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11. HIV, Hepatitis & Drug Policy Reform

Author:
Global Commission On Drug Policy
Publication Date:
12-2023
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
This report, “HIV, Hepatitis & Drug Policy Reform” follows the Global Commission’s thematic reports on “The War on Drugs and HIV/AIDS” (2012) and “The Negative Impact of the War on Drugs on Public Health: The Hidden Hepatitis C Epidemic” (2013). Despite a decade-old call for urgent action, current drug control efforts fail, with HIV and hepatitis prevalence persisting among drug users. In 2023, approximately 354 million people around the world are currently living with hepatitis B or C. People who use drugs, especially people who inject drugs, are at a higher risk for blood- borne HIV, hepatitis B and hepatitis C. Although there has been some success — for example, the scale-up of antiretroviral treatments that reduced HIV related deaths to their lowest in almost three decades — progress has been uneven and people who use drugs are still left behind. This must change. Prohibition and criminalization of drug use hinder HIV and hepatitis prevention, escalating risks and obstructing treatment. People who use drugs face disproportionate incarceration, abusive policing, and stigma. Inadequate resources are dedicated to proven harm reduction options while billions are spent on punitive law enforcement measures. Achievable UN targets for ending these epidemics by 2030 exist, but a crucial course correction demands political will to embrace a new approach to drugs. The time to act is now.
Topic:
HIV/AIDS, Reform, Drugs, Public Health, and Hepatitis
Political Geography:
Global Focus

12. The Relationship between COVID-19 Entry Restrictions and Immigration

Author:
Youngook Jang and Dong-Hee Joe
Publication Date:
12-2023
Content Type:
Working Paper
Institution:
Korea Institute for International Economic Policy (KIEP)
Abstract:
In this paper, we investigate the relationship between COVID-19 entry restrictions and dependence on immigrants. In response to the global COVID-19 pandemic, countries worldwide implemented international travel restrictions to reduce the entry of infected individuals. These measures included entry and exit bans, mandatory quarantine of travelers, and vaccination requirements, significantly altering global mobility patterns. Despite their proven effectiveness, entry restrictions also impose substantial economic costs, particularly evident in the form of reduced immigration and subsequent labor shortages in sectors reliant on immigrant labor. We introduce a theoretical framework to shed light on the factors influencing the determination of entry restrictions, encompassing both health and economic considerations. Empirical analyses reveal that countries heavily dependent on foreign labor are inclined to adopt less stringent border controls, balancing the economic costs associated with reduced immigrant workforce. Moreover, we argue that the strength of entry restrictions is determined by a government’s capacity to manage infection waves through means other than entry bans. Finally, we offer policy implications based on our research, on how to control the spread of infectious diseases while minimizing the costs imposed by reducing immigration and the cost imposed on the immigrants themselves.
Topic:
Immigration, Border Control, Public Health, and COVID-19
Political Geography:
Global Focus

13. Good Practices in the Provision of Global Public Goods: How multilateral development banks build on global public goods in their operations

Author:
Johanna Neuhoff and Hannah Zick
Publication Date:
07-2023
Content Type:
Special Report
Institution:
Oxford Economics
Abstract:
In our flagship report, ‘Multilateral Development Banks for Global Public Goods’, commissioned by Deutsche Gesellschaft für Internationale Zusammenarbeit on behalf of the German Federal Ministry for Economic Cooperation and Development, Oxford Economics highlighted the positive role that the use of GPGs can play in preventing and addressing crises that cross national boundaries. As part of that work, we wanted to identify and share promising practices and good examples of how the provision of GPGs can be supported through international funding—and in particular through MDBs. We gathered a longlist of 99 examples of MDBs supporting GPG provision based on comprehensive desk research and interviews with over 30 key actors in the realm of project development. From this, we selected 20 case studies to carry out “deep dive” research to showcase good practices of provision of GPGs by MDBs based on whether the intervention: benefitted not only people inside the country of implementation but also beyond the country’s borders; supported the implementation of framework conditions that change the incentive structure for the provision of GPGs; could be replicated in other countries; and rated a good practice in reports or named a good practice by interview partners from MDBs. As a result, we gathered examples of GPG projects supported by MDBs and multilateral institutions at the country level that might not have been intended to only support GPG provision—such as those GPG projects mostly financed via Trust Funds and FIFs—but which also produced high GPG effects by maximising the synergies between national and global benefits. The case studies are designed to inform stakeholders from MDBs and receiving countries involved in the programming and project designing of development cooperation alike. The case studies showcase promising and highly replicable ways of supporting the provision of GPGs in the MDBs’ country engagement—considering both national and cross-country benefits of an intervention. Furthermore, valuable lessons can be learned on the institutional set-up, financing, quantification etc. concerning the support of GPGs by MDBs. They include examples of projects in sub-Saharan Africa, East Asia & Pacific, Latin America and the Caribbean, and South Asia, and which covered issues such as climate and the environment, global public health, peace and security, financial resilience, and a fair international trading system. In a synthesis report, we set out 12 recommendations to organisations implementing GPGs to ensure they maximise the benefits on the ground, based on our findings from the analysis of the case studies. These range from using cost-benefit analysis and focusing on projects with high cross-country benefits to helping coordination of in-country provision and encouraging regional learning.
Topic:
Climate Change, Development, Environment, International Trade and Finance, Institutions, Public Health, and Multilateral Development Banks (MDBs)
Political Geography:
South Asia, East Asia, Germany, Latin America, Caribbean, Asia-Pacific, Global Focus, and Sub-Saharan Africa

