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Through the example of a “regulatory ranking” – an index produced with the aim to regulate the pharmaceutical market by pushing companies in the direction of providing greater access to medicine in developing countries – this chapter focuses on indexing and ranking as infrastructural processes which inscribe global problem spaces as unfolding actionable territories for market intervention. It foregrounds the “Indexal thinking” which structures and informs regulatory rankings – their aspiration to align the interests of different stakeholders and to entice competition among the ranked companies. The authors detail the infrastructural work through which such ambitions are enacted, detailing processes of infrastructural layering/collage and patchwork through which analysts naturalize/denaturalize various contested categories in the ranking’s territory. They reflect on the consequences of such attempts at reconfiguring global topologies for the problems these governance initiatives seek to address.

The 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS) was an abrupt reminder that infectious diseases pose a continuing threat to human health. In 1967, U.S. Surgeon General William H. Stewart declared “it was time to close the book on infectious diseases” (Garrett, 1994, citing W.H. Stewart, “A Mandate for State Action,” presented at the Association of State and Territorial Health Officers, Washington, DC, December 4, 1967). In the latter half of the twentieth century, many shared this bold view that medical science had vanquished infectious disease. As a result, public health struggled to remain relevant in the face of advances in pharmaceuticals, surgery, genetics and other areas that were becoming increasingly dominant in the quest to extend and enhance human life. SARS forced many to rethink the significance of public health and the crisis, though relatively short-lived, (for commentary on the disparities between the responses to HIV and SARS, see e.g. Altman (2003)) underscored the need to rebuild public health capacity that had been allowed to slip down the health system priority list.

There is no doubt that global climate change poses a threat to human health in a number of ways. Globally, 23% of all deaths in 2012 were attributed to the environment and an additional 250,000 potential deaths per year from 2030 to 2050 due to the effects of climate change. Heat waves, storms, droughts and floods pose an immediate risk of infectious diseases in humans. Temperature affects the survival rates of pathogens. Some populations and some areas are more vulnerable to infectious diseases due to their lack of ability to respond effectively to the stresses of high temperatures. Excessive rainfall could cause sewage to overflow and promote the onset and spread of infectious diseases ranging in severity from mild gastroenteritis to life-threatening illnesses such as cholera, dysentery and other diseases. Infectious diseases are a category of health problems that are particularly affected by climate change. Infections that occur are air-borne, water-borne and zoonotic. They are affected by the increase of the temperature, but also by the increase of the viral load in the water due to changes in the rainfall. Transmission can also take place through the migration of environmental refugees. Such an important topic could be the subject for students learning English. The purpose of this study will be to highlight the association of climate change with infectious-communicable diseases in order to take action and to create the structure by which students could learn English by studying these definitions.

Primary care (PC) is a strong determinant of overall health care. Children make up around a fifth of the population of the European Union and European Economic Area and have their own needs and uptake of PC. However, there is little research into how well PC services address their needs. There are large differences in childhood mortality and morbidity patterns in the EU and EEA countries, and there has been a major epidemiological shift in the past half century from predominantly communicable disease, to non-communicable diseases presenting and increasingly managed in PC. This increase in multifactorial morbidities, such as obesity and learning disability, has led to the need for PC systems to adapt to accommodate these changes. Europe presents a challenging picture of unexplained variation in health care delivery and style and of children’s different health experiences and health-related behaviour. The Models of Child Health Appraised (MOCHA) project aimed to describe the PC systems in detail, analyse their components and appraise them from a number of different viewpoints, including professional, public, political and economic lenses. It did this through nine work packages supported by a core management team, and a network of national agents, individuals in each MOCHA country who had the expertise in research and knowledge of their national health care system to answer a wide range of questions posed by the MOCHA scientific teams.

There is sufficient evidence to prove that the improved health status of a nation’s citizens results in economic growth and development via improved functionality and productivity of labor. It is also commonly accepted that healthcare expenditure significantly influences health status through, for instance, improving life expectancy at birth and reducing morbidity, death, and infant mortality rates. Within healthcare, medicines account for a considerable share of health-related expenditure in both developed and developing countries. Therefore, it seems reasonable to assume that improved access to medicines is likely to contribute not only to the well-being of families and individuals but also to the economic growth and development in all societies. It has been widely advocated that pharmaceutical multinational enterprises (MNEs) can play an important role to address this problem, as they develop and supply a significant proportion of the drugs imported by low- and middle-income countries. This chapter is dedicated to a systematic review of literature in order to identify the strategies implemented by pharmaceutical MNEs to improve access to medicines in the low- and middle-income countries. A total of 76 research articles have been identified, and we have found that the main strategies of pharmaceutical MNEs are related to improving health outcomes through R&D, establishing partnerships for product development, pricing strategies to improve access to medicines, technology transfer, licensing agreements, and nonmarket efforts to improve access to medicines, among other strategies to overcome barriers imposed by intellectual property rights. We have also found that pharmaceutical MNEs’ strategies take place within a complex system and often involve interactions with a wide range of actors, such as international organizations, governments, private not-for-profit sector, universities and research institutes, and generic manufacturers. However, there is still a need for major progress in the field of access to medicines, and pharmaceutical MNEs should be more active in this field in order to avoid potential negative consequences, such as loss of legitimacy and compulsory licensing of their patented medicines.

In order to assess the state of health of Europe’s children, or to appraise the systems and models of healthcare delivery, data about children are essential, with as much precision and accuracy as possible by small group characteristic. Unfortunately, the experience of the Models of Child Health Appraised (MOCHA) project and its scientists shows that this ideal is seldom met, and thus the accuracy of appraisal or planning work is compromised. In the project, we explored the data collected on children by a number of databases used in Europe and globally, to find that although the four quinquennial age bands are common, it is impossible to represent children aged 0–17 years as a legally defined group in statistical analysis. Adolescents, in particular, are the most invisible age group despite this being a time of life when they are rapidly changing and facing increasing challenges. In terms of measurement and monitoring, there is little progress from work of nearly two decades ago that recommended an information system, and no focus on the creation of a policy and ethical framework to allow collaborative analysis of the rich anonymised databases that hold real-world people-based data. In respect of data systems and surveillance, nearly all systems in European society pay lip service to the importance of children, but do not accommodate them in a practical and statistical sense.

At least 35 years have passed since Slovic's (1987) seminal article on the ‘Perception of Risk’, wherein the conceptual foundations for understanding general risk and the psychometric properties underlying how individuals perceive risks were laid. Over the same time span, research on risk perception in the context of travel has become voluminous and recurrent. It is therefore fitting that in a modern, post-COVID age, Slovic's theory of risk perception is re-examined in the travel context, given the recent dramatic transformation of travel, the emergence of novel tourism-related risks and persistent scholarly attempts to understand travel risk theory. Using modern data mining methods and content analysis techniques, this chapter examines the stability and validity of long-standing categories and taxonomies of perceived travel risks, based on data archived in a sizeable database of scholarly studies related to travel risk (n = 17,790 studies), across an extensive 35-year period from 1990 to 2022. Findings infer two higher-order dimensions that likely underpin the taxonomic organization and relational ordering of different travel risk types and clusters. Findings also suggest a possible shift from Slovic's original theory in the way risks are perceived, at least in the travel context.