Publications
Journal articles, reports, and analysis from the Spark Street team.
Artificial intelligence for research capacity strengthening: Two reviews and a pathway to shift power in global health
Global health research has long been shaped by inequalities rooted in colonial legacies, with researchers in wealthier countries generally leading the setting of research priorities. This paper examines whether AI tools...
Read more →Global Health Equity Considerations of Political Decisions: Trump, The US, and Immunization
The paper examines how political choices on global health funding affect the four key dimensions of vaccination and immunization in LMICs: access, affordability, availability, and acceptability. It shows how reductions...
Read more →Adoption of pandemic treaty is historic: Compliance and accountability must now follow
The Pandemic Treaty adopted at the 78th World Health Assembly (WHA78) is a landmark achievement in global health. Adoption is just a first step. As negotiators continue to work on Pathogen Access and Benefits Sharing,...
Read more →The pandemic treaty: A forensic review of process and pitfalls
This article examines efforts to develop a pandemic treaty through World Health Organization member state agreement from 2021 to 2025, focusing on challenges during the process. The COVID-19 pandemic showed the critical...
Read more →Pandemic treaty is a win for multilateralism and global health
The World Health Organization's new Pandemic Agreement marks a historic step toward global health security and equity. Reached after three years of negotiations, the Treaty outlines commitments to strengthen health...
Read more →The lessons New York still has not learned from the Covid vaccine rollout
New York's early COVID-19 vaccine rollout failed its most vulnerable residents. Drawing on firsthand experience and data, this article reports how older adults in low-income neighborhoods were left behind. New York's...
Read more →Why we need a pandemic treaty now
With just one week of formal negotiations left, the world may be nearing its last chance to secure a global pandemic treaty that strengthens preparedness and response. Despite legal assurances that national sovereignty...
Read more →Achieving gender justice for global health equity: the Lancet Commission on gender and global health
Achieving gender justice in global health has the potential to improve health outcomes, reduce inequities, and transform workplaces and governance. Yet gender has become a polarizing concept, and efforts to advance...
Read more →An 'impact hub' approach to transforming global maternal health outcomes by 2030
Preventing maternal mortality remains a persistent global challenge. Eliminating preventable deaths requires more than isolated success stories, it demands a coordinated, systemic approach rooted in equity, local...
Read more →Zero-Draft Framework for Tracking Implementation of the Pandemic Agreement
The Pandemic Agreement directs the Conference of Parties (COP) to create a mechanism to facilitate and strengthen implementation, including by monitoring key commitments and progress. This zero-draft framework is...
Read more →HPV Vaccination in Out-of-school Context
HPV vaccination programs worldwide have primarily deployed school-based delivery strategies, with very little effort to reach girls who are temporarily or permanently out of school or beyond school age. This global...
Read more →HPV Vaccination in Out-of-school Context: Assessment Tool
Companion tool to the global review, developed with the Bill & Melinda Gates Foundation, Pathfinder, Acasus, and Social Impact — a standardized approach to identify entry points and partners for reaching out-of-school girls with HPV vaccinations...
Read more →Mpox: Neglect has led to a more dangerous virus now spreading across borders
The ongoing mpox outbreaks in Africa, driven by various clades including a newly identified Ib variant, are a severe concern. Despite mpox being endemic in several African countries for years, international attention...
Read more →The pandemic agreement: Achieving an African win for health security inequity
The COVID-19 pandemic exposed the frailty and disparities of global health systems, especially in Africa. Vaccine nationalism and lack of inclusivity characterized early responses, raising concerns about global health...
Read more →Beyond "business as usual": Lessons from FIFA for fair benefit-sharing in global health
Researchers and agencies from low- and middle-income countries often contribute significantly to public health data but lack adequate compensation. Incentivizing data sharing is crucial for effective pandemic response,...
Read more →From lemming to leader: Moving beyond Gross Domestic Product (GDP) to bring health financing assistance into the 21st century
Nearly 90 years after GDP was introduced to measure economic growth, there are increasing calls to stop using it and GNI for broader purposes, such as determining eligibility for development assistance. These measures...