14. Overworked and Undervalued: Unmasking Primary Care Physicians’ Dissatisfaction in 10 High-Income Countries

Author:
Evan D. Gumas, Munira Z. Gunja, Arnav Shah, and Reginald D. Williams II
Publication Date:
08-2023
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
In many countries, including the United States, primary care physicians are reaching a breaking point.1 In 2021, an estimated 117,000 physicians in the U.S. left the workforce for reasons like retirement, burnout, and pandemic-related stressors.2 During the COVID-19 pandemic, primary care physicians around the world saw a dramatic fall in in-person visits in favor of telehealth, accompanied in some countries by decreases in revenue.3 The Commonwealth Fund also found that most primary care physicians experienced increases in their workload because of more time spent processing insurance payments, getting patients medications or treatments because of coverage restrictions, and reporting clinical or quality of care data to external entities. This has contributed to increased stress, emotional distress, demoralization, and burnout.4 This brief explores primary care physician work satisfaction in the first year of the pandemic — 2020 to 2021 — drawing from the 2022 Commonwealth Fund International Health Policy Survey of Primary Care Physicians. (See “How We Conducted This Survey” for more details.) Understanding how primary care physicians feel about their everyday work is crucial to improving their patients’ quality of care and to reversing the steady stream of professionals exiting the primary health care workforce. Across 10 high-income countries, including the U.S., we compare primary care physicians’ time spent with patients, number of patients seen, and job satisfaction.
Topic:
Health Care Policy, Public Health, Primary Care, and Dissatisfaction
Political Geography:
North America, Global Focus, and United States of America

15. Multilateralism Index: Pilot Report

Author:
International Peace Institute
Publication Date:
09-2022
Content Type:
Policy Brief
Institution:
International Peace Institute (IPI)
Abstract:
In the past several years, there has been a much-discussed rise in strain on multilateralism. However, there have been few efforts to quantifiably assess the state of the multilateral system. This Multilateralism Index (MI) report is the first known attempt to do so. It focuses on developments in the system over the past decade, providing a snapshot of its relative strength in 2020 compared to 2010. It seeks to answer questions including: What is the state of the multilateral system? What is working? What is not? And how has the multilateral system changed over time? The MI examines five domains of multilateral coordination: Peace and Security, Human Rights, Environment, Public Health, and Trade. Each domain is evaluated across three dimensions: Participation, Performance, and Inclusivity. Analysis of sixty-five indicators across these domains and dimensions reveals several trends in multilateral cooperation over the past decade: Participation scores for Human Rights, Public Health, and Trade have improved, while the scores for Peace and Security and Environment have deteriorated. Performance scores have deteriorated in four out of five domains. Inclusivity scores have improved across all five domains. These trends shed light on the nature of the crisis of multilateralism. Rather than decreased international cooperation and widespread exit from multilateral institutions, we are seeing a battle over the nature and purpose of the multilateral system—not decay, but transformation. The MI provides a basis for tracking this transformation and informing decision making on the future of multilateralism.
Topic:
Security, Environment, Human Rights, Multilateralism, Peace, Trade, and Public Health
Political Geography:
Global Focus

16. The Rise and Fall of Social Housing? Housing Decommodification in Long-Run Perspective

Author:
K.A. Kholodilin, Sebastian Kohl, and F. Mueller
Publication Date:
01-2022
Content Type:
Working Paper
Institution:
Max Planck Institute for the Study of Societies
Abstract:
The comparative study of housing decommodification lags behind classical welfare state research, while housing research itself is rich in homeownership studies but lacks comparative accounts of private and social rentals due to missing comparative data. Building on existing works and various primary sources, this study presents a new collection of up to forty-eight countries’ social housing shares in stock and new construction since the first housing laws around 1900. The interpolated benchmark time series generally describe the rise and fall of social housing across a residual, a socialist, and a Northern-European housing group. The decline was steeper than for the classical welfare state, but the degree of erosion was surprisingly small in some countries where public housing associations remained resilient. Within the broader housing welfare state, social housing correlates positively with rent regulation and allowances, but negatively with homeownership subsidies and liberal mortgage regulation. A multivariate analysis shows that social housing is rather explained by housing shortages and complementarities with rental and welfare policies than by typical welfare state theories (GDP, political parties). Generally, the paper shows that conventional housing typologies are difficult to defend over time and argues more generally for including housing decommodification in welfare state research.
Topic:
Welfare, Public Health, Housing, and Social Order
Political Geography:
Global Focus

