A loosely aligned, informal grouping of developing states is pressing for a strong plastics treaty. This article evaluates the past influence and future prospects of this “quasi-bloc” of high-ambition developing countries (HADCs). We argue that the HADC quasi-bloc is driving demands for stringent controls across the full life cycle of plastics, including on oil and gas feedstock, petrochemical processing and product design. It is also energizing calls for robust financing to support just transitions to low-plastic economies, while amplifying the demands of Indigenous peoples and civil society to address the injustices of plastic pollution. Notably, during treaty talks in Busan in 2024 and Geneva in 2025, the HADC quasi-bloc stood firm against petrostates and industry interests seeking to weaken the treaty. HADCs share much in common, including histories of subjugation and disproportionate vulnerability to plastic pollution. Yet the cohesion and power of the HADC quasi-bloc should not be overstated. This is not a formal coalition, but rather an ad hoc, fluid grouping of states with shared interests and concerns. Looking ahead, the HADC quasi-bloc, alongside high-ambition states in the Global North, appears to have enough power to block a weak treaty, but achieving strong obligations presents a far greater political challenge.

Suicide attempts arise from an environment of many interconnected psychosocial and other factors. Yet, the relationships between these factors have not been studied widely in low- and middle-income countries, where an estimated 73% of suicides occur. We aimed to identify the patterns and complexrelationships between the factors associated with suicide attempts. We conducted a network analysis on data from 25,761 school-going adolescents across12 low- and lower middle-income countries (LLMICs), obtained from the Global School-based Health Survey. Using Ising network analysis, we examined theinterrelationships between past-year suicide attempts and several factors; we estimated centrality measures and examined network stability usingbootstrapping. Suicide attempt prevalence was 11.8%. The network analysis identified three clusters: mental health, physical harm and behavioral factors. Suicide attempts showed strong conditional associations with drug use, bullying and worrying, while having close friends was a prominent protective factor.Behavioral factors: alcohol use, drug use and smoking were the most central nodes, showing the highest expected influence. This study provides novel insightsinto the interplay between factors associated with adolescent suicide attempts in LLMICs. Comprehensive interventions could focus on clustered risk factors,while empowering protective factors and addressing behavioral factors could conditionally attenuate other associations in the network.

The Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) set an advanced benchmark for digital trade rules by mandating cross-border data transfers and prohibiting data localisation requirements. This article examines how three Asian developing members, Vietnam, Malaysia, and Brunei Darussalam, have implemented these stringent obligations. It shows that the binding CPTPP data-related provisions have driven domestic data law reforms across all three jurisdictions. Although ensuring compliance with the CPTPP’s commitments, all domestic data legal regimes retain varying degrees of restrictiveness by preserving their national regulatory autonomy. I argue that while such domestic data measures do not fundamentally breach the CPTPP, they run counter to its liberal spirit of facilitating cross-border data flows and impede digital trade liberalisation in the long term.

The relationship between education and mental health is not well understood. Findings are mixed, especially in low- and middle-income countries. We examine the impact of education on mental health using individual-level data from over 120,000 participants across 121 countries, comprising 42 high-income countries and 79 low- and middle-income countries. Results show that better-educated individuals are less likely to experience mental health issues in the overall sample. We observe the same effect in low- and middle-income countries (LMICs); however, the effect is not significant in high-income countries (HICs). The study suggests that mental health policy should be tailored to the socioeconomic environments of LMICs and HICs. In LMICs, education can be leveraged as an important tool for improving mental health by strengthening access to material and social resources. In HICs, where education alone appears insufficient to improve mental health outcomes, the findings point to the need for broader interventions that address social, economic and psychosocial stressors across the population. Coordination between health and education sectors remains essential for developing effective and context-specific policy responses.

Blockchain is frequently proposed as a solution to tenure insecurity, administrative inefficiencies, and corruption, where conventional land reforms have fallen short. However, evidence of its institutional effectiveness remains limited. Drawing on Williamsonian transaction cost economics and an analytical autoethnographic research design, we undertake a comparative analysis of blockchain’s ability to curb opportunism and safeguard the interests of land-transacting parties relative to Ghana’s customary and statutory land-governance structures. Our findings show that while blockchain performs well at some ex ante safeguards, it offers no clear advantage over existing governance structures at the ex post stage. Of the seven identified forms of post-transaction opportunism that buyers often face, blockchain was superior only in minimising hold-up risks. We conclude with implications for policymakers and technologists considering blockchain adoption.