Read more →Assessing New York City's COVID-19 Vaccine Rollout Strategy: A Case for Risk-Informed Distribution
This study reviews the impact of early COVID-19 vaccine eligibility policies on coverage and outcomes in New York City. Using data from the Census Bureau and New York City Health, the authors assessed vaccination...
Read more →Governance provisions in the WHO Pandemic Agreement draft
The WHO Pandemic Agreement draft lacks sufficient accountability measures. While it introduces a Conference of the Parties (COP) for governance, crucial details such as review scope and consequences for non-compliance...
Read more →Shaping Global Health Law through United Nations Governance: The UN High-Level Meeting on Pandemic PPR
The UN General Assembly High-Level Meeting on pandemic prevention, preparedness, and response failed to garner significant high-level commitment and momentum for global health emergency governance. This article explores...
Read more →Getting in Formation: WHO Constitutional Heads of Power and the Pandemic Agreement
WHO Member States are nearing the end of negotiations for a proposed Pandemic Agreement, considering whether to adopt it under Article 19 or Article 21 of the WHO Constitution. While this may seem a simple 'opt in' or...
Read more →The new pandemic treaty: Are we in safer hands? Probably not
The latest draft of the pandemic treaty falls short of expectations with governance revisions that lack accountability measures, leaving oversight to Member States through a World Health Assembly committee. Without...
Read more →WHO Member States are negotiating a Pandemic Treaty. But will countries follow the new rules?
An independent monitoring mechanism is essential for the Pandemic Accord. Negotiators must remember to keep Member States accountable. It's feasible, viable, achievable and vital for preparing for the inevitable next...
Read more →Where there is a will, there is a way: independent assessment of member state compliance with the pandemic agreement
On Oct 16, the world got its first glimpse of the complete draft negotiating text of the proposed pandemic agreement. In analysis of the preliminary draft, the authors found gaps in crucial areas such as health system...
Read more →Independent Monitoring for the Pandemic Agreement – A Proposal for Action
Based on evidence from monitoring other treaties, expert interviews, and analysis of various forms of independence, this report outlines the draft zero Terms of Reference for a Pandemic Agreement Independent Monitoring...
Read more →Learning Organizations: Theory and Practice
This report explores organizational learning, summarizing theoretical and practical aspects. It examines key concepts, models, and enablers of learning that help organizations adapt and develop, and, by analyzing six...
Read more →Independent monitoring and the new pandemic agreement
Negotiations are ongoing at the WHO for a binding pandemic prevention agreement, but past agreements haven't guaranteed effective implementation. While enforcement mechanisms are crucial, they're inconsistently applied...
Read more →Primary health care: a cornerstone of pandemic prevention, preparedness, response, and recovery
The COVID-19 crisis highlighted the devastating consequences of neglecting primary health care before, during, and after a pandemic. This regression created a vicious cycle of vulnerability, especially for groups at high...
Read more →We cannot give up on the global pandemic treaty
Nearly two years after countries agreed to develop a new pandemic treaty, the prospect of achieving a bold new global agreement to prepare and respond to future disease threats is slipping away. The UN General Assembly's...
Read more →Bold moves for vaccine manufacturing equity
The COVID-19 pandemic resulted in an unprecedented global crisis, and although there was unprecedented speed in developing new vaccines, the benefits from licensing effective vaccines in record time were not felt by all....
Read more →Independent monitoring for the pandemic accord: a non-negotiable provision
The COVID-19 pandemic exposed the need for a coordinated global response to pandemics. In response, the Intergovernmental Negotiating Body for a pandemic accord discussed a zero draft in February 2023. Based on a...
Read more →Independent Review and Investigation Mechanisms to Prevent Future Pandemics: A Proposed Way Forward
To inform the design of an accountability system for a pandemic treaty, this report explores institutional mechanisms with a mandate to review state compliance with key international agreements and conduct independent...
Read more →We need a pandemic treaty — but it must hold nations accountable
The cycle of state denial and downplaying followed by disastrous consequences is a familiar pattern in public health crises, as demonstrated during the COVID-19 pandemic. To prevent similar outcomes in the future, it is...
