Health – Ideas in ALL

The Regulation of Assisted Human Reproductive Technologies in Ireland: Ethical, Legal & Societal Considerations – Recent Developments and Maynooth Workshop

Research Stream: Lived Experiences

Authors: Prof Aisling McMahon, Professor of Law, Department of Law and Criminology and ALL Institute, Maynooth University. Alanna Kells, PhD Candidate in the Department of Law and Criminology, Maynooth University.

Introduction

On the 24th and 25th April 2025, Prof Aisling McMahon and Alanna Kells (PhD Candidate), School of Law and Criminology, Maynooth University, hosted a timely multi-disciplinary workshop examining the ‘Regulation of Assisted Human Reproductive Technologies in Ireland: Current, Emerging & Future – Ethical, Legal and Societal Considerations’ in Maynooth University.

Over the course of two days, the workshop brought together 20 leading national and international speakers drawn from a range of academic disciplines and practice, including law, business, health, social sciences, ethics, and clinical practice. The workshop focused on examining the ethical, legal, and societal issues related to the regulation of emerging assisted human reproductive technologies in Ireland and internationally. It focused on two key aspects: first, it examined the recent Health (Assisted Human Reproduction) Act 2024 (which was signed into law in Ireland on 2nd July 2024, and is currently awaiting commencement) and how provisions within this Act will address emerging ethical, legal, and societal issues in the field; Second, and relatedly, papers also examined the ethical, legal and societal issues posed by emerging assisted human reproductive technologies more generally and the implications of such developments for Irish and international regulatory frameworks.

Health (Assisted Human Reproduction) Act 2024

The Health (Assisted Human Reproduction) Act 2024 provides for a tailored legal and regulatory framework for assisted human reproduction in Ireland, including providing for the establishment of a new regulatory body, the Assisted Human Reproduction Regulatory Authority (AHRRA). The Act is comprised of 13 parts and 7 schedules. It includes provisions related to embryo and gamete (egg or sperm) donation; the storage of gametes, embryos and tissues; posthumous assisted human reproduction; pre-implantation genetic testing, and surrogacy. The Act (once commenced) will operate within various existing national and international legal frameworks, including, amongst others, relevant provisions of the Irish Constitution, European Union law etc. Its interpretation will need to consider the human rights of the various parties involved, including relevant human rights protections under the European Convention on Human Rights. Furthermore, the Irish Health Products Regulatory Authority (HPRA) plays an important role in this context in Ireland, including in the regulation of the safety and quality of tissues and cells for use in human treatment such as in fertility context, and the regulation of relevant establishments involving in the processing, preservation, storage etc of human tissues and cells

We currently await the commencement of the Act. However, in October 2024, the then Minister for Health Stephen Donnelly secured government approval to draft amending legislation to the Health (Assisted Human Reproduction) Act 2024. At that time, it was reported that this amending legislation will include provisions that aim to address and provide greater clarity for Irish residents/citizens undertaking donor-assisted human reproduction (DAHR) procedures abroad, and for Irish citizens living abroad who access DAHR or surrogacy abroad to have their legal parentage recognised in Ireland (where this is not already the case). The amending legislation has not yet been published, however, in February 2025, Minister for Health Jennifer Carroll MacNeill described the drafting of the Amendment Bill, Health (Assisted Human Reproduction) (Amendment) Bill, as ‘well underway’ and that ‘[…] while the drafting process is still ongoing, a defined list of amendments to the AHR Act 2024 cannot be provided.’ She further noted that while a ‘definitive timeline’ for the Bill to be brought to Cabinet could not be given at that stage, she wished to ‘[…] progress this much-needed legislation as soon as practicable fundamentally so that a robust regulatory framework for AHR in this country is put in place.’

The Health (Assisted Human Reproduction) Act 2024 is an historic development in the regulation of assisted human reproductive technologies in Ireland. The need for a tailored regulatory framework in Ireland for assisted human reproduction has been called for in Ireland for many years. The adoption of the Act comes almost two decades after the publication of the Report of the Commission on Assisted Human Reproduction in Ireland (April 2005). Thus, the Health (Assisted Human Reproduction) Act 2024 is much welcomed in providing clarity in relation to various aspects of the law related to assisted human reproduction in Ireland. Nonetheless, ongoing consideration will be needed around how the Act, once commenced, will be interpreted and apply in various contexts and the extent to which it will address the various (often complex) ethical, legal and societal issues arising in the assisted human reproductive context, particularly given the pace of emerging technologies in the field.