Inaugurated in 1948 with initially 23 signatories, the General Agreement on Tariffs and Trade (GATT) constituted a vital part of the post-war economic architecture. While traditionally the founding of the GATT has been strongly identified with the role of US hegemonic power and free trade enthusiasm, this article reframes the GATT’s origins by highlighting how (anti-)imperial dynamics shaped negotiations over its basic elements, including participation, membership, and permissible exceptions to most-favoured nation principles. Drawing on sources from the GATT archives and government documents from the United Kingdom and the United States, it highlights how empires sought to preserve key elements of imperial economic relations, including by incorporating imperial authority structures, preserving colonial preference systems, and creating other exceptions to trade liberalization. It also shows how developing countries leveraged the trade negotiations to loosen the grip of empires, expand participation, and promote regional and developmental cooperation. Consequently, the final GATT outcome represents a hybrid and transitionary organization, with the organization preserving key elements of imperial economic relations even as it incorporated some demands for the equality of states and economic justice.

Mental health conditions represent a major global burden. However, minimally adequate treatment coverage for common mental disorders remains critically low. Task-sharing solutions using non-specialist providers are promising, but successful implementation requires understanding local culture and context. This study explored facilitators and barriers to implementing non-specialist mental health interventions in Senegal. We conducted in-depth qualitative interviews with 53 stakeholders, including social protection program facilitators, beneficiaries and community members. Data were analyzed using thematic analysis. Four primary themes were constructed: (1) implementation barriers, (2) facilitating factors, (3) health-seeking beliefs and practices and (4) community recommendations. Key barriers include strong preferences for family-based problem-solving, stigma and financial constraints. Facilitators included recognition of the therapeutic benefit of interpersonal dialogue, empathetic values towards helping those with mental health conditions and community enthusiasm for mental health interventions. Culturally adapted interventions need to navigate cultural norms and leverage existing community strengths in interpersonal support. The coexistence of stigma and empathy, alongside both resistance and openness to non-specialist services, highlights a dynamic tension that not only challenges implementation but also presents an opportunity for change. These findings contribute essential formative evidence for designing effective, sustainable non-specialist mental health interventions in Senegal and the sub-Saharan African region.

Low insurance uptake in developing countries poses a strong obstacle to financial resilience and poverty reduction. Although behavioural biases, such as ambiguity aversion, myopia and distrust, are acknowledged as key barriers, their combined effects are not directly observed. Therefore, this study relies on regulatory and administrative proxies linked to these biases. This study goes beyond analysing these proxies separately to explore how they co-occur in shaping insurance outcomes. Using a novel crisp-set Qualitative Comparative Analysis (csQCA) on a sample of 40 developing countries across Africa, Asia, Central and Eastern Europe and the Americas, we identify multiple, equifinal configurations of regulatory and institutional conditions associated with higher insurance uptake. Our necessity analysis reveals that transparent pricing is central to regulatory environments associated with insurance uptake. In addition, product suitability and design standards, as well as deposit insurance coverage, are sufficient regulatory requirements when combined. The csQCA results show that no condition works in isolation; outcomes are associated with specific combinations of regulatory and institutional conditions. The findings indicate that interventions should be interpreted as configurational regulatory packages.

Bipolar disorder (BD) is associated with substantial disability and caregiver burden. In Pakistan, prevalence is unusually high, and limited mental health services place families at the center of care. Cultural and religious beliefs strongly shape how the illness is recognized, understood and managed. This study explored how individuals living with BD and their caregivers understand and navigate the illness within this context. Semi-structured interviews were conducted with 12 adults diagnosed with BD (type I or II) and 12 caregivers recruited through a national registry. Open-ended questions explored illness understanding, caregiving challenges, cultural influences and preferences for family intervention. Interviews were conducted in Roman Urdu, audio-recorded, transcribed verbatim and analyzed using Braun and Clarke’s reflexive thematic analysis. Purposive and snowball sampling ensured diversity in gender, socioeconomic status and residence. Patients described blended biomedical and cultural explanations of BD, symptom-related disruption, treatment barriers, stigma and coping through routines and religious practices. Caregivers reported confusion at illness onset, financial and emotional burden, inconsistent support and the need to navigate biomedical and spiritual care pathways. Both groups emphasized the need for accessible, family-inclusive interventions. The findings support development of culturally tailored, scalable and faith-sensitive family interventions.

Perinatal depression and anxiety are major contributors to maternal morbidity, with a disproportionate burden in low- and middle-income countries. In Pakistan, common and modifiable biological risks, including anemia and vitamin D deficiency, may interact with psychosocial factors to influence perinatal mental health. This cohort study enrolled 152 pregnant women from a public hospital in Islamabad; 147 completed baseline assessments (12–32 weeks gestation) and 100 were followed at 6–8 weeks postpartum. Validated Urdu versions of the EPDS, GAD-7, and MSPSS were used alongside hemoglobin and vitamin D assessments at both time points. Longitudinal analyses were conducted using generalized linear mixed models, supplemented by cross-sectional and mediation analyses.Depression was prevalent antenatally (41.5%) and increased postpartum (57.0%), while anxiety declined from 25.2% to 12.0%. Higher hemoglobin was protective against antenatal depression (OR = 0.66) and anxiety (OR = 0.65), but not in longitudinal models. Vitamin D deficiency predicted postnatal depression (OR = 3.15), while sufficiency was associated with remission. Social support showed a strong protective effect (OR = 0.24) and mediated 40% of the hemoglobin–depression association. Baseline symptom severity was the strongest predictor of postpartum outcomes. These findings highlight a substantial burden and point to modifiable nutritional and psychosocial targets for intervention.

