Political economy of vaccine diplomacy: explaining varying strategies of China, India, and Russia's COVID-19 vaccine diplomacy

The COVID-19 pandemic and global responses to this crisis reveal the changing landscape of global health governance. As countries around the world struggle to secure COVID-19 vaccines for their citizens, some non-Western powers have actively distributed vaccines internationally – an act broadly recognized as vaccine diplomacy. While existing literature suggests that geopolitical concerns affect the selection of recipient countries, it has yet to explain other aspects of vaccine diplomacy. Why are some countries focused on vaccine sales while others are more open to donation? Why do some prefer bilateral to multilateral channels in distributing vaccines? Through comparative analysis of China, India, and Russia, this article shows that political economic factors, in addition to geopolitics, shape the ways non-Western powers conduct vaccine diplomacy. We argue that these countries adjust their strategies in line with their relative advantages in development, manufacturing, and delivery of vaccines. Each country has unique strengths and weakness, which gives rise to the varied patterns in vaccine diplomacy. Our findings suggest that their strategies of vaccine diplomacy are enabled as well as constrained by their economic realities, and the rise of these countries in this field does not necessarily mean an outright challenge to the existing international system. [ FROM AUTHOR] Copyright of Review of International Political Economy is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Italian debate on the digital COVID certificate: co-producing epistemic and normative rationalities

Italy's digital Covid certificate, known nationally as the ‘Green Pass,' was enforced through unusual restrictions for a liberal democracy, as part of the government's effort to bolster the Covid-19 vaccination campaign. Since July 2021, the Green Pass provided the main authorizing tool for the public to access a wide spectrum of social spaces and activities, from leisure to public transport and from education to workplaces. The Green Pass therefore served as a normative technology, and triggered intense political controversy and heated debates in the Italian public discourse. In constructing claims about the Green Pass, advocates and critics alike co-produced normative arguments with understandings of scientific evidence. Notably, they articulated competing framings around: conceptions of freedom during a pandemic;what should be considered as ‘evidence that matters' regarding the effectiveness of Covid-19 vaccines;value-laden projections of vaccination as either a solidaristic practice or an act of self-protection;the proper relationship between the state and its citizens;and the most appropriate modes of public health intervention. Accordingly, Italy's Green Pass offers a revealing case study for probing the implications of a normative technology with respect to public health effectiveness and the safeguarding of individual and social rights. It also provides an opportunity for scrutinizing the (re-)structuring of scientific and public health governance in a major Western democracy during a public health crisis. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

The Broad Impact of Infectious Disease Epidemics on Human Civilization: A Public Health Perspective

Slow acceptance and delayed response of the state/public have been a common feature in the history of infectious disease pandemics. Globalization affects both the genesis and the control strategies of the pandemics. The general public, health professionals, political leaders as well as administrative authorities, all have shown some or other changes in their routine working or living style while handling the COVID-19 situation. Gradually, the new ways of living ‘the new normal' have transformed into new behaviour. The response of different sections of society has also been different. The bulk of the changes was linked to the fear and panic about the chances of spread/catching of infection which brought the world to its knees. The second wave of the Corona pandemic in 2021 saw shortage and black marketeering of medical supply essentials. Vaccination has emerged as the dominant strategy this time. In the atmosphere of too many rumours, fake news, disinformation and so on, a third wave has now been predicted. There is a significant role of public health discipline in controlling any pandemic like Corona. Generic, age-old preventive measures are the only way out for the infections which spread through the respiratory route, with a fast person-to-person spread. Corona pandemic has provided a lesson for us that for communicable disease control, there is a need to inculcate a nature-friendly responsible behaviour to ensure peaceful co-existence between people and microbes. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.

The Challenges of the Global Health Governance System in the Covid-19 Pandemic: Current Limitations and Possibilities for Reform

The COVID-19 pandemic has awakened latent reflections on the WHO's normative and institutional capacities to respond to pandemics, prompting the international community to rethink alternatives to prevent the reoccurrence of a similar crisis. To this end, this article enumerates suggestions to improve existing mechanisms in the global health governance system, as well as new proposals resulting from a normative and institutional reform of the WHO.

