Health system lessons from the global fund-supported procurement and supply chain investments in Zimbabwe: a mixed methods study.

BACKGROUND: The Global Fund partnered with the Zimbabwean government to provide end-to-end support to strengthen the procurement and supply chain within the health system. This was accomplished through a series of strategic investments that included infrastructure and fleet improvement, training of personnel, modern equipment acquisition and warehouse optimisation. This assessment sought to determine the effects of the project on the health system. METHODS: This study employed a mixed methods design combining quantitative and qualitative research methods. The quantitative part entailed a descriptive analysis of procurement and supply chain data from the Zimbabwe healthcare system covering 2018 - 2021. The qualitative part comprised key informant interviews using a structured interview guide. Informants included health system stakeholders privy to the Global Fund-supported initiatives in Zimbabwe. The data collected through the interviews were transcribed in full and subjected to thematic content analysis. RESULTS: Approximately 90% of public health facilities were covered by the procurement and distribution system. Timeliness of order fulfillment (within 90 days) at the facility level improved from an average of 42% to over 90% within the 4-year implementation period. Stockout rates for HIV drugs and test kits declined by 14% and 49% respectively. Population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence of people living with HIV. The value of expired commodities was reduced by 93% over the 4-year period. Majority of the system stakeholders interviewed agreed that support from Global Fund was instrumental in improving the country's procurement and supply chain capacity. Key areas include improved infrastructure and equipment, data and information systems, health workforce and financing. Many of the participants also cited the Global Fund-supported warehouse optimization as critical to improving inventory management practices. CONCLUSION: It is imperative for governments and donors keen to strengthen health systems to pay close attention to the procurement and distribution of medicines and health commodities. There is need to collaborate through joint planning and implementation to optimize the available resources. Organizational autonomy and sharing of best practices in management while strengthening accountability systems are fundamentally important in the efforts to build institutional capacity.

From isolation to revival: trade recovery amid global health crises.

BACKGROUND: The COVID-19 pandemic has highlighted the importance of designing effective trade recovery measures in response to global health events (GHEs). This study combines international trade risk management theory and multi-case comparative analysis of past GHEs to present a theoretical framework for designing national trade recovery measures for future events. RESULTS: The research finds that during GHEs, trade risks shift to fundamental uncertainty, requiring spatial-temporal-subject dimension recovery measures. The study suggests changing the focus of trade recovery policy design from emergency-oriented and single-dimension measures to reserve-oriented and enduring-effect measures of comprehensive dimensions at micro- and macroeconomic levels. CONCLUSION: The study contributes to the debate on managing trade risks in times of crisis, where there is a need to develop effective trade recovery measures that account for the complexities of global trade and the unique challenges of GHEs. The findings provide practical guidance for trade officials and policymakers to design measures in response to GHEs to improve a country's overall trade recovery.

An NLP-based novel approach for assessing national influence in clause dissemination across bilateral investment treaties.

International investment agreements (IIAs) promote foreign investment. However, they can undermine crucial health programs, creating a dilemma for governments between corporate and public health interests. For this reason, including clauses that safeguard health has become an essential practice in IIAs. According to the current literature, some countries have played a pivotal role in leading this inclusion, while others follow the former ones. However, the existing literature needs a unique approach that can quantify the influence strength of a country in disseminating clauses that explicitly mention health provisions to others. Following an NLP (Natural Language Processing)-based text similarity analysis of Bilateral Investment Treaties (BITs), this study proposes a metric, 'Influence' (INF), which provides insights into the role of different countries or regions in the propagation of IIA texts among BITs. We demonstrate a comprehensive application of this metric using a large agreement dataset. Our findings from this application corroborate the evidence in the current literature, supporting the validity of the proposed metric. According to the INF, Germany, Canada, and Brazil emerged as the most influential players in defensive, neutral, and offensive health mentions, respectively. These countries wield substantial bargaining power in international investment law and policy, and their innovative approaches to BITs set a path for others to follow. These countries provide crucial insights into the direction and sources of influence of international investment regulations to safeguard health. The proposed metric holds substantial usage for policymakers and investors. This can help them identify vital global countries in IIA text dissemination and create new policy guidelines to safeguard health while balancing economic development and public health protection. A software tool based on the proposed INF measure can be found at https://inftool.com/.

Evaluating strategies for developing renewable energies considering economic, social, and environmental aspects: a case study.

Due to fast industrial expansion and the increasing population in Vietnam, this country is confronting a mounting lack of energy. While this country has considerable renewable energy (RE) potentials, including wind, solar, biomass, and hydropower sources, it has yet to exploit them entirely because of a lack of proper planning. This research aimed to find and assess solutions for encouraging RE growth in Vietnam. RE development solutions were formulated through SWOT analysis and evaluated in terms of their social, economic, and environmental dimensions. The SWARA approach weighed the strategy evaluation criteria. The most influential sub-criteria were initial investment cost, reduction of adverse environmental impacts, and natural capacity of the region, with weights of 0.155, 0.127, and 0.114, respectively. Strategy evaluation was performed using the Gray ARAS, and the results were validated with the Gray COPRAS, the Gray TOPSIS-G, and the Gray MABAC. In the strategy ranking, the top strategy is to reduce the cost of renewable power generation. This can be achieved by using advanced technologies and promoting cooperation between domestic and foreign industries and companies. Increasing domestic and foreign investment in RE infrastructure by providing financial facilities for investors, developing domestic and international cooperation, and creating a competitive environment between different companies to reduce electricity production costs were the most suitable strategies.

Rifts over equity imperil WHO's pandemic treaty.

As deadline nears, negotiations continue over sharing pathogen sequences and vaccine doses.

China and the WHO pandemic treaty: a dive into stance, underpinnings, and implications.