Workshop Key Themes

Given the recent adoption of the Health (Assisted Human Reproduction) Act 2024, alongside the ongoing developments in the field more generally, this workshop provided a timely opportunity to consider the ethical, legal and societal issues relevant in terms of the Irish context, and also the regulation of emerging technologies in the field. Over the two days the workshop featured presentations by 20 leading national and international experts on assisted human reproduction from a range of disciplines and practice, including law, ethics, embryology, and clinical practice.

Speakers discussed two key aspects of the legal framework governing assisted human reproduction in Ireland. First, they examined the Health (Assisted Human Reproduction) Act 2024, considering how this new legislation will interact with existing legal, constitutional, and regulatory frameworks. Speakers also explored how specific provisions of the Act aim to address longstanding ethical, legal, and societal issues in this area, including matters related to surrogacy and the use, storage, and donation of gametes (sperm and eggs) and embryos.

Alongside this, the workshop featured papers examining ethical, legal and societal issues arising around the regulation of emerging assisted reproductive technologies and broader developments in the field including around the regulation of emerging assisted human reproductive technologies. These included consideration of: mitochondrial donation techniques, which are currently permissible in certain limited circumstances in some jurisdictions such as the UK. These techniques involve replacing mitochondria in an egg to prevent the transmission of certain severe mitochondrial disease; It also considered other technologies currently under development, which may be possible in future, such as: gametogenesis, a process by which eggs and sperm are created from human stem cells; and ectogenesis, the development of embryos or fetuses in artificial wombs outside the human body. These types of emerging technologies raise novel questions about the nature of assisted human reproduction, parenthood, and family formation. Discussions at the workshop considered a range of ethical, legal, and societal challenges related to such emerging technologies, how these issues are being considered in other jurisdictions, and the potential future implications for the Irish context, including for the operation of the Health (Assisted Human Reproduction) Act 2024, once commenced.

Approximately 30 participants attended over the course of the two-day event, which featured timely multi-disciplinary discussions from leading experts in law, ethics, healthcare, and reproductive science. A full report on the workshop is available here.

Conclusion

In short, the Health (Assisted Human Reproduction) Act 2024 is a very welcome and long-overdue development, and the commencement of this Act as soon as possible is encouraged. Nonetheless, in terms of its impact, much will likely depend on how the Act is interpreted in practice once commenced. Furthermore, given the rapid pace of scientific developments in the assisted human reproduction field, ongoing multi-disciplinary dialogue is critical to the regulation of this area in Ireland and internationally, in order to pre-empt and engage with the likely ethical, legal and societal issues arising to ensure that legal frameworks are as responsive as possible to future developments in the assisted human reproduction field.

It is a picture of attendees at the workshop. Left to Right; A. Campbell, C. McGovern, N. Richardson, A. Kells, N. Maddox, F. Duffy, M. Wingfield, L. Bracken, J. Cloherty, A. Hayes, B. Tobin, P. Thompson, M. Donnelly, L. van de Wiel, I. Turkmendag, C. Romanis, L. Donovan, A. McMahon, S. Masterson, S. Adedapo. — (L-R) A. Campbell, C. McGovern, N. Richardson, A. Kells, N. Maddox, F. Duffy, M. Wingfield, L. Bracken, J. Cloherty, A. Hayes, B. Tobin, P. Thompson, M. Donnelly, L. van de Wiel, I. Turkmendag, C. Romanis, L. Donovan, A. McMahon, S. Masterson, S. Adedapo.

