group, for example, limiting PM₂.₅ concentrations to 5 µg/m³ would have reduced the estimated number of low birth weight cases from 8,349 to 7,974, a reduction of 759 cases (-9.1%), while in the secondary and tertiary groups the cases reduced by 2.2% and 2.6%, respectively. Limiting NO₂ to 10 µg/m³ would have resulted in an estimated reduction of 376 cases (-4.5%) in the primary group, while in the secondary and tertiary groups the cases reduced by 0.7% and 1.4%, respectively. These results highlight that air pollution reduction policies have the potential to reduce social health inequalities.

Increasing maternal education would have had a greater effect

The study also considered a hypothetical scenario in which all mothers had attained tertiary education, meaning advanced vocational training or a university degree. Under this scenario, the team estimated a reduction of 9,246 cases of low birth weight for PM₂.₅ and 9,275 cases for NO₂. The estimated prevalence of low birth weight would fall from 4.6% to 3.96%.

“Combining measures to reduce air pollution with social policies aimed at improving mothers’ educational attainment could significantly reduce the burden of low birth weight in Spain, particularly among the most vulnerable populations, helping to improve health equity,” says Cathryn Tonne, ISGlobal researcher and senior author of the study. 
 

Reference:

Sieber, S., Ballester, J., Nieuwenhuijsen, M., Pozzer, A., Tonne, C. The impact of improved air quality on low birth weight and health inequalities in Spain from 2010 to 2018. International Journal of Epidemiology, 2026. Doi: 10.1093/ije/dyag130 

The PRIME Commission, established by the National University of Singapore and The Lancet in 2023, brings together 41 experts from around the world and draws on work in 20 countries. The Commission found persistent gaps between what was promised, such as vaccines or social protection benefits, and what people could actually access when systems came under stress.

“What the PRIME Commission found is that people themselves aren’t ‘vulnerable’, but rather, that systems create vulnerability,” said Professor Helena Legido-Quigley, Co-Chair of the Commission and Professor at Imperial College.

“Pandemic preparedness cannot stop at having plans and capacities on paper. We need to make sure enabling systems can actually reach and protect people when they come under pressure,” said Alberto García-Basteiro, ISGlobal researcher and author of the Commission report.

From passive preparedness to 360° readiness

The report shifts the focus from pandemic preparedness, which asks whether plans and capacities exist, to pandemic readiness, which asks whether these work in a health emergency.

The Commission’s blueprint sets out six calls to action: move from preparedness to 360° readiness; institutionalise community participation; cooperate to save millions of lives; fix vulnerable systems, not “vulnerable people”; govern for trust; and commit to protection and accountability.

Vaccine access: millions of lives could be saved through a more equitable approach

The Commission modelled future pandemic scenarios and found that, in a hypothetical influenza A pandemic, rapid vaccine development could reduce deaths by 59%, from 58.5 million to 23.9 million. A more equitable allocation, based on population size rather than purchasing power, reduces global mortality by 64%, to 21·2 million deaths, equivalent to 37·3 million deaths averted, saving a further 2·7 million lives particular in middle-income countries. Measures to improve vaccine confidence would reduce deaths further still, by another 1.9m lives. 

A blueprint for Governments to protect all-of-society

The NUS-Lancet Commission provides a practical framework for governments to work with communities and create plans aimed at protecting everyone, for 360° pandemic readiness.

“The PRIME Commission brings an important perspective to pandemic preparedness by asking a simple but often overlooked question: will these plans actually work for everyone? Its focus on equity, community participation and trust is highly relevant to building stronger and more resilient health systems, by promoting a whole of society approach” said Elizabet Diago, Coordinator of the Preparedness Hub at ISGlobal. 

Reference

Calderón-Larrañaga S, Bakhti R, Etemadi M et al. The NUS–Lancet PRIME Commission: transforming pandemic readiness for equity. The Lancet, 2026.

  Formulario de inscripción

 

Agenda

• 16.30h-17h. Bienvenida socias
• 17h-17.15h. Bienvenida (Virginia Rodríguez, ISGlobal y WGH Spain/Judith García Aymerich, ISGlobal/Barcelona Activa)
• 17.15h-17.30h. Ponencia central (Helena Casadevall Adroher)
• 17.30h-18.30h. Mesa redonda con ponentes expertas (Helena Casadevall Adroher, Helena Montasell y Judith Vall) 
• 18.30h-18.50h. Mesa redonda con socias (Silvia Gómez y Alba Cuixart, ISGlobal y WGH Spain) 
• 18.50h-19h. Cierre de la sesión
• 19h-20h. Espacio de networking

Women in Global Health Spain

Women in Global Health Spain forma parte de Women in Global Health, una organización internacional sin ánimo de lucro que trabaja para promover la equidad de género y fortalecer el liderazgo de las mujeres en la salud global.

A través de su red internacional de capítulos, WGH impulsa el cambio movilizando a una comunidad diversa de profesionales, investigadoras, responsables políticas y personas aliadas para promover sistemas de salud más equitativos, inclusivos y sensibles al género.

 

 Formulario de inscripción

During infection in human blood, the malaria parasite Plasmodium falciparum faces two competing demands: on the one hand, it must multiply to sustain the infection; on the other, some parasites must develop into sexual forms known as gametocytes in order to be transmitted to other people through mosquitoes. Whether to continue multiplying or become gametocytes is the key decision in the life cycle of P. falciparum, the parasite responsible for most severe cases of malaria.

It has long been known that the parasite can detect changes in its host’s environment, such as fever or shortages of specific nutrients, and adjust its production of gametocytes accordingly: when conditions become unfavourable, it is advantageous for the parasite to invest more resources in transmission to a mosquito in order to infect another human host.

A single mechanism for responding to different types of stress

In recent years, researchers have identified regulators such as gdv1 and ap2-g, which play a central role in initiating the formation of gametocytes. It was also known that stressful conditions for the parasite, such as nutrient limitation, promote gametocyte production, but the molecular mechanism triggering this response remained unknown.

To uncover it, the research team combined genomics, epigenomics, transcriptomics, proteomics and genetic engineering. Parasites were exposed separately to three stress conditions: nutrient limitation, treatment with the antimalarial drug DHA, and a simulated fever episode. The researchers then analysed which genes were activated, which proteins increased in abundance, and how the organisation of chromatin—the structure that regulates access to DNA—changed. The same experiments were also carried out in parasites in which the regulators involved in the process had been genetically modified.

“All three stimuli activated the same regulatory pathway. They all triggered similar changes in the gdv1 and ap2-g genes,” explains Elisabet Tintó, ISGlobal researcher and first author of the study.

GDV1 and gdv1-as: switching sexual development on and off

The study, supported by CaixaResearch, shows that the stress response does not simply involve switching genes on, but also reorganising heterochromatin, a form of DNA packaging that keeps certain genes silenced. The system also includes its own built-in control mechanism. Once activated, GDV1 triggers conversion into gametocytes, while simultaneously inducing the production of gdv1-as, an RNA molecule that represses gdv1 activity. This regulatory feedback loop acts as a braking system: it enables a rapid response to stress while preventing GDV1 expression from remaining active for longer than necessary, which could otherwise prove lethal for the parasite.

AP2-HS: a control hub for responding to the environment

The study also reveals that AP2-HS, a protein that regulates gene expression, acts as the control hub that enables the parasite to respond to different types of stress. Its role is crucial: when it detects stressful conditions, AP2-HS activates GDV1 expression, thereby initiating gametocyte production. At the same time, AP2-HS also activates other stress-survival mechanisms, revealing this gene as a key factor in the resilience of malaria parasites.

“When we deleted the ap2-hs gene, the parasites completely lost their ability to develop into gametocytes, even under stressful conditions such as fever, DHA treatment or nutrient limitation. Moreover, the few gametocytes that began to develop failed to become viable,” explains Tintó.

“This work helps answer a question that had remained unresolved for years: how the parasite adapts its life cycle to a changing environment and produces the transmissible forms that are essential for its survival at the population level,” says Alfred Cortés, ICREA researcher at ISGlobal and coordinator of the study.

Reference

Tintó-Font, E., Casas-Vila, N., Martínez-Guardiola, C., Pérez-Cantero, A., Ràfols, N., Nyarko, P. B., & Cortés, A. (2026). AP2-HS and a GDV1 regulatory feedback loop mediate environmental induction of sexual conversion in Plasmodium falciparum. Nature Microbiology. https://doi.org/10.1038/s41564-026-02473-6

*Open access link: https://rdcu.be/gQB7cttRfJDa

Between 2016 and 2024, CHAMPS identified 18,784 eligible deaths across seven countries: Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone and South Africa. In 9,415 cases, minimally invasive tissue sampling (MITS), a technique developed and validated by ISGlobal, was used to obtain tissue samples through a minimally invasive procedure. In total, 8,500 cases were reviewed by multidisciplinary teams to determine the causes of death.