The Legal Duty of States to Cooperate in the Fight Against Pandemic Disease under the International Health Regulations

The paper outlines the contemporary legal framework of global health focusing on the legal duty of States to cooperate in the surveillance, prevention, and control of epidemic and pandemic disease. The paper details, in particular, the content and nature of States' duty to cooperate under the International Health Regulations – the primary international legal instrument governing the global response to such events. It also examines the role of the World Health Organization and other UN bodies in fostering cooperation between States in the fight against epidemics and pandemics. [ FROM AUTHOR] Copyright of International Community Law Review is the property of Brill Academic Publishers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Unpacking opportunities and challenges for responsible healthcare: Nigeria's Covid-19 experience

Nigeria remains the largest economy in Africa. However, its health sector is described as weak. It continues to battle several challenges ranging from poor health infrastructure, inaccessibility of good quality health care, corruption, substandard drugs circulating, poor funding, shortage of healthcare personnel, high cost of healthcare amidst poverty-stricken masses, among others. The outbreak of Covid-19 and the global oil price crash have further impacted Nigeria's dwindling healthcare service delivery/ indicators. This chapter thus takes stock of the status of the healthcare indicators, healthcare systems, and healthcare governance in Nigeria before and during the Covid-19 pandemic to decipher the impact of the damage caused by Covid-19 on the already weak Nigeria's health sector. It discusses healthcare indicators, system constraints and responses, and the demand and supply of health care in Nigeria in the era of Covid-19. This chapter shows how Covid-19 has negatively and positively affected the healthcare sector in Nigeria. However, the negative impact remains overwhelming and has potentially grave consequences. This study thus develops a policy framework and time-tested strategy to recover Nigeria's health sector while factoring in the present capabilities of Nigeria's health sector. This study thus recommends that adequate infrastructure investment and welfare for healthcare workers are important for the recovery of Nigeria's health sector. © 2023 Kemi Ogunyemi and Adaora I. Onaga. All rights reserved.

What's the ideal World Health Organization (WHO)?

The World Health Organization (WHO) is tasked with the 'attainment by all peoples of the highest possible level of health', yet, it is widely struggling to meet this mandate, and COVID-19 has revealed significant limitations of the organisation. Despite clear guidance provided by the institution as to how best to respond to the pathogen, many governments departed from WHO's guidance in their response efforts. Is this a new crisis for WHO? Does WHO need to restore its legitimacy in the eyes of the global community? As renewed calls for changes to WHO emerge, in this perspective we lay out the obstacles WHO face to become the WHO 'we' need. The assumption is that UN member states need an empowered and well-funded organisation. Yet, many years of discussion of reform of WHO have failed to lead to meaningful change, and glaring challenges remain in its financing, governance and politics, which are considered in turn. The reality may be that we have the WHO that UN member states need - one that can provide guidance and advice, but also take criticism for health governance failures when states want to avoid blame or responsibility. We discuss this, by analysing three key areas of WHO'S challenges: mandate and scope; structure, governance and money and domestic vs international.

PHEIC and Global Health Governance: Do Human Rights and Sovereignty Carry Any Value?

The emergence of COVID-19 and subsequent declaration of a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) has brought into focus the role of the international health body in global health governance. Declaration of PHEIC under the ‘International Health Regulations' empowers the WHO Director General (DG) to make emergency recommendations for measures which may require suspension of travel, halting of movement of goods suspected of spreading the disease;isolation or quarantine of suspected cases of infection and compulsory medical examination of individuals in certain cases. The declaration of a PHEIC may also amount to a threat to international peace and security as the ‘Security Council' has determined through its resolution 2177 in the case of the Ebola crisis. In this context, the article seeks to investigate the importance of the two principles that play a role in the governance of health during a pandemic—one is the principle of human rights of individuals since it is the fundamental principle which forms a part of a governance regime;second, the principle of sovereignty since it is the States that decide whether to impose the measures and the extent to which the measures must be imposed. © 2023 Institute for Human Development.

