Public Health in Asia during the COVID-19 Pandemic

Every nation in Asia has dealt with COVID-19 differently and with varying levels of success in the absence of clear and effective leadership from the WHO. As a result, the WHO’s role in Asia as a global health organization is coming under increasing pressure. As its credibility is slowly being eroded by public displays of incompetence and negligence, it has also become an arena of contestation. Moreover, while the pandemic continues to undermine the future of global health governance as a whole, the highly interdependent economies in Asia have exposed the speed with which pandemics can spread, as intensive regional travel and business connections have caused every area in the region to be hit hard. The migrant labor necessary to sustain globalized economies has been strained and the security of international workers is now more precarious than ever, as millions have been left stranded, seen their entry blocked, or have limited access to health services. This volume provides an accessible framework for the understanding the effects of the COVID-19 pandemic in Asia, with a specific emphasis on global governance in health and labor.

China’s innovation-based approach in the fight of Covid-19. An estimation of China’s impact for global health to come

When the infectious coronavirus SARS-CoV-2 broke out it resulted in a global crisis. In the fight of Covid-19, China’s government relied on its strength to apply new technologies, i.e. for controlling and containment of the virus by tracing and tracking Chinese citizens. Relying on the trajectory of industrialisation, China has pursued a path of innovation. While it is reasoned that China’s advantage might have origin in the experience of the SARS outbreak almost two decades ago, this article argues that mainly China’s innovation- driven climate has favoured the application of new technologies in combatting the current crisis. Based on the innovation-driven trajectory this article explores China’s pathway out the corona crisis and how this might strengthen China’s role in global health governance. In order to pursue this aim, this article explores several areas, in which the next generation of technologies, such as AI-based diagnostic or intelligent robots were applied and concludes with an outlook based on the formulated political agenda, strategic considerations and initial international cooperation regarding China’s impact for global health.

Assessing community health governance for evidence-informed decision-making: a cross-sectional study across nine districts of India

PurposeThe authors intend to assess the village health sanitation and nutrition committees (VHSNC) on six parameters, including their formation, composition, meeting frequencies, activities, supervisory mechanisms and funds receipt and expenditures across nine districts of the three states of India.Design/methodology/approachThe cross-sectional study, conducted in the states of Uttar Pradesh (five districts), Odisha (two districts) and Rajasthan (two districts), used a quantitative research design. The community health workers of 140 VHSNCs were interviewed using a semi-structured questionnaire. The details about the funds' receipt and expenditures were verified from the VHSNC records (cashbook). Additionally, the authors asked about the role of health workers in the VHSNC meetings, and the issues and challenges faced.FindingsThe average number of members in VHSNCs varied from 10 in Odisha to 15 in Rajasthan. Activities were regularly organized in Rajasthan and Odisha (one per month) compared to Uttar Pradesh (one every alternate month). Most commonly, health promotion activities, cleanliness drives, community monitoring and facilitation of service providers were done by VHSNCs. Funds were received regularly in Odisha compared to Rajasthan and Uttar Pradesh. Funds were received late and less compared to the demands or needs of VHSNCs.Research limitations/implications This comprehensive analysis of VHSNCs' functioning in the selected study areas sheds light on the gaps in many components, including the untimely and inadequate receipt of funds, poor documentation of expenditures and involvement of VHSNC heads and inadequate supportive supervision.Originality/value VHSNCs assessment has been done for improving community health governance.

Strengthening Local Governance in Health Financing in China: A Text-Mining Analysis of Policy Changes between 2009 and 2020