The COVID-19 pandemic exposed gaps in global health governance, catalyzing proposals for a new WHO pandemic treaty. This paper investigates China's stance on the treaty, recognizing it as reflective of many developing countries' concerns, through a qualitative analysis of its interventions during the treaty's drafting and negotiations and an examination of historical and geopolitical factors. Findings reveal China's emphasis on respecting state sovereignty, differentiated obligations for developing nations, preventing stigma, and concrete capacity building-concerns shared across the Global South. Its posture balances pragmatism and principle, reflecting differentiated responsibilities as a major power and developing country along with philosophical divergences from Western legal thinking. While endorsing global cooperation, China insists on voluntary terms without impinging on policy space. Implications suggest that accommodating China's concerns about invasive compliance mechanisms and inequitable burdens through flexible provisions can shape the treaty's acceptance and architecture. Creative solutions reconciling sovereignty and collective action combined with concrete equity measures and depoliticized cooperation will determine the treaty's success. China's major role indicates its endorsement, representative of the Global South's voice, is essential for an impactful pandemic treaty and reformed global health governance.

Development assistance, donor-recipient dynamic, and domestic policy: a case study of two health interventions supported by World Bank-UK and Global Fund in China.

BACKGROUND: This study views sustainability after the exit of development assistance for health (DAH) as a shared responsibility between donors and recipients and sees transitioning DAH-supported interventions into domestic health policy as a pathway to this sustainability. It aims to uncover and understand the reemergent aspects of the donor-recipient dynamic in DAH and how they contribute to formulating domestic health policy and post-DAH sustainability. METHODS: We conducted a case study on two DAH-supported interventions: medical financial assistance in the Basic Health Services Project supported by the World Bank and UK (1998-2007) and civil society engagement in the HIV/AIDS Rolling Continuation Channel supported by the Global Fund (2010-2013) in China. From December 2021 to December 2022, we analyzed 129 documents and interviewed 46 key informants. Our data collection and coding were guided by a conceptual framework based on Walt and Gilson's health policy analysis model and the World Health Organization's health system building blocks. We used process tracing for analysis. RESULTS: According to the collected data, our case study identified three reemergent, interrelated aspects of donor-recipient dynamics: different preferences and compromise, partnership dialogues, and responsiveness to the changing context. In the case of medical financial assistance, the dynamic was characterized by long-term commitment to addressing local needs, on-site mutual learning and understanding, and local expertise cultivation and knowledge generation, enabling proactive responses to the changing context. In contrast, the dynamic in the case of HIV/AIDS civil society engagement marginalized genuine civil society engagement, lacked sufficient dialogue, and exhibited a passive response to the context. These differences led to varying outcomes in transnational policy diffusion and sustainability of DAH-supported interventions between the cases. CONCLUSIONS: Given the similarities in potential alternative factors observed in the two cases, we emphasize the significance of the donor-recipient dynamic in transnational policy diffusion through DAH. The study implies that achieving post-DAH sustainability requires a balance between donor priorities and recipient ownership to address local needs, partnership dialogues for mutual understanding and learning, and collaborative international-domestic expert partnerships to identify and respond to contextual enablers and barriers.

It's not special treatment That's part of the Treaty of Waitangi! Organisational barriers to enhancing the Aged Residential Care environment for older Maori and Whanau in New Zealand.

BACKGROUND: New Zealand's older Indigenous Maori people experience poorer health and reduced access to healthcare than their older non-Maori counterparts. Organisational factors (such as leadership or workforce) may influence the attitudes and perceptions of older Maori and their family (whanau) to use aged residential care services. Currently, there is a paucity of research surrounding the organisational barriers that impact the experiences of older Maori people who seek care in aged residential care (ARC) services. METHODS: This study used a Kaupapa Maori qualitative research approach that legitimises Maori knowledge and critiques structures that subjugate Maori autonomy and control over their wellbeing. Interviews regarding their experiences of care were carried out with older Maori (n = 30) and whanau (family) members (n = 18) who had used, or declined to use an aged residential care facility. Narrative data were analysed inductively for themes that illustrated organisational barriers. RESULTS: The key organisational theme was 'Culturally safe care', within which there were three barriers: 'Acceptability and Adequacy of Facility', 'Interface Between Aged Residential Care and Whanau Models of Care', and 'Workforce'. Collectively, these barriers emphasise the importance of an organisational approach to improving the quality of care delivered to older Maori and whanau in ARC. CONCLUSION: Fostering a collective culture of equity within ARC provider services and equipping healthcare leaders and staff with the skills and knowledge to deliver culturally safe care is critical to addressing organisational barriers to ARC.

Political statement of the WHO European Healthy Cities Network: towards thriving societies - advancing health in the well-being economy

Cities are drivers of innovation across public and private sectors towards enabling an economy that works for everyone. The following Political Statement has been developed through consultation with member cities and WHO European Office for Investment for Health and Development and reflects commitment to the Health and Well-Being Economy Pilot initiated by the WHO European Healthy Cities Network. The pilot aims to bring expertise together to support action in cities towards well-being economies.

Стратегія співробітництва ВООЗ з Україною на період до 2030 року / CCS Ukraine

Стратегія співробітництва Всесвітньої організації охорони здоров’я з Україною на період до 2030 року (Стратегія співробітництва), також відома як Програма роботи в Україні, визначає курс на досягнення більш здорового майбутнього України. Вона узгоджується з пріоритетами України в сфері охорони здоров’я, сприяє посиленню стійкості та спрямована на досягнення відчутних змін врамках партнерської взаємодії. В основі Стратегії співробітництва лежить людиноцентристький та орієнтований на права людини підхід до охорони здоров’я; вона також спрямована на інновації,якісні дані та адаптивність.