The causes of ill health and death are changing and, as we live longer, new health-preventable problems emerge, bringing new challenges. Improving health (physical, mental or both) and promoting general well-being remain major priorities.

Just as important, the difference in health status between rich and poor continues to grow. At a global level, the picture is even more complex. Although there is some evidence that life expectancy is beginning to plateau in developed countries such as the UK, the biggest potential to improve health still lies in addressing inequality between or within countries.

Therefore, this chapter:

• summarizes the models of health improvement that are prevalent today;

• introduces a combined conceptual model to describe the factors affecting health in modern times; and

• presents some case studies of interventions designed to improve health which offer important insight and learning.

This chapter extends the consideration of the changing global burden of diseases and discusses what is required to mount an effective response to public health challenges, particularly in countries where people are living in extreme poverty. It considers the role of international development assistance and the responsibilities of the international community in improving the health of poor people.

This chapter examines how the digital financial infrastructure that emerged in the wake of the 2008 GFC assisted to address the financial, economic, and health challenges presented by the COVID-19 pandemic. While the 2008 Crisis was a financial crisis that impacted the real economy, COVID-19 was a health and geopolitical crisis that impacted the real economy. In fact, during COVID-19 the financial system turned from problem child to crisis manager, having provided effective tools to support the crisis response. Notwithstanding the former, digital finance has also created new forms of risk (TechRisk).

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the pandemic declared in March 2020. While many of the manifestations (i.e., acute respiratory distress syndrome [ARDS]) are similar to other severe respiratory viruses, there is an increasing number of specific therapeutics found to be effective in combating coronavirus disease 2019 (COVID-19). As data emerge on the optimal treatment of COVID-19, the recommendations in this chapter are based on the current consensus from large global health and infectious disease authorities but are subject to evolution of the evidence.

Many treatment and vaccine candidates for COVID-19 will receive some form of exclusivity rights that protect against domestic and international competition. The COVID-19 pandemic has magnified the need to expediently develop vaccines and therapeutics, and exclusivities exist to incentivize research and development. However, we have seen in the past that exclusivities have unintended consequences – increased costs to patients and payers, shortages due to limited manufacturing capabilities, and efforts to forestall competition, particularly for lucrative products. Three forms of exclusivities are relevant in the context of COVID-19, which are cumulative but can also exist separately: data, patent, and regulatory exclusivity. This article compares each of these exclusivities in Europe and in the United States, focusing on implications for pricing, production and global access of therapeutics and vaccines for COVID-19. Given the need to develop, rigorously test, mass produce, and widely disseminate treatments and vaccines once available, exclusivity rights may be used as nationalistic shields, favoring provision to certain nations over others and posing an impediment to global treatment for and eradication of COVID-19. We suggest system improvements for COVID-19 and future emerging infectious disease outbreaks that balance the need to incentivize research and development without sacrificing cost, availability, or access. In public health emergencies such as pandemics, policies should be in place to optimize provision of essential products across the globe. We also explore potential reforms of the patent, regulatory, and antitrust systems that will help broaden access to essential treatments and vaccines in response to extraordinary situations such as COVID-19.

Stress associated with the COVID-19 pandemic can threaten the ability to successfully maintain established romantic relationships as well as navigate the initiation and development of new relationships. Drawing on the vulnerability-stress-adaptation (VSA) model, we propose that the extent to which pandemic-related stress will undermine couples’ relationships, as well as the initiation of new relationships, will depend on the amount and severity of pandemic-related and preexisting levels of stress combined with enduring personal vulnerabilities such as attachment insecurity. We review a growing body of research examining relationship processes and functioning prior to and during the initial stages of the pandemic that provides evidence consistent with this framework and draws on related research suggesting routes to minimize relationship disruptions and promote resilience. In addition, we review newly emerging research examining how pandemic-related stress might impact the initiation of relationships. Finally, we discuss several directions for future research to facilitate an understanding of the longer-term implications of the pandemic for ongoing and newly developing romantic relationships.