Lessons learned from developing a COVID-19 algorithm governance framework in Aotearoa New Zealand

Aotearoa New Zealand's response to the COVID-19 pandemic has included the use of algorithms that could aid decision making. Te Pokapū Hātepe o Aotearoa, the New Zealand Algorithm Hub, was established to evaluate and host COVID-19 related models and algorithms, and provide a central and secure infrastructure to support the country's pandemic response. A critical aspect of the Hub was the formation of an appropriate governance group to ensure that algorithms being deployed underwent cross-disciplinary scrutiny prior to being made available for quick and safe implementation. This framework necessarily canvassed a broad range of perspectives, including from data science, clinical, Māori, consumer, ethical, public health, privacy, legal and governmental perspectives. To our knowledge, this is the first implementation of national algorithm governance of this type, building upon broad local and global discussion of guidelines in recent years. This paper describes the experiences and lessons learned through this process from the perspective of governance group members, emphasising the role of robust governance processes in building a high-trust platform that enables rapid translation of algorithms from research to practice.

China's health silk road construction during the COVID-19 pandemic.

China has been contributing to new approaches to global governance. The Health Silk Road (HSR), a significant component of the Belt and Road Initiative (BRI), was proposed by China in 2016. This paper claims that HSR is a new institution introduced alongside the existing WHO-led multilateral health system, and its relationship with the existing system can be described as layering. Having explored the new development of HSR during COVID-19, this paper further argues that while HSR has its unique strength in making contributions to global health governance and economic recovery, it faces a prominent issue of securitisation in the context of China-U.S. strategic competition, suspicion of the quality of medical products and sectoral fragmentation.

Assessing the Governance of Digital Contact Tracing in Response to COVID-19: Results of a Multi-National Study.

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The "data protection model" emphasizes privacy protections at the expense of public health benefit, while the "emergency response model" sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use of DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health."

The emergence of the Biodiversity/Health nexus: making biodiversity a health issue.

Before the COVID-19 pandemic, a French epistemic community has forged and promoted a Biodiversity/Health nexus, which legitimizes biodiversity as a health issue. The relationship between biodiversity and health is now part of French local government agendas, after being included in new international programs. Based on observation of this nexus's epistemic community and 35 semi-structured interviews conducted in France between 2017 and 2020, this article aims to show which actors and groups have been forging and promoting this nexus, and to understand how such an emergent environmental nexus challenges the governance of the present biomedical- and technical expertise-based health system. This article discusses environmental nexus from the perspective of building a new cause by reconstituting chains of causality to "demonstrate" the new problem (Barthe, Politix, 23(91), 77-102, 2010), and the growing importance of integration of concepts as a new ideal of policy-making (Cairns & Krzywoszynska, Environmental Science and Policy, 64, 164-170, 2016). As well as a justification (Boltanski & Thevenot, 1991) of their effectiveness in legitimizing the cause of defending biodiversity, environmental nexuses contain a challenge to recognize knowledge, calling for a change in governance methods in a One Health approach.

Implications from COVID-19 for future pandemic global health governance.

BACKGROUND: Limitations of current global health governance revealed during the COVID-19 pandemic can inform the ongoing deliberations of an international treaty on pandemics. OBJECTIVES: To report on WHO definitions for governance and the enforcement of treaties in the context of a proposed international treaty on pandemics. SOURCES: This narrative review was based on keyword searches related to public health, global health governance, and enforcement in PubMed/Medline and Google Scholar. Snowballing for additional articles followed the keyword search review. CONTENT: WHO lacks a consistent definition of global health governance. Moreover, in its current state, the proposed international treaty on pandemics lacks articulated compliance, accountability, or enforcement mechanisms. Findings reveal that humanitarian treaties often fail to achieve their aims absent clear enforcement mechanisms. The proposed international treaty on public health is garnering a range of perspectives. Decision-makers should evaluate whether a globally aligned definition of global health governance is needed. Decision-makers should also consider whether the proposed international treaty on pandemics should be opposed if it lacks sufficiently clear compliance, accountability, and enforcement mechanisms. IMPLICATIONS: To our knowledge, this narrative review is believed to be the first of its kind to search scientific-oriented databases regarding governance and international pandemic treaties. The review includes several findings that advance the literature. These findings, in turn, reveal two key implications for decision-makers. First, whether an aligned definition for governance addressing compliance, accountability, and enforcement mechanisms is needed. Second, whether a draft treaty lacking enforcement mechanisms should be approved.

