Identifying the trends and patterns of bioethics research in the Eastern Mediterranean Region provides valuable insights into research interests and productivity. This study aimed to evaluate the region's bioethics research outputs between 1974-2022 using a bibliometric approach. Publications from countries in the region indexed in Web of Science, Scopus, and PubMed were analysed. The results showed a clear upward trend, with an average annual growth rate of 39 per cent in bioethics publications, while the growth rate of citations was nearly twice as high. Iran was identified as the most prolific country, followed by Saudi Arabia and Pakistan. However, intra-regional and extra-regional co-authorships accounted for only 7 per cent and 17 per cent of publications, respectively, indicating limited research collaboration. The main non-regional collaborators were the United States, Canada, and the United Kingdom. Further development of bioethics research in the region requires strengthened capacity building at both national and regional levels.

IntroductionThere is limited research on public health-related networks in the Eastern Mediterranean Region (EMR) and Arab world, where vulnerabilities are multiple, interconnected and the need for effective collaborative action is urgent. This study aimed at gaining a deeper understanding of the experiences of current and former public health-related networks in the EMR/Arab world, identifying the factors that facilitated or hindered their functioning, and providing guidance on best practices that can inform the design of sustainable and resilient regional networks.MethodsWe identified nine regional public health-related networks in the EMR/Arab world. A desk review of these networks was conducted followed by key informant interviews with 16 current or former members of these networks. Inductive thematic analysis was performed on the data generated from these semi-structured interviews.ResultsAnalysis showed that networks exist primarily to build connections among individuals and institutions in the region. Successful networks are marked by strong institutionalization of capacity-building initiatives and rapid mobilization into public health crises. However, networks often struggle or fail due to lack of sustained, flexible financing and fragmented governance, including dependence on individual leaders. Key recommendations from participants included institutionalizing leadership, diversifying financing, enhancing regular communication, strategic planning, and investing in new leaders. Informants widely agreed that robust, sustainable networks are vital to advancing public health in the region.ConclusionTo foster resilient and sustainable public health networks across the region, future initiatives should focus on demonstrating value, building trust, and strengthening institutional frameworks. Networks should learn from each other’s experiences. The literature on regional networks has mostly emphasized activities and achievements but offered limited critical analysis of underlying enabling and constraining conditions.

Knowledge Translation (KT) research investigates methods to promote the uptake of research by practitioners, managers and policy-makers. Rooted in decades of interdisciplinary scholarship showing that evidence use is shaped by social sense‑making, institutions and politics, KT has moved beyond a linear “research to policy” model. Yet, persistent gaps between evidence and decision‑making, as well as uneven institutional capacity and fragmented KT research motivated the development of WHO’s Global Research Agenda: to prioritize rigorous, context‑sensitive KT research that addresses systemic, governance and practical barriers to sustained evidence‑informed policy-making (EIP). From October 2023 to March 2025, a structured five-step approach was undertaken, starting with synthesizing existing evidence on KT strategies and priorities, and complemented by primary data from a global survey. These inputs were used to develop a conceptual framework to organize KT research priority areas. This framework guided a global consultative process, which engaged diverse interest-holders through online consultations and Delphi surveys to jointly identify research gaps, opportunities and priority areas for inclusion in the final research agenda. The initial step of evidence synthesis identified 120 research areas. Through the global consultative process, these were refined to 19 priority research areas organized into three domains: (1) research on KT/EIP interventions, (2) research on barriers, facilitators and opportunities for KT/EIP and (3) research on KT/EIP methods, standards, measurement, theories and frameworks. Specific research areas include strategies to institutionalize KT, contextual factors influencing evidence uptake and exploring innovative technologies such as Artificial Intelligence. This study proposes a prioritized research agenda to guide future KT/EIP research and inform funding decisions. The agenda requires sustained engagement with interest-holders to maximize its impact. Future research should validate and refine the priorities, and ensure relevance, utility and effective implementation across diverse settings. The GRA is more than a technical checklist; it is a strategic roadmap for navigating the political and institutional dimensions of evidence use, enabling a shift beyond supply-side fixes toward a relational, politically aware KT/EIP approach. This shift is essential to embed evidence use in routine decision-making, strengthen system resilience and advance health equity through sustained institutional reform.

