factors can also be used to develop a holistic-comprehen- sive healthpolicy to achieving sustainable development goals.
Strengthening pandemic readiness and response to COVID-19 is the key to successful health outcomes. A fast and effective response can delay a local outbreak from becoming a global threat. Before the pandemic, health professionals can work together and create colla - bo ration with the government, civil society, stakeholders, and policymakers to develop community resilience and recovery after the outbreak. We can prepare a program that could strengthen the community, how to respond to COVID-19 issues, and build social networks to support during the crisis. We can improve the coordination of care and connect individuals with community resources. We can manage available resources, such as social media, the internet, and local newspapers to provide trusted in- formation and keep people informed during the out- break. Coordinating the supply of essential medicines and emergency referral centers is also important as this is the fundamental aspect of care. Public health surveillance for emerging threats is needed to inform disease transmis- sion and prepare for prevention and promotion interven- tions related to the COVID-19. 23,24
cies were considered or adopted expressly by 11 out of the 13 countries, but nothing was found in this regard for Greece. Many governments, whilst considering the limita- tion of visitors to care homes as important, were initially hesitant to introduce blanket rules prohibiting all visits. Some US states, including Washington State, moved from regulations restricting visitors to prohibiting them inside long-term care facilities within a few days in mid-March (O’Sullivan, 2020; Washington Governor, 2020 a/b; New York State Department of Health, 2020; American Health Care Association, 2020). In New Zealand, government advice was for staff and visitors, “to stay away from aged care facilities” if they felt ill, and to be symptom free from any flu and cold for 48 hours before visiting (Ministry of Health New Zealand, 2020). However, it was reported that the managers of some care homes in New Zealand decided themselves to prohibit visits altogether (Gibson, 2020). The federal government of Germany guided care homes to ban all non-essential visits (Altenheim, 2020), whereas federal states such as Bavaria issued their own rules. In Bavaria, visits were restricted to one visitor for every resi- dent per day and the prohibition of visits by children aged 16 or under, and those individuals experiencing a cough until13 March 2020, after which all visitors to care homes were banned (Bayerisches Staatsministerium für Gesund- heit und Pflege, 2020). Under its Emergency Powers Act, the Finnish government used its emergency powers to ban visitors from care institutions, health care units and hospitals, with some family exceptions on a case-by-case basis (Ammattiliitto Pro, 2020).
At the centre of these is the EU4Health Programme, announced in May and currently awaiting adoption by the legislature (European Commission 2020a ). EU4Health saw renewed ambition from the Commission, reversing pre-existing plans that would have seen health absorbed into the much broader European Social Fund Plus and earmarked just €413 million in the new multi-annual financial framework. The stand-alone EU4Health Programme is likely to see a budget of €1.7 billion, an unprecedented sum for healthpolicy 3 and lists the objectives of increasing preparedness for cross-border healththreats, strengthening health systems, and making medicines and medical devices available and affordable. Though similar to previous programmes and yet to be elaborated into tangible actions, EU4Health’s objec- tives are based on broad recognition of ‘a general need for . . . structural transformation . . . and systemic reforms of health systems across the Union’ (European Commission 2020a : para 15). If stretched to their fullest, these provisions would underpin a significant expansion in the EU’s health activity, into politically sensitive and substantively complex areas.
The CHIP program provides an important safety net for children. In the absence of CHIP funding, an estimated 3.7 million children enrolled in separate CHIP programs in 36 states would need to obtain coverage elsewhere in 2016. We find that about half these children would be eligible for subsidized coverage in the marketplace. In general, families would face much higher out-of-pocket costs and less- comprehensive benefits when they use services in marketplace plans than they would under CHIP (Bly, Lerche, and Rustagi 2014). For 63 percent of children in this situation, their parents would already be enrolled in subsidized marketplace coverage, and the family would face no additional premiums to cover them. For other families, the whole family would need to enroll in marketplace coverage to cover the children, making the incremental costs much higher than covering the child under CHIP. The other half of the children projected to have separate CHIP coverage in 2016 would have employer offers of coverage that are deemed affordable under the current interpretation of the firewall for determining eligibility for marketplace tax credits because the employee costs for a single policy are less than 9.5 percent of their family income. Half the children deemed to have “affordable” offers of employer- sponsored coverage are in families where the cost of family coverage exceeds 9.5 percent of their income. In other words, they are caught in the family affordability glitch and would face high costs as a share of their income to cover their children. Unlike children eligible for marketplace tax credits, only 22 percent of children in families with “affordable” employer offers would face no incremental premium costs to cover the children.