Government as a Facilitator versus Inhibitor of Social Entrepreneurship in Times of Public Health Emergencies.

COVID-19 established the need for even more social entrepreneurship globally. It is important for keeping society together in times of crises because it creates an environment that improves the quality of life during hard times and public health emergencies such as COVID-19. Even though it plays a unique role in returning things back to normal after a crisis, it faces opposition from many parts of society, especially the government. Still, there are not many studies that look at what the government should do to help or stop social enterprise during public health emergencies. That is why the goal of this study was to find out how the government has helped or hindered social entrepreneurs. Content analysis was conducted on the carefully mined data from the internet. The research found that regulations for social enterprises should be loosened, especially during and after pandemics and disasters. This could also make it easier to accomplish things in the government. It was also found that, in addition to financial help, capacity building through training can help social enterprises do more and make a bigger difference. This research provides broader guidelines for policymakers and new entrants in the field.

Impact of the COVID-19 epidemic on medical product imports from china from outbreak to stabilization: Monthly panel data regression and instrumental variable test.

This study conduct regressions of panal data with OLS and test with IV, empirically examines the COVID-19 epidemic's impact on the import of medical products from China from the perspective of the importing countries, exporting country, and other trading partners, and analyzes the inter-temporal impact across different product categories. The empirical results reveal that, in importing countries, the COVID-19 epidemic increased the import of medical products from China. In China, as an exporting country, the epidemic inhibited the export of medical products; by contrast, for other trading partners, it promoted the import of medical products from China. Among them, key medical products were most affected by the epidemic, followed by general medical products and medical equipment. However, the effect was generally found to wane after the outbreak period. Additionally, we focus on how political relations shape China's medical product export pattern and how the Chinese government is using trade means to improve external relations. In the post-COVID-19 era, countries should prioritize the stability of supply chains for key medical products and actively engage in international cooperation on health governance to further combat the epidemic.

Global law, policy, and governance for effective prevention and control of COVID-19: A comparative analysis of the law and policy of Pakistan, China, and Russia.

Global health governance is a developing system in this complex institutional regime. The local and regional health policies sometimes challenge global health governance due to diverse discourse in various countries. In the wake of COVID-19, global health governance was reaffirmed as indifferent modules to control and eliminate the pandemic; however, the global agencies later dissected their own opinion and said that "countries must learn to live with a pandemic." Given the controversial statement, this research focuses on the strong and effective policies of the Russian Federation, Pakistan, and China. The research uses the law and governance results and newly developed policies of the three countries formed under the global health policies. The conclusion is based on the statement that in order to live with the pandemic, strong health measures are required at each level.

Rebels, vigilantes and mavericks: heterodox actors in global health governance

COVID-19 has exposed profound governance challenges that demand more diverse and creative approaches to global health governance moving forward. This article works towards such a pluralization of the field by foregrounding the vital role played by heterodox actors during the pandemic. Heterodox global health actors are backgrounded actors who improve health in different parts of the world, but who remain politically marginalized – and epistemically invisibilized – because they depart in crucial respects from the liberal orthodoxy pervading the field of global health governance. The article analytically foregrounds those heterodox actors through an architectural inversion – a relational approach to the study of global health governance that builds upon recent methodological insights from postcolonial studies, infrastructure studies, and science and technology studies. The article then harnesses that methodological approach to empirically investigate the COVID-19 activities of three different heterodox actors: rebel groups providing public health in the borderlands of Myanmar, a women's vigilante movement stitching face masks in the Czech Republic, and a maverick scientific platform for the international sharing of viral sequence data. Performing that architectural inversion begins to loosen the dominance of the liberal episteme within the practice and study of global health governance. It further visibilizes how that field is continually co-produced by the background activities of many such heterodox actors. It also lays conceptual foundations for a more heterodox future research agenda on global health governance – and arguably global governance more broadly – in response to the numerous unresolved challenges revealed by COVID-19. [ FROM AUTHOR]