IntroductionThis work aimed at mapping research ethics governance at EMR countries.MethodsThe study used two tools shared with Eastern Mediterranean Region (EMR) countries. The first enquired about legal provisions and regulatory frameworks, as well as Research Ethics Committee (REC) composition, resources, procedures. The second covered ethical oversight of clinical trials (CTs), including coordination of ethical reviews.ResultsMost respondents (85%) indicated that they have national provisions requiring human subjects' research to be REC-reviewed. Around half (46%) reported having legal provisions requiring CTs to be registered on a registry; having a national or institution-specific CT registry (43%); and protecting participants from any financial consequences if they suffer injury as result of their participation (54%).RecommendationsEMR countries are encouraged to develop / foster / accredit national and institution-based RECs, as well as national CT registries. Members of REC committees should have knowledge and skills to ethically review research, in compliance with international standards.

Background The effective translation of evidence into policy requires strategic engagement among interest-holders to identify current knowledge gaps, align funding, and minimize research duplication. This study outlines the methods and results of a multi-stage process to develop WHO’s first Global Research Agenda (GRA) on Knowledge Translation and Evidence-informed Policy-making (KT/EIP), aimed at improving research efficiency, guiding funding, increasing evidence use, fostering collaboration, and raising awareness of KT research. Methods From October 2023 to March 2025, a structured five-step approach was undertaken, starting with synthesizing existing evidence on KT strategies and priorities and complemented by primary data from a global survey. These inputs were used to develop a conceptual framework to organize research priority areas. This framework guided a global consultative process, which engaged diverse interest-holders through online consultations and Delphi surveys to jointly identify research gaps, opportunities, and priority areas for inclusion in the final research agenda. Results The initial step of evidence synthesis identified 120 research areas. Through the global consultative process, these were refined to 19 priority research areas organized into three domains: 1) Research on KT/EIP interventions, 2) Research on barriers, facilitators, and opportunities for KT/EIP, and 3) Research on KT/EIP methods, standards, measurement, theories, and frameworks. Specific research areas include strategies to institutionalize KT, targeted approaches for public health emergencies, contextual factors influencing KT/EIP uptake, and the exploration of innovative technologies like Artificial Intelligence. Conclusions This study proposes a prioritized research agenda to guide future KT/EIP research and inform funding decisions. This resource for researchers, policy-makers, and funders requires sustained engagement with interest-holders to maximize its impact. Future research should validate and refine this agenda, and ensure relevance, utility, and effective implementation across diverse settings.

Looking at SRHR as an isolated set of elements, as is the current practice, does not do justice to the needs and rights of people and communities and may be one of the reasons why challenges remain in the attainment of SRHR for all. SRHR Infographic snapshots were developed for all 194 WHO Member States and included 120 indicators covering a broad range of policy, health systems and service delivery interventions. The snapshots were created using data less than 10 years old publicly available in data repositories maintained by international and global agencies. Data availability was not consistent across countries with low and lower-middle income countries having higher data availability (71%) compared to high income countries (40%). SRHR data that is easily accessible and consistently reported can improve accountability and opportunities for learning to improve people-centred approaches to accelerate the attainment of SRHR for all.

Background: Several bibliometric analyses have been conducted in the Eastern Mediterranean Region (EMR), however, there is limited data from such analyses for the establishment of national or regional health research agenda. Aim: To assess the biomedical and health research outputs in EMR countries for 2004-2018 and their alignment with the regional strategic health priority areas identified by the WHO Regional Office for the Eastern Mediterranean. Methods: We searched and reviewed health-related articles indexed in PubMed and originating from EMR countries from 2004 to 2018 and used these as indicators of the country's total biomedical research publication level. Data from a very large collection of over 300 000 articles were weighted to EMR's contribution to the global research output. We used the mean and standard deviation to summarise the continuous variables and used frequencies and percentages to summarise the categorical variables. Results: Biomedical research publication in the EMR increased between 2004 and 2018. Five countries - Islamic Republic of Iran (43%), Egypt (14%), Saudi Arabia (11%), Pakistan (8%), and Tunisia (6%) - contributed 82% of all the publications, while the other countries contributed less than 4%. On average, EMR contributed 2.0% of the global biomedical research publications and 3.12 publications per 100 000 population for 2004-2018. Conclusion: Biomedical and health research publication increased unevenly across the EMR countries during the study period. Considering the complexity of the public health challenges in the region, there is a need for multidisciplinary and holistic approaches to health research to generate evidence for policy and to improve clinical and public health outcomes.

