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100 seconds to midnight and special thanks to JPHP contributors

The Bulletin of the Atomic Scientists now shows the hands of The Doomsday Clock at just "100 s to midnight" – reflecting "the most dangerous situation that humanity has ever faced" [1]. The clock’s acceleration, set in motion by Russia’s invasion of Ukraine, portrays an imminent risk of nuclear weapons use as the war escalates. The risk is further exacerbated by challenges of the powerplants’ safety in conflict zones.

The world is far from having recovered from the COVID-19 pandemics, which severely depleted already scarce resources. The conflict in Ukraine brings a new shockwave with casualties, trauma, migration, and food and medication shortages, with very many consequences. The response from the world public health community in condemning violence and the use of military forces is strong. Yet, it is insufficient to stop the chain of health threats for the directly and indirectly affected populations in Europe and the wider world.

Five years ago, the Editors of JPHP invited colleagues around the world to submit original research, analyses, and descriptions of ongoing and emerging threats to population health [2]. We call readers’ attention to public health issues-related violence as highlighted in the Special Supplement of 2016 [3]. We want to remind our readers that violent conflict is a public health hazard that can be countered by interventions deployed under a public health approach [4]. The call for research communities to conceptualize and highlight these health threats is now as urgent as ever.

In resource-restricted regions, data on deaths, injuries, diseases, mental health conditions, and malnutrition are difficult to collect. During crisis when one war is chasing another and inequalities are staggering, when many communities are affected by nature-made and man-made disasters, data gathering is understandably a low priority. We want to reinforce the message that in times when reliable channels of information are blocked or health data are distorted, the public is left with guesses, conspiracy theories, and misinformation.

Three editions of the Global Burden of Armed Violence of 2008, 2011, and 2015 initiated detailed reporting of deaths due to violence in both conflict and non-conflict settings [5]. Now platforms, like the Armed Conflict Location & Event Data Project (ACLED) [6] – a global real-time repository of disaggregated data on fatalities, are tracking violent events and their characteristics coded by location and time. Yet, the efforts are insufficient given the complexity of counting potential victims of conflicts who are missing from the population rosters after a conflict, whose social networks that could report them dead are destroyed, whose fates as victims are not observed by organizations that monitor the conflict. With later discoveries of mass graves and surfaced information on atrocities, data curators should systematically revise and update the archives [7].

For public health professionals dealing with such archives, behind each number, there is a human – someone who collects, curates, and acts upon available data; and someone whose information is collected, curated, and owned. Thus, health data and ethics are deeply intertwined and linked to human rights to life, dignity, privacy, rights to education, and rights to freedom of thought. In times of conflict, humans violate others’ rights, crucial information is often suppressed, and suffering multiplies by misinformation and injustice. Along with the call from physicians, nurses, and other health professionals to stop wars and violence, we also need to join our voices and actions to share health data related to wars and violence.

Data and analytical models – produced with those data – are the instruments created by humans to reflect the past and present and to guide the decisions that affect future generations. These instruments are subject to distortions, misconceptions, and limitations; they require continuous assessment and oversight. Data on health threats related to wars and violence should power the policies and strategies to overcome, mitigate, and prevent conflicts. As we are unable to find non-violent solutions, openly shared data should reveal the price of conflicts that must be paid by future generations.

Data and models are not free, they are monetized, they are expensive, and they require human and natural resources to create and maintain. The cost of data collected but not used is the cost of wasted human capital and resources. As with any capital, the use of public health data should be properly regulated; data ownership should be transparent and properly credited; and the labor involved at all stages of the data life cycle from the design to dissemination should be properly recognized and compensated.

The world's data in any sphere of human activity – communication, transportation, entertainment, business, government, and security – are stored, managed, and distributed by data centers. Data centers require a tremendous amount of energy to operate, water for liquid cooling, and human and natural recourses to maintain. The United States houses nearly one-quarter of all data center servers globally, contributing to 0.5% of total US greenhouse gas emissions [8]. In debating sustainability of data centers, we should establish clear priorities for developing and managing health data infrastructure, with understanding of the value for protecting information powering humanity survival.

When the question comes about what to keep in preserving the history of human health, we should have an answer. When history is lost, history repeats, especially wars and conflicts.

In this issue, we share our experiences in assembling health records from 2016 to 2019 on the cholera epidemic during the ongoing Yemeni war and illustrating the value of and the needs for collective efforts to exchange health information during military conflicts [9]. In the presented paper, we arrange the records to show the dynamics of the outbreak and ACLED-reported casualties as a set of animated maps exposing how both processes were unfolding during the war. We compiled a comprehensive dataset of health records from epidemiological bulletins of the World Health Organization. When shared with public, these records are typically presented in various formats preventing automatic vetting and merging. Even minimal agreements among the data holders on preparing data for public use could substantially reduce the workload for many people who collect and examine health records. Such agreements on data standardization will also help us to develop and use new tools to communicate the public health messages effectively and clearly.

With the growing assortment of tools to collect and disseminate various information, we invite readers and contributors:

  • to suggest new strategies to better recognize potential threats to health;

  • to share new ideas for how we can validate and verify health-related information, store and reexamine historic health records, develop, and implement data-driven action plans to protect health.