A closer look at causes of death

To determine the causes of death, CHAMPS teams use a post-mortem approach that combines different sources of information: minimally invasive tissue sampling, laboratory analyses, interviews with relatives or caregivers (verbal autopsy), and reviews of paediatric and maternal medical records. Multidisciplinary teams then integrate all this evidence to assign one or more causes to each death and assess its potential preventability.

This approach makes it possible to identify not only the underlying cause of death, but also other conditions that contributed to it. The published results show that causes of death are complex and that different factors often coexist. Among stillbirths, the most frequent cause was perinatal asphyxia or hypoxia (lack of oxygen), often associated with hypertensive disorders of pregnancy, placental complications or infections. Among neonatal deaths, the main causes included complications of prematurity, asphyxia or hypoxia, and sepsis. Among babies and children under five, respiratory infections, sepsis, malnutrition, malaria and diarrhoeal diseases were among the main factors identified. 

From data to prevention

Of the 7,558 deaths assessed, 6,103 were considered preventable or potentially preventable, meaning that approximately four in five deaths could have been prevented. These findings highlight opportunities to strengthen maternal, neonatal and child health interventions, particularly antenatal care, obstetric and emergency care during childbirth, infection prevention and control, paediatric care, and nutritional support. 

CHAMPS findings have also contributed to changes in health services. In Kenya, they informed interventions that included expanding kangaroo mother care and training in emergency obstetric and neonatal care. In South Africa, the data contributed to expanding access to antenatal ultrasound and incorporating aspirin for the prevention of hypertensive disorders of pregnancy into the national formulary. In Sierra Leone, findings on malnutrition supported the country’s first national procurement of ready-to-use therapeutic food for children with malnutrition.

A technique developed in Barcelona

One of the cornerstones of CHAMPS is minimally invasive autopsy, a technique developed and validated by ISGlobal research teams through the CaDMIA and CaDMIA-plus projects. The technique makes it possible to obtain small samples from different organs using fine needles for subsequent analysis and provides an alternative to conventional autopsy in settings where the latter may be difficult to perform due to limited infrastructure or cultural considerations.

Ten years after its launch, CHAMPS has provided detailed information on the causes of death among newborns and children under five. These data can help strengthen surveillance systems and better guide interventions aimed at preventing avoidable deaths. 

Reference

Madewell ZJ, Dangor Z, Mutevedzi PC, et al. Causes of Death Among Stillbirths and Children Aged <5 Years in Africa and South Asia — Child Health and Mortality Prevention Surveillance, Seven Countries, 2016–2024. MMWR Surveill Summ 2026;75(No. SS-6):1–24. DOI: http://dx.doi.org/10.15585/mmwr.ss7506a1

A changing profile of diagnosed individuals

For many years, research has shown that certain characteristics are more common among people diagnosed with ADHD or ASD than among the general population. These include pregnancy- and birth-related factors such as preterm birth and low birth weight; family and socioeconomic factors such as lower parental education or household income; a parental history of psychiatric disorders; and greater use of healthcare services before diagnosis.

To investigate whether the profile of diagnosed individuals has changed over time, the researchers analysed data from more than 2.1 million children and adolescents living in Denmark. They compared more than 71,000 individuals diagnosed with ADHD or ASD between 2012 and 2022 with more than 713,000 peers without these diagnoses.

The results show that, although children and adolescents diagnosed with ADHD or ASD were still more likely than their peers to present these characteristics, the differences became progressively smaller over the study period. For example, ten years ago, children born with low birth weight were 54% more likely to receive a subsequent diagnosis of ADHD or ASD than those born at a normal weight. By the end of the study period, that difference had fallen to 17%. Similar reductions were observed for preterm birth and several indicators of socioeconomic disadvantage.

"The key message is not that these risk factors are no longer important," says Magnus Elias Tarp, PhD student at Aarhus University and first author of the study. "What we found is that people diagnosed in recent years resemble the general population more closely than those who received the same diagnoses a decade ago."

A new perspective on the rise in diagnoses

Most research on ADHD and ASD has focused on why diagnoses are increasing or on identifying factors that increase the risk of developing these conditions. This study asks a different question: whether the characteristics of the people receiving these diagnoses have also changed over time.

The authors suggest that this shift may reflect several factors, including greater awareness of ADHD and ASD, improved identification by healthcare and educational services, broader access to diagnostic assessment, or changes in the threshold at which neurodevelopmental traits are considered clinically impairing. While the study cannot determine the relative contribution of each of these factors, it suggests that the increase in diagnoses should not be interpreted solely as evidence of an increase in the underlying occurrence of ADHD or ASD.

"Our findings help us better understand why ADHD and autism diagnoses have increased so markedly in recent years," says Oleguer Plana-Ripoll, researcher at ISGlobal and Aarhus University and senior author of the study. "They do not show that these conditions are being overdiagnosed or that they have become less severe. Rather, they indicate that the population receiving these diagnoses has changed over time, and this needs to be taken into account when interpreting current trends. Further research in other countries would be needed to determine whether these findings can be replicated elsewhere", he adds. 

Implications for research and service planning

According to the researchers, these findings have important implications for interpreting trends in the prevalence of ADHD and ASD and for planning healthcare, educational and social services.

The results also suggest that some of the improvements reported in recent studies on outcomes among people with ADHD or ASD may partly reflect changes in the profile of the diagnosed population rather than changes in the prognosis of these conditions themselves.

Reference:
Tarp ME, Lousdal ML, Rask CU, Keyes KM, Formánek T, Brikell I, Liu X, Maseras GT, Plana-Ripoll O. Changes in Characteristics Associated With ADHD and ASD Diagnoses in Denmark Over Time (2012–2022). JAMA Psychiatry. 2026. DOI:10.1001/jamapsychiatry.2026.2722

Utilizing the "3E" framework (Equity, Ethics, and Efficiency), the workshop shifts the focus from data volume to the flow of benefits and decision-making authority for disadvantaged regions. It will promote synergy across research streams, discuss equitable innovative solutions regarding multidisciplinary data integration and the implementation of sovereign, federated data systems, and identify actionable steps to rectify historical power imbalances in data management, analysis and use.

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Day 1

Challenges and opportunities in data sharing to transform global partnerships

Presentation: “Collective action for responsible global health data sharing and use”

Practical exercise: Learn to recognise the challenges in data sharing from a use case

Panel Discussion on challenges and opportunities

Day 2

Practical considerations on responsible data sharing

Use case: Collaborating with the MoH in Mozambique in data analysis

Panel discussion on practical considerations

Tools and implementations to promote equitable, ethical, and efficient data sharing

Presentation of the ADBEx platform

Panel discussion on tools and implementations

Speakers

Lauren Fromont (ISGlobal): Organiser and chair

Alfredo Mayor (CISM, ISGlobal): Organiser, chair, and presenter

Dawit Wolday (MacMaster): Panelist

Esperança Sevene (Universidade Eduardo Mondlane): Panelist

Stélio Tembe (Ministry of Health, Mozambique): Panelist

Arnau Pujol (ISGlobal): Presenter

Beatriz Arregui (ISGlobal): Presenter

Tsaone Tamuhla (SANBI): Presenter and panelist

Juan Ramón González (ISGlobal): Panelist

Diya Uberoi (McGill): Panelist

Lalama Jabby (ISGlobal): Moderator

With the support of the Centre of Excellence Severo Ochoa Programme (CEX 2023-001290-S) funded by MCIN/AEI/ 10.13039/501100011033.

The study analysed data from 59 low-income and lower-middle-income countries between 2002 and 2021 and projected future scenarios through 2030. Researchers first estimated the relationship between ODA funding and mortality. They then used these estimates to model the potential health impacts of different wealth redistribution policies designed to offset the decline in ODA funding.

A baseline scenario of declining aid

The analysis found that higher levels of development assistance were associated with a 24% reduction in overall mortality and a 33% reduction in mortality among children under five.

The researchers then modelled a scenario in which current reductions in development assistance continue through 2030. Under this scenario, they projected approximately 7.6 million additional deaths, including 1.4 million among children under five. This defunding scenario served as the baseline against which different wealth redistribution policies were evaluated.

Alternative financing mechanisms

The researchers assessed ten policies that have been proposed in recent high-level international agreements and policy discussions. These included taxes on ultra-high-net-worth individuals (billionaires), multinational corporations, financial transactions, carbon emissions, cryptocurrencies, and interest earned on sovereign debt.