EMW is articulated. I also include some analysis of politicians’ interventions in these and related fields. As I noted in the introduction, social problems are always problems for someone. They are constructed by the social policy process itself. This occurs both through the language and the institutions and structures of power involved in the practice of policy. Firstly, the way in which the problem has been defined needs to be understood. Secondly, and not unrelatedly, why particular solutions are posited in response needs to be understood. The intelligibility relies on a shared framing of the problem and a shared vocabulary. The policy objective is to defuse the risk of terrorism and specifically, post 2005, prevent ‘home grown’ terrorism. In this chapter, through consideration of specific and associated policy texts, I analyse how we are to understand the rationale of Prevent and the EMW initiatives. How can these initiatives “stop people wanting to become terrorists”? The first section focuses on how, despite emphatic disavowals, the Prevent agenda remains inflected with the wider global discourse of Samuel Huntington’s ‘clash of civilisations’. As such it positions the Prevent agenda in terms of global politics, related national policies around terrorism and immigration, as well as debates around multiculturalism and Britishness. I explore the way in which the concept of 'culture' is invoked and implicitly (and sometimes explicitly) defined. For example, I look at the way that both Al Qaeda inspired and far-right extremism are discussed in parallel even though attempts to highlight their similarities only serve to demonise the ‘Muslim community’ more acutely. This is partly done through the “asymmetric ascription of culture” (Narayan 1997); the causes of far right extremism are not attributed to British ‘culture’, whereas Islamic terrorism almost always is. Furthermore, these policy discourses are by their very nature gendered. The risk of terrorist activity is located in young disaffected men, yet the bodies and rights of Muslim women are a crucial defining feature in the quest for shared values and the 'battle for hearts and minds'.
4. Militarizing African states carries its own set of risks, especially when
combined with democracy promotion. Improving military resources without pushing for transparency and accountability within partner governments makes democratic
backsliding imminent. Robert Dorff argues that promoting democracy is in the security interests of the U.S., but has to be done carefully. Good governance is crucial for security, but the United States must avoid attempting overly simplistic solutions for democratizing. Dorff writes that “[too] often we seemed to believe that intra-state conflict could be halted and peace restored through a rather simplistic combination of military force followed by institution building, usually in the form of holding elections.” 128 Especially in states fraught with ethnic divisions, changing the leadership structure does not ensure long term stability. He cautions against a policy of “stopping the fighting, holding elections, declaring victory, and coming home.” 129 Focusing on states and their leaders leads to the belief that getting rid of authoritarian leaders can solve the problem. He suggests embracing the need for long-term solutions and better cooperation between those in charge of development assistance and security.
VI. Sovereignty and Autonomy of District Facilities.
The District has agreed to allow the Red Cross to take over its school buildings in the event of a natural disaster. Higher governmental authority may also commandeer the district’s facilities. Accordingly, the District should declare the Education Services Center (ESC) as its own command center, vital to the fulfillment of its responsibilities during any flu pandemic, declare it as sovereign, and not allow any other agency or governmental body access to it.
CHRISTINE KERNS ERIKA SUZUKI
Erika Suzuki is the Assistant Director of the University of California, Berkeley’s Nuclear Policy Working Group (NPWG) in support of the Nuclear Science and Security Consortium’s policy and educational programs. In the past, Erika has developed and taught three student-elective courses through the Democratic Education at Cal program, and also interned at a number of public service and political organizations, including Congresswoman Nancy Pelosi’s San Francisco district office. She is an alumna of the 2012 Berkeley Haas School of Business Summer Program, as well as an alumna of Delta Phi Epsilon, a co-ed, professional Foreign Service and international affairs frater- nity. Erika’s research focuses on integrating nuclear science and security policy in educational and training programs, understanding the societal responses to and perspectives on nuclear issues, and pioneering new methods to engage the millennial generation in nuclear security issues through the use of technology. She has a Bachelor of Arts degree in Political Science and Public Policy from the University of California, Berkeley.
Estas modificaciones forman parte del proceso de normalización de la política de defensa nipona que comenzó con la creación de las FAD en la década de los 60, como se mencionó en la introducción. Los hitos más importantes en este proceso se dieron en 1992, cuando una ley autorizó a las FAD a salir del país para participar de Operaciones de Mantenimiento de la Paz de Naciones Unidas, y en 2003, cuando también a través de una legislación, las FAD participaron en la guerra en Irak realizando tareas de apoyo más que nada. Los ajustes realizados por Abe representan un paso más en este proceso y de ahí que no deban ser leídos como revolucionarios, sino como incrementales, como sostiene Liff (2015, p.81) “Since the end of the Cold War, Japan’s leaders have made incremental changes designed to ensure that the JSDF and U.S.-Japan alliance adapt to changing re- gional and global threats.” 20 Es importante rescatar esto, dado que muchas veces se han tomado los ajustes realizados como hechos aislados y como parte de una estrategia de Japón y sobre todo del gobierno de Abe de volver al país asiático al militarismo del siglo pasado. Los ajustes introducidos están basados en el pacifismo de la constitución y han permitido que Japón participe con sus FAD en numerosas iniciativas de seguridad inter- nacional comandadas por la ONU, como así también en numerosas tareas de ayuda humanitaria y de asistencia ante desastres naturales.
