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1. U.S. and Global Approaches to Financing Long-Term Care: Understanding the Patchwork

Author:
Celli Horstman, Evan D. Gumas, and Gretchen Jacobson
Publication Date:
02-2023
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Most United States adults age 65 and older will need long-term care toward the end of their lives.1 Long-term care, provided in the home, community, or in institutional settings like a nursing home, includes medical care as well as personal, nonmedical care for people who are unable to perform activities of daily living, like cooking or bathing. Some services also may support social needs for those unable to perform what are known as instrumental activities of daily living, such as shopping or medication management. In 2018, more than 5 million people in the United States used home health care, including adult day care or home health agency services, and nearly 4 million people resided in nursing homes or residential care communities.2 Despite the widespread need for long-term care, the U.S. has no national program to cover the costs of long-term care. While certain states have implemented their own programs, the resulting patchwork of funding has left many Americans with no sustainable way to pay for the services they require. Other developed countries have comprehensive, national long-term care financing systems featuring broad eligibility and high levels of financial support. In this brief, we analyze data from multiple sources on long-term care costs in the U.S., as well as spending data from the Organisation for Economic Co-operation and Development (OECD), to better understand long-term care financing strategies in 12 high-income countries. In addition to these data, we synthesized initiatives to long-term care funding in these 12 countries. (For details, see “How We Conducted This Study.”) Since the U.S. does not have a national funding strategy, we also focused on individual state approaches. International and U.S. state approaches may provide insights to policymakers seeking to advance comprehensive long-term care funding.
Topic:
Health, Health Care Policy, Inequality, and Social Services
Political Geography:
Global Focus

2. Non-economic loss and damage: closing the knowledge gap

Author:
International Centre for Climate Change and Development (ICCCAD)
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
International Centre for Climate Change and Development (ICCCAD)
Abstract:
Climate-related loss and damage is escalating, with many countries experiencing new forms of climate impact, of increasing intensity. The focus until now has been on calculating the economic repercussions of climate risk. Its wider impacts and resulting hidden costs of climate change — such as loss of cultural heritage — are less understood and harder to quantify. This knowledge gap on non-economic loss and damage, which is largely due to limited coordination around research and sparse evidence originating from the global South, urgently needs addressing. This briefing proposes a comprehensive approach for building the evidence base on non-economic loss and damage, particularly the creation of a Loss and Damage Research Observatory. This online platform will lay the foundations for a collaborative South–South–North community of practitioners, ultimately leading to informed policy on this critical area of climate action.
Topic:
Climate Change, Health, Displacement, Conservation, Indigenous, Resilience, and Biodiversity
Political Geography:
Global Focus

3. The UN’s Response to the COVID-19 Infodemic

Author:
Gabriel Delsol and Albert Trithart
Publication Date:
05-2023
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
The COVID-19 pandemic has been accompanied by a related “infodemic.” This infodemic emerged as widespread demand for information about the public health emergency was met with large volumes of false and misleading information. Many of the national and international institutions leading the response to the COVID-19 pandemic, including the UN, quickly recognized that they also needed to respond to the infodemic. This led to a quick, broad-based response by a broad array of UN agencies and partners. To date, however, there has been no systematic mapping or assessment of the range of initiatives across the UN system. To begin filling that gap, this paper provides an overview of the UN system’s response to the COVID-19 infodemic across four areas: monitoring harmful information related to COVID-19; dispelling false information and providing authoritative information; building information resilience; and setting the agenda. It then assesses some of the successes and challenges of the response across four areas: external partnerships, including with governments, civil society, academia, and social media companies; coordination within the UN system; financial, human, and technological capacity; and impact assessment. The report concludes that the UN’s infodemic response finds itself at a pivotal point: Due to donor fatigue around COVID-19, funding for the infodemic response is falling even while the need for a robust infrastructure to address infodemics and other information disorders may be increasing. UN entities working to address the infodemic and other information disorders should therefore consider the following: Engaging in a consultative process to develop a shared understanding of the infodemic by defining its specific harms in relation to each of their mandates; Sustaining and building capacity to counter infodemics and other information disorders, both in communications departments and in other sections working on infodemic management; Adopting a more standardized, system-wide approach to the use of new technologies and engagement with technology platforms; and Continuing to strengthen long-term information resilience by building the capacity of governments to manage infodemics and supporting strong, independent media.
Topic:
Health, Science and Technology, United Nations, and COVID-19
Political Geography:
Global Focus

4. Disease Mix and How Economic Freedom Matters for Health Outcomes

Author:
Vincent Geloso, Kelly Hyde, and Ilia Murtazashvili
Publication Date:
03-2023
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
We investigate the institutional foundations of public health. We argue that a key distinction in analysis of disease is between diseases of commerce (diseases associated with movement of people and with affluence) and diseases of poverty (primarily noncommunicable diseases that depend on wealth and income). We show that the mix of disease – the ratio of communicable diseases and those associated with longevity to diseases of poverty – increases in economically free countries. We argue that increasing burdens of diseases of commerce reflects the quality of institutions, as those diseases are better than living shorter, brutish lives where diseases of poverty claim many lives. This analysis also highlights an institutional trade‐​off: economically free institutions reduce certain types of disease while contributing to others.
Topic:
Health, Infectious Diseases, Economy, Institutions, and Public Health
Political Geography:
Global Focus