Each redistribution scenario was modelled on top of the projected aid reduction scenario, allowing the researchers to estimate the extent to which additional revenues could offset the health impacts of declining assistance.

Across all scenarios, the policies generated sufficient resources to offset part—or, in most cases, all—of the projected negative health impacts associated with current aid reductions. Depending on the mechanism and level of taxation, these measures were estimated to prevent between 6.6 million and 29.5 million deaths by 2030.

Among the policies analysed, a 3% tax on the wealth of billionaires was associated with up to 29.5 million deaths averted by 2030. A global minimum tax on large multinational corporations was associated with approximately 20 million deaths averted, while taxes on financial transactions were associated with around 24 million deaths averted.

“We first estimated how the current reduction in humanitarian and development assistance could lead to millions of avoidable deaths in the world’s most vulnerable countries,” says Gonzalo Barreix, researcher at ISGlobal and first author of the study.

“With donor countries facing growing indebtedness and increasingly reallocating resources towards military spending, funding humanitarian assistance via the taxation of large fortunes was one of the most viable strategies” says Lucio Esposito, senior economist of the study and researcher at the ICESI School of Economics and University of East Anglia School of Global Development.

“Our models showed that maintaining, or even increasing, humanitarian and development assistance could save millions of lives over the coming years,” says Rodrigo Anderle, researcher at the Institute for Collective Health in Brazil and one of the modellers of the study.

Policies already under discussion

The study comes at a time when development assistance from several major donor countries has undergone abrupt cuts. At the same time, international discussions on financing for development have increasingly focused on alternative mechanisms to mobilise resources.

Recent initiatives, including commitments discussed by the G20, the Fourth International Conference on Financing for Development held in Seville in 2025, and the OECD/G20 Inclusive Framework on international taxation, have renewed interest in wealth taxes, minimum corporate taxation and other redistribution measures.

The authors stress that the aim of their study is not to advocate for a specific policy, but rather to estimate the potential health impact of a range of financing mechanisms that are already part of international policy discussions.

“We live in an extremely unequal world, where a small number of individuals and corporations are accumulating wealth at an unprecedented pace and scale, while millions of vulnerable people continue to die for lack of access to basic, often low-cost, humanitarian interventions,” says Davide Rasella, ICREA Professor at ISGlobal, who conceived and coordinated the study. “Our findings show that implementing even modest wealth redistribution policies, such as those proposed in recent international agreements, could literally save tens of millions of lives in the coming years.”

Reference

Barreix, G., Rezende, RV., Ferreira, A., de Oliveira Ferreira, L. et al., Rasella, D. Wealth Redistribution Policies to Mitigate the Impact of Development Assistance Defunding: A Retrospective Evaluation and Forecasting Analysis up to 2030, The Lancet, 2026. Doi: 10.1016/S0140-6736(26)00975-X

The Tony McMichael Mid-Term Career Award is a major international recognition in the field of environmental epidemiology. Created in memory of pioneering environmental epidemiologist Tony McMichael, it recognises mid-career scientists who combine scientific excellence and innovation with mentorship, leadership and a commitment to applying environmental epidemiology to improve public health. 

A career advancing environmental and occupational health

Over the course of her career, Turner’s research has helped advance understanding of how environmental and occupational exposures affect human health, with a particular focus on air pollution, cancer and occupational hazards. Her work has included large-scale studies on the long-term health effects of air pollution and, more recently, has explored how climate change and the shift towards more sustainable ways of working can affect workers’ health.

She currently coordinates INTERCAMBIO, a five-year Horizon Europe project investigating how climate change, sustainable working practices and green jobs affect workers’ physical and mental health. Through participatory and intervention-based research across sectors including construction, healthcare, public transport, renewable energy and waste management, the project aims to generate evidence that can inform future occupational health policies.

"It is a great honour to receive an award that bears Tony McMichael's name. His work continues to inspire generations of environmental epidemiologists, and I am grateful to the colleagues who have been part of this journey,” says Turner. “This recognition reinforces the importance of conducting novel research that can help protect health in the face of environmental and climate challenges." 

Scientific leadership and impact beyond research

Turner has also contributed to major international assessments that help translate epidemiological evidence into public health action. Most recently, she played a leading role in the International Agency for Research on Cancer (IARC) Monographs Volume 138 on automotive gasoline and some oxygenated additives. The evaluation concluded that automotive gasoline is carcinogenic to humans, providing an important evidence base for cancer prevention and occupational and environmental health.

Beyond her research, Turner has taken on prominent roles within the international environmental health community. She has served on several World Health Organization advisory groups and has contributed to ISEE for many years, including through her role as Secretary-Treasurer.

Mentorship and support for the next generation of environmental epidemiologists have also been a central part of her scientific career. Her nomination highlighted her commitment to mentoring early-career researchers, promoting equity in environmental health and strengthening the connection between scientific evidence and policymaking.

The award was presented during the 2026 ISEE Annual Conference, held in Munich, Germany, from 30 August to 2 September 2026.

SENTITS is based on a different way of connecting research with the territory. Through co-creation, citizen science and multi-stakeholder collaboration, the project seeks to bring together researchers, public administrations, civil society and other local actors to identify challenges and develop solutions that respond to real needs.

“Territorial actors identify a collective need, while universities and research centres contribute the scientific knowledge and resources needed to respond, with the final aim of generating systemic transformations” explains Josep M. Antó, who played a key role in developing the project proposal.

From territorial challenges to transformative action

SENTITS will work through two closely interconnected lines of action.

The first will support the development and scaling up of transformative research and innovation activities addressing challenges identified with the actors in the territory. These actions will build on existing research and collaborations and use participatory approaches to co-design, test and evaluate solutions in real-world settings. The work will focus particularly on areas such as community and planetary health, sustainable mobility, and urban resilience and climate adaptation.

The second line of action is the creation of the Laboratory for Transformative Social Innovation (LIST), which will provide a common structure to coordinate and support the activities. This also includes providing methodological support, facilitating shared agendas and partnerships, and monitoring the progress and impact of the actions.

“Our Impact Unit is well placed to help coordinate the different research and translation teams in ISGlobal that are already working with local actors in planetary health, urban health and preparedness and resilience,” says Adelaida Sarukhan, SENTITS coordinator. “By responding to local needs and engaging with other centres in shared agendas, we can develop and scale up transformative actions that generate meaningful changes in the territory.”

SENTITS will run until December 2028.

On 13 November, the Auditorium of the Barcelona Biomedical Research Park (PRBB) will host the INCLUDE Final Conference, bringing together researchers, institutional representatives, health professionals and other key stakeholders to reflect on how to move towards more equitable, diverse and scientifically rigorous biomedical research.

Organised by the INCLUDE consortium, the conference will provide an opportunity to share the main lessons learned, tools and experiences developed throughout the project, as well as to open a space for dialogue on the challenges that still persist within scientific institutions and the transformations needed to address them.

The programme will offer a journey from analysing the structural inequalities that shape science and health to identifying and discussing concrete strategies to drive institutional change.

Topics will include the integration of gender and intersectional perspectives into biomedical research; diversity in research teams and knowledge production; geopolitical inequalities in science; the creation of safe and equitable working environments; the role of Gender Equality Plans; and the resistance, learning and opportunities that accompany processes of institutional transformation.

The conference will also present the main results and resources developed by INCLUDE, including the Manifesto for Equity and Diversity in Biomedical Research, the INCLUDE Toolkit, the Policy Brief and the Community of Practice.

As a pre-event, on 12 November, a session will take place at the Museu de la Ciència CosmoCaixa, featuring a public lecture by Professor Quarraisha Abdool Karim, one of the world's leading HIV researchers. Admission will be free for INCLUDE participants, subject to prior registration.

We invite researchers, health professionals, institutional representatives, civil society organisations and everyone committed to a more critical, equitable and inclusive approach to science and health to take part.

Participation in both events is free of charge, subject to prior registration. See the full programme. 

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The conference aims to build on this process and open the conversation to experiences from other territories. Over two days, we will explore initiatives connecting nature and health through diverse contexts, scales and approaches. We will share what is being done, what has been learned so far, and the challenges and opportunities involved in putting these proposals into practice.

The event aims to provide a space to exchange experiences, foster connections between stakeholders and explore how these lessons can help strengthen the relationship between nature and health in the province of Barcelona. At the same time, the conference seeks to foster new collaborations between the health sector, territorial management and community organisations, building on the collaborative process initiated within the Barcelona Resilience Hub.