We are launching several initiatives. First, the JPHP is joining cross-journal efforts to address a major public health concern related to a rapid spread of false or misleading health information. Second, we assembled a collection of papers published by the Journal over the last 30 years underscoring the ongoing and emerging threats to health. With these two new topical collections on ‘Misinformation and Health’ and ‘100 Seconds to Midnight: Global Threats and Public Health,’ we aim to stimulate actions and discussions from those working in public health research, policy, and practice.

In response to geopolitical conflict, I want to remind readers, reviewers, and authors the principles developed by the World Association of Medical Editors in 2004 [10], to which we adhere:

“Decisions to edit and publish manuscripts submitted to biomedical journals should be based on characteristics of the manuscripts themselves and how they relate to the journal's purposes and readers. Among these characteristics are importance of the topic, originality, scientific strength, clarity and completeness of written expression, and potential interest to readers. Editors should also take into account whether studies are ethical and whether their publication might cause harm to readers or to the public interest.

Editorial decisions should not be affected by the origins of the manuscript, including the nationality, ethnicity, political beliefs, race, or religion of the authors. Decisions to edit and publish should not be determined by the policies of governments or other agencies outside of the journal itself.

Editors should defend this principle, as they do other principles of sound editorial practice, and enlist their colleagues' support in this effort if necessary.”

In 2021, we received another record of 638 submissions from more than 75 countries. We received ten or more submissions from the contributors residing in United States of America (146), India (70), China (46), Turkey (27), Iran (24), Saudi Arabia (21), the United Kingdom (19), Italy (18), Germany (17), Pakistan (17), Brazil (15), Canada (13), Korea (South) (13), Bangladesh (10), and Indonesia (10). Authors from Australia, Colombia, Egypt, Ethiopia, Greece, Hong Kong, Iraq, Israel, Japan, Jordan, Kuwait, Malaysia, Mexico, Nepal, The Netherland, Palestine, Poland, Portugal, Poland, Russia, Spain, Sweden, Switzerland, and Taiwan contributed three or more manuscripts (see Fig. 1).

Fig. 1
figure 1

JPHP received three or more manuscripts from 638 countries in 2021

In March of 2020, we set up the Topical Collection on Public Health Response to COVID-19 and as of March18, 2022 we have published 34 Original Articles, Viewpoints, and Letters to the Editors highlighting the challenges, recommendations, and achievements of public health professionals. As expected, many our contributors and reviewers experienced the pressure of being on the frontline and we are immensely thankful for their committed time and dedication.

We thank the constructive guidance and timeliness provided by 100 reviewers representing Australia, Brazil, Canada, China, Ecuador, France, Germany, India, Indonesia, Israel, Italy, Malaysia, Mexico, New Zealand, Nigeria, Saudi Arabia, Switzerland, United Kingdom, and USA, who completed 135 reviews over the past year. We would like to express our gratitude to:

Anthonia Adindu
Farida Ahmad
Tania Mercedes Alarcon- Falconi
Shelly Arora
Debasis Bagchi
Peter Baker
Ruchita Bhattacharya
Irene Bosch
Larissa Calancie
Francois Castonguay
James Chauvin
Ilana Cliffer
JeanneCoffin-Schmitt
Steven Cohen
Arantxa Colchero
Alessandro Colombo
Jordan Covvey
Richard A. Daynard
Harshal Deshmukh
Elizabeth Erdman
BerthaEstrella
Iro Evlampidou
Kirk Evoy
David Fedson
Kay Franks
Sarah Frise
Lance Gable
Neil Gordon
Allison Groom
David Gute
Guanghua Han
Josh Havens
Ira Helfand
Sarah Hill
Allen Hogge
Jennifer Horney
Priyadarshini HR
Richard Isralowitz
Shelley Jacob
JessicaJeffrey
JessicaJones-Smith
Patrece Joseph
KamalKasturi
Susan Koch-Weser
Alexandra Kulinkina
Ted Kyle
RobynLandry
Laura Lara-Castor
DavidLegge
Peter Levine
Yihong Liu
Jon Macy
Kristine Madsen
NithinManchery
Adolfo Martinez Valle
Santi Martini
David Michaels
Carlos Molina
Alicia Monroe
Rob Moodie
Matthew Neilson
Paul Newton
Ariadne Nichol
Mollent Okech
Charles Olatubara
Stephen Onufrak
Peter Orris
Marcin Orzechowski
Al Ozonoff
Deepak Pateel
Sanghamitra Pati
Enrico Pavignani
Carl Reddy
Samuel Reis-Dennis
Doris Rocha Ruiz
Lauren Rossen
Rajiv Sarkar
David Sclar
Remmy Shawa
Apurba Shil
Noureen Siraj
Lindsey Smith-Taillie
Merianne Rose Spencer
Neil Squires
Heather Stobaugh
Shreyas Tikare
Catherine Troisi
Andre Verani
RachelVickers-Smith
Maria Fernando Vinueza-Veloz
Wendy Wagner
Edward Wallace
John Walley
Michelle Wood
Yong Yang
Mustafa Younis
Guanyang Zou

As we live in the troubling times and divided world, I have a special plea: be willing to listen different points of view without rushing to judge and to be proactive in offering help, kindness, knowledge, and skills to those need them the most.

Elena N. Naumova, Editor-in-Chief.

References

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Naumova, E.N. 100 seconds to midnight and special thanks to JPHP contributors. J Public Health Pol 43, 179–184 (2022). https://doi.org/10.1057/s41271-022-00349-7

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