Sexually transmitted infections (STIs) are widespread worldwide and negatively affect sexual and reproductive health. Gaps in evidence and in available tools have long hindered STI programmes and policies, particularly in resource-limited settings. In 2022, WHO initiated a research prioritisation process to identify the most important STI research areas to address the global public health need. Using an adapted Child Health and Nutrition Research Initiative methodology including two global stakeholder surveys, the process identified 40 priority STI research needs. The top priorities centred on developing and implementing affordable, feasible, rapid point-of-care STI diagnostic tests and new treatments, especially for gonorrhoea, chlamydia, and syphilis; designing new multipurpose prevention technologies and vaccines for STIs; and collecting improved STI epidemiologic data on both infection and disease outcomes. The priorities also included innovative programmatic approaches, such as new STI communication and partner management strategies. An additional six research areas related to mpox (formerly known as monkeypox) reflect the need for STI-related research during disease outbreaks where sexual transmission can have a key role. These STI research priorities provide a call to action for focus, investment, and innovation to address existing roadblocks in STI prevention, control, and management to advance sexual and reproductive health and wellbeing for all.

Background: Harnessing digital technology for health service provision is inevitable, especially after the dramatic increase in demand during the COVID-19 pandemic and the observed global disruption of health services especially for People Living with Noncommunicable Diseases (PLWNCDs). Aims: To document and share experiences, challenges and lessons learned from the use of digital health interventions (DHIs) for noncommunicable disease (NCD) service delivery during the COVID-19 pandemic in the Eastern Mediterranean Region (EMR). Methods: We conducted a documentary research on the use of DHIs for continuity of NCD services during the COVID-19 pandemic in EMR. We collected our data using a questionnaire that was developed and administered by email to WHO NCD focal persons at the ministries of health of all EMR countries. Using the WHO classification of DHIs we then mapped the various interventions and the stakeholders involved. Results: Seven countries - Islamic Republic of Iran, Jordan, Oman, Qatar, Saudi Arabia, Sudan, and United Arab Emirates - shared their documentations. Documented DHIs used by countries to overcome the disruption of services during the pandemic were mostly on the use of client -to -provider telemedicine for NCD services. The level of implementation varied between countries. NCD and mental health helplines and COVID-19 prevention awareness campaigns for PLWNCDs were the most mentioned interventions. Conclusions: DHIs for NCD service provision were implemented during the COVID-19 pandemic in all settings: highmiddle- and low-income countries in the EMR. There is a high potential for incorporating DHIs within health systems to increase access to health services beyond the pandemic. Documentation, regulation and national capacity -building for mainstreaming DHIs in public health services in the EMR are strongly encouraged, based on each country's needs.

Ethical review systems need to build on their experiences of COVID-19 research to enhance their preparedness for future pandemics. Recommendations from representatives from over twenty countries include: improving relationships across the research ecosystem; demonstrating willingness to reform and adapt systems and processes; and making the case robustly for better resourcing.