Agenda

Tuesday 27 October, Hospital del Mar 

8.30am - Welcome and registration

9.00am - Opening of the conference

• Esteve Fernández Muñoz, Secretary of Public Health of the Government of Catalonia
• Celia Santos Tapia, RESONATE Project, ISGlobal
• Rocío Cebrián, Deputy Director of Hospital del Mar

9.15am - Mindfulness and connection with nature: guided meditation

• Irene Cervera-Buisán, Les trenades
• Maite Tacías, Floreix

9.30am - From utility to relationship: nature-based interventions and an ecosocial perspective on health

• Silvia Gili Olmeda | University of Barcelona

10.15am - How can we implement the Blue Prescription along the Barcelona coastline?

Moderator: Mònica Ubalde-Lopez, Barcelona Institute for Global Health (ISGlobal)

Experiences:

• Carme Pigem, CAP Llançà
• Xènia Ros, Som Mar Association

11.15am - Coffee break

11.45am - Benefits of the connection between nature and health

Moderator: Raquel Céspedes, coordinator of the "Environment, Health (One Health) and Prevention" Group of REiCOP (Spanish Network for Research on Long COVID)

Experiences:

• Maite Tacias, clinical psychologist and founder of Floreix. Member of the COPC and FEATF
• Mayte Serrat, Fibrowalk, Fibromyalgia and ME/CFS Unit, Vall d’Hebron Hospital

12.45pm - Lunch break [not included]

2.00pm - From evidence to practice: transforming the approach to life’s distress in primary care, from medicalisation to nature-based social prescribing

Moderator: Laura Illamola Martin, family and community physician and member of the Research and Innovation Committee of Baix Llobregat (ICS)

Experience:

• Ramon Gilbert, Community Emotional Wellbeing Lead, EAP Can Vidalet-CAP Bòbila, and member of the RECETAS project

3.00pm - From theory to reality. Practical experiences of nature-based therapies (in person)

Participants will have the opportunity to choose one practical experience

• Cartography of Silence – Blue therapy, art and nature interventions by the sea | COPC Psychoenvironmental Health Working Group (Les trenades, Sinegrow and Blava)
• Breathing the Sea – Blue therapy, art and nature interventions by the sea | COPC Psychoenvironmental Health Working Group (Les trenades, Sinegrow and Blava)
• Experiential therapeutic Stand Up Paddle session on an urban beach | Carolina Navalón-Martínez and Laura Gil (Blue Soler)
• Som Mar Blue Prescription | Mònica Ubalde (VerdeMare) and Xènia Ros (Som Mar)

5.00pm - End of the day

Wednesday 28 October, Barcelona Biomedical Research Park (PRBB)

9.00am - Mindfulness Self-Compassion. Guided meditation on compassionate breathing

• Elisabet Asensio, Badalona Serveis Assistencials

9.15am - Childhood, nature and health: sowing wellbeing for the future

Moderator: Irene Cervera-Buisán, Catalonia Health and Nature Roundtable, COPC and Les trenades

Experiences:

• Júlia Moya Garcia, social educator, SEO/BirdLife Catalonia Education Programme, Education Area, Society and Territory Unit
• Meritxell Ponce, paediatrician at Hospital de Barcelona, member of the Environmental Paediatrics Promotion Group of L’Hospitalet de Llobregat
• Elena Codina Sampera, paediatrician at the Paediatric Environmental Health Unit of Sant Joan de Déu Hospital
• Montse Masó-Aguado, environmental scientist and nurse. Coordinator of the Childhood, Adolescence and Youth Section of the Health and Nature Roundtable, Paediatric Environmental Health Unit of Fundació Hospital d’Olot i Comarcal de la Garrotxa

10.15am - Forest bathing with migrant people: an experience from a community and ecosocial perspective

Moderator: Isis Saiz, Espai Ambiental Cooperativa

Experiences:

• Maria Eugenia Encinoza Tosta, participant
• María Julia Sánchez Salame, participant and biodanza facilitator
• Oliver Calzas Bollinger, forest bathing guide
• Silvia Simó Castelló, social worker at CAP Sagrada Família

11.15am - Coffee break

12.00pm - Nature-based therapy experiences in the healthcare sector: Blue, Green and Virtual Reality in Badalona and Terrassa

Moderator: Elisabet Asensio, Badalona Serveis Assistencials

Experiences:

• Elena López Villabona, REBEC CAP Progrés-Raval, and Maria José Ciudad, neuropsychologist, Centre d’Atenció Intermèdia el Carme, Badalona Serveis Assistencials
• Marta Ribó, Health Officer at Badalona City Council
• Emma Bueno, Coordinator of Espai Mar Badalona
• Elena Martínez, social worker at Consorci Sanitari de Terrassa

1.00pm - Lunch break [not included]

2.30pm - Project incubator (in person)

Participants will have the opportunity to take part in a project incubator

• Session 1. How can the Blue Prescription be incorporated along the Barcelona coastline? Facilitators: Mònica Ubalde ISGlobal - VerdeMare), Pilar Vendrell (Directorate-General for Environmental Policies and Natural Heritage – Government of Catalonia); Pat Gonzalez (A Bordo Lab-B)-TBC
• Session 2. Regional Health and Nature Roundtable for Barcelona: which stakeholders are involved and how can it be integrated into the Catalonia Nature and Health Roundtable? Facilitators: Nora Maristany and Sandra Carrera
• Session 3. Making nature an everyday option: spaces, resources and opportunities. Facilitator: Irene Cervera-Buisán | Les trenades
• Session 4. Community action for health and the ecosocial transition. Proposals for taking action in Barcelona. Facilitators: Isis Sainz and Andrés Garcia (Espai Ambiental).

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ISGlobal researcher Manolis Kogevinas has been honoured with the EPICOH Lifetime Award, the highest distinction granted by the Scientific Committee on Epidemiology in Occupational Health (EPICOH) of the International Commission on Occupational Health (ICOH). The award recognises his outstanding career in occupational epidemiology and his contribution to the development of evidence-based public health policies. The distinction was presented on 26 August during the annual EPICOH conference held in Stockholm.

The EPICOH Lifetime Award highlights more than three decades of scientific leadership by Kogevinas, helping to transform our understanding of how occupational exposures influence the development of chronic diseases, particularly cancer and respiratory diseases. Throughout his career, he has led some of the most influential international studies in occupational and environmental epidemiology, incorporating innovative approaches such as the exposome, advanced exposure assessment and the study of interactions between environmental and genetic factors.

The EPICOH committee also highlighted the impact of his work on risk assessment and prevention. His contributions have been instrumental in the international classification of occupational carcinogens through the development of key reference tools such as CAREX and the formulation of recommendations that have influenced European legislation and international strategies for the prevention of cancer and other work-related diseases.

In addition to his scientific contributions, the award highlights his role in the creation of international research networks, the training of new generations of epidemiologists, and his ability to translate scientific evidence into practice and public policy.

With this award, EPICOH recognises a scientific career that has helped establish occupational epidemiology as an essential discipline for understanding the impact of work on health and for promoting preventive policies that protect the health of workers worldwide.
 

The ceremony marked the conclusion of the Master's in Global Health, tropEd Master's in Global Health and Master's in Applied Clinical Research: Global Health Specialisation, jointly taught by UB and ISGlobal.

Looking back at the journey and ahead to future challenges

During her speech, Núria Casamitjana, Director of Education and Training at ISGlobal, and director of the Master's in Global Health and the tropEd Master's in Global Health, recalled the first days of class, when the students “seemed expectant, curious, uncertain and perhaps a little worried about what lay ahead”. After a year of learning and growth, she highlighted that they are now “ready to pursue a career in what they enjoy most”.

“You may need time and you will encounter difficulties, but you are prepared to tackle them”, added Dr Casamitjana, who encouraged the new graduates to approach their work “with passion, generosity and kindness”.

The event also featured Quique Bassat, Director General and Scientific Director of ISGlobal, ICREA Research Professor, and co-director of the Master's in Global Health, and Alberto García-Basteiro, ISGlobal researcher and Head of the Preventive Medicine and Epidemiology Service at Hospital Clínic Barcelona, who was chosen by the students to deliver the speech on behalf of the teaching staff. The guest lecture was delivered by Aitor Zabalgogeazkoa, Emergency Coordinator at Médecins Sans Frontières (MSF).

Representing the students, Lucia Emefa Agroh, from the tropEd Master's in Global Health, and Sevan Balian, from the Applied Clinical Research programme, shared their reflections on their experience during the academic year.

Final projects: different approaches to global health challenges

The students presented their master's final projects before academic panels. The projects reflect the diversity of topics and perspectives encompassed by global health.

