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.

"A Promise Unfulfilled": Stakeholder Influence and the 2018 UN High-Level Meeting on NCDs; Comment on "Competing Frames in Global Health Governance: an Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases

In recognition of the global burden of noncommunicable diseases (NCDs), the past decade has seen three U.N. High Level Meetings on NCDs. Yet progress in terms of political or financial commitments has been very slow. At the 2018 meeting, a political declaration was approved but featured language that had been watered down in terms of commitments. In "Competing Frames of Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases," Suzuki et al analyze the documents that were submitted by Member States, NGOs and the private sector during the consultation period and conclude that the private sector and several high-income countries appeared to oppose regulatory frameworks for products associated with NCDs , that wealthier countries resisted financing commitments, and that general power asymmetries affected the final document. This comment supports their findings and provides additional considerations for why the NCD response has yet to produce significant commitments.

Powerful Allies and Weak Consensus: Towards a Deeper Understanding of how Health-Harming Industries Seek to Influence Global Health Governance; Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases"

Suzuki et al. have identified commonalities in the policy positions adopted at a global forum by commercial sector actors and high-income countries, on the one hand, and non-governmental organizations and low- and middle-income countries, on the other, in ways that may allow commercial sector actors to block or delay evidence-based policies through the creation of political controversy. The ability of industry actors to draw on the support of the most politically and economically powerful countries for their favoured policy agenda is an important contribution to understanding the dynamics of global health governance in the area of non-communicable diseases and beyond. Here we assess the relevance of this paper for the field of corporate actors’ research and the potential avenues this opens up for further study. More specifically we emphasize the need for comparative, cross disciplinary research to examine the power of heath-harming industries and the relevance of these findings for decolonizing global health.

Lacking Clarity or Strategic Ambiguity? Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-Communicable Diseases"

This commentary engages with Suzuki and colleagues’ analysis about the ambiguity of multi-stakeholder discourses in the United Nations (UN) Political Declaration of the 3rd High-Level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (HLM-NCDs), suggesting that blurring between public and private sector in this declaration reflects broader debates about multi-stakeholder partnerships (MSPs) and public-private partnerships (PPPs) in health governance. We argue that the ambiguity between the roles and responsibilities of public and private actors involved may downplay the role (and regulation) of conflicts of interest (COI) between unhealthy commodity industries and public health. We argue that this ambiguity is not simply an artefact of the Political Declaration process, but a feature of multi-stakeholderism, which assumes that commercial actors´ interests can be aligned with the public interest. To safeguard global health governance, we recommend further empirical and conceptual research on COI and how it can be managed.

Beware the Kindleberger Trap in Global Health Governance

The Covid-19 pandemic is both a public health crisis and a stress test for global health governance. Effective health governance hinges on the provision of global public goods for health. Generally, the hegemon underwrites the operation and stability of the global public health architecture by ensuring the sustained supply of global public goods for health. But when the hegemon is unable or unwilling to shoulder this responsibility, global health governance may run the risk of falling into a Kindleberger Trap. The leadership vacuum that is opening up amid the coronavirus pandemic is accelerating the process. At present, China should adopt a three-pronged approach to promote bilateral health cooperation with leading countries like the United States, strengthen regional institution-building with ASEAN, South Korea, Japan, and Belt and Road countries, and improve the performance, credibility, and integrity of global organizations like the WHO and G-20. The Kindleberger Trap in global health governance can be overcome by adapting regional health coordination to make it more agile and effective.

Thinking Politically About UN Political Declarations: A Recipe for Healthier Commitments—Free of Commercial Interests Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases"

As evidence mounts that corporate actor engagement in United Nations (UN) policy-making processes leads to weaker and shallower public health commitments, greater attention is being paid to how to minimise undue interference and manage conflicts of interest (CoI). While we welcome efforts to develop normative guidance on managing such conflicts, we argue that there is the need to go further. In particular, we propose that an index be developed that would assess the health impacts of individual corporate actors, and those actors who fail to achieve a set benchmark would not have engagement privileges. We further propose the establishment of an independent panel of experts to advise on corporate actor engagement as well as on ambiguous and potentially health-harming commitments in text under negotiation in the UN. Recognising that the implementation of such measures will be contested, we recommend a number of practical steps to make their implementation more politically palatable.