5. INFORMING GLOBAL HEALTH DIPLOMACY: EXAMINING HEALTH AND PEACE THROUGH THE LENS OF THE GLOBAL BURDEN OF DISEASE

Author:
Tomislav Mestrovic, Driton Kuqi, and Goran Bandov
Publication Date:
07-2023
Content Type:
Journal Article
Journal:
Journal of Liberty and International Affairs
Institution:
Institute for Research and European Studies (IRES)
Abstract:
In this study, we aimed to examine the interconnectedness of health and peace, recognizing its significance within global health diplomacy, international relations, and human rights. For that purpose, we used the results from previous and ongoing Global Burden of Disease studies, which represent a comprehensive systematic appraisal of health problems and risks affecting populations worldwide. This paper could use its methodological underpinnings to analyze the impact of war, conflict, and terrorism on mortality and overall human health. In 2000, war and conflict were responsible for an estimated 310,000 deaths globally, compared to 2019, when this number decreased to 69,000. Recent findings reinforced the association between war, conflict, and increased all-cause mortality. Interpersonal violence also significantly contributed to human health loss resulting from disrupted peace. In Europe, disability-adjusted life years due to injury – including those caused by conflict – declined between 2000 and 2019. As we prioritize global health, peace-building initiatives, and global health diplomacy, big data will increasingly play a substantial role in accurately predicting and describing the health effects related to conflicts.
Topic:
Diplomacy, Health, Terrorism, Conflict, Peace, and Disease
Political Geography:
Global Focus

6. Five Urgent Questions on Ecological Security

Author:
Dan Smith and Rod Schoonover
Publication Date:
04-2023
Content Type:
Commentary and Analysis
Institution:
Stockholm International Peace Research Institute
Abstract:
The increasing pressure of ecological disruption on people and on security means that ideas and policy on peace and security must increasingly address the need for ecological security. This paper poses five research questions concerning: (a) amplification of antimicrobial resistance (pathogens that are increasingly drug-resistant); (b) the physiological consequences of pollution; (c) the loss of nature’s contribution to people’s well-being; (d) local and regional ecological tipping points; and (e) detrimental organisms and processes that thrive in the rapidly changing planet. Each question has a human health dimension, with likely socio-economic impacts and effects on behaviour, as well as potential effects on security and political stability. Understanding these issues is essential if appropriate responses are to be developed. More research is needed in both the natural and the social sciences, with interdisciplinary work that is in close contact with the policy world. The situation is urgent and policy responses cannot wait until all the answers are known and uncertainty has been fully eliminated.
Topic:
Security, Health, Pollution, and Ecology
Political Geography:
Global Focus

7. Planetary health: A holistic vision for people and the planet

Author:
Danielle Brady
Publication Date:
09-2023
Content Type:
Working Paper
Institution:
European Policy Centre (EPC)
Abstract:
The nexus between health and the environment has been underscored by crises such as COVID-19 and the climate crisis. As awareness of policy interlinkages grows, so does the need for more coordinated EU and national policymaking. Calls for a more holistic approach have long been recognised, but the pandemic has further emphasised the importance of dismantling existing barriers in policymaking to improve the health status of people, animals, and the planet. This Discussion Paper, funded by Sitra, the Finnish Innovation Fund, advocates for implementing a planetary health approach across all levels of governance to encourage transdisciplinary action and puts forward ten recommendations: Pursue coordinated policymaking by breaking down silos. Appoint an Executive Vice President for the Well-being Economy. Plan and implement national roadmaps and establish common indicators. Create best practices platforms. Adopt planetary health for health systems. Promote education on planetary health. Adopt a European-wide communication campaign. Invest in research and innovation. Foster the integration of the European Health Data Space with future data spaces. Work with international partners to adopt a global planetary health approach. Planetary health offers many benefits for health and the environment. However, without concentrated efforts to move beyond the traditional siloed approach to policymaking, the benefits may never be realised.
Topic:
Climate Change, Health, European Union, and COVID-19
Political Geography:
Global Focus