Master's in Applied Clinical Research: Global Health Specialisation

• Development of STI risk prediction models among migrants attending primary care in Catalonia using electronic health record data
• Positive Commercial Determinants of Health: A Conceptual Review of Governance Mechanisms that Enable Health-Promoting Commercial Contributions
• Sexual and reproductive health needs and health service utilisation among migrant women after irregular maritime migration to the Canary Islands
• Walnut consumption and risk of dementia in the Framingham Heart Study
• GUT MICROBIOTA ALPHA DIVERSITY AND SHORT-CHAIN FATTY ACIDS CONCENTRATIONS AND RESPIRATORY CHEST INFECTIONS AND WHEEZING IN EARLY LIFE
• Heat adaptation strategies in the homes of older adults: A Scoping review and case study in Barcelona
• Factors Associated with Hepatotoxicity in Patients Initiating Tuberculostatic Drugs for Latent Tuberculosis Infection at Hospital Clinic of Barcelona (2020–2025)
• Development of an aptamer-based rapid diagnostic test for malaria severity assessment
• Exploring feasibility, acceptability, and perceived impact of heat-mitigation interventions for migrant agricultural workers in Spain: A multi-stakeholder qualitative study

Master's in Global Health / tropEd Master's in Global Health

• Current distribution and role of the malaria vector Anopheles stephensi in malaria transmission in Africa: A Systematic Review
• Educational attainment and major cardiovascular events in the individuals with diabetes mellitus: a systematic review
• Antimicrobial Resistance in Wildlife as a One Health Sentinel
• Mortality and Cause of Death Among HIV-Exposed and HIV-Unexposed Children: A 15-Year Population-Based Cohort Study in Manhiça, Southern Mozambique
• Community-based preparedness for health system resilience in anticipation of siege. A desk review and lessons learned from Syria, Sudan and Gaza.
• Cultural and Social Barriers to Reproductive Healthcare for Moroccan Migrant Women in Europe: A Rapid Scoping Review
• Sex Differences in Atherosclerotic Plaque Prevalence in Femoral and Carotid Arteries: A Population-Based Study
• Long-term educational effects of the 2015 Magude malaria elimination initiative: evidence from Southern Mozambique, 2017–2022
• Urban Nature and Women's Mental Health: A Scoping Review of Outcomes, Mechanisms and Inequalities Through an Intersectional Lens
• Seguimos Adelante: Immigration Enforcement, Labor Conditions, and the Health of Undocumented Mexican Laborers in California. A Narrative Literature Review
• Mindfulness Interventions in Green and Blue Spaces and Their Effects on Mental Health Outcomes for People Globally: A Scoping Review
• Scoping review on Preparedness and Response Plans and Strategies for Citizens in Catalonia
• The Role of Social Connection in the Association Between Socioeconomic Status and Depression: A Systematic Review
• Urban environment and sleep outcomes in children and adolescents. An Umbrella Review
• Amazon Tipping Point: The Economic and Health Cost
• Mapping Research Gaps in Paediatric Advanced HIV Management and Challenges from Healthcare Workers in Nigeria
• Women Inclusive Leadership and Care Provisions in the Mental Health Policy of Uganda; A Critical Narrative Policy Review
• Mental Health and Climate Change: A Rapid Review of Traditional Communities and Proposed Exploratory Qualitative Case Study of Ribeirinho Communities in Belém do Pará, Brazil
• The Impacts of Nature Exposure on Perinatal Mental Health in Canada: A Qualitative Research Protocol

A new graduating class ready to contribute to global health

The ceremony marked the end of a year of learning, research and exchange among students from diverse backgrounds. The new graduates now become part of an international community of professionals who will work, through research, clinical practice, public policy or humanitarian action, on challenges such as migrant health, the effects of climate change, mental health and the response of health systems to conflicts and emergencies.

As Casamitjana noted, the professional path will not always be immediate or straightforward, but the graduates complete this stage with the knowledge, skills and tools they need to move towards what they want to do and contribute to improving people's health in an equitable and sustainable way.

Loneliness is increasingly recognised as a major public health concern, with consequences for both physical and mental health. In Spain, around 20% of the population reports experiencing loneliness, while in Barcelona an estimated 100,000 people are affected.

Social prescribing seeks to address social and emotional needs by connecting people with resources and activities available in their communities. Nature-based social prescribing (NBSP) adds engagement with nature to this approach, for example through activities in parks, gardens or other natural spaces.

The EU-funded RECETAS project tested Friends in Nature (FiN), an intervention that combines contact with nature with peer support and facilitated group activities. “FiN combines strategies by building groups with peer support, providing social opportunities that are strengthened by experiences in nature, and by developing social skills,” says Laura Coll-Planas, first author of the study and current researcher at the University of Vic.

Two approaches to reconnect with nature and others

The trial recruited 320 adults aged 18 and over, experiencing loneliness from 12 socioeconomically vulnerable neighbourhoods in the Barcelona metropolitan area. Participants had a median age of approximately 63 years and 80% were women.

Half were assigned to the FiN programme, which consisted in meeting in small groups for 2 hours each week over nine weeks, accompanied by trained facilitators. Sessions combined group dynamics and peer support with outdoor activities in the local area, including visits to gardens, parks, riverways, coastal areas and cultural heritage sites. The activities were selected from a menu of neighbourhood-specific options developed with local stakeholders. The other half received a 30-minute motivational interview and information about nature-based activities available in their neighbourhood, which they could pursue independently.

Loneliness decreased across the study population by an average of 10.5% after three months, reaching a 16.8% reduction after one year, with no significant difference in loneliness between the two groups at three-months. The study also found no significant changes in health-related quality of life.

A closer analysis revealed an important difference according to participants' situation at the start of the study. Those with higher levels of loneliness and poorer emotional wellbeing benefited more from the facilitated FiN groups. In contrast, among those with less loneliness and better emotional wellbeing, the lighter-touch approach of an interview and signposting to local nature activities produced comparable reductions in loneliness.

Tailoring support to people's needs

The findings suggest that there may not be a single approach to tackling loneliness that works equally well for everyone. People experiencing greater emotional and social difficulties may need the additional peer support, group dynamics and facilitation offered by FiN, while others may benefit from simply being helped to identify and access opportunities already available in their communities.

The Barcelona results differ from those of another RECETAS trial conducted in Helsinki among frail older adults living in assisted-living facilities. In that study, the FiN intervention produced greater reductions in loneliness than the control group and improved several dimensions of health-related quality of life. The differences between the two populations reinforce the importance of adapting NBSP programmes to the needs and circumstances of the people they are designed to support.

The study has some limitations: most participants were women and the median age was around 63, which may limit how widely the findings can be generalised to men and younger adults. Nevertheless, for ISGlobal researcher and senior author of the study Jill Litt, “Our findings provide novel insights that will advance NBSP as a strategy to build community assets and improve social health in urban populations.” They also suggest that NBSP pathways can be more or less effective depending on people’s baseline needs.

The approach goes beyond viewing contact with nature as a passive health intervention, as Litt and colleagues explain in a Nature comment. By bringing people together around shared experiences in natural spaces, NBSP can create opportunities to form relationships, become more actively involved in one's community, and feel part of the natural world. This, Litt says, “is vital for generating the ingredients for a life well-lived - with purpose, belonging and meaning”.
 

Reference

Coll-Planas L, Masó-Aguado M, Briones-Buizassa L et al. Effectiveness of a nature-based social prescribing intervention on loneliness and health-related quality of life among vulnerable urban adults (RECETAS-BCN): an observer-blinded randomised controlled trial. 2026. The Lancet Regional Health Europe. https://doi.org/10.1016/j.lanepe.2026.101821

Comentario: Litt, J.S., Tate, W. & Chawla, L. We are nature: expanding theoretical foundations for nature and health research and practice. 2026. Nat. Mental Health. https://doi.org/10.1038/s44220-026-00706-5

Cutaneous leishmaniasis is a parasitic disease transmitted through the bite of Phlebotomine, tiny insects commonly known as “sand flies”. Although it is not usually life-threatening, it causes skin lesions and ulcers that may persist for months or even years and can leave permanent scarring, with significant physical, psychological and social consequences. It is estimated that there are around one million new cases worldwide each year, particularly across the Mediterranean Basin, the Middle East, Central Asia and the Americas.

Until now, early warning systems for climate-sensitive diseases had been developed mainly for tropical regions, where phenomena such as ‘El Niño’ make it possible to produce forecasts several months ahead. In temperate regions, by contrast, the atmosphere has been considered far less predictable, making it difficult to develop similar tools for vector-borne diseases.

