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81. Transitory Legality: The Health Implication of Ending DACA

Author:
Marie L. Mallet and Lisa Garcia Bedolla
Publication Date:
06-2019
Content Type:
Journal Article
Journal:
California Journal of Politics and Policy
Institution:
Institute of Governmental Studies, UC Berkeley
Abstract:
This paper examines the effects of the rescission announcement of the DACA program on the health outcomes of Latino DACA recipients in California. Research shows that undocumented immigrants face poorer health outcomes than their documented counterparts and U.S. citizens, and that being offered legal status (e.g. DACA) considerably improves their health outcomes. Even though studies have examined the impact of shifting legal status on incorporation, to our knowledge no studies have considered the effects of announcing the rescission of the DACA program on its recipients. However, this is important because it may have implications on their health outcomes. This study addresses this gap by using in-depth interviews with 43 Latino DACA recipients living in the California San Francisco Bay Area in 2017 and 2018. Our findings suggest that rescission announcement of DACA has led to worsening health outcomes for DACA recipients. Specifically, we find that it created what we call a state of transitory legality among the 1.5 generation, which causes DACA recipients to experience health outcomes that are worse than those before DACA. Our results are important in the field of sociology, public policy and heath care because they show the negative effects of reversing inclusionary immigration policies on the health outcomes of undocumented Latino immigrants.
Topic:
Health, Immigration, Citizenship, Immigrants, and Public Health
Political Geography:
United States and California

82. European Migrant Crisis: Health and Policy Implications

Author:
Adetayo Olorunlana
Publication Date:
07-2019
Content Type:
Research Paper
Institution:
Ìrìnkèrindò: a Journal of African Migration
Abstract:
Over 65 million people are displaced worldwide. Some have migrated to Europe, seeking refuge from wars, conflict and natural disasters. Migration and refugee health have significant repercussions for European governments and the European Union (EU), which were somewhat unprepared to address such issues. The EU proposed Health 2020 as immediate measures to address the health needs of refugees and migrants. The initiative was adopted to improve health for all, and to reduce health inequalities through public policy. However, there are legal restrictions barring irregular migrants from accessing these services. In addition, health service policies for irregular migrants varies in the EU region. There is inadequate response to some diseases affecting migrants from African origin. Consequently, refugee and migrant health is neglected, producing an inequitable situation and unnecessary suffering for the migrants, as well as potential risk to population in their host country.
Topic:
Health, Migration, Population, Public Health, and Health Crisis
Political Geography:
Africa, Europe, and European Union

83. Discussion Brief: Costs of Inequality and Exclusion

Author:
Paul von Chamier
Publication Date:
10-2019
Content Type:
Policy Brief
Institution:
Center on International Cooperation
Abstract:
This discussion brief is a contribution to the Grand Challenge on Inequality and Exclusion, an initiative of the Pathfinders for Peaceful, Just and Inclusive Societies. Inequality and exclusion harm society in a number of ways, ranging from fraying trust in institutions and increasing volatility in politics, to causing economic damage, physical insecurity, and higher rates of crime and suicide. This brief lays out an array of tangible costs to show that inequality is damaging not only on normative, but also social and economic grounds. The areas of analysis include public health problems, such as anxiety, obesity, and unplanned teenage pregnancies; impacts on safety and security, including homicide rates and violent conflict; and the economic effects of GPD gaps caused by gender discrimination, vertical income inequality, and ethnicity-based discrimination. It also addresses the territorial dimensions of inequality and exclusion, and presents evidence that inequality is a force driving volatile politics, social unrest, and falling levels of trust in public institutions today.
Topic:
Security, Inequality, Public Health, Exclusion, and Civil Unrest
Political Geography:
Global Focus