8. April 2022 Issue

Author:
Stephen Hummel, F. John Burpo, Jeremy Hershfield, Andrew Kick, and Kevin J. O'Donovan
Publication Date:
04-2022
Content Type:
Journal Article
Journal:
CTC Sentinel
Institution:
The Combating Terrorism Center at West Point
Abstract:
The COVID-19 pandemic has claimed nearly one million American lives. It has upended many more and produced disastrous consequences around the world. But it could have been even more catastrophic had Western nations and companies not developed highly effective vaccines. As the world hopefully begins to emerge from the pandemic, it is important to reassess the global biological threat landscape, including the possibility that bioterrorists or other bad actors might seek to exploit advances in biotechnology to engineer a future pandemic. In a joint effort, the Combating Terrorism Center and the Department of Chemistry and Life Science at West Point have assembled some of the best and brightest thinkers in the counterterrorism, policy, and scientific communities around the world for their perspectives and analysis on the evolution of the biological threat picture. The result is a two-volume set of special issues, with the second volume being published next month. The feature article of this volume anticipates how bioterrorists may exploit tunable viral agents in a new age of bioterrorism. The article is authored by Major Stephen Hummel and Colonel F. John Burpo with Lieutenant Colonel Jeremy Hershfield, Lieutenant Colonel Andrew Kick, Kevin O’Donovan, and Colonel Jason Barnhill. They write: “Components of a disease such as transmissibility, lethality, and the infectious window can potentially be modified for desired tactical, operational, or strategic effects. While this capability is currently beyond the skills and knowledge of the biology enthusiast, a trained individual would possess such skills and knowledge, though they may lack the necessary material and infrastructure support. Hence, it is necessary to develop and maintain capabilities that can respond to a variety of pathogens and possible effects.” This issue features an interview with Lawrence Kerr, who until his retirement from government service earlier this year was the Director of the Office of Pandemics and Emerging Threats in the Office of Global Affairs at the U.S. Department of Health and Human Services. We also interview Brad Ringeisen, the Executive Director of the Innovative Genomics Institute. Before his retirement from government service in July 2020, Dr. Ringeisen served as the Director of the Biological Technologies Office at the Defense Advanced Research Projects Agency (DARPA). Filippa Lentzos, Gregory Koblentz, and Joseph Rodgers argue “the biological risk landscape is rapidly evolving and presents significant new challenges to preventing the accidental, reckless, or malicious misuse of biology. At the same time, oversight systems to ensure that life sciences research is conducted safely, securely, and responsibly are falling behind. An urgent overhaul to realign biorisk management with contemporary risks is needed.”
Topic:
Health, Counter-terrorism, Risk, Pandemic, and Bioterrorism
Political Geography:
Global Focus

9. The Next Game Changers: A Priority Innovation Agenda for Global Health

Author:
Cordelia Kenney and Rachel Silverman
Publication Date:
10-2022
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Over the last century, scientific and technological innovation has led to unprecedented improvements in health outcomes—yet research and development (R&D) investments and progress to address health threats has been uneven. Commercial R&D has focused where investors can expect substantial financial returns: rich countries, the diseases that affect them, and high-tech solutions designed for the richest and most sophisticated systems. Despite supplemental funding from philanthropic and government grants, R&D to address many leading causes of death and disability—especially those that primarily affect low- and middle-income countries (LMICs) or insure against future risk—has been consistently underfunded relative to potential health gain. This implies that many untapped opportunities remain to dramatically improve global health and welfare via biomedical innovation. In this paper, we report the results of a horizon-scanning exercise to source opportunities for global health R&D investment—that is, high-value potential biomedical innovations which are currently underfunded but which could be transformative for health, quality of life, and health security in LMICs and around the world. Drawing from a literature review and expert interviews with researchers, economists, funders, advocates, and implementers, we lay out an expansive and high-promise (though non-comprehensive) biomedical innovation agenda for global health spanning the unfinished MDG agenda; non-communicable diseases; and global health security. We conclude with a discussion of implications for research, funding, and practice.
Topic:
Development, Health, Science and Technology, Innovation, and Emerging Technology
Political Geography:
Global Focus

10. A Fund for Global Health Security and Pandemic Preparedness

Author:
Amanda Glassman, Eleni Smitham, and Erin Collinson
Publication Date:
05-2022
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
The COVID-19 crisis has served as a painful demonstration that no country is fully prepared for a pandemic and that the existing global health architecture remains ill-equipped to finance pandemic prevention, preparedness, and response (PPR). The rationale for preventing and containing pandemics is self-evident: the price of preparedness is a fraction of the cost of responding to catastrophic outbreaks, both in terms of human and economic well-being.[1] In the aftermath of the 2003 SARS outbreak, 2009 H1N1 pandemic, and the 2014-2016 West Africa Ebola outbreak, experts called for scaling up sustainable financing to ensure the world was better prepared to face that next global health threat. But even amid efforts to better understand and measure preparedness gaps,[2] little action was taken to mobilize financing and incentivize investments in strengthening detection, prevention, and response capabilities. As global health threats evolve, countries’ capacity to prepare for and respond to disease outbreaks is increasingly a global imperative. Now is the time to take concrete steps toward establishing sustained financing for pandemic PPR to help bring an end to the ongoing COVID-19 pandemic, combat future health security threats, and break the costly cycle of neglect.
Topic:
Security, Health, Pandemic, and COVID-19
Political Geography:
Global Focus