The study, published in Science Advances, shows that this limitation can be overcome by incorporating two major patterns of Atlantic climate variability: the North Atlantic Oscillation (NAO) and the Atlantic Multidecadal Variability (AMV). The NAO is an atmospheric phenomenon that modulates winds over the Atlantic and influences winter rainfall across Europe and North Africa, while the AMV describes slow changes in Atlantic sea surface temperatures that unfold over years or even decades. The study’s findings show that the interaction between these two patterns modulates rainfall across North Africa and, indirectly, influences the evolution of leishmaniasis.

From Atlantic climate to disease transmission

Variations in Atlantic sea surface temperatures alter atmospheric circulation and the winds that transport moisture towards North Africa, thereby influencing rainfall. These rains regulate vegetation growth in desert ecosystems and, in turn, the populations of rodents that act as reservoirs for the parasite. Because cutaneous leishmaniasis depends closely on this chain of processes, its occurrence can also be predicted from Atlantic climate signals.

“The desert acts as a natural filter that reveals the Atlantic’s climate memory. Because it is influenced by fewer climate processes, it allows the Atlantic signal in rainfall patterns to be isolated much more clearly. Thanks to this, we identified a region where rainfall is remarkably predictable, the deserts of Tunisia and Morocco, and demonstrated that this predictability is also transferred to an infectious disease,” says Adrià San-José, ISGlobal researcher and first author of the study.

Building on this understanding of disease transmission, the research team developed a dynamic model that reproduces transmission of the parasite between humans, sand flies and rodents. The model integrates local temperature and rainfall with information from both the atmosphere and the Atlantic Ocean. As a result, it was able to predict both the timing and intensity of outbreaks of Leishmania major and Leishmania tropica in Morocco and Tunisia up to 12 months in advance. In Tunisia, however, where the Atlantic’s climatic influence is weaker and more heterogeneous, improvements in forecasting were more modest.

Implications for public health

“It was widely believed that this type of forecasting was only possible in the tropics. What is remarkable is that we have identified a source of predictability in a temperate region as well and incorporated it into a model that is ready for operational use. In this respect, our study is clearly pioneering and opens up new opportunities to develop early warning systems in places where they were previously considered unfeasible,” explains Xavier Rodó, ICREA researcher at ISGlobal and senior author of the study.

The ability to anticipate risk several months in advance provides valuable time to implement preventive measures, such as vector control, management of animal reservoirs and preparation of healthcare systems for potential outbreaks. Beyond leishmaniasis, the research team believes that the methodology developed could also be applied to other rainfall-modulated diseases across both Europe and North Africa.
 

Reference

San-José, A., Aoun, K.; Lemrani, M., López, L., Idris, M., Bouratbine, A., Paul, R., Rodó, X. Coupled Atlantic Atmosphere–Ocean Variability modulates Cutaneous Leishmaniasis in North Africa, enabling long-lead seasonal forecasts. Science Advances, 2026. DOI: 10.1126/sciadv.aeb0774

Las resistencias antimicrobianas se producen cuando las bacterias, los virus, los hongos o los parásitos dejan de responder a los antibióticos que utilizamos para combatirlos. Este fenómeno dificulta el tratamiento de las infecciones y constituye uno de los grandes retos actuales para la salud global.

Bajo el lema En un mundo en el que viajamos constantemente, también lo hacen las bacterias, la campaña traslada este problema a los espacios cotidianos de la ciudadanía. Vídeos en stop motion, murales en el transporte público, una exposición artística y un ciclo de mesas redondas invitarán a reflexionar sobre cómo nuestras decisiones pueden contribuir a frenar esta “pandemia invisible”.

Con gestos cotidianos y decisiones informadas podemos prevenir infecciones, evitar la propagación de bacterias resistentes y preservar la eficacia de los antibióticos: cuídate, infórmate y actúa.

Ciclo de mesas redondas

Durante el mes de noviembre se organizarán cuatro sesiones abiertas al público en diferentes equipamientos de Barcelona. Profesionales de la microbiología, la salud pública, la prevención de infecciones, la salud ambiental y otras disciplinas conversarán con la ciudadanía sobre los mitos y las decisiones cotidianas relacionadas con la higiene, los antibióticos y las resistencias antimicrobianas.

Las sesiones permitirán plantear preguntas, analizar situaciones cercanas e identificar acciones individuales y colectivas que pueden contribuir a proteger nuestra salud.

Mitos, manías y fake news: los hábitos de higiene que hacen más mal que bien

¿Desinfectarlo todo es siempre mejor? ¿Es necesario utilizar productos antibacterianos para lavar la ropa o limpiar el hogar? ¿Los antibióticos sirven para curar un resfriado?

Esta sesión desmontará algunas de las falsas creencias más habituales sobre la higiene, las infecciones y los antibióticos. También ofrecerá herramientas para distinguir la información fiable de la desinformación y adoptar hábitos realmente efectivos para prevenir infecciones.

📍 Lugar: Centre Cívic El Guinardó
📅 Fecha: 11 de noviembre de 2026, a las 19 h

Antibióticos: ¿los utilizamos bien? Decisiones cotidianas que protegen nuestra salud

Los antibióticos han revolucionado la medicina, pero utilizarlos de manera inadecuada acelera la aparición de bacterias resistentes.

A partir de casos y situaciones cotidianas, la mesa redonda abordará cuándo es necesario tomar antibióticos y cuándo no, qué ocurre si interrumpimos un tratamiento, qué debemos hacer con los medicamentos sobrantes, cómo deben gestionarse las posibles alergias y qué riesgos conlleva la automedicación.

📍 Lugar: Centre Cívic Vil·la Urània
📅 Fecha: 18 de noviembre de 2026, de 18.30 a 20 h

Una sola salud: ¿cómo conectan los antibióticos, los animales, el medio ambiente y nosotros?

La salud de las personas está estrechamente relacionada con la de los animales y la del medio ambiente. Los antibióticos utilizados en la medicina humana, la ganadería o los sistemas productivos pueden favorecer la circulación de bacterias resistentes entre diferentes ecosistemas.

Esta sesión introducirá el concepto de Una Sola Salud —o One Health— mediante ejemplos relacionados con la producción alimentaria, la salud animal, la calidad ambiental, la seguridad alimentaria y la prevención de infecciones. También abordará cómo las crisis humanitarias, los conflictos, los desastres naturales y las migraciones pueden influir en la propagación de las resistencias antimicrobianas.

📍 Lugar: Casal de Barri de Vallcarca – Can Carol
📅 Fecha: 19 de noviembre de 2026, a las 19 h

Mitos, manías y fake news: los hábitos de higiene que hacen más mal que bien

Una nueva sesión abierta al vecindario para revisar nuestras rutinas de higiene, resolver dudas sobre el uso de los antibióticos y desmentir creencias que pueden llevarnos a adoptar prácticas innecesarias o contraproducentes.

📍 Lugar: Biblioteca El Carmel – Juan Marsé
📅 Fecha: 24 de noviembre de 2026, a las 10 h

Exposición «Una Sola Salud»

Durante todo el mes de noviembre, el Casal de Barri de Vallcarca – Can Carol acogerá una instalación artística inmersiva e interactiva dedicada a las resistencias antimicrobianas.

La experiencia permitirá descubrir, desde una perspectiva artística y divulgativa, cómo aparecen y se propagan las bacterias resistentes, qué impacto puede tener el consumo de antibióticos sobre el medio ambiente y por qué la salud humana, la animal y la ambiental no pueden entenderse por separado.

📍 Lugar: Casal de Barri de Vallcarca – Can Carol
📅 Fechas: del 1 al 30 de noviembre de 2026

Las resistencias antimicrobianas viajan en transporte público

La campaña también saldrá a la calle mediante vídeos en stop motion y murales instalados en estaciones, metros, autobuses y otros espacios del transporte público de diferentes ciudades del Estado.

Estas acciones visuales mostrarán cómo las bacterias pueden desplazarse con nosotros y recordarán algunas medidas sencillas para prevenir infecciones, reducir los contagios y evitar la aparición de nuevas resistencias.

El vídeo de la campaña, disponible en catalán, castellano, inglés, italiano y portugués, se proyectará en pantallas del transporte público. Paralelamente, los murales acercarán los principales mensajes de la campaña a miles de personas durante sus trayectos cotidianos.

De la sensibilización a la acción

Las actividades quieren abrir el debate sobre las resistencias antimicrobianas a toda la ciudadanía y generar espacios de conversación entre personas expertas, profesionales sanitarios, responsables públicos y sociedad civil.

