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Wang Z, Liang Z, Dong X, Gao L, Zhou S, Yin H, Jin Y, Zheng ZJ. Health policy competencies in regional organizations: a retrospective analysis for 76 regional organizations from 1945 to 2015. Global Health 2024; 20:17. [PMID: 38409001 PMCID: PMC10895825 DOI: 10.1186/s12992-024-01023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Health policy competencies of regional organizations include mandates to create regional health laws and policies, as well as authorities that allow member states to undertake collective actions in the health field. The examination of the health policy competencies of regional organizations is essential, as it constitutes an important prerequisite for regional organizations to govern regional health. This study aims to map the development trajectory of health policy competencies in regional organizations worldwide and investigate their potential correlates. This will contribute to the enhanced promotion of both existing and new regional health cooperation. METHODS This retrospective analysis utilized the health policy competencies of the 76 regional organizations worldwide from 1945 to 2015, as investigated in the Regional Organizations Competencies Database. By aggregating member state data from various sources such as the IHME Global Burden of Disease 2019, the World Bank, and the World Trade Organization, we extracted the mean values and coefficients of variation for the covariates in regional organization characteristics, socioeconomic and demographic factors, health status and health-system capacity. The correlation between changes in the health policy scope of regional organizations and independent variables was analyzed using Poisson pseudo-likelihood regression with multiple levels of fixed effects. RESULTS From 1945 to 2015, the number of regional organizations with health policy competencies experienced a slow growth stage before 1991 and an explosive growth stage post-1991. By 2015, 48 out of the 71 existing regional organizations had developed their health policy competencies, yet 26 (54.2%) of these organizations possessed only 1-2 health policy competencies. An enhancement in the health policy scope of a regional organization correlated with its founding year, a greater number of policy fields, higher under-five mortality, and larger disparities in trade and healthcare access and quality indexes among member states. In contrast, larger disparities in population, under-five mortality and health worker density among member states, along with more hospital beds per capita, were negatively correlated with the expansion of a regional organization's health policy scope. CONCLUSION Since 1991, there has been a surge of interest in health among regional organizations, although health remains a secondary priority for them. The health policy competencies of regional organizations are pivotal for promoting social equity within regional communities. Its establishment is also closely linked to the level and disparities among member states in aspects such as trade, population, child mortality rates, and health system capacity.
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Affiliation(s)
- Zongbin Wang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhisheng Liang
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Xuejie Dong
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Liqun Gao
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Shuduo Zhou
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Hui Yin
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
- Institute for Global Health and Development, Peking University, Beijing, China.
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Fischer SE, Vitale L, Agutu AL, Kavanagh MM. Intellectual Property and the Politics of Public Good during COVID-19: Framing Law, Institutions, and Ideas during TRIPS Waiver Negotiations at the WTO. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2024; 49:9-42. [PMID: 37522338 DOI: 10.1215/03616878-10910269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
CONTEXT To facilitate the manufacturing of COVID-19 medical products, in October 2020 India and South Africa proposed a waiver of certain intellectual property (IP) provisions of a World Trade Organization (WTO) agreement. After nearly two years, a narrow waiver agreement that did little for vaccine access passed the ministerial despite the pandemic's impact on global trade, which the WTO is mandated to safeguard. METHODS The authors conducted a content analysis of WTO legal texts, key-actor statements, media reporting, and the WTO's procedural framework to explore legal, institutional, and ideational explanations for the delay. FINDINGS IP waivers are neither legally complex nor unprecedented within WTO law, yet these waiver negotiations exceeded their mandated 90-day negotiation period by approximately 18 months. Waiver opponents and supporters engaged in escalating strategic framing that justified and eventually secured political attention at head-of-state level, sidelining other pandemic solutions. The frames deployed discouraged consensus on a meaningful waiver, which ultimately favored the status quo that opponents preferred. WTO institutional design encouraged drawn-out negotiation while limiting legitimate players in the debate to trade ministers, empowering narrow interest group politics. CONCLUSIONS Despite global political attention, the WTO process contributed little to emergency vaccine production, suggesting a pressing need for reforms aimed at more efficient and equitable multilateral processes.