Read more →We need a new global compact on vaccines
Amid the emergence of monkeypox cases in the US and Europe, efforts are underway to vaccinate populations using the smallpox vaccine, which offers some cross-protection but is in limited supply. The global vaccine...
Read more →Strengthening Gavi is a way forward for global vaccine equity
The upcoming Biden administration COVID-19 summit shone a spotlight on global vaccine equity failure, where only 16% of people in low-income countries were vaccinated, compared to 80% in high-income nations. Lessons from...
Read more →Why we still need a pandemic treaty
The 2022 World Health Assembly saw Member States discussing amendments to the International Health Regulations. Despite meeting in person for the first time since COVID-19, little progress was made on solutions for...
Read more →Use of financial incentives to increase adult vaccination coverage: A narrative review of lessons learned from COVID-19
To encourage COVID-19 vaccination, governments have offered a wide range of incentives ranging from cash to cows. This narrative review sought to understand the evidence base informing these programs and the extent to...
Read more →Independent Monitoring Mechanism for the Pandemic Accord - Accountability for a Safer World
This analysis features a proposal for independent monitoring of state compliance with an eventual pandemic accord, based on analysis of monitoring approaches to relevant international treaties, literature reviews, and...
Read more →Increasing efficiency in vaccine production: A primer for change
The COVID-19 pandemic highlighted the importance of vaccines as public health and pandemic preparedness tools and amplified issues ranging from equitable distribution to reliable supply. Delays in time from the first...
Read more →Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview
Although digital interventions for mental health can be effective for both supplementing and supplanting traditional treatment, only a small proportion of existing digital platforms are evidence based. Their...
Read more →The World Should Treat Pandemics Like It Treats Chemical Weapons
While the world was still battling COVID-19, it was time to start preparing for the next pandemic, above all, how to prevent it. This piece argues for taking pandemic containment as seriously as other dangers of mass...
Read more →Data Sharing and Global Public Health: Defining What We Mean by Data
As the volume of public health data expands and data become more interconnected, a broad range of data is being used to support research and inform global health policies and practice. This paper expands on an existing...
Read more →Artificial intelligence (AI) and the future of global health
Although AI-driven health interventions can help address several existing and emerging health challenges, many issues are not sufficiently described in the literature and warrant further exploration. These relate to the...
Read more →Accelerating access to medicines in a changing world
Many access tools were designed and implemented by donors, with relatively little engagement from patients or interaction with the systems into which the product is or will be introduced.
Read more →COVID-19: Rethinking risk
Although older age and underlying conditions are visible markers of increased risk, people subject to structural inequities are more likely to develop underlying conditions and receive poor quality health care for...
Read more →Why are we closing schools?
Keeping kids out of the classroom will make recovering from the pandemic harder in the long term, while not keeping us any safer in the near term. Reopening schools doesn't appear to meaningfully increase the level of...
Read more →Apples and oranges? Can second-generation vaccines become as low cost as generic medicines?
A step change in cost will require fundamental shifts in vaccine technologies and how they are developed, regulated and even manufactured.
Read more →Expanding the use of community health workers in urban settings
As global and national policymakers deliberate approaches to achieving the SDGs, including universal health coverage, the delivery of community-based interventions involving community health workers in urban settings...
Read more →Global Public Goods for Health (GPGs)
In a new policy paper, the authors examine the potential support for global public goods for health from four organizations that provide the most development assistance for health: Gavi, the Global Fund, World Bank, and...
Read more →Artificial intelligence (AI) and global health
As resource-poor settings become more connected and the data they produce of higher quality, the ability of AI to address health challenges will likely expand.
Read more →Time's up for journal gender bias
From January 2013 through February 2018, The Lancet published the reports of 39 Commissions. Only 34% of all named commissioners have been women.
Read more →Maternal and child health and non-communicable diseases
Following a life-course approach, maternal and child health interventions, before delivery and during childhood and adolescence, can prevent non-communicable diseases.
Read more →Generation Men
The Fearless Girl statue that faces down Wall Street's charging bull grabbed international headlines and triggered a debate about the glass ceiling that continues to obstruct women.
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