84. Burundi on the Brink Again? Identifying Risks Before the 2020 elections

Author:
Nina Wilen
Publication Date:
10-2019
Content Type:
Working Paper
Institution:
EGMONT - The Royal Institute for International Relations
Abstract:
In less than a year Burundi will hold its first elections since the 2015 political crisis was triggered by the president’s bid for a third term. Almost five years after the start of the crisis, Burundi is still stuck in a political impasse with strong authoritarian undertones and with little hope of conducting free and fair elections. This policy brief identifies four developments which could turn the current situation into a high- intensity violent crisis: forced refugee return; repression of the opposition; implosion of the ruling party CNDD-FDD and the threat of an Ebola outbreak. Given the tense climate and the limited space available to foreign actors, it is suggested that external actors scale down expectations for democratic elections. Instead, focus should be on keeping options open to provide humanitarian assistance in the event of a large-scale outbreak of violence or Ebola, while maintaining political pressure for democratic space.
Topic:
Elections, Ebola, Refugees, Election watch, and Public Health
Political Geography:
Africa and Burundi

85. Driving Growth and Innovation in the Food Industry: Lessons from the Automobile Industry’s CAFE Standards

Author:
Hank Cardello
Publication Date:
12-2019
Content Type:
Working Paper
Institution:
Hudson Institute
Abstract:
Poor dietary patterns are the leading cause of noncommunicable disease in the U.S., and they are creating a significant burden on the economy and on quality of life. Diet-related disease is having a large impact on health outcomes among children and adults, leading to increasing healthcare costs, which has led to a focus on regulatory measures to curb the rising tide. Regulation has largely focused on the U.S. food system, as it provides low-cost, calorie-dense foods, which have been linked to a substantial increase in calories in the food supply and excessive calorie consumption. Substandard eating habits are linked to a number of health conditions, such as diabetes and obesity. Diabetes rates in the U.S. have more than tripled since 1970, and nearly 40 percent of adults are categorized as having obesity. The cost to the healthcare system is significant, and a myriad of health issues are linked to its pervasive spread in the country. Particularly concerning are increasing obesity rates among children, amidst continued public health interventions at the local, state, and national levels. Public health officials continue to advocate for additional regulation to shift dietary patterns. Policy efforts have ranged from voluntary commitments by the food industry to government-driven regulations such as taxes on sugar-sweetened beverages and package-labeling provisions. Most of the government regulatory approaches to date have been piecemeal, typically led by local government bodies and focusing on a specific type of food or beverage for taxation, or tending to address a particular component, such as food package labeling. For example, Berkeley, CA passed a sugar-sweetened beverage tax in 2014, and the FDA has mandated changes to food labels to increase transparency about calories and added sugars. This paper seeks to open the discussion on a broader policy approach to reduce excessive consumption of calories, sugars, saturated fats, and sodium, which are linked to conditions such as diabetes, obesity, cardiovascular disease, and certain cancers. It will do this by exploring Corporate Average Fuel Economy (CAFE) standards, an automobile industry “cap and trade” regulatory model.
Topic:
Economics, Food, Governance, Culture, Regulation, Economic growth, Innovation, Public Health, Society, and Obesity
Political Geography:
North America and United States of America

86. Aggregating Demand for Pharmaceuticals is Appealing, but Pooling Is Not a Panacea

Author:
Cassandra Nemzoff, Kalipso Chalkidou, and Mead Over
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
As low- and middle-income countries reduce their reliance on donor aid, they are increasingly obliged to assume some degree of financial responsibility for donor projects. This challenge will be particularly complex in the procurement of health commodities. In recent decades, recipient countries have benefitted from donor-aggregated demand and pooling mechanisms, negotiated prices, purchasing, and delivery of commodities. However, as countries shift away from donor support, their challenge will be finding a way to aggregate demand in order to achieve the benefits that the pooled purchasing arrangements of vertical health programs now provide. As a first step in tackling this challenge, much can be learned from a diverse group of pooled procurement initiatives that have developed over the past 40 years in high-, middle-, and low-income countries. This note reviews the rationale and functions of these initiatives, notes their potential benefits and barriers, and draws lessons regarding how best to incorporate pooled pharmaceutical purchasing models into the design and implementation of health financing reforms in countries in transition. We first provide a brief background on the procurement challenges faced by countries in transition. In section 2, we provide an overview of different types of pooling initiatives, highlighting the key features of each. Leveraging our research and key interviews, we outline the real and potential benefits of pooling in section 3, and the most pressing barriers that organizations or countries will face as they seek ways to aggregate demand in section 4. In section 5 we discuss some of the issues that countries and development partners should address when considering pooled procurement initiatives and make two recommendations: (1) countries and development partners should conduct further research on the merits of pooled procurement, and (2) they should develop a straw model of a pooled procurement governance structure that could be tested using a series of pilots.
Topic:
Budget, Public Health, Medicine, and Pharmaceuticals
Political Geography:
Global Focus