Acknowledgments: The organisers are very grateful to the workshop speakers and participants for attending and participating in this workshop. Speakers and participants were (listed in alphabetical order by surname): Sharon Adedapo, Research Assistant, School of Law and Criminology, Maynooth University; Dr Lydia Bracken, Associate Professor in Law, University of Limerick; Dr Aoife Campbell, Merrion Fertility Clinic; Prof Marian Crowley-Henry, School of Business, Maynooth University; Professor Mary Donnelly, University College Cork, Ireland; Jenny Cloherty, Health Products Regulatory Authority; Professor Edward (Ted) Dove, School of Law and Criminology, Maynooth University; Fiona Duffy, Solicitor, Patrick F. O’Reilly and Company Solicitors; Anne Hayes, Health Products Regulatory Authority; Lauren Kane, Research Assistant, School of Law and Criminology, Maynooth University; Opeyemi Kolawole, Postdoctoral Researcher, School of Law and Criminology, Maynooth University; Alanna Kells, PhD Candidate, Maynooth University; Dr Neil Maddox, Associate Professor, School of Law and Criminology, Maynooth University; Dr. Claire McGovern, Assistant Lecturer, School of Law and Criminology, Maynooth University; Sinéad Masterson, School of Law and Criminology, Maynooth University; Professor Aisling McMahon, School of Law and Criminology, Maynooth University; Dr Andrea Mulligan, Associate Professor of Law, Trinity College Dublin; Dr Laura O’Donovan, Lecturer in Law, University of Sheffield; Natasha Richardson, PhD Candidate, School of Law and Criminology, Maynooth University; Dr Elizabeth Chloe Romanis, Associate Professor in Biolaw, Durham University, UK;  Prof Fergus Ryan, Head of School of Law & Criminology, Maynooth University; Peter Thompson, Chief Executive, Human Fertilisation and Embryology Authority, UK; Dr Brian Tobin, Associate Professor in Law, School of Law, University of Galway; Dr Ilke Turkmendag, Reader in Biomedicine and Society, Newcastle Law School, Newcastle University, UK; Dr Lucy van de Wiel, King’s College London; Prof Mary Wingfield, MD FRCOG, Former Consultant National Maternity Hospital and Clinical Director of Merrion Fertility Clinic, Associate Clinical Professor, Obstetrics & Gynaecology, University College Dublin.

The organisers are very grateful to the Assisted Living and Learning (ALL Institute) and School of Law and Criminology, Maynooth University for their support in the organisation and funding for this event

You can read the workshop report at the following link

Intellectual Property Injunctions over Health-Related Technologies: Balancing Patient Interests and Intellectual Property Rights

Research Stream: Social Structures

Author: Sharon Adedapo Research Assistant, PatentsInHumans Project, ALL Institute and Department of Law and Criminology

There are a range of different types of intellectual property rights (IPR), including patents which offer protection over inventions, copyright protection which can be used to offer protection to literary or artistic works, and trademarks which can be used to protect for example, certain commercial symbols, images associated with a product etc. There are also various justifications for different types of IPRs, however, in the case of patent rights a key rationale often relates to how such rights can offer an incentive to inventors to develop new inventions by enabling such inventors to gain recognition or financial benefits from their work. For instance, patents enable rightsholders to develop a financial return from a patented technology because patents are exclusive rights (granted for a minimum of 20 years). When granted a patent means the rightsholder can control various aspects such as the use, production, and sale of their inventions for commercial purposes. If others wish to use that patented technology for commercial purposes, they must seek permission or a license from the rightsholder, which is typically granted in return for payment or other exchange.

Pharmaceutical worker in gown, mask and gloves, preparing a large silver machine for work in pharmaceutical factory. Image credit: iStock — Image credit: iStock

Patents and Health

Patents are often seen as particularly significant in the context of health technologies, and within the pharmaceutical sector. This is largely due to the fact that the research and development process for new health-technologies can take several years, and is a costly process that requires significant investment. Therefore, it is sometimes argued including by industry that patents and other IPRs are a key incentive for such investment. Having said this, patents and other IPRs can also have a considerable impact on access to health-technologies , including medicines, vaccines, and tests. Accordingly, while patents have an important role in the healthcare sector, a careful balance is needed in relation to considering their potential incentivising role alongside their potential impact on access to health-technologies.

Injunctions as a Remedy to Patent Infringement

Where rightsholders of the patent perceived there has been an infringement of their patent right, they may seek to enforce these rights against the infringer. One legal tool for enforcing a patent is to seek an injunction which is an equitable remedy that is issued at the court’s discretion. There are various types of injunctions, but the two main types that will be discussed in this article are interlocutory/interim injunctions and perpetual/permanent injunctions. Interlocutory injunctions are granted at the early stages of a court case to maintain the situation until the full trial. Perpetual injunctions are granted at the conclusion of the legal proceedings and permanently prohibit a party from engaging in a specific action. In the patent context, for example, an injunction could be applied for seeking a legal order to prevent the alleged patent infringer from continuing to carry out the alleged infringing act. For example, if a company, A, is producing a medicine and that medicine is found to be an infringement of company B’s patented medicine, company B could seek an injunction to stop the production of the infringing product.

