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Healthcare Governance:
Lessons from Emerging Markets

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Let us enter 2021 with real yet cautious optimism. Let us resolve to extend the public-health successes of the Asia-Pacific region and the new vaccines developed in the US, Europe, Russia and China to benefit the entire world.

For the most part of 2020, lockdowns were implemented around the world in order to restrict movements of people and the spread of COVID-19. When 2021 was welcomed, there were positive news, such as the production and dissemination of COVID-19 vaccinations, to shed some light to world.

In this issue of Core Insights, the articles discuss the glimmer of hope that vaccinations can provide for people, difference in countries' responsiveness in dealing with the pandemic as well as how our current day-to-day lives are considered the "new normal". This issue includes Jeffrey Sachs, Ngaire Woods, Ngozi Okonjo-Iweala and Jim O'Neill as our guest authors.

Optimism for the New Year

By Jeffrey D. Sachs

Sachs identified five reasons for optimism in 2021. Firstly, many countries took the responsibility to control the spread of the coronavirus. This includes countries and regions with diversified cultures and political status. Secondly, vaccination programmes were ready to be rolled out by early 2021. Technologically breakthroughs were demonstrated as trials and testings were accelerated to facilitate worldwide vaccination. Thirdly, former US president Donald Trump was defeated in the November elections. Trump's desperate attempt to hold power was ceased when the public and US institutions made the right decision during elections. Fourthly, the United Nations remained strong and preserved the three fronts - peace, human rights and sustainable development - despite Trump's negative administration. Finally, the use of technology can be a double-edged sword for us. The digital age has equipped us to solve global concerns. However, with that comes social harms caused when digital technologies are being abused and exploited by some governments and private companies. All things considered, there is optimism to look out for this new year. However, there is a lot still to be done on a global level to overcome ongoing universal problems.

The Brutal Governance Lessons of 2020

By Ngaire Woods

Wealthy countries are expected to manage the COVID-19 crisis better - however, the reverse might be true. Some countries, which were ranked among the lowest on the Global Health Security Index (GHSI), were more efficient in deploying their resources, expertise and institutions compared to those ranked in the top 20. One of them includes Senegal (ranked 95th on the GHSI), who were already in the midst of preparation when the World Health Organisation (WHO) declared COVID-19 a global pandemic. Secondly, Sri Lanka (ranked 120th on the GHSI) was quick to react to the outbreak. Similar to Senegal, they used the contract-tracing approach, established isolation facilities as well as enforced the use of face masks in public. Lastly, Vietnam (ranked 50th on the GHSI), despite having a poorly developed healthcare system, managed to curb the virus from spreading throughout the nation via rapid testing, contact tracing and exercised isolation of suspected cases. In October 2020, Vietnam reported only 35 deaths, despite sharing borders with China. The three countries mentioned have proven that governments with a clear approach, together with the public who coherently understands them, will succeed in this post-pandemic recovery.

Globalising the COVID Vaccine

By Ngozi Okonjo-Iweala

The development and authorisation of the COVID-19 vaccination within a year was a feat. It is also equally incredible that the vaccines will be distributed to people around the world about the same time - rich or poor economies regardless. Concerted efforts by COVID-19 Vaccines Global Access (COVAX) to distribute two billion vaccine doses in the upcoming year is a way to ensure that everyone is protected by mid-2021. This global initiative is established to prevent vaccine nationalism from taking place. By ensuring that the vaccines were also distributed to the those who cannot afford gives an equal opportunity for everyone. A problem arises when governments request more doses than needed. This caused unnecessary pressure on the global supply during the crucial starting phase.

Reflections on a Plague Year

By Jim O'Neill

O'Neill reviews the tumultuous year of 2020. Firstly, he realises that once a threatening virus develops, immediate action should be put in place as soon as possible. When we compare Asia-Pacific countries to Western countries, it is clear that the former is in a much stronger position because of the precaution taken earlier. Secondly, vaccinations are not a signal to lift lockdowns. With variants of the virus still going around, vaccinations might not be the most effective means of resistance. Thirdly, the COVID-19 vaccines were produced, tested, approved and distributed - all within a year. This proves that the pharmaceutical industry are efficient and productive thus, this goes to show that medical supplies can be accelerated in the future. O'Neill's next point demonstrates that governments are more fiscally ambitious than what others may think. Since not all sectors of the country weighs the same, every government have to smartly allocate their budget for each of them well. Governments are also responsible for providing technologies to the public as it is another crucial factor in this pandemic that has helped to keep it under control. With heavy reliance on technology, O'Neill mentioned that brick-and-mortar businesses were affected by the pandemic. Thus, policymakers would have to re-evaluate some aspects to make sure that those business have an even chance to continue their position. The next point reflects on the "new normal", where working-from-home is a flexible approach and could even bring about productivity. This also affects the dynamics of offices. The idea that office or shop spaces can be shared may become a "new normal" in this generation too. Finally, the pandemic has allowed Asia to experience an economic upswing, especially with China's lead. China's governance compared to the Western democracies might bring up some concerns for leaders than it already has.


Jeffrey Sachs

  • Director of Columbia's Centre for Sustainable Development & the UN Sustainable Development Solutions Network


Ngozi Okonjo-Iweala

  • Director General of World Trade Organisation

  • Former board chair of Gavi, the Vaccine Alliance Former African Union special envoy on COVID-19

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Ngaire Woods

  • Dean of Blavatnik School of Government at the University of Oxford


Jim O'Neill

  • Current chair of Chatham House

  • Former chairman of Goldman Sachs Asset Management

  • Former UK treasury minister

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