This article critically examines the inequities in the access to COVID-19 vaccine and the lessons for global health law. Despite the rapid development and approval of COVID-19 vaccines, the rollout exposed severe systemic failures rooted in preexisting economic distortions and market inefficiencies. The article argues that addressing vaccine inequity requires more than improved distribution and solidarity, but effective reinvention of the global vaccine supply chain through evidence-based and meaningful market-shaping measures. It calls for a transformative approach to global health governance, emphasising the need for a comprehensive, human rights-compliant policy framework to correct structural problems in international markets, moving beyond superficial exhortations to equity.

We explore the efficiency and distributive implications of a multilateral bargaining model with endogenous production of the surplus under two different timings: ex ante and ex post bargaining. Both timings are commonly observed in business partnerships and alliance formations. The theoretical predictions confirm an intuitive economic tenet: in ex post bargaining, effort is considered sunk and opportunistic bargaining behavior will dissuade players from producing. On the other hand, ex ante bargaining entails an allocation of ownership shares that induces at least certain members to invest in the common fund because their return is guaranteed. Experiments show opposite results: ex post bargaining yields almost fully efficient outcomes while the reverse timing entails near zero efficiency. The psychological theory of inequity is useful in reconciling these divergent results.

The socioeconomics of the Anthropocene is exposing coastal regions to multiple pressures, including climate change hazards, resource degradation, urban development and inequality. Tourism is often raised as either a panacea to, or exacerbator of, such threats to ecosystems and sustainable livelihoods. To better understand the impacts of tourism on coastal areas, Scopus and Web of Science databases were searched for the top 100 cited papers on coastal tourism. Web of Science suggested ‘highly cited’ papers were also included to allow for more recent high-impact papers. Of the papers retrieved, 44 focused on the impacts of tourism. Social/cultural and environmental impacts were viewed as mostly negative, while economic impacts were viewed as mostly positive but only of actual benefit to a few. In addition, when compared with recent whole-of-sector reviews and reports it was evident that coastal tourism is increasingly a global enterprise dominated by large corporations that leverage various interests across local to transnational scales. Through this global enterprise, even the positive economic benefits identified were overshadowed by a broader system of land and property development fuelling local wealth inequity and furthering the interests of offshore beneficiaries. Only two highly cited papers discussed tourism within a broader context of integrated coastal zone management, suggesting that tourism is mostly assessed as a discrete sector within the coastal zone and peripheral to other coastal management considerations or the global tourism sector as a whole. The findings have relevance to the holistic management of coasts, coastal tourism and the achievement of sustainable development goals in a way that considers the increasing threats from coastal hazards, resource extraction and urbanisation, as well as the pervasive impacts of international business systems from local to global scales.

Ensuring distributive fairness in the long-term care sector is vitally important in the context of global population ageing and rising care needs. This study, part of the DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) programme, investigates socioeconomic inequality and inequity in the utilisation of long-term care for older people with and without dementia in England. The data come from three waves of the English Longitudinal Study of Ageing (ELSA, Waves 6–8, N = 16,458). We find that older people with dementia have higher levels of care needs and a lower socioeconomic status than those without dementia. The distribution of formal and informal care is strongly pro-poor. When care needs are controlled for, there is no significant inequality of formal or informal care among people with dementia, nor of informal care among people without dementia, but there is a significant pro-rich distribution of formal care among people without dementia. Unmet care needs are significantly concentrated among poorer people, both with and without dementia. We argue that the long-term care system in England plays a constructive role in promoting socioeconomic equality of long-term care for people with dementia, but support for older people with lower financial means and substantial care needs remains insufficient. Increased government support for older people is needed to break the circle between care inequality and health inequality.

We investigate gender differences across multiple dimensions after 3 months of the first UK lockdown of March 2020, using an online sample of approximately 1,500 Prolific respondents’ residents in the UK. We find that women's mental health was worse than men along the four metrics we collected data on, that women were more concerned about getting and spreading the virus, and that women perceived the virus as more prevalent and lethal than men did. Women were also more likely to expect a new lockdown or virus outbreak by the end of 2020, and were more pessimistic about the contemporaneous and future state of the UK economy, as measured by their forecasted contemporaneous and future unemployment rates. We also show that between earlier in 2020 before the outbreak of the Coronavirus pandemic and June 2020, women had increased childcare and housework more than men. Neither the gender gaps in COVID-19-related health and economic concerns nor the gender gaps in the increase in hours of childcare and housework can be accounted for by a rich set of control variables. Instead, we find that the gender gap in mental health can be partially accounted for by the difference in COVID-19-related health concerns between men and women.

The distressing reality that mental healthcare for children and young people in acute trust settings in the UK is woefully underprovided is not news. But with acute trust debts being written off, hospital trusts and commissioners of services have a timely opportunity to address this age- and condition-based discrimination.

Delivering a just service for under-18s depends on attitude, resources and adequate knowledge of the tasks involved. This article aims to describe the current landscape, summarise the arguments for better integrating mental healthcare into physical healthcare settings, articulate the tasks involved and the challenges for commissioning and providing, and finally share examples of current service models across the country.

Ultimately, commissioning and provider choices will be constrained by resource pressures, but this article aims to underscore why commissioning and providing a portmanteau ‘no wrong door’ hospital service for children, young people and families is worth the headache of thinking outside old commissioning and provider boxes.

Older women living alone are at risk of being socially and financially disadvantaged, which impacts their wellbeing. Currently there is a significant gap in knowledge relating to older women living alone. This study aimed to identify the barriers and enablers to service access in this group. We undertook a qualitative study comprising semi-structured interviews in metropolitan Melbourne, Australia. Thematic analysis was conducted to elucidate key themes. Thirty-seven women were interviewed between May and August 2017. Six key themes were identified: financial; mental and emotional health; mobility and ability; transport; social connections; and knowledge. Access issues for older women living alone are multifaceted and interconnected. Barriers and enablers to service access, as well as their intersections with gender and living situation, should be considered in service design and re-design.