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Hindsight is 2020? Lessons in global health governance one year into the pandemic
Fourteen months into the SARS-CoV-2 pandemic, we identify key lessons in the global and national responses to the pandemic. The World Health Organization has played a pivotal technical, normative and coordinating role, but has been constrained by its lack of authority over sovereign member states. Many governments also mistakenly attempted to manage COVID-19 like influenza, resulting in repeated lockdowns, high excess morbidity and mortality, and poor economic recovery. Despite the incredible speed of the development and approval of effective and safe vaccines, the emergence of new SARS-CoV-2 variants means that all countries will have to rely on a globally coordinated public health effort for several years to defeat this pandemic.
Global coordination of public health efforts will be needed to defeat the COVID-19 pandemic and to prepare for future public health emergencies.
Journal Article
Criminal law, philosophy and public health practice
\"The goal of improving public health involves the use of different tools, with the law being one way to influence the activities of institutions and individuals. Of the regulatory mechanisms afforded by law to achieve this end, criminal law remains a perennial mechanism to delimit the scope of individual and group conduct. Utilising criminal law may promote or hinder public health goals, and its use raises a number of complex questions that merit exploration. This examination of the interface between criminal law and public health brings together international experts from a variety of disciplines, including law, criminology, public health, philosophy and health policy, in order to examine the theoretical and practical implications of using criminal law to improve public health\"-- Provided by publisher.
Book
COVID-19: unprecedented but expected
The COVID-19 pandemic provides an opportunity to reimagine preparedness for and responses to future pandemics.
Journal Article
The innovator's prescription : a disruptive solution for health care
\"Our health care system is in critical condition. The Affordable Care Act has insured more Americans than ever, yet deductibles keep rising and costs continue to climb. Now more than ever, the industry needs a shot in the arm. It needs The innovator's prescription, the now-classic approach to efficient affordable, affordable health care\"--Back cover.
Book
Leveraging Health Department Capacities, Partnerships, and Health Insurance for Infectious Disease Response in Massachusetts, 2014-2018
Policies facilitating integration of public health programs can improve the public health response, but the literature on approaches to integration across multiple system levels is limited. We describe the efforts of the Massachusetts Department of Public Health to integrate its HIV, viral hepatitis, sexually transmitted infection (STI), and tuberculosis response through policies that mandated contracted organizations to submit specimens for testing to the Massachusetts State Public Health Laboratory; co-test blood specimens for HIV, hepatitis C virus (HCV), and syphilis; integrate HIV, viral hepatitis, and STI disease surveillance and case management in a single data system; and implement an integrated infectious disease drug assistance program. From 2014 through 2018, the number of tests performed by the Massachusetts State Public Health Laboratory increased from 16 321 to 33 674 for HIV, from 11 054 to 33 670 for HCV, and from 19 169 to 30830 for syphilis. Service contracts enabled rapid response to outbreaks of HIV, hepatitis A, and hepatitis B. Key challenges included lack of a billing infrastructure at the Massachusetts State Public Health Laboratory; the need to complete negotiations with insurers and to establish a retained revenue account to receive health insurance reimbursements for testing services; and time to train testing providers in phlebotomy for required testing. Investing in laboratory infrastructure; creating billing mechanisms to maximize health insurance reimbursement; proactively engaging providers, community members, and other stakeholders; and building capacity to transform practices are needed. Using multilevel policy approaches to integrate the public health response to HIV, STI, viral hepatitis, and tuberculosis is feasible and adaptable to other public health programs.
Journal Article
Federalism and decentralization in health care : a decision space approach
\"A unique scholarly contribution to the field of comparative federalism, decentralization, and health care policy. This collection offers a systematic perspective on health care decentralization in a diverse group of federal countries that includes high-income (Switzerland, Canada, & Germany), high middle-income (Brazil, Mexico and South Africa) and low middle income (Nigeria & Pakistan) countries. This collecton should be a valuable resource for those studying health care policy in federal systems and especially those interested in comparative aspects of the topic.\"-- Provided by publisher.