Balancing IPRs and Patient Interests: Tailored Injunctions & Patent Infringement

However, such scenarios give rise to difficult questions where the patented product is a health-technology. For example, imagine a situation where a medical device which is being used to improve patients’ condition is found by the court to be infringing another party’s IPRs and that other party seeks an injunction against the infringer to halt their use/production of that technology. Should the courts grant an injunction to immediately cease its use which could impact the availability of a suitable device for other patients/procedures? What happens if there are no alternative suitable devices available for patients in such cases? Such scenarios give rise to a range of potential legal issues, including tensions between upholding rightsholders IPRs and the implications this may have for patients or health-care systems.

In some cases, courts have sought to balance such interests, including by tailoring the injunctive relief grant. An injunction is tailored when the court modifies the court order to fit the particular circumstances of the case and the parties involved. It can be done, for example, by prohibiting or requiring certain actions, setting a time frame, or delaying the granting of the injunction. Such scenarios were recently considered by English courts in the cases of Edwards Lifesciences v Boston Scientific [2018], and Evalve v Edwards Lifescience [2020].

Recent English Cases – Tailored Injunctions, Patent Infringement and Health-Technologies

These two recent English cases on this topic provide an illustration of some of the issues at stake. First, in Edwards Lifesciences v Boston Scientific [2018], Boston Scientific applied for an injunction against Edwards Lifesciences to prevent the continued sale and use of Edwards’ Sapien 3 transcatheter heart valve. In deciding on whether to grant the injunction, the court considered the impact of granting this on patients who were using the Sapein device. Ultimately, while the court held that Edwards device infringed Bostons’ patent, they acknowledged that a certain group of patients relied on the Sapien 3, and thus tailored the injunction. The court issued a 12-month stay on the injunction to give clinicians time to retrain alternative devices that could be used (paragraphs 22-31). Additionally, the court allowed patients with no other appropriate alternative to continue using the Sapien 3 for as long practitioners determined were necessary until a suitable alternative was available (paras 52-54 and 68-71). This could be seen as a reflection of the court using the proportionality principle to weigh public interests involved and private interests in protection of IPRs.

More recently, the role of public interest in the issuance of injunctions was considered by the English courts in Evalve v Edwards Lifescience [2020]. In this case, Evalve was the owner of patents for the MitraClip device, which is used to treat mitral valve regurgitation, and the High Court held that Edwards’ PASCAL device infringed Evalves’ patent. Edwards argued that an injunction would harm patients who could only rely on their PASCAL device. The court acknowledged that, in certain rare circumstances, the public interest can justify the denial of an injunction, specifically if the infringing product is the only effective treatment available for certain patients (paras 73-91). In this case, the court held that the MitraClip was generally suitable and thus the injunction was granted. However, the court tailored the effect of a full injunction by creating an exception where it would not apply for specific cases when the PASCAL device was the sole device available for certain patients.

Conclusion

The enforcement of patent rights in the healthcare sector via private law remedies, including questions around the grant or refusal of injunctions, highlights tensions which can arise in certain contexts between balancing the need for protection of IPRs and also ensuring access to life-saving treatments. While patents are an important tool for fostering medical and pharmaceutical advancements, in certain contexts their strict enforcement can have unintended negative consequences for patients. The recent English court cases demonstrate that courts are increasingly recognising this tension, leading to more nuanced approaches which consider public interests on a case-by-case basis. A flexible approach to IP enforcement by tailoring injunctions, delaying enforcement, and allowing exceptions in cases of life-saving treatment can present a useful avenue for balancing IP rights with public health needs.

As part of the ERC PatentsInHumans project, together with Prof Aisling McMahon (PI), we are currently conducting research on injunctions as a remedy for IP infringement and the scope of courts to consider patient and other third-party interests in the health context, including how such issues are being addressed by the recently established unified patent court.

You can find out more about the PatentsInHumans project, including ongoing work at: https://patentsinhumans.eu/

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This research is funded by the European Union (ERC, PatentsInHumans, Project No. 101042147). Views and opinions expressed are however those of the author only and do not necessarily reflect those of the European Union or the European Research Council Executive Agency. Neither the European Union nor the granting authority can be held responsible for them.