Research mapping relies on bibliometric analyses to estimate and analyze research productivity of an institution, country or region, in general, or investigate a specific domain of research. Bibliometric methods offer the advantage of using data from bibliographic databases with minimal bias or involvement from the researchers themselves. Numerous bibliometric analyses have taken place in the Eastern Mediterranean Region (EMR) to assess the publication situation either at a national scale or with a disease-specific focus. Yet, there are not enough data to establish a national/regional health research agenda. To assess biomedical and health research outputs over two decades in all EMR countries for the years 2004-2018. To measure their year-to-year alignment with the regional strategic health priority areas identified by the WHO Regional Office for the Eastern Mediterranean (WHO-EMRO); namely, Health System Strengthening (HSS), Maternal and Child Health (MCH), Non-Communicable Diseases (NCD), Communicable Diseases (CD), and Emergency Preparedness and Response (EPR). The number of biomedical and health articles originating from EMR each country of the EMR for the study period, as obtained from the PubMed search, was used as an indicator of a country’s total biomedical research production level. Data were weighted to take into account global research output, represented by the total number of articles indexed in PubMed per year, and the population size of each country. By inspecting the overall raw data for biomedical research productivity in the EMR, a clear increasing trend is observed. Notably, five most-performing countries contributed to nearly 82% of all published biomedical research during 2004-2018, namely Iran (43%), followed by Egypt (14%), Saudi Arabia (11%), Pakistan (8%), and Tunisia (6%). According to the World Bank Group's economic classification, most of the performing countries in the EMR belong to the lower- and upper-middle income categories. All other remaining EMR countries had contributions of less than 4% of the overall biomedical research publications during the study period. While data collected in this study offer a modest view of the social organization in the EMR through patterns of co-authorship and research collaborations, it is important to develop robust methodologies to be able to investigate this important aspect in more detail in the future.

Background:For decades, WHO has been providing targeted funding for health research on priority areas of public health in the Eastern Mediterranean Region through different grant schemes. Aims:This paper investigated the impact of WHO/EMRO's funding schemes and factors facilitating or hindering such impact. Methods:We assessed the impact of health research funded by WHO/EMRO during 2010-2018 from the health, economic, decision-making, and knowledge translation perspectives, emphasizing accountability and analysis, using the Payback framework, mixed-method approach (quantitative, qualitative), and triangulation. Results:Principal investigators of 45 (45.9%) out of the 98 funded projects responded to the questionnaire. Almost all (88.0%) the 45 projects reported developing at least one decision-making document. Less than half reported producing peer-reviewed documents and conducting target group empowerment, while 24.0% said they secured research funds from other organizations. For 23 projects (51.0%), research results could have had a direct impact on health and on economy, and 25 (56.0%) projects conducted at least one active knowledge translation activity. Using multiple logistic regression, there was no significant association between the country of research and impact on decision-making and implementation of result if health or economic impact was expected. Conclusion:To strengthen the impact of research, WHO/EMRO should embark on a series of interventions to guide and empower countries in the use of research results. Discrepancies between health research systems in the Eastern Mediterranean Region and differences in individual and organizational capacities in the different countries require targeted interventions.

Health research, innovation and knowledge management remain major priorities of the WHO's response to the COVID-19 pandemic. WHO's Eastern Mediterranean Regional Office (EMRO) supports priority research initiatives that address gaps in current knowledge regarding the COVID-19 pandemic. Through a specific call for proposals, 122 research proposals were received and reviewed in 2020, of which 17 were recommended for funding from eight countries. Ten countries in the region participated in the global solidarity trial to assess potential therapies for COVID-19. In addition, WHO advocated for early serological and epidemiological investigations ('COVID-19 Unity Studies') on the general population, healthcare workers, pregnant women and neonates, and extending technical, financial and material support for them.Starting in early 2020, scholarly articles on COVID-19 have been published in every issue of the Eastern Mediterranean Health Journal More than 6300 publications on COVID-19 were made available on the WHO knowledge management portal in the last year alone. WHO is also supporting countries in conducting studies to assess the field effectiveness of vaccines deployed nationally. To build and strengthen country capacities, regional webinars and intercountry meetings were conducted on research ethics, national health information systems and evidence-based health policy making. With support from WHO EMRO's new research and knowledge management pillar, countries in the region were well equipped to contribute to a global understanding of the novel virus's characteristics, as well as employ a national response based on informed evidence.