Además de sensibilizar y promover un uso más responsable de los antibióticos, las aportaciones recogidas durante la campaña contribuirán a elaborar un informe final sobre las medidas y regulaciones necesarias para facilitar acciones más ágiles y efectivas frente a las resistencias antimicrobianas.

Studies in humans show that disrupting the body's internal clock can weaken immune responses and increase susceptibility to infections. During the COVID-19 pandemic, a study in UK found that sleep disturbances were linked to a higher risk of SARS-CoV-2 infection. “However, no previous study had evaluated whether disrupting the body’s biological clock also increases the risk of developing long COVID”, says first author Kyriaki Papantoniou, Associate Professor at the Medical University of Vienna and Associated Researcher at ISGlobal. 

Night shift workers at increased risk of long COVID

In this study, the research team followed 2,941 adults in the population-based COVICAT cohort in Catalonia between 2021 and 2023. Among the 1,899 participants who became infected with SARS-CoV-2, 284 developed long COVID - defined as having persistent symptoms lasting for more than three months after the infection - during the 2-year follow-up.

Compared with day workers, those working night shifts had an 88% higher risk (i.e. almost double) of developing long COVID after accounting for other risk factors such as vaccination history or chronic diseases. This association was stronger in night workers with obesity. Moreover, the increased risk was observed both in current and former night workers, suggesting that it reflects longer-term effects of circadian disruption rather than short-term changes.

In contrast, night shift work was not associated with a higher risk of becoming infected, suggesting that disruption of the biological clock may influence how the body recovers from infection rather than the likelihood of catching the virus.

"Our findings suggest that circadian disruption plays a role in the transition from acute infection to persistent symptoms," says ISGlobal researcher Manolis Kogevinas, who coordinated the study.

Poor sleep further amplifies the risk

The researchers found that chronic insomnia also increased the risk of long COVID by 42%, independently of night shift work. Together, the two factors had a synergistic effect: night shift workers with chronic insomnia were 2.7 times more likely to develop long COVID than day workers without insomnia.

The biological mechanisms involved are not yet fully understood, but the time of day when the body encounters a pathogen may influence the immune response. In addition, disruption of the body's biological clock can impair the immune system’s ability to clear the infection. 

Improving sleep as a preventive strategy

Given the increase of insomnia prevalence in the general population, the authors underline the need to understand the short and long-term effects of disturbed sleep on infection-related outcomes. In any case, the findings point to sleep as a potentially modifiable factor in preventing long COVID and other post-infectious conditions.

"Promoting healthy sleep habits and minimising circadian disruption could represent simple, low-cost strategies to reduce the long-term consequences of viral infections, particularly among people who work night shifts," concludes Kogevinas.

The researchers note that the study's strengths include the use of a well-characterised population-based cohort with detailed information on work schedules, sleep habits and health, as well as an internationally recognised definition of long COVID. However, the participants were aged 40 to 65 years, so the findings may not necessarily apply to younger or older populations, and other occupational factors, such as work-related stress, cannot be completely ruled out.
 

Reference

K. Papantoniou, A. Espinosa, M Karachaliou, C Lassale, G Castaño-Vinyals, B Harding, De Matteis S, Straif K, E Alonso, C Dobaño, G Moncunill, N Blay, S Iraola-Guzmán, R de Cid, J Garcia-Aymerich, M Kogevinas. Night work, sleep disruption and long-COVID risk: a population-based cohort study. SJWEH. 2026.

Through practical, hands-on seminars, participants will explore state-of-the-art analytical frameworks and statistical workflows recently developed in exposomics. Each session will combine theoretical concepts with codes and implementation resources, enabling participants to apply the presented techniques in their own research endeavours.

Please see research themes below. You can consult the speaker list and full program and the full program with session abstracts.

Register here

Participation is free of charge.

About the workshop series

Integrating multiple omics layers with environmental data is essential for advancing precision environmental health and epidemiology, but it also involves major computational and methodological challenges.

This workshop series introduces state-of-the-art analytical frameworks and statistical workflows developed to address these challenges. Participants will begin with multi-block dimensionality reduction, used to transform high-dimensional and collinear exposomics data into biologically meaningful signatures.

The sessions will then explore methods for relating exposures to biological mechanisms through mediation and causal frameworks, analysing complex environmental mixtures, connecting molecular and exposure layers through network-based approaches, and integrating emerging omic layers such as the microbiome.

Participants will also discover strategies for working with missing or incomplete data, imbalanced outcomes and longitudinal analyses. Finally, the series will examine the role of Large Language Models (LLMs), generative AI and eXplainable Artificial Intelligence (XAI) in creating trustworthy, interpretable and practical multi-omics workflows.

Together, these approaches provide researchers with a practical and actionable toolkit for addressing modern epidemiological and precision environmental health challenges.

Code and materials

Designed as a highly practical, hands-on experience, the seminars will give participants access to the codes and resources needed to implement the presented techniques. All session codes and materials will be available directly and free of charge during and after the workshop through our Github and YouTube channel.

Audience

This workshop is aimed at Master/PhD students, researchers, clinicians, and other professionals working in exposomics, epidemiology, or toxicology who are interested in understanding how omics data, including the exposome, can be integrated into epidemiological research.

Research Topics

Module 1: Foundations of exposomics data integration & multi-block dimensionality reduction

• Introduction to multi-omics data integration: an overview of approaches
• Foundations of Dimensionality Reduction and Multi-Block Data Integration

Module 2: From exposures to biology: a tour of exposomics data integration frameworks in practice

• Multivariate Mediation Frameworks in Environmental Epidemiology
• Statistical Frameworks for Evaluating Complex Co-Exposures and Mixtures
• RGCCA for Exposomic Data Integration in Youth Health
• Network-Based Approaches for Multi-Omics and Environmental data Integration and Interpretation
• Metagenomics and the Microbiome as an Omic Layer in Health Research
• Longitudinal Methods and Frameworks for Multi-Omics and Environmental data Integration
• Outcome-wide analysis for exposomics 

Module 3: Machine Learning & AI frontiers

• eXplainable Artificial Intelligence (XAI) for making predictions in exposomics
• Biological Knowledge-Guided Machine Learning to Decode Environment-Disease Mechanisms
• Developing an Integrative Exposomics Platform (ExposomeX) to Expedite Discovery of the “Exposure–Biology–Disease” Nexus

Organisers

This workshop series has been organised by Léa Maitre and Augusto Anguita. Please contact Anna Oje (anna.oje@isglobal.org) for any queries or further information.

Do you want to revisit the first series?

Recordings of all 2024 sessions are available on YouTube. To access the slides and codes, please click HERE, or explore the workshop proceedings HERE.

With the support of the grant CEX2023-001290-S funded by MCIN/AEI/ 10.13039/501100011033.

Role of cattle in malaria transmission

Scientists have spent decades developing strategies to control malaria vectors. One of the most debated questions concerns the role of cattle in malaria transmission, giving rise to two competing hypotheses: zooprophylaxis and zoopotentiation. The former suggests that cattle can act as an alternative blood source, diverting malaria-carrying mosquitoes away from humans. The latter proposes that livestock may increase mosquito populations and, consequently, enhance disease transmission. However, previous studies have typically treated livestock as a household-level resource, without considering its broader role as an environmental exposure across the wider landscape shared by multiple households.

Environmental epidemiology framework

The new study introduces a spatial approach based on cattle density within a defined area, treating livestock as an environmental variable rather than solely as a household characteristic. According to the study's first author, Almudena Sanz, a researcher at ISGlobal at the time of the study and currently at Virginia Tech, this approach captures spatial effects that extend beyond the household where the cattle are kept, "applying an environmental epidemiology framework for the first time, which may help explain why previous studies have produced conflicting results."

According to Carlos Chaccour, the study's principal investigator, also at ISGlobal at the time of the study and currently at the University of Navarra, this new methodology "could be used to evaluate livestock-based malaria control strategies and help resolve the long-standing debate between zooprophylaxis and zoopotentiation."

This study was carried out as part of the BOHEMIA project, funded by Unitaid, which conducted a trial in Mozambique and Kenya using a One Health approach. Ivermectin, a well-tolerated antiparasitic drug, was administered to both humans and livestock through mass drug administration campaigns to reduce the mosquito population and, consequently, malaria transmission.

Reference

Sanz Gutierrez A, Otuko R, Xie K, et al. Spatial exploration of the impact of cattle on risk of malarial infection using data from a cluster randomised trial. BMJ Global Health. 2026;0. doi:10.1136/bmjgh-2025-022607

The event will introduce key concepts such as the exposome and healthy urban planning, explaining in a clear and engaging way how urban planning and design decisions can either promote or undermine population health. To this end, visual examples, live questions and interactive activities will help participants connect their everyday urban experiences with the latest scientific evidence.