30 years of the TRIPS Agreement: The Need to Balance Intellectual Property Rights with the Right to Health

Research Stream: Social Structures

Author: Lauren Kane, Research Assistant, PatentsInHumans Project, ALL Institute and Department of Law and Criminology

World Intellectual Property Day took place on the 26th of April 2025. On this day, many people celebrate the role of intellectual property rights (IPRs) such as patents, trademarks, industrial designs and copyright, in incentivising creativity and innovation. Indeed, IPRs have an important role in incentivising innovation, in certain contexts. For example, patents allow the rightsholders an exclusive right over the patented technology which they can use to develop new health technologies to generate an income stream from that technology. In this way, such rights are often seen as incentivising the development of new medicines. However, in this context, it is also important to reflect on the broader impacts of certain uses of IPRs on society, including their potential impact on access to technologies (such as medicines) in the healthcare context. Such issues are particularly timely in 2025, as this year marks the 30^th anniversary of the coming into force of the World Trade Organisation’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement, an international agreement which provides for uniform minimum standards in relation to the protection and enforcement of intellectual property rights.

Intellectual Property Rights in the Healthcare Context

Intellectual Property rights, including patents, can have a significant impact for access to health-technologies. For context, a patent is a type of intellectual property right which confers the rights-holder an exclusionary right to control key aspects, including the sale, supply, production of their patented technology for commercial purposes, generally for a period of twenty years.

In practice, for health-technologies, patents can provide rights-holders with legal avenues to prevent others from developing an equivalent (generic) version of a patented medicine during this period and therefore, rightsholders have significant power to control competition. This, in turn, can enable rightsholders to command high prices which in some cases can be greatly in excess of production costs. It is acknowledged that such prices are often justified as necessary to compensate for the investment costs of research and development (R&D) of developing new and more effective drugs. Nonetheless, in such contexts, such prices (and IPRs can be a key role in this) can potentially impede access to medicines, with implications for healthcare and the right to health.

https://www.ideasinall.com/wp-content/uploads/2025/05/iStock-alexandrumagurean.png

What is the Human Right to Health?

A human right to health was first proclaimed at the global level within the World Health Organisation (WHO) Constitution, which was adopted in 1946 and came into force in 1948. The right to health is now articulated in various international and regional instruments, and over 100 national constitutions worldwide.

A key provision in this context is Article 12 of the International Covenant on Economic, Social and Cultural Rights 1966 (ICESCR), which provides that:

“The States Parties to the present Covenant recognise the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”

States Parties that have ratified the Convention are required to respect, protect and fulfil the right to health, through progressive realisation, and within the limits of their individual resources. Additionally, the Committee of Economic, Social and Cultural Rights, the UN body responsible for monitoring the implementation of the ICESCR, has also confirmed under General Comment 14 (2000) that a key component of the right to health is that States must ensure accessibility of medicines, including economic accessibility. However, the right to health may be negatively impacted by patents, for example, if medicines (or other health technologies) necessary for health are marketed at a price which significantly impedes access, which can create conflict between the human rights and intellectual property regimes.

Conceptual image representing The state of health in Europe. Thermometer and medicines against Europe political map — Credit iStock and alexandrumagreen

The Impact of the TRIPS Agreement

Moreover, since the TRIPS Agreement came into force on the 1^st of January 1995, the tensions arising in the relationship between human rights and intellectual property rights have arguably been heightened, and these tensions have been the subject of significant discussion and debate. Prior to the establishment of the TRIPS Agreement, countries used a diverse range of approaches to intellectual property protection, including tailoring their individual level circumstances to meet the health needs of populations. For example, pre-TRIPS era, developing countries could acquire equivalent, generic medicines from countries that did not offer patent protection to pharmaceuticals at that time, such as India. Under the minimum standards set down by TRIPS, this is longer possible as all TRIPS Contracting States must ensure protection of IPRs over all fields of technology. Consequently, such States have limited discretion under TRIPS over IP protections, and for this and other reasons, LMICs may struggle to provide access to expensive patented medicines for those who require them.

Some examples of the impacts IPRs can have on access to health in the health emergency context are discussed in detail elsewhere and include the HIV/AIDS crisis during the 1990s/2000s, and more recently, the COVID-19 pandemic. Increasingly, such impacts are also evident in everyday healthcare contexts, particularly in relation to novel medicines which treat cancer and rare diseases. This means that high costs are increasingly posing access issues for LMICs and high-income countries (HICs). While it is important to acknowledge that IPRs are not the sole factor contributing to such costs, how such rights can be used arguably represent a key element contributing to this.