In regards to education, the Ministry of Education and Culture (MOEC) has boosted the transformation of educational institutions through the Learning From Home (LFH) policy. LFH concerns with serving students for learning activities through the distance learning either via online or offline. The goal of this policy aimed at mitigating its immediate impact, which means the rapid spread of COVID- 19 can hopefully be decreased while at the same time the quality of learning process could be maintained. In doing so, MOEC decided to push all school activities by at- home online/distance learning through its Circular Letter No. 4/2020 (Azzahra, 2020). This policy is just like other countries made in response to the COVID-19 outbreak. In many cases, the school closures also has taken place in US, Hong Kong, Taiwan, Singapore, China, Mongolia, and UK (Viner et all, 2020; Cronert, 2020; Rundle, 2020). The School closure strategies are carried out in response to student infection rates (Viner et.all, 2020) by which Governments employ proactive to slow transmission (delay phase), decrease burden on health care, or protect at-risk populations (mitigate phase), both the benefits for transmission and the adverse community effects should be considered (Armitage and Nellums, 2020).
The Council already work closely with its partner organisations and agencies to deliver continuity of service to the public and minimise disruption for our customers and staff. For example, the Council will work together with Recruitment Agencies to decide on the use of agency staff during a flu pandemic. Agency staff should be managed in the same way as HCC staff to ensure that there is no health and safety risk, and training should be provided for them. Managers should ensure that they communicate with these staff on a regular basis and provide adequate information for them.
What is to be done about those enterprises and workers who were working in the undeclared econ- omy prior to the pandemic? Before the current cri- sis, the goal of European governments was to trans- form undeclared work into declared work (European Commission, 2016). To achieve this, the policy ap- proach was based on the view that enterprises and workers engaged in undeclared work when the ex- pected costs (i.e., the likelihood of being caught and punished) were lower than the beneits of do- ing so (Allingham and Sandmo 1972; Grabiner 2000; Hasseldine and Li 1999; OECD 2017; Richardson and Sawyer 2001; Williams and Franic 2016; World Bank 2019). To change this cost/beneit ratio to make de- clared work a rational choice, European governments focused upon raising the costs of participating in un- declared work. This was achieved by increasing the sanctions and probability of detection and doing this was widely accepted by European governments as the most important and efective way of trans- forming undeclared work into undeclared work (see Williams 2019). The result was that scholars and gov- ernments paid little attention to increasing the ben- eits of declared work to change the cost/beneit ratio. Nevertheless, with the pandemic, increasing the pen- alties and risk of detection has become obsolete since most undeclared work has now ceased. However, increasing the beneits of declared work to pull en- terprises and workers into the declared economy re- mains an option. The current temporary inancial sup- port available to those in declared work provides an opportunity to attract these undeclared enterprises and workers out of the shadows and to bring them onto the radar of the state authorities to facilitate compliant behaviour in future by these workers and enterprises.
In the face of the emerging coronavirus disease 2019 (COVID-19) epidemic, on March 16, 2020, health of ﬁ cers from 7 San Francisco Bay Area health counties were among the ﬁ rst in the nation to issue orders for residents to shelter in place. The orders were intended to protect public health while allowing residents to engage in “essential activities.” Recognizing the health importance of exercise and time in nature, 1 of 5 essential activities allowed was “to engage in outdoor recreation activity,” including “walking, hiking, biking and running outdoors,” if one kept a distance from others. The weekend after these orders, warm weather inspired large numbers of residents to leave their homes for parks, creating crowds in which it was not possible to socially distance. People who had stayed at home expressed anger that park goers endangered the collective community. 1 As a consequence, 2 of the health of ﬁ cers were compelled to close access to county parks, which were in turn followed by partial and full park closures of many regional, city, and state parks throughout California. 2
The HHS P3CO Framework states: “if funded, research that is reasonably anticipated to create, transfer or use an enhanced PPP may require additional risk mitigation strategies which may include, but are not limited to: . . .methodologies for responsible communication of results.” There is no deﬁnition or clarity in the Framework regarding methodologies of responsible communication of results. Given the appropriate require- ment of funders like NIH for open publication of results, the results of NIH-funded PPP work will be available everywhere globally from that point forward. Sequence data would facilitate the reconstruction of the enhanced potential pandemic pathogen. It is impossible to control where such efforts to duplicate the work would take place. Moreover, journal requirements for resource sharing postpublication might require researchers to share enhanced PPPs or reagents to create them with parties whose possession of them would threaten security and/or safety. While HHS might have determined that the original enhanced PPP experiments were taking place at an institution capable of sufﬁcient biosafety and biosecurity controls, they cannot know the context or biosafety or biosecurity conditions that other scientists will employ in efforts to reproduce the research or use the products thereof.