In addition, participants will be introduced to open-access tools for exploring urban health indicators and comparing different cities, fostering a better-informed public with greater capacity to interpret data about their own environment. The programme will also include practical demonstrations of environmental sensors and healthy building materials, highlighting the importance of transparency and public access to information as key drivers for promoting healthier urban environments and better-informed policies.

This interdisciplinary dialogue aims to raise public awareness of the crucial role that the urban environment plays in collective health and to inspire a shared reflection on how to design cities that are healthier, more sustainable and more liveable for everyone.

Register here

Ivermectin is one of the most widely used antiparasitic drugs worldwide and is administered through mass drug administration campaigns to control neglected tropical diseases. Although it has shown potential to reduce malaria transmission by killing the mosquitoes that spread the disease, its use during pregnancy remains contraindicated because of the limited evidence available in humans.

Each year, inadvertent exposure to ivermectin occurs during very early pregnancy, as many women are still unaware that they are pregnant during the first few weeks. Despite this, evidence on its safety remains very limited, particularly during the first trimester. To generate new data, the research team analysed a prospective cohort embedded within the BOHEMIA trials, conducted in Mozambique and Kenya to evaluate the impact of mass ivermectin administration on malaria transmission.

“The substudy included 238 women who became pregnant between two weeks before and four weeks after receiving ivermectin or albendazole, which was used as the comparator treatment. All participants were followed up monthly until the end of pregnancy,” explains Patricia Nicolas, first author of the study and an ISGlobal researcher at the time the research was conducted.

The largest cohort studied to date

Of the 238 women included in the study, 129 had been potentially exposed to ivermectin and 109 to albendazole. Among those with a known pregnancy outcome, adverse outcomes (miscarriage, stillbirth or major congenital anomalies) occurred in 22.9% of the group treated with ivermectin and 19.5% of the group treated with albendazole. The differences between the two groups were not statistically significant.

“This trial represents the largest prospective cohort published to date on exposure to ivermectin during the first weeks of pregnancy and complements the limited evidence available so far, which included fewer than one hundred documented first-trimester exposures,” says Nicolas.

Prenatal care: a key factor

In addition to the effect of treatment, the study showed that women who experienced adverse pregnancy outcomes were much less likely to have received antenatal care and recommended preventive measures during pregnancy, such as iron and folic acid supplementation, insecticide-treated bed nets and preventive treatment against malaria. However, it should be noted that women who experience very early miscarriages have fewer opportunities to attend antenatal care visits.

More evidence, but still not enough

“Our findings help strengthen the evidence base on inadvertent exposure to ivermectin in early pregnancy, but the number of documented pregnancies remains too small to support changes to clinical or regulatory recommendations. Further evidence from additional studies and surveillance systems will be needed,” concludes Carlos Chaccour, co-principal investigator of BOHEMIA and an ISGlobal researcher at the time of the study.

Reference
Nicolas, P., Mundaca, H., Brazeal, A., Houana, A., Ngama, M., Macucha, A., Matano, A., Elobolobo, E., Vegove, V., Martinho, S., Kariuki, M., Mbanze, J., Mitora, S., Montañà, J., Ringera, I., Túnez, L., Imputiua, S., Munguambe, H., Mutepa, V., … Chaccour, C. (2026). Risk of adverse pregnancy outcomes following inadvertent exposure to ivermectin during the periconception period: findings from two cluster-randomized trials in Mozambique and Kenya. eClinicalMedicine, 97(104069), 104069. https://doi.org/10.1016/j.eclinm.2026.104069

The Lancet Countdown Europe is an international, interdisciplinary research initiative that aims to develop open, transparent and rigorous indicators to track the impact of climate change on population health. As well as monitoring the health impacts of climate change, it follows the adaptation and mitigation actions taken, the economic and financial aspects, and public and political engagement across Europe. This special edition of the Lancet Countdown in Europe report will be published in the Lancet Public Health journal on September 10, 2026.

This report will be launched in Barcelona. Prof. Cathryn Tonne, co-Director of The Lancet Countdown in Europe, will present the main findings. International, European, and local organisations will follow. They will highlight the progress developed on the ground, and the gaps needed to accelerate climate change action in cities

A panel discussion with local representatives and experts will follow. The discussion will explore the key ingredients needed for successful integrated climate and health action: How does transformative change actually happen? What role do indicators play in driving equitable progress? How are cities turning climate policy into practice? And how do we bring people along to build the social support that ambitious action demands, supported throughout by strong implementation, monitoring, partnerships and societal engagement?

The event is open to everyone, either in person or online. Refreshments will be served at the end of the event, and there will be an opportunity to meet the researchers who contributed to the Europe Cities report of the Lancet Countdown, as well as the keynote speakers and panelists.

Follow the event live 

You can follow the event in streaming using the following link. 

Agenda

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

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

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

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

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

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 - Quique Bassat (General and Scientific Director at ISGlobal) & Teresa Sanchis (Director-General for Research at the Department of Research and Universities of the Government of Catalonia)

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 Saint-Gelais (Mind-Body & Executive Coach)

14h45 – 15h45: Retaining Talent: Training Programs

Round Table:

• María José Merino (moderator): HR and Organisational Development coordinator at ISGlobal
• Vanessa Saint-Gelais: 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)
• Julio Gómez: Head of Human Resources at the Catalan Institute of Nanoscience and Nanotechnology (ICN2)

15h45 – 16h00: Final remarks

Keynote sessions

Marta Agostinho

From Talent to Thriving: The next frontier for research careers in Europe

The future of European research depends not only on scientific excellence, but on our ability to create career paths that allow researchers to grow, contribute and flourish. This keynote will reflect on the evolution of research careers in Europe and offer a forward-looking vision for the conditions needed to support talent across the entire research lifecycle—from attraction and selection to development, leadership and long-term impact.

About the speaker

Marta Agostinho is the Executive Director of EU-LIFE, an alliance of leading European research institutes in the life sciences. Her work spans science policy, research governance and culture, strategic science management, communication and public engagement. She co-designs and oversees EU-LIFE’s overall strategy, leads its science policy activities and represents the alliance externally.

She holds a PhD in Cell Biology and a post-graduation in Science Communication, and has over 15 years of experience in knowledge mediation, following a decade in life sciences research. Her previous roles include Director of the Communication & Training Unit at Instituto de Medicina Molecular in Lisbon and Project Manager at NOVA Medical School, where she coordinated a European Joint Action in Mental Health policy. She also has experience as a trainer, lecturer and EU expert evaluator.

Michele Rosa-Clot

The European Charter for Researchers and its implementation process: a framework for institutional change

The European Charter for Researchers and its implementation through the HR Excellence in Research Award provide a framework for attractive and sustainable research careers through institutional change. The Award translates principles into a practical toolkit for stakeholder engagement, organisational development and continuous improvement, supporting institutions across the research talent lifecycle and moving implementation beyond compliance towards meaningful institutional transformation.

About the speaker

Michele Rosa-Clot has been the HR Excellence in Research Award Portfolio Owner at the European Commission, DG RTD, in the Unit “ERA, Spreading Excellence and Research Careers” since 2019. In this role, he contributes to the development of the European Charter for Researchers and coordinates its implementation through the HR Excellence in Research process. Previously, he worked in the European Commission’s Directorate for the Galileo satellite system at DG GROW.

A former international researcher, he holds a PhD in Political Science from the University of Pisa and an MA in History from the City University of New York. As a Fulbright scholar, he spent several years studying, researching and teaching in New York. His professional career has also included research on migration, renewable energy policy and work in the arts.

Vanessa Saint-Gelais

Research Yourself: Navigating Career Crossroads and What Comes Next

Career crossroads are a natural part of a research career, not a sign that something went wrong. This keynote speaks to both, those navigating their own next step and those supporting researchers to do the same. Drawing on her journey from PhD neuroscientist to corporate leadership in pharma and running her own business, Vanessa Saint-Gelais explores how to figure out your options and what to actually do next.

About the speaker

Vanessa Saint-Gelais, a PhD-trained neuroscientist, built her career across research, corporate leadership in the pharmaceutical industry, and now her own coaching and consulting practice. She coaches professionals and executives through career transitions, leadership development, and complex decisions. Her approach draws on neuroscience, somatic coaching, and over a decade of corporate experience to help people move forward with clarity.

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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 for Health
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)

Posters / Rapid fire presentations (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 Priorities" statement to guide future directions
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.

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.

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. 

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

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.

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.

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

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.

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