The United Nations launched the Sustainable Development Agenda 2030 and its 17 Sustainable Development Goals (SDGs) in 2015, as a more detailed and ambitious follow-up to the Millennium Developments Goals (MDGs). Health and wellbeing of all, at all ages, is addressed by the third SDG (SDG3) and health-related targets of other SDGs. However, progress to date on the health-related SDGs in the Eastern Mediterranean Region (EMR) is not on track. Although there was progress in over half of the 50 health-related SDG targets and indicators between 2015 and 2019, there is still a long way to go. Progress is required, among others, in reducing maternal, child and neonatal mortality; increasing vaccination coverage; reducing the number of cases of malaria and HIV; and in tackling the increase in mortality rates due to noncommunicable diseases. Much progress is needed in many health-related SDGs considered as important social, economic and environmental determinants of health.

At the 2014 World Health Assembly (WHA), the ministers of health of all 194 World Health Organization (WHO) Member States affirmed that palliative care, the prevention and alleviation of pain and suffering of any kind associated with serious illness, "is an ethical responsibility of health systems". The Assembly acknowledged "the urgent need to include palliation across the continuum of care, especially at the primary care level," and emphasized that "inadequate integration of palliative care into health and social care systems is a major contributing factor to the lack of equitable access to such care." This WHA Resolution (WHA 67.19) differs from other resolutions regarding specific diseases, interventions, populations, or other aspects of health care. It differs not only because palliative care is essential to the care of adults and children affected by serious illness or humanitarian crisis of any type, but also because the Resolution draws attention to the essence of medicine and nursing, the prevention and relief of human suffering. It does so by amplifying the too-often unheard call of the suffering, the poorest, sickest, and most vulnerable.

Background: COVID-19 is the first pandemic during which innovative technologies are being used to keep people connected, safe, and productive while being physically and socially apart. Aims: This study aimed to map health innovations in response to the pandemic in the Eastern Mediterranean Region. Methods: Health innovations are defined as novel methods, models, processes, products, services, or a combination that produce notable public health impact in people, families, and communities at large. We used two approaches: an online survey using a specially designed data collection tool and a review of publicly available literature using PubMed, IMEMR, Google Scholar, Google, and INSERM search engines. Data collection was conducted between September 2020 and February 2021. Results: We describe 80 innovations in this region, of which 13 were identified through the online survey and 76 via literature review. For the purposes of this paper, we subclassified two-thirds of these innovations (n = 52; 65%) as "digital health innovations", including telehealth and telemedicine, surveillance, and contact tracing. The rest were classified as "non-digital health innovations", including prevention and clinical management. Conclusion: This mapping exercise provides baseline information on response to the pandemic by the public and private sectors, innovation hubs within and outside the region, as well as by entrepreneurs and innovators. In-depth studies measuring the impact of health innovations will likely only become available when the pandemic is under better control and experts are able to assess the replicability, sustainability and scalability of the health innovations introduced.

The COVID-19 pandemic has placed the use of evidence for policy-making high up on the international agenda. To fight the pandemic, Governments around the world have publicly stressed the need to draw on evidence by engaging scientific advisors and advisory bodies [1]. Furthermore, the increased demand for evidence has led to a global push for innovative solutions such as the scaling-up of living evidence syntheses [2]. At the same time, COVID-19 revealed fatal structural and systemic weaknesses in the production and use of evidence-flaws which have cost lives [3]. In many cases, institutional mechanisms and capacities to systematically mobilize and contextualize the best available evidence for rapid decision-making were missing [4]. As a consequence, policy-makers, practitioners and citizens alike were confronted with a deluge of competing claims and misinformation, severely limiting suitable decisionmaking and taking action [5]. The related surge of vaccine hesitancy has disproportionally impacted ethnic minorities and deprived communities, with the lowest vaccine uptake, worryingly, to be seen among the most vulnerable people-the older, the more clinically vulnerable, and those living in the most deprived areas-worsening pre-existing disparities in vaccine use, health inequalities and socio-economic marginalization [6, 7]. To assess different institutional responses in terms of the evidence-policy-society nexus and to learn lessons on how to build equity-centred, agile and responsive evidence-informed decision- making mechanisms, WHO convened its first Global Evidence-to-Policy Summit [8] in late 2021. The Summit, organized by the newly created Evidence to Policy Unit at WHO headquarters in collaboration with the corresponding teams in WHO regional offices, brought together more than 2,500 policy-makers, knowledge brokers, health actors, civil society representatives and researchers from around the world.