17. Delay, Detect, Defend: Preparing for a Future in which Thousands Can Release New Pandemics

Author:
Kevin M. Esvelt
Publication Date:
11-2022
Content Type:
Working Paper
Institution:
The Geneva Centre for Security Policy
Abstract:
The world is demonstrably vulnerable to the introduction of a single pandemic virus with a comparatively low case fatality rate. The deliberate and simultaneous release of many pandemic viruses across travel hubs could threaten the stability of civilisation. Current trends suggest that within a decade, tens of thousands of skilled individuals will be able to access the information required for them to single-handedly cause new pandemics. Safeguarding civilisation from the catastrophic misuse of biotechnology requires delaying the development and misuse of pandemic-class agents while building systems capable of reliably detecting threats and preventing nearly all infections.
Topic:
Security, Public Health, Pandemic, and Health Crisis
Political Geography:
Global Focus

18. Patents, Pandemics, and the Private Sector: The Battle Over Public Health Norms During COVID-19

Author:
Vartika Neeraj
Publication Date:
05-2022
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
The COVID-19 pandemic has revealed the influence that private pharmaceutical companies and philanthropic foundations have on global health governance. Private actors have been able to maintain the norm of intellectual property rights, despite opposition from developing countries and growing opposition from powerful actors in developed countries. This article examines how private actors have wielded their material resources, expert authority, and discursive powers to overrule the wishes of governments. It concludes by exploring the public health consequences of their growing hold on international governance and offers some policy recommendations to mitigate distorted public health outcomes.
Topic:
International Relations, Intellectual Property/Copyright, International Development, Public Health, Vaccine, and COVID-19
Political Geography:
Global Focus

19. The failure of global public health governance: a forensic analysis

Author:
Jean Pisani-Ferry, Anne Bucher, and George Papaconstantinou
Publication Date:
02-2022
Content Type:
Policy Brief
Institution:
Bruegel
Abstract:
COVID-19 has underlined that in a context of recurring pandemics, public health is a basic global public good, the provision of which presupposes effective and timely collective action at global level. It has exposed the limitations of the prevailing framework. This Policy Contribution positions global public health governance in the wider debate on the reform of international governance arrangements. It distinguishes between the ‘before’ phase of pandemic preparedness, characterised by ‘denial and neglect’; the first phase (‘addressing the outbreak’), with scientific cooperation and an uncoordinated response to the outbreak; the second phase (‘responding and containing’), with a scaling up of testing, but also competition for scarce equipment and slow development of tests; the third ‘protecting’ phase, with the exceptional development of new vaccines but also rival vaccine diplomacy; and the final ‘exit’ phase, with ramping up of vaccine distribution, but also a glaring failure to vaccinate poor countries. In the evolution of global governance arrangements in different policy areas, six ingredients have been important, and two were clearly present in public health: joint identification of the problem, and shared expertise, as demonstrated especially in the scientific and institutional response. This was much less the case with two others: common action principles, and transparent reporting mechanisms. Finally, there have been significant problems with the last two ingredients: there is no accepted outcome-evaluation process to assess results and adapt instruments, while trust issues continue to hamper the work of the World Health Organisation. The decision to work towards a new pandemic treaty should be assessed against the reform agenda of global health security governance. Four proposals can be made. The WHO should be turned it into a strong and independent standard-setting and surveillance authority for preparedness, prevention, and response, while existing institutions and initiatives should be streamlined and consolidated to better provide essential medical supplies globally. Meanwhile, a G20-type body should be established to provide leadership and ensure a whole-of-government approach that repositions global health governance in the world order and puts it on par with economic interdependence or financial stability in terms of governance, institutional backing and resources. Adequate funding should be provided through a self-standing fund to address the shortfalls COVID-19 has revealed in preparedness of national health systems, detection and containment, and shortages and misallocations of critical medical supplies.
Topic:
Governance, Public Health, COVID-19, and Forensic Science
Political Geography:
Global Focus

20. A lockdown a day keeps the doctor away: The effectiveness of non-pharmaceutical interventions during the Covid-19 pandemic

Author:
Anthonin Levelu and Alexander Sandkamp
Publication Date:
05-2022
Content Type:
Working Paper
Institution:
Kiel Institute for the World Economy (IfW)
Abstract:
Countries have employed a variety of non-pharmaceutical interventions (NPIs) in order to curtail the COVID-19 pandemic. However, the success of individual measures in reducing the number of infections remains controversial. This paper exploits a panel data set of 107 countries to estimate the effects of 14 NPIs on the spread of the disease. While almost all measures had a dampening effect on the reproduction rate of the virus, public information campaigns and school closings were most effective, followed by testing policies, contact tracing and international travel restrictions. Public event cancellation and school closings were less effective during the second wave of the pandemic, while public information campaigns and the obligation to wear masks worked better. Several NPIs had a stronger impact on infections in autocratic countries, while others were less effective.
Topic:
Health, Economy, Public Policy, Public Health, and COVID-19
Political Geography:
Global Focus