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Wouters OJ, Forman R, Anderson M, Mossialos E, McKee M. The launch of the EU Health Emergency Preparedness and Response Authority (HERA): Improving global pandemic preparedness? Health Policy 2023; 133:104844. [PMID: 37269803 DOI: 10.1016/j.healthpol.2023.104844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023]
Abstract
The crowded global health landscape has been joined by the European Union Health Emergency Preparedness and Response Authority (HERA). HERA will assume four broad areas of responsibility: horizon scanning for major health threats; research and development; support for capacity to manufacture drugs, vaccines, and equipment; and procuring and stockpiling key medical countermeasures. In this Health Reform Monitor article, we outline the reform process and describe HERA's structure and responsibilities, explore issues that arise from the creation of this new organisation, and suggest options for collaboration with existing bodies in Europe and beyond. The COVID-19 pandemic and other infectious disease outbreaks have shown the need to treat health as a cross-border issue, and there is now a broad consensus that greater direction and coordination at the European level is needed. This ambition has been matched with a considerable increase in EU funding to tackle cross-border health threats, and HERA can be used to deploy this funding in an effective manner. Yet this is contingent upon clearly defining its role and responsibilities vis-à-vis existing agencies to reduce redundancies.
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Affiliation(s)
- Olivier J Wouters
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
| | - Rebecca Forman
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Teerawattananon Y, Dabak SV, Isaranuwatchai W, Lertwilairatanapong T, Shafie AA, Suwantika AA, Oh C, Srisasalux J, Cheanklin N. What Can We Learn From Others to Develop a Regional Centre for Infectious Diseases in ASEAN? Comment on "Operationalising Regional Cooperation for Infectious Disease Control: A Scoping Review of Regional Disease Control Bodies and Networks". Int J Health Policy Manag 2022; 11:3141-3144. [PMID: 35942957 PMCID: PMC10105200 DOI: 10.34172/ijhpm.2022.7281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/23/2022] [Indexed: 11/09/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has brought the need for regional collaboration on disease prevention and control to the fore. The review by Durrance-Bagale et al offers insights on the enablers, barriers and lessons learned from the experience of various regional initiatives. Translating these lessons into action, however, remains a challenge. The Association of Southeast Asian Nations (ASEAN) planned to establish a regional centre for disease control; however, many factors have slowed the realisation of these efforts. Going forward, regional initiatives should be able to address the complexity of emerging infectious diseases through a One Health approach, assess the social and economic impact of diseases on the region and study the real-world effectiveness of regional collaborations. The initiatives should seek to be inclusive of stakeholders including those from the private sector and should identify innovative measures for financing. This advancement will enable regions such as ASEAN to effectively prepare for the next pandemic.
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Affiliation(s)
- Yot Teerawattananon
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Saudamini Vishwanath Dabak
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Asrul Akmal Shafie
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Auliya A. Suwantika
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Bandung, Indonesia
| | - Cecilia Oh
- HIV, Health and Development Team, United Nations Development Programme, Bangkok, Thailand
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Jit M, Ananthakrishnan A, McKee M, Wouters OJ, Beutels P, Teerawattananon Y. Multi-country collaboration in responding to global infectious disease threats: lessons for Europe from the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. EUROPE 2021; 9:100221. [PMID: 34642675 PMCID: PMC8495250 DOI: 10.1016/j.lanepe.2021.100221] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Since 2005, the world has faced several public health emergencies of international concern arising from infectious disease outbreaks. Of these, the COVID-19 pandemic has had by far the greatest health and economic consequences. During these emergencies, responses taken by one country often have an impact on other countries. The implication is that coordination between countries is likely to achieve better outcomes, individually and collectively, than each country independently pursuing its own self-interest. During the COVID-19 pandemic, gaps in multilateral cooperation on research and information sharing, vaccine development and deployment, and travel policies have hampered the speed and equity of global recovery. In this Health Policy article, we explore how multilateral collaboration between countries is crucial to successful responses to public health emergencies linked to infectious disease outbreaks. Responding to future global infectious disease threats and other health emergencies will require the creation of stronger mechanisms for multilateral collaboration before they arise. A change to the governance of multilateral institutions is a logical next step, with a focus on providing equal ownership and leadership opportunities to all member countries. Europe can be an example and advocate for stronger and better governed multilateral institutions.
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Affiliation(s)
- Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
| | - Martin McKee
- Department of Health Services and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Olivier J. Wouters
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- School of Public health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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