Global public health
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Global public health · Sep 2020
The comparative politics of COVID-19: The need to understand government responses.
COVID-19 has created a ramifying public health, economic, and political crisis throughout many countries in the world. While globally the pandemic is at different stages and far from under control in some countries, now is the time for public health researchers and political scientists to start understanding how and why governments responded the way they have, explore how effective these responses appear to be, and what lessons we can draw about effective public health policymaking in preparation of the next wave of COVID-19 or the next infectious disease pandemic. ⋯ We propose four key focuses to understand the reasons for COVID-19 responses: social policies to crisis management as well as recovery, regime type (democracy or autocracy), formal political institutions (federalism, presidentialism), and state capacity (control over health care systems and public administration). A research agenda to address the COVID-19 pandemic that takes politics as a serious focus can enable the development of more realistic, sustainable interventions in policies and shape our broader understanding of the politics of public health.
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Global public health · Sep 2020
A call for a gender-responsive, intersectional approach to address COVID-19.
The COVID-19 pandemic exacerbates existing health inequities, including gender disparities, and we must learn from previous global public health threats to build a gender-responsive, intersectional approach to address immediate and long-term consequences. While a narrow gender focus alone can reinforce binary and competing understandings of disease burden by gender, an intersectionality approach encourages understanding of the dimensions of power, historical structural inequalities, and the role of social determinants and lived experience to inform a multidimensional, gender-informed response to this and future emerging infectious diseases. We provide specific, actionable recommendations for critical healthcare, public health, and policy to use an intersectional approach to COVID-19 pandemic preparedness, response and resiliency.
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Global public health · Sep 2020
Governing COVID-19 without government in Brazil: Ignorance, neoliberal authoritarianism, and the collapse of public health leadership.
Brazil's governance of the COVID-19 pandemic has been described as nothing short of tragic by several commentators. President Jair Bolsonaro's dangerous brew of neoliberal authoritarianism, science denialism and ableism has plunged this country into catastrophe. In this article we argue that this form (or lack) of public health governance can best be described as governance without (central) government. ⋯ Finally, we sketch the main features of this emerging form of (non)governance of COVID-19. We highlight the new forms of solidarity and mutual aid that have emerged in favelas and Indigenous communities, which have stepped in to fill the void left by a limited federal presence. The article concludes by reflecting on what this collapse of public health reveals about the limitations of democratic governance in the age of Bolsonaro.
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Global public health · Aug 2020
Health system's response to the COVID-19 pandemic in conflict settings: Policy reflections from Palestine.
As the COVID-19 pandemic spreads, concerns are particularly serious in conflict and humanitarian settings. Tackling the pandemic in those countries is challenging due to the fragility of socioeconomic and health systems. Palestine is one of those countries that is facing compounding challenges, instability, fragility, living conditions, poverty, and mobility, all of which are caused by multifactorial etiology. ⋯ A little collaboration and inter-agency task forces in preparedness and response was observed, and the mechanisms and governance remain ambiguous. A consolidated and evidence-based nation-wide plan is required, whereby state and non-state actors have a clear and transparent exit strategy. A new thinking approach to promote the public health system and evidence-informed policies in Palestine is an urgent national priority.
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Global public health · Aug 2020
Structural barriers to adhering to health behaviours in the context of the COVID-19 crisis: Considerations for low- and middle-income countries.
In seeking to limit the number of new infections of COVID-19, governments around the world have implemented national lockdowns and guidelines about safe behaviours. Lockdown requires people to stay home and only leave when essential such as to purchase groceries and medication. In low- and middle-income countries, many of which have large proportions of the population living in precarity, lockdown forces millions of people to spend prolonged periods of time together in close proximity to one another and with limited resources. ⋯ In this paper, we explore the barriers to implementation of lockdown rules in conditions of precarity. We conceptualise the structural barriers by drawing on the Theoretical Domains Framework to explain how these barriers influence adherence to lockdown rules. We argue that without sufficient support or intervention to help poor communities mitigate these structural barriers, adhering to lockdown rules is difficult, resulting in continued COVID-19 infections.