Publications | GLACIER One Health Project

Institutional reform and social policies in post-covid Cuba: an agenda for cooperation

by GLACIER | Jul 4, 2025 | Other, Publications

Cuba and the European signed the Political Dialogue and Cooperation Agreement (PDCA) in December 2016. In many ways it has been a very long six years. Four years of Trump’s US government disrupted the world and, with regard to Cuba, abruptly cut short the normalisation process begun under the Obama administration. Instead, the US embargo has been tightened.
Moreover, a shrill rhetoric has returned, as much from Republicans in Washington as from the Cuban-American community in Miami, that casts long shadows over any ideas of dialogue and reconciliation.

At the same time the Cuban economy has gone from bad to worse. The COVID-19 pandemic brought international tourism to a standstill and led to dramatic disruptions of the island’s economic and social life. Hopes for increased political tolerance in the post-Castro era have not been fulfilled. When popular frustration erupted in street protests on July 11th 2021, the state responded heavy-handedly. Hundreds were put on trial and given often draconic jail sentences. As plane traffic resumed, emigration soared.

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Shared Challenges, Shared Responsibilities: Lessons Learnt for EU-LAC Cooperation in Global Health

by GLACIER | Jul 4, 2025 | Other, Publications

This policy brief examines the lessons learned from the COVID-19 pandemic and the urgent need to strengthen bi-regional cooperation between Europe and Latin America and the Caribbean to improve preparedness for future health crises. It highlights the inequalities in vaccine availability and mortality, as well as the importance of reinforcing health systems, particularly primary care, to ensure equity and universal coverage.

Additionally, it emphasizes the need to increase regional production of medicines and vaccines, promoting mutual knowledge transfer. International cooperation, training of health personnel, and strengthening supranational networks are essential to address global health challenges, including those arising from climate change and tropical diseases.

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Desafíos Compartidos, Responsabilidades Comunes: Lecciones Aprendidas para la Cooperación UE-ALC en Salud Global

by GLACIER | Jul 4, 2025 | Other, Publications

Este Informe de Políticas es el resultado de los diálogos mantenidos durante el Simposio Internacional “Colaborando por la Salud Global: Desafíos y Responsabilidades Compartidas. Un Diálogo Transatlántico de Políticas entre Europa y América Latina y el Caribe”, coorganizado por la Fundación EU-LAC, el Centro Alemano-Latinoamericano para la Investigación en Infección y Epidemiología (GLACIER), el Instituto Alemán de Estudios Globales y de Área (GIGA) y el Instituto de Salud Global de Barcelona (ISGlobal) el 25 de junio de 2024, en la Charité de Berlín. Los organizadores agradecen el apoyo financiero de la Unión Europea, el Ministerio Federal de Relaciones Exteriores de Alemania y el Servicio Alemán de Intercambio Académico (DAAD).

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The social determinants of maternal and congenital syphilis at the Colombia-Venezuela border: A qualitative study of twenty mothers of newborns with congenital syphilis

by GLACIER | Jul 4, 2025 | Other, Publications

Humanitarian crises and resulting out-migration have created contexts in which treatable diseases such as syphilis have expanded in prevalence. Untreated syphilis can have potentially irreversible and devastating consequences, especially for infants born with congenital syphilis. Our study aimed to understand the experiences of postpartum mothers whose newborns have been diagnosed with congenital syphilis and explore the social determinants of maternal and congenital syphilis. The setting of our study is the main public hospital in Cúcuta, Colombia, at the border with Venezuela, which provides emergency care to everyone regardless of documentation and thus receives a high share of Venezuelan migrants. We conducted twenty in-depth interviews with women who had their newborns hospitalized with a diagnosis of congenital syphilis. Sampling was conducted purposively at the hospital, between March and June 2023. Study participants were mostly Venezuelan migrants and Colombian returnees, from their teens to their forties. We used a grounded theory technique to conduct thematic analysis. Four major themes emerged: 1) experiencing a pregnancy in the context of a lack of resources, violence and ignorance; 2) guilt with and reinfection of syphilis; 3) challenges and limitations in accessing health care; and 4) limited support networks and machismo. Reported challenges were intertwined with the high costs of health care in the country of origin, the lack of knowledge of sexually transmitted infections, the limited public health education targeting this population group, and the absence of Colombian public policies that promote care for the non-regularized migrant population.

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Shock y política pública: determinantes político-institucionales de la vacunación contra COVID-19 en Centroamérica (Shock and public policy: political and institutional determinants of COVID-19 vaccination in Central America)

by GLACIER | Jul 4, 2025 | Other, Publications

The COVID-19 pandemic, as a shock scenario, provided an opportunity to study the performance of the same policy instrument implemented simultaneously across diverse national contexts. This research addresses the question: How do institutions and political management of COVID-19 vaccination explain the variable performance across Central American countries throughout 2021? The study aimed to first characterize and then account for this performance variation. To operationalize vaccination performance, the study considered aspects addressed in existing literature, integrating three fundamental dimensions: coverage, sufficiency, and sustainability. Each dimension was operationalized through specific indicators linked to different immunization stages (first, second, and third doses), combining public policy metrics—such as population coverage—with epidemiological indicators—such as vaccination speed. This comprehensive analytical framework captures the complexity of the immunization process during a health crisis, particularly relevant for a region that faced the pandemic under adverse structural conditions. The regional analysis is complemented by process tracing within a paired comparison framework, establishing three country pairs: Costa Rica-Panama, El Salvador-Nicaragua, and Honduras-Guatemala. This allowed for a deeper understanding of COVID-19 vaccination performance by examining convergences and divergences between comparable national cases. Empirical research revealed heterogeneous vaccination policy performance across Central America, manifesting in three distinct levels: high (Costa Rica and Panama), intermediate (El Salvador and Nicaragua), and low (Honduras and Guatemala). Rather than simply reproducing expected performance levels based on pre-pandemic factors, this pattern reflected political and institutional factors that this study sought to unravel. The theoretical framework developed in this research generates new analytical perspectives for the field of social policy studies. It builds upon established theories for social policy development in “normal times.” These theories recognize the weight of sectoral factors such as policy legacies, state capacity, and public policy architectures, as well as macro-political factors like political regimes and leadership. This study combined these elements to explain the response to a shock. The work is structured in four main sections: a problematization chapter establishing justification, background, and research object; a theoretical-conceptual framework chapter presenting the methodological design; a comparative regional analysis examining identified dynamics and patterns; and three chapters dedicated to detailed analysis of results obtained through country-pair comparisons.

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Evolución histórica del concepto de comunidad y su relación con la salud pública (Historical evolution of the concept of community and its relationship to public health)

by GLACIER | Jul 4, 2025 | Other, Publications

Introduction: The clearest origin of the term community can be traced back to the late 19th century, in the political discourse of the time, in the works of authors such as Hegel and Marx. Objective: To understand the historical evolution of the concept of community and its relationship to public health. Methods: A literature review was conducted on the term community and its approach from various angles, from ancient Greece to the present day. Results: The origin of the term community dates back to ancient times, when people grouped together as a means of protection against the threats of nature and to ensure the survival of the group through the provision of food. Community action to improve health should not be determined in the classic way of health interventions, that is, from academia or government to the population, but should be generated in the opposite direction: from the community and the team to the central-higher level. Conclusions: Over time, the concept of community has been used in most of the processes of territory construction. Community health is a model of care that involves comprehensiveness, interdisciplinarity, intersectorality, and social development.

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