87. Struggling with Scale: Ebola’s Lessons for the Next Pandemic

Author:
Jeremy Konyndyk
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The next pandemic is a matter of when, not if. Preparing for this inevitability requires that policymakers understand not just the science of limiting disease transmission or engineering a drug, but also the practical challenges of expanding a response strategy to a regional or global level. Achieving success at such scales is largely an issue of operational, strategic, and policy choices—areas of pandemic preparedness that remain underexplored.
Topic:
International Cooperation, Ebola, Public Health, and Pandemic
Political Geography:
Global Focus

88. Modicare Post-Election: Recommendations to Enhance the Impact of Public Health Insurance on UHC Goals in India

Author:
Kalipso Chalkidou, Nishant Jain, Françoise Cluzeau, and Amanda Glassman
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.[1] In this note, we describe the program, with an emphasis on its better-known secondary and tertiary care component, and offer policy recommendations to strengthen the scheme post-election to enhance its contribution to India’s vision for universal health coverage (UHC). In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly 1 percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the world’s performance against the Sustainable Development Goals over the coming decade.
Topic:
Health, Health Care Policy, Public Health, and Health Insurance
Political Geography:
India and Asia

89. Understanding the Opportunity Cost, Seizing the Opportunity: Report of the Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines

Author:
The Working Group on Incorporating Economics and Modeling in Global Health Goals and Guidelines
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Internationally set goals and guidelines directly influ­ence the setting of health care priorities at the national level, affecting how limited resources are generated and allocated across health care needs. The influence of global priority setting, such as through the formu­lation of overarching goals or normative guidelines for specific disease areas, is particularly significant in low- and middle-income countries that rely heavily on overseas development assistance. Because no sys­tematic approach exists for dealing with resource con­straints, however, which vary across countries, goals and guidance are often inappropriate for some country contexts; their implementation can, therefore, reduce the efficiency and equity of health care spending. The Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines, co-convened by the Center for Global Development, Thanzi la Onse, and the HIV Modelling Consortium, has brought together disease specialists, policymakers, economists, and modelers from national governments, international organizations, and academic institutions across the globe to address these issues, to take stock of current approaches, and make recommendations for better practice. The Working Group deliberated on the roles and purposes of goals and guidelines and consid­ered how economic evidence might be formally incor­porated into policy recommendations and health care decision making. The target audiences for this report are international health institutions, large stakehold­ers in disease programs across the world, and national governments.
Topic:
Development, Health, Health Care Policy, and Public Health
Political Geography:
Global Focus

90. Imagining the Alternative Worlds of 2030: Policy Implications for the Future of Global Health Procurement

Author:
Janeen Madam Keller and William Savedoff
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The availability and affordability of health products—medicines, diagnostics, devices, and equipment—are critical to achieving universal health coverage and improving health outcomes. Yet low- and middle-income countries face multiple challenges in procuring health products related to institutional inefficiencies, market failure, and fragmented demand. At the same time, the world is evolving rapidly in ways that will affect health procurement, from changes in countries’ eligibility for foreign assistance to advances in information technologies. Looking forward, efforts to improve global health procurement must proactively address the sweeping changes on the horizon. Drawing on a range of political, economic, and social trends, this paper envisions how the global landscape might change between now and 2030, with a focus on the implications for global health, particularly the procurement of health products. The paper develops three possible but distinct futures—worlds characterized as atomistic, privately led, or multilateral.It concludes by describing the policy options and locus of action to improve global health procurement in light of these scenarios, emphasizing three areas of work: financing and modes of collaboration, procurement procedures and tools, and procurement capacity.
Topic:
Health, Health Care Policy, Public Health, and Health Crisis
Political Geography:
Global Focus