Spotlight on Young Researchers: Towards fair health for all

Access to essential health services is considered normal in high-income countries, while they are out of reach for many in low-income countries – gaps allowing preventable diseases to spread on a global scale. Field epidemiologists are working to understand what works in global health and how to improve public health responses to ensure equal health.

Global health research has paved the way for significant progress in areas ranging from rapid tuberculosis and HIV diagnostics to improved vaccine delivery in hard-to-reach areas. These advances underline the crucial role implementation research thereby plays in identifying what works, where, and why.

“In countries like Rwanda and Malawi, e.g., it supported the scale-up of community-based HIV prevention and treatment, substantially reducing new infections and disease mortality. In Ethiopia, it informed last-mile strategies that improved childhood vaccination rates, reducing or even avoiding disease outbreaks. If effectively bridging policy and practice, implementation research can foster smarter, more effective global and public health action,” explains Luxembourg national Nadine Muller, field epidemiologist, clinician scientist and medical doctor.

Understanding what works in global health

In high-income countries it is often taken as a matter of course – even taken for granted – to have access to essential health services: Vaccinations, antenatal care, treatment for tuberculosis or HIV, to name a few examples of important health services that are often not available in low-income settings.

“In Madagascar, one of my focus countries, around 1 in 3 children – nearly one million – have never received any routine vaccine, and 4 in 10 people with tuberculosis (TB) – about 10,000 annually – remain undiagnosed or untreated. These gaps allow preventable diseases like measles, polio, and TB to spread globally. My research at Charité – Universitätsmedizin Berlin focuses on understanding what works in global health, how to improve public health responses, and how barriers can be overcome to ensure equitable healthcare for all.”

A healthcare worker of a mobile TB clinic prepares samples in an empty classroom. Research shows these clinics are a highly cost-effective way to expand TB care in underserved areas. 

Samples collected at a mobile TB clinic. Research shows these clinics are a cost-effective way to expand TB care in underserved areas. 

Focus on where services meet communities and frontline workers

Nadine’s research is focused on healthcare delivery at the “last mile”, meaning where services meet communities and frontline healthcare workers. Together with local and national partners, exploring the factors enabling or obstructing access and quality of care. The goal: to identify effective, scalable solutions.

Together with her team, Nadine has for example conducted an impact and cost-effectiveness analysis of a low-tech mobile clinics approach. The analysis was clear about how many funds are needed for each patient treated and “each health live reached in a setting where evidence is largely lacking towards effectively scaling. This analysis substantially helps organizations and funders in choosing their approach and planning effectively towards expansion and scale.”

Collaboration across sectors essential for real change

Nadine explains that it represents a significant challenge that research is often seen as separate from public or global health action and that the idea that researchers are only meant to inform policymakers is outdated.

“To drive real change, we must actively collaborate across sectors, engaging with governments, civil society, and the private sector, to make evidence accessible, relevant, and usable for those shaping policy and public health measures.”

What stands in the way of solving this challenge is not a lack of knowledge or ideas on how to solve particular questions, Nadine explains, but a combination of limited collaboration and weak mechanisms to translate evidence into action.

“Complex health systems, political interests, and fragmented funding further slow progress. Research must be better integrated with practice through trust, dialogue, and shared ownership across all actors involved.”