The amount of people worldwide who regularly used opioids in 2021 is staggering, and if something is not done to change the course of this epidemic, the numbers will continue to increase year over year, just as they have done over the last decade. Roughly 275 million people globally report having used drugs of any kind in the past year, an increase of almost 50 million people over the past ten years. While some of this increase was due to the 10% rise in global population over the same period, this alone cannot account for the entirety of the 22% rise in global drug use. Health-care systems around the world are being stretched beyond their capabilities to manage a population this large, and the number of people with opioid use disorder is projected to continue to increase in size over the next decade. The effects of the opioid epidemic on healthcare systems are particularly devastating in poorer and middle-income countries with less robust resources. Over the past decade the number of individuals with opioid use disorder has increased by almost 9 million, an increase of over 33%, and now affects 0.7% of the current global population.

In light of growing geopolitical tensions between China and the West, the chapter focuses on areas of persistently shared interests and common concerns of humankind. Climate change, the protection of biodiversity and pandemics cannot be addressed in isolation but require common efforts and international cooperation in the dissemination of technologies and knowledge, despite ideological differences. The paper stresses the importance of existing WTO law and sets a trade-related agenda for these areas. Finally, it submits that a future principle of Common Concern of Humankind offers guidance in finding common ground for multilateral negotiations on trade, competition and investment in the WTO. It is capable of protecting the interests of a global community increasingly caught in big-power rivalry.

This chapter applies Pragmatic Constructivism to assess communities of practice in global health governance. It focuses on the problem of containing contagious diseases. This is one of the tasks of the World Health Organization (WHO) and its practice of declaring a Public Health Emergency of International Concern (PHEIC). Given the uncertainty surrounding such a practice, which could lead to the isolation of an effected state, the decision inevitably involves judgement calls rather than the pre-reflexive implementation of pre-planned steps. Applying the first Pragmatic Constructivist test to this practice means asking if the community of practice charged with making that judgement is properly constituted and sufficiently inclusive. The evidence suggests that it is not. The chapter problematizes practice that unduly privileges technical (in this case epidemiological) expertise over social and political advice. A second application of the two Pragmatic Constructivist tests focuses on an inconsistency internal to global health practices as they relate to the distribution of vaccines. Practices that achieve more comprehensive coverage, such as the local manufacture of vaccines, are being prevented by intellectual property practices. The chapter considers how the knowledge of the Covid pandemic challenges the epistemic authority of intellectual property practices.

Chapter 7 analyzes misinformation and conspiracy theories as contemporary examples of fake news. These include the “death panels” controversy, the Obama “birther” conspiracy, Pizzagate, QAnon, and Covid-19–related myths and conspiracies. Not all conspiracy theories originate from the American right, although this chapter documents how the highest profile ones are embraced by right-wing media and the Republican Party. These conspiracies rise to prominence after being indulged by Republican officials, right-wing media outlets, and in social media. Social media increasingly serve as prime disseminators of reactionary conspiracies. I also examine how traditional “agenda setting” news media have held the line against these conspiracies, with consumption of these venues associated with increased rejection of the conspiracies. In contrast, social media consumption – in general and particularly for Republican Americans – is regularly associated with embrace of conspiracies. This rising culture of conspiratorialism has reached crisis levels with movements like QAnon, and with the Covid-19 pandemic and the failure of millions of Americans to take the crisis seriously or think about it in factual ways. In an era when traditional media gatekeepers are being pushed aside in favor of social media venues, people curate their own information and construct echo chambers, allowing conspiracy theories free reign.

Working online and by phone can be useful in certain circumstances. However, it is important to be mindful that psychodynamic therapy online or by phone requires a shift in frame, boundaries, and setting. In order for the therapy to remain helpful and containing, both therapist and patient should be clear on the new framework and be able to review and consider in-person sessions if needed. This chapter uses clinical examples to illustrate some of these differences and how they might offer opportunities and also challenges. In addition, it includes discussion on technical and practical issues to consider if embarking on psychodynamic therapy online or by phone.