Between nation and empire: how the state matters in global health

The role of the state has been underplayed in scholarship on global health. Taking a historical view, this paper argues that state institutions, practices and ideologies have in fact been crucial to the realisation of contemporary global health governance and to its predecessor regimes. Drawing on state theory, work on governmentality, and Third World approaches to international law, it traces the origins of the 'health state' in late colonial developmentalism, which held out the prospect of conditional independence for the subjects of European empires. Progress in health was also a key goal for nationalist governments in the Global South, one which they sought to realise autonomously as part of a New International Economic Order. The defeat of that challenge to the dominance of the Global North in the 1980s led to the rise of 'global governance' in health. Far from rendering the state redundant, the latter was realised through the co-option and disciplining of institutions at national level. To that extent, the current order has an unmistakably imperial character, one which undercuts its declared cosmopolitan aspirations, as evidenced in the approach to vaccine distribution and travel bans during the Covid-19 pandemic.

Digital Transformation and Open Innovation Planning of Response to COVID-19 Outbreak: A Systematic Literature Review and Future Research Agenda.

The COVID-19 pandemic highlights the importance of digital technology in a specific region's epidemic prevention and control, and the digital transformation strategy based on the open innovation system is an emerging way to tackle conceivable outbreaks. Based on the bibliometric study of relevant literature data, this paper evaluated the research and development status in this field, and conducted a systematic literature review on the basis of the core articles identified. The results of bibliometric analysis software, including CiteSpace, CitNetExplorer and VOSViewer, showed that the development of relevant research presented rapidity and decentralization, and the evolution process of literature topics further implies the necessity of interdisciplinary and multisectoral collaboration. Furthermore, this paper summarized the specific implementation strategies for constructing an open innovation system, and discussed the role and development plan of digital technology in epidemic prevention and control.

Democratizing Public Health: Participatory Policymaking Institutions, Mosquito Control, and Zika in the Americas.

The Zika virus is a mosquito-borne virus spread primarily by Aedes mosquitoes. Zika cases have been detected throughout the mosquito's range, with an epidemic occurring from 2015 to 2017 in Brazil. Many Zika cases are mild or asymptomatic, but infections in pregnant women can cause microcephaly in children, and a small percentage of cases result in Guillan-Barré syndrome. There is currently little systematic information surrounding the municipal spread of the Zika Virus in Brazil. This article uses coarsened exact matching with negative binomial estimation and ordinary least squares estimation to assess the determinants of Zika incidence across the ~280,000 cases confirmed and recorded by Brazil's Ministry of Health in 2016 and 2017. These data come from Freedom of Information Act (FOIA) requests in Brazil and have not been published. We use data on the universe of individual Zika cases in Brazil and Geographic Information Systems (GIS) software to examine the virus at the municipal level across 5570 municipalities and construct a unique, unusually rich dataset covering daily Zika transmission. Additionally, our dataset includes corresponding local data on democratic governance, mosquito control efforts, and environmental conditions to estimate their relationship to Zika transmission. The results demonstrate that the presence of subnational democratic, participatory policymaking institutions and high levels of local state capacity are associated with low rates of Zika contraction. These models control for local healthcare spending and economic conditions, among other factors, that also influence Zika contraction rates. In turn, these findings provide a better understanding of what works for local health governance and mosquito control and makes important data public so that scholars and practitioners can perform their own analyses. Stronger models of Zika transmission will then inform mosquito abatement efforts across the Global South, as well as provide a blueprint for combatting Dengue fever, which is also transmitted by Aedes mosquitoes.