In the last two decades, developing countries have increasingly engaged in improving the governance of their health systems and promoting policy design to strengthen their health governance capacity. Although many well-designed national policy strategies have been promulgated, obstacles to policy implementation and compliance among localities may undermine these efforts, particularly in decentralized health systems. Studies on health governance have rarely adopted a central-local analysis to investigate in detail local governments’ distinct experiences, orientations, and dynamics in implementing the same national policy initiative. This study examines the policy orientations of prefectural governments in strengthening governance in health financing in China, which has transitioned from emphasizing the approach of fiscal resource input to that of marketization promotion and cost-containment regulation enforcement at the national level since 2009. Employing text-mining methodologies, we analyzed health policy documents issued by multi-level governments after 2009. The analysis revealed three salient findings. First, compared to higher-level authorities, prefectural governments generally opted to use fiscal resource input over marketization promotion and cost-containment regulation enforcement between 2009 and 2020. Second, policy choices of prefectural governments varied considerably in terms of enforcing cost-containment regulations during the same period. Third, the extent of the prefectural government’s orientation toward marketization promotion or cost-containment regulation enforcement was not only determined by the top-down orders of higher-level authorities but was also incentivized by the government’s fiscal dependency and the policy orientations of peer governments. These findings contribute to the health governance literature by providing an overview of local discretion in policy choices, and the political and fiscal dynamics of local policy orientations in promoting health governance in a decentralized health system.

Lessons from Covid-19: A Plan for Action (Pages 59-67) in Journal of the Harvard Club of India

The need for a National Public Health Agency in India is of crucial relevance today. Along with a responsive public health system, we need to focus on preventive healthcare and the promotion of healthy lifestyles. The country, as it marks its 75th year of Independence, must remember that it is essential to bring in structural change for effective public health governance.

Austria’s Digital Vaccination Registry: Stakeholder Views and Implications for Governance

In this study, we explore the recent setup of a digital vaccination record in Austria. Working from a social-scientific perspective, we find that the introduction of the electronic vaccination pass was substantially accelerated by the COVID-19 pandemic. Our interviews with key stakeholders (n = 16) indicated that three main factors drove this acceleration. The pandemic (1) sidelined historical conflicts regarding data ownership and invoked a shared sense of the value of data, (2) accentuated the need for enhanced administrative efficiency in an institutionally fragmented system, and (3) helped invoke the national vaccination registry as an indispensable infrastructure for public health governance with the potential to innovate its healthcare system in the long term.

Health Literacy Promotion and Its Institutional Arrangements: Rethinking collaborative health promotion in Thailand

This research explores institutional arrangements that govern health literacy promotion policies in Thailand since 2014. This study sets the main questions as what are the main institutional arrangements that governed health literacy promotion policies in Thailand since 2014 and can these arrangements be viewed as collaborative health governance? This paper argues that the military coup in 2014 transformed institutional-governing arrangements on health system management and health promotion greatly as many legal-political institutions and various social-political agencies were involved and brought together to promote health and health literacy. A so-called principle of ‘collaborative governance’ has been employed and implemented to promote health in Thailand recently, however, this study argues that the institutional constraints under authoritarian regime offer a ‘fictitious-collaborative health governance’ instead. Furthermore, deliberative processes on health literacy promotion regulated by many legal - institutional constraints had characteristics of ‘pseudo-deliberation’. This work is qualitative research, and it analyzes and explains research results by looking through theoretical concepts of institutionalism and collaborative governance. This study argues that to reach the goal of health literate community and society, Thai health agencies and authorities should re-approach health and health literacy promotion from the bottom-up perspective. Also, overcoming fictitious collaborative health promotion and pseudo-deliberation are necessary. To do that, we need a long-term project of building up a ‘critical health regime’ based on critical education and anti-authoritarianism as major principles. (*The paper was presented at The Hong Kong Polytechnic University’s College of Professional and Continuing Education (CPCE) Conference “Post-pandemic health and long-term care: A new paradigm”. September 2021)

Rethinking the Infodemic: Global Health Security and Information Disorder

The discourse on the infodemic constructs the combination of the pandemic and disinformation as a new source of insecurity on a global scale. How can we make sense – analytically and politically– of this newly politicized nexus of public health, information management, and global security? This article proposes approaching the phenomenon of the infodemic as an intersecting securitization of information disorder and health governance. Specifically, it argues that there are two distinct frames of security mobilized in the context of infodemic governance: information as a disease and information as a weapon. Drawing on literatures on global health and the emerging research on disinformation, the paper situates the two framings of the infodemic in broader discourses on the medicalization of security, and securitization of information disorder, respectively. The article critically reflects on each framing and offers some preliminary thoughts on how to approach the entanglements of health, security, and information disorder in contemporary global politics.