The TRIPS Agreement did provide for some exceptions or ‘flexibilities’ to better enable developing countries to apply TRIPS in a manner which allows them to effectively balance the protection of IPRs with public health needs, affirmed by the 2001 Doha Declaration. For instance, a compulsory license is one type of flexibility that can issued by national States to allow for cheaper, generic production of a patented health technology in certain circumstances. Such measures have traditionally faced several limitations, including but not limited to the threat of potential retaliation in the form of trade sanctions against States that have utilised such flexibilities. Such issues and other factors can deter States from using TRIPS flexibilities. Nonetheless, the ability to use such measures when needed to provide access to health technologies is important to better allow States to deliver on access to health and to fulfil States human rights obligations.

To conclude, as we reflect on IPRs and World IP Day in 2025, alongside some of the benefits of IPRs for society, there is also a need for greater consideration of the potential human rights implications of how IPRs can be used in the healthcare context. There is a need to ensure the incentivising function of IPRs is balanced in a manner which appropriately takes patients’ need for access into account. Such issues, including the role of the right to health, and the extent to which this right can offer an avenue for greater accessibility of patented health-technologies is a key theme explored within the ERC PatentsInHumans Project at Maynooth University.

With Prof Aisling McMahon (Principal Investigator, ERC PatentsInHumans), we are currently examining the impact of IPRs on the accessibility component of the right to health. We are also developing a deeper analysis of the role and scope of the right to health to be used at a national level by individuals and States to facilitate a greater balance between IP rightsholder interests and patients’ access to medicines. The theme of ‘accessibility’ including of health technologies, aligns with a core value of the ‘Assisted Living and Learning’ (ALL) Institute where this project is co-hosted with the School of Law and Criminology, Maynooth University.

You can find out more about the PatentsInHumans project, including ongoing work at: www.patentsinhumans.

GoGreen Routes in Burgas: Nature-Based Solutions for a Healthier City

Research Stream: Social Lives

Author: Tom Hall, Research Assistant, Go Green Routes Project, Maynooth University

GoGreen Routes

The GoGreen Routes project lead by Principal Investigator Dr. Tadhg McIntyre carried out research in six “Cultivating Cities”: Burgas (Bulgaria), Lahti (Finland), Limerick (Ireland), Tallinn (Estonia), Umeå (Sweden) and Versailles (France). This blog focuses on research undertaken in Burgas (Bulgaria) at “Healing Island” nature-based solutions site in June 2024. Here Tadhg was joined by GoGreen Routes Research Assistant Tom Hall and Project Intern Solène Caron. Assistance was provided by Ivalo Trendilov from the EU Projects Team in the Burgas municipality. The team spent four days collecting observational, interview, environmental and air quality data in order to assess the overall impact that Healing Island is making for the people of Burgas.

The picture shows an overhead view of the park. There is a circular fountain at the center, a raised platform to the left side of this, and a wooden walkway on the right.

GoGreen Routes Aims

GoGreen Routes is a large-scale multinational project which aims to enhance the physical and mental well-being of urban residents by increasing their connection to nature in an inclusive way. To achieve this aim, the project has implemented a collection of nature based solutions (NbS). These solutions center around the use of green corridors, linear parks, pocket parks and shared walkways. By maximizing the available public space, people have greater opportunities to move about cities more actively, enjoy their free time and interact with others. Other NbS benefits include: reduced air and noise pollution, improved urban ventilation and providing ecosystem services and habitat to plant and animal species.

Reclaiming Public Space

The creation of NbS such as Healing Island are crucial due to the lack of green spaces in European cities. Research from the European Environmental Agency (EEA) on public accessibility to green infrastructure (allotments, private gardens, parks, street trees, water and wetlands) indicates that there is limited accessible space available. Here it was found that whilst green space makes up on average 42% of the city area in 38 EEA member countries, publicly accessible green space amounts to 3% (on average) of the total city area. This being so, the focus must be on reclaiming public space and maximising the area available.

“Healing Island”

As the site where Healing Island sits had previously been the location of a derelict and abandoned building, Healing Island represents a fine example of how urban locations can be reclaimed as a green space. Healing Island is so-called due to its proximity to three nearby hospitals. As such, the park provides a place where people can relax and recuperate. Shaded seating areas help cool the park and a running fountain built from local volcanic rock adds to the peacefulness of the environment.