Global migration is reshaping mental healthcare, creating challenges and opportunities that demand intercultural dialogue. In 2021 the World Psychiatry Exchange Program was launched under the auspices of the World Psychiatric Association to promote global collaboration and mutual learning. Its third call for applications, opened in October 2023, received 162 applications from 68 individuals, more than double the number from the second edition. Applicants represented a diverse geographical distribution (Asia 58.8%, Africa 22.1%, Europe 10.3%, South America 5.9% and North America 2.9%), with ages ranging from 25 to 52 years (mean 34 years). Just over half (53%) were early career psychiatrists within 7 years of specialising, while 47% were psychiatry trainees. Following a competitive selection process, 15 psychiatrists undertook exchanges in 2024 across Europe, Africa and Asia, with placements in Croatia, India, Iran, Malaysia, Tunisia, Spain and the United Kingdom. Evaluation data showed consistently positive feedback: 82% strongly endorsed the clarity and ease of the application process, and all participants reported feeling well supported by local coordinators.As psychiatry responds to global demographic change, investment in intercultural competencies and flexible training pathways is essential. The psychiatrist of the future is a global psychiatrist, equipped to deliver care, education, and leadership globally.

Since third sector research emerged as a fully fledged inter-disciplinary academic field during the late 1980s, a separation has usually been maintained—in common with many other social science disciplines—between communities of researchers who are primarily concerned with the study of the third sector in rich Western countries and those who work on the third sector in the so-called ‘developing world’. While internationally focused researchers tend to use the language of ‘non-governmental organizations’, those in domestic settings usually prefer the terms ‘non-profit organization’ or ‘voluntary organization’, even though both sub-sectors share common principles and are equally internally diverse in terms of organizations and activities. While there has long been common-sense logic to distinguishing between wealthier and poorer regions of the world based on differences in the scale of human need, the ‘developed’ versus ‘developing’ category can also be criticized as being rather simplistic and unhelpfully ideological. As the categories of ‘developing’ and ‘developed’ countries become less clear-cut, and global inter-connectedness between third sectors and their ideas grows, this paper argues that we need to reconsider the value of maintaining these parallel worlds of research, and instead develop a more unified approach.

This article analyses the influence of national context on civil society strength based on four key dimensions: level of democracy, political stability, rule of law and economic development. Whereas existing studies mainly focus on Western and post-communist countries, we explicitly include developing countries in our analysis. We use associational membership as proxy for civil society strength and include data of 53 countries. Rule of law, economic development and (to a lesser extent) political stability emerge from our multilevel regression models as the main factors affecting civil society membership. Unlike previous studies, we show that these relations are quadratic instead of linear. This means that where existing theories predict a drop in memberships in developing countries, we find a rise. In other words, harsh conditions actually strengthen civil society in terms of membership levels. We argue that this could be the case because reasons for CSO membership are essentially different in the developed and in the developing world. Contrary to theoretical assumptions, democratic rights do not appear critically important for civil society membership.

In this article, the probability of opening to trade is related to a country's propensity to learn from other countries in its region. It is argued that countries have different motivations to learn, depending upon the responsiveness and accountability of their political regimes. Whereas democracies cannot afford to be dogmatic, authoritarian regimes are less motivated to learn from the experience of others, even if they embrace policies that fail. Using data on trade liberalisation for 57 developing countries in the period 1970–1999, it is found that democracies confronting economic crises are more likely to liberalise trade as a result of learning; among democracies, presidential systems seem to learn more, whereas personalist dictatorial regimes are the most resistant to learning from the experience of others.

The non-NGO literature provides evidence that employees’ perceptions about their organization’s support to them influences their commitment to the organization. NGOs, which have an increasing presence in developing countries, have not been a target for this type of organizational research. This cross-sectional study, based in a health NGO in Pakistan, examined relationship between employees’ perceived organizational support (POS) and their organizational commitment, and relationship between perceptions about organizational fairness, supervisor support, and job conditions with POS. The current organizational commitment literature guided the design of the survey tool. Focus group discussions were carried out at another health NGO to identify NGO and developing country specific items for inclusion in the survey tool. A total of 249 employees participated in the study, yielding a response rate of 96%. Factor analysis of the survey items indicated that the current scales used for measuring the study variables in the non-NGO sector were valid for the NGO sector as well. In addition, three new variables, namely female supportiveness, personal supportiveness, and favorableness of work conditions were assessed. Findings revealed that POS was significantly related with organizational commitment and actions, such as organizational fairness, supervisor support, and extrinsically satisfying job conditions. Female and personal supportiveness, which are generally ignored in developing countries on the pretext of limited resources and lack of organizational capacity to address them, were also found to be important in influencing POS.