Riley County’s recent local public health system assessment acknowledged a strength in disease identification, epidemiology, and investigation. Additionally, local emergency response agencies have shown great capabilities and capacities in preparing for and responding to daily emergencies. Information sharing, emergency operations coordination, and public information and warning capabilities recently received a favorable evaluation. The broader Riley County public health system, however, may be much less prepared and capable than those commonly identified as core emergency response agencies (police, fire, emergency medical services, and emergency management). Interagency communication and coordination are especially in need of development. If the local public health system is unable to respond as necessary to a complex public health emergency, such as an influenza pandemic, the local infrastructure may fail. Well- developed public health preparedness in advance of these public health emergencies are key to the success of the jurisdiction.
G LOBAL H EALTH G OVERNANCE, V OLUME III, N O . 2 (S PRING 2010) http://www.ghgj.org levels and “(w)elcom[ing] the rapid action taken by the Member States in the framework of the WHO’s IHR.” 45 Months later, the unrelated Council of Europe (an independent treaty-based organization with 47 member states) convened the first of a planned series of public hearings to investigate whether the pharmaceutical industry influenced WHO’s decision to declare a pandemic in June 2009 in order to profit from the response. Experts called by the Council questioned whether WHO should hold authority to declare a pandemic, given the economic consequences (approximately $18 billion) of the 2009 decision. 46 In response, Keiji Fukuda of WHO refuted accusations of influence by the pharmaceutical industry as unfounded. He asserted that the decision to declare a pandemic stemmed from scientifically sound evidence, and stated that the IHR “provide the world with an orderly, rules-based framework for detecting, assessing, reporting, declaring and responding to public health emergencies of international concern. They also provide the world with a system of checks and balances to ensure that no one, including the WHO Director-General, has unfettered power when making decisions.” 47 These ongoing arguments reveal the tensions in maintaining state support for a regime deliberately designed to value expert assessments over national interests. Apart from the contentiousness of the pandemic declaration, concerns arose about the role of the expert committee in validating public health measures. Not only did WHO turn to the IHR Emergency Committee for advice on transmission patterns and health risks, but for views on the pandemic declaration itself. Some have argued that the IHR Emergency Committee’s mandate never authorized such a role, and that the committee should restrict its advice to technical rather than procedural matters. 48 The WHO Pandemic Plan specifically cites the role of the IHR Emergency Committee in developing temporary recommendations and advising the Director General if the event is declared a PHEIC (as it was), but does not explicitly discuss the role of the committee in advising on pandemic phases, an issue that clearly needs to be re-examined in the post-pandemic period. 49
should go forward. Health department officials and other public health profes- sionals may not have the power to imple- ment all programs that they think would be beneficial, but they do have a responsibil- ity both to advocate for programs that do improve health and to remove from policy debate programs that are unethical, either because of insufficient data, clearly dis- criminatory procedures, or unjustified lim- itations on personal liberties. And yet while most reasonable people will agree in the abstract that burdens and benefits must be balanced, and that the most burden- some programs can be implemented only in the context of extensive and important benefits, disagreements can be all but guaranteed over the relevant details. Depending on one’s perspective, there will be differing views over how burdensome various programs are, such as having one’s name reported to the state, or requiring immunizations before starting school. Citizens can be expected to differ over how important it is to protect a water sup- ply for future generations, particularly if it means significantly higher taxes or the prohibition of recreational use of public bodies of water, clearly a benefit, not only in terms of individual pleasure, but also in terms of community cohesiveness.
Taking the whole population into consideration, some groups may be more susceptible than others to the psychosocial effects of the pandemic. Mostly, people who contract the disease, those at sharp risk for it including the elderly, people with less immune function, and those living or receiving care in congregate settings, and people with pre-existing medical, psychiatric, or substance abuse problems are at increased risk for adverse psychosocial outcomes (Pfefferbaum and North, 2020). Healthcare professionals (HCPs) comparative to other occupational groups also have a higher probability of suicidality due to work-related stress. Many doctors find it hard to tell their colleagues or employers about their mental health problems. The most common reasons may be perceived as stigma and anticipated damage to future career prospects (Bedini, 2000). Suicidal thoughts in doctors can present particularly strong fears of ostracism (Galbraith et al., 2020). Feelings of shame and professional failure may strengthen such concerns, and associated worries about fitness to practice and licence restrictions. The problem with contemporaries, they are often unwilling to get professional help too. Research shows that many doctors would relatively seek help from friends and family than look for psychological/psychiatric consultation.