The park can be navigated along bright paths made from recycled granite paving stones. A podium in the centre of the park provides a versatile space for health-related activities such as yoga or Tai-Chi, and can also be used as a stage for events. Beyond this, there is a soft wood-chip play area for children, as well as carved wooden animals and bug hotels for insects. A seesaw made from recycled timber along with interactive and musical features dotted around the park add to the variety of activities available. Despite the park being located close to the city centre, there is a diversity of birdlife which can be seen and heard about the park. Among these is a nearby seagull nest and the sounds of various birds including a woodpecker. Taken together, these features make Healing Island stand out as a sustainable nature-based solution which can be used by all to benefit diverse groups in society.

Access to Green Spaces

A key component of the GoGreen Routes research carried out in Burgas was to examine access to Healing Island. The World Health Organisation (WHO) recognises the contribution that access to green areas has on the health and wellbeing of urban residents. It recommends that citizens should have access to public green spaces which measure at least 1/2 football field and is located within 300 metres’ linear distance (around 5 minutes’ walk) from their homes.

The consequences of not achieving this WHO target were examined in a study led by GoGreenRoutes project partner ISGlobal. This research used satellite imagery to assess the impact of green space on mortality in 922 European cities. As part of the study, it was found that 62% of the urban populations have lower green space access than recommended. Consequently, it was estimated that 42,968 annual natural-cause deaths in these cities could be prevented if the WHO standard was brought about.

With this in mind, the GoGreen Routes team recorded the numbers of citizens using Healing Island over three days. Walking interviews with local residents added context to how people use and perceive the park. The data recorded at this time will be compared with similar data recorded a year earlier (before the park was constructed). In the final report on the project, these figures will indicate how successful Healing Island has been in attracting increased footfall.

360 Degree Health Approach

Beyond the number of people using the park, their activities (such as walking, standing, biking etc.) were recorded to allow for physical and psychological health measurements to be assessed. This is part of 360-Health approach taken by the GoGreen Routes project. This approach integrates multiple health domains. It focuses on mental health and well-being, physical activity, nutrition, sleep, cognition and performance, social health, human-nature interaction and sustainability in relation to urban nature. The results of the research in these areas are important as they can indicate the impact of Healing Island on the well-being of residents in a very powerful way.

Provisional Results

Among the provisional results of data collection in Burgas, local residents expressed their happiness at the building of Healing Island, stating that it was a much-needed amenity. Some reflected on the usefulness of the park as a place to relax and spend time with family and friends. Others including local planning professionals, pointed out that there is a future need for more green areas similar to Healing Island in the city of Burgas.

Overall, the GoGreen Routes research in Burgas has demonstrated that infrastructure projects such as Healing Island represent a viable naturebased solution which benefits people as well as nature. This can be achieved by reclaiming public spaces and providing accessible and safe places where all residents’ physical and psychological health and well-being needs can be met.

Funding Acknowledgement: The GoGreenRoutes Project is supported by the European Union’s Horizon 2020 research and innovation programme under grant agreeement No 869764.

Nothing Without Us: Considering Public Patient Involvement in Research

Social Technologies

Author: Joan Alaboson is a Doctoral Researcher in the Department of Psychology, Maynooth University. She has a background in medicine and an MSc in Public Health with broad research interests in non-communicable diseases, particularly mental health, social determinants of health and quality of life.

‘What can be done to make settling into the PhD, better?’ asked Dirk, the Director of the Science Foundation Ireland’s Centre for Research Training in Advance Networks for Sustainable Societies (ADVANCE CRT) at a meeting with funded PhD students. Being the only one in the room that had recently commenced my studies, at that moment I felt there was a deep sense of concern for my well-being by ‘management’. It was the first of such fora I’d attended, and I left with a lasting impression of being in relatable company during my studies.

True inclusion, however, could often be elusive, despite best efforts. There is hardly any organization, entity or group that does not seek to represent the interests of those concerned. It may be expressed in a vision, mission, goals, or activities. Yet, many can be left out. Sometimes, it is a fault inherent in group development, when diverse people are not present to consciously bring unique perspectives to the fore. Similarly, it may result from work protocols or culture that fail to recognize and may neglect, systematically, the views and or needs of diverse people.

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