Book
Blind spot
Neoliberalism has been the defining paradigm in global health since the latter part of the twentieth century. What started as an untested and unproven theory that the creation of unfettered markets would give rise to political democracy led to policies that promoted the belief that private markets were the optimal agents for the distribution of social goods, including health care. A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan's remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a \"revolving drug fund\" program—used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities. Provocative, rigorous, and accessible, Blind Spot offers a cautionary tale about the forces driving decision making in health and development policy today, illustrating how the privatization of health care can have catastrophic outcomes for some of the world's most vulnerable populations.
eBook
Pandemics, publics, and politics : staging responses to public health crises
Pandemics are potentially very destructive phenomena, and for that reason, they both fascinate and frighten us. And because they are shot through with uncertainty, they often become sites of contestation and conflict. This book presents research on the 2009 pandemic and other public health crises in an attempt to describe and analyze the distinctive challenges that such diseases pose today. Thanks to vaccines, more reliable provision of medical services, more effective means of communication, and a more educated public, some argue we will not see a new Black Plague - or even Spanish Flu - in our time. Today we face new challenges, however, which can both enable diseases to reach pandemic scales and affect our ability to enact an appropriate response. Those include fragmentation of media, tribalization of \"knowledge regimes,\" the increasingly troubled status of scientific and political expertise, growing cross-continental mobility, as well as the globalization and commercialization of pandemic response systems. These distinctive complexities make the need to stage public action in response to pandemics and other public health crises a crucial problem, on which thousands of human lives hinge. This volume consists of a handful of social science and humanities studies of precisely such complexities, and thus offers a much-needed supplement to existing research on pandemics and pandemic response.-- Provided by publisher.
Book
A Longitudinal Analysis of Wait Times for Bariatric Surgery in a Publicly Funded, Regionalized Bariatric Care System
BackgroundBariatric surgery is proven to be the most effective strategy for management of obesity and its related comorbidities. However, in Canada, patients awaiting bariatric surgery can be subjected to prolonged wait times, thereby subjecting them to increased morbidity and mortality, as well as decreased psychosocial well-being.ObjectiveTo assess the factors associated with prolonged wait times for bariatric surgery within a publicly funded, provincial bariatric network.MethodsThis was a retrospective population-based study of all patients aged > 18 years who were referred for bariatric surgery from April 2009 to May 2015 using linked administrative databases to capture patient demographic data, socioeconomic variables, healthcare utilization, and institutional factors. The main outcome of interest was a wait time greater than 18 months. Multivariate logistic regression modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI).ResultsA total of 18,854 patients underwent bariatric surgery from April 2009 to December 2016, of which 2407 patients experienced wait times of > 18 months. On average, yearly wait times have increased for patients receiving surgery with wait times of 10.98 months (SD 5.48) in 2010 and 13.09 (SD 6.69) in 2016 (p < 0.001). Increasing age (OR 1.12, 95% CI 1.05–1.19, p = 0.0004), BMI (OR 1.08, 95% CI 1.04–1.11, p < 0.001), and male gender (OR 1.47, 95% CI 1.28–1.70, p < 0.001) were significantly associated with increased bariatric surgery wait times. Additionally, smoking status (OR 1.46, 95% CI 1.09–1.97, p = 0.0118) and obesity-related comorbidities particularly diabetes (OR 1.29, 95% CI 1.14–1.44, p < 0.001) and heart failure (OR 1.72, 95% CI 1.43–2.07, p < 0.001) were correlated with prolonged wait times for surgery. Socioeconomic variables including disability (OR 1.64, 95% CI 1.38–1.92, p < 0.001) and immigration status (OR 1.35, 95% 1.11–1.64, p = 0.003) were correlated with increased odds of longer wait times, as were regions with regionalized assessment and treatment centres (RATC) when referenced against centers of excellence (COEs) in number of days added with 20.45 (95% CI 13.20–27.70, p < 0.001).ConclusionWait times for bariatric surgery in a publicly funded, regionalized bariatric program are influenced by certain patient characteristics, socioeconomic variables, and institutional factors. This warrants further intervention and study to help improve these inequities when encountering potentially vulnerable populations awaiting bariatric surgery.
Journal Article