Asia & the Pacific Policy Studies最新文献

Around the world, policymakers have found it difficult to sustain fee-free education policies. This article shows how politicians can significantly undermine national fee-free education policies by redirecting resources to subnational administrations, where funds can be used to shore up political support. To do so it examines changes to political support towards Papua New Guinea’s longest running fee-free education policy. The Tuition Fee Free (TFF) policy was introduced in 2012 under the government of Prime Minister Peter O’Neill before the policy was abolished, and the subsidy supporting it reduced, in 2019 by a new government led by Prime Minister James Marape. Following the introduction of the TFF policy in 2012, national politicians empowered subnational governments to control TFF subsidies, while education and other funding had started to flow to newly created district administrations. This paved the way for politicians to maintain fee-free education policy in some subnational administrations when the Marape government cut the TFF subsidy. This article suggests that in Papua New Guinea, as in some other developing countries, politicians are incentivised to administer fee-free education policies at subnational rather than national administrative scales. Sustaining universal fee-free education policies will require changing these incentives.

Since the onset of the COVID-19 pandemic, the Australian Government has been ambiguous in the way it has communicated the aid budget. On some occasions, it has sought to downplay increases in aid spending, while at other times it has sought to downplay cuts to aid spending. We draw on interviews with federal parliamentarians and key informants to understand these dynamics, in the context of obtaining their views on changes to Australia's post-COVID-19 aid policy. We find evidence that a new political consensus is forming around Australian aid. While this ‘cautious consensus’ countenances aid spending increases, motivated in part by humanitarian concerns but especially by anxiety about increasing Chinese influence in the region, these priorities are tempered by considerable concern about public backlash at a time of significant economic challenges for Australian citizens. Based on this evidence, we define the contours of an emerging ‘cautious consensus’ by showing how it will differ from the earlier ‘golden consensus’ era of Australian aid.

Using cross-country data, we find little evidence that economic openness has an impact on the level of nationalism in countries. We use three waves of the World Values Survey from 1999 through 2014 combined with data on economic openness from the Penn World Tables. Across all three waves, we find no statistically significant relationship between economic openness and nationalism. However, there is evidence for a negative association between economic openness and nationalism from 2001 to 2007 and a positive association between 2007 and 2014. This corresponds to the rising nationalistic and anti-trade sentiment evident throughout the world despite the general trend of increasing economic openness.

As Timor-Leste nears the end of its petroleum-exporting era, the transition to a sustainable economy has become even more challenging due to partisan political competition, disastrous flooding and the pandemic. This article describes the current economic context, and deteriorating trends. After a brief discussion of the political situation and the impacts of COVID-19, it explores expenditure and income trends in recent state budgets, with a particular focus on dependency on oil and gas revenues and their investments, which pay for 80% of state spending and may run out within a decade. It then assesses in detail revenue prospects from current and future oil and gas activities, including Greater Sunrise and the planned Tasi Mane petroleum infrastructure project. The analysis shows that it is highly likely that resource revenue will continue to decline. Diversification is not an option; it is the only way forward.

The path to malaria elimination in the Asia-Pacific region, encompassing 21 countries spanning from Afghanistan to Vanuatu, is at an unprecedented crossroad. To be certain, there has been remarkable progress over the past decade. Countries such as Sri Lanka and China have been certified as having eliminated malaria; Malaysia, Bhutan and Timor-Leste are on the cusp of elimination with zero to very few indigenous cases reported in the past 2 to 3 years. The Greater Mekong Subregion has achieved dramatic success: Cambodia has reported zero deaths since 2018 while there has been a reduction of 60%–90% of P. falciparum malaria cases across the subregion from 2020 to 2021, despite COVID-19 disruptions (World Health Organization, 2021).At the same time, with the 2030 goal of elimination committed to by 21 Heads of State firmly before us, there remains much work to be done in the decade ahead. Together, India, Indonesia, Pakistan and Papua New Guinea account for over 80% of the total region's malaria burden (World Health Organization, 2020). Indeed, there are several key challenges ahead.

Many of the highest pockets of endemicity are in the hardest-to-reach communities. Surveillance remains a high order of priority in need of strengthening particularly in rural and remote areas. While remarkable progress has been made with regards to P. falciparum, P. vivax continues to present considerable challenges in terms of case management and treatment. Policy reform in areas such as making malaria a notifiable disease still needs robust advocacy efforts. In an era of diminishing resources, malaria elimination efforts increasingly need ways to maximise the long-term benefit of donor funding while increasing domestic resources for malaria and health systems strengthening in the long term.

This special issue entitled Malaria elimination in the Asia-Pacific provides critical evidence in many of the areas outlined above, such as reaching hard-to-reach populations, the adequate treatment of P. vivax, examining donor support and policy reform. Wangdi et al. (2021) emphasise the importance of ensuring access to effective interventions for patients at risk in border or forested areas through, for example, mobile clinics, screening posts and village volunteers. Burkot and Gilbert (2021) offer a country perspective from the Solomon Islands on the impact of foreign aid on malaria elimination efforts with recommendations for future priorities on the integration of malaria services within the general health system. Ruwanpura et al. (2021) summarise the missing gaps in data that can help inform a safer and more effective radical cure for P. vivax malaria, including for example on the cost-effectiveness of novel treatment options. Finally, Lamy et al. (2021) explain why making malaria a notifiable disease is an essential policy milestone for coun

In Indonesia, the national universal health coverage scheme (Jaminan Kesehatan Nasional [JKN]) has consistently overspent against its budget since it was introduced in 2014. In 2017, a new regulation diverted 37.5% of tobacco tax revenue collected at the district and city level to the central government in order to increase government contributions to the JKN. Through a review of policy documents and interviews and focus group discussions with relevant stakeholders, this article explores the history of the JKN and its relationship to local tobacco taxes. Offering an ex-post assessment of the policy and its implementation, we find it negative on three fronts: funding for local anti-smoking initiatives and services was cut, the procedures for implementing the policy were complex and time-consuming, and it did not contribute as much as anticipated to the JKN. These findings underscore potential pitfalls of politically motivated policy that fails to consider implementation and impact. We recommend that the policy be revoked, and local tobacco tax revenue reallocated to its initial purpose, which includes promoting local smoking prevention programs and health service delivery.

There has been good progress in the bid to eliminate malaria from the Asia-Pacific region by 2030. Malaria elimination has been certified by the World Health Organization in Sri Lanka and China, is expected to be certified in Malaysia, and is within reach in Bhutan and Timor-Leste. The countries in the Greater Mekong Subregion have also made good progress and reached many milestones of success. However, the COVID-19 pandemic has threatened derailment of these impressive gains as countries in the region divert their attention and resources to combating the pandemic.

Much of the success in malaria control can be attributed to the vertical nature of the malaria program both at the global level and national level. That is, a program with clear objectives, quantifiable targets, focused on a single condition, and implemented with centralised management and dedicated means (staff, funds, etc). The last mile to elimination, however, is posing new challenges and new approaches are needed.

First, we need to tackle the challenge of reaching the hardest to reach communities. For example, those living in remote, rural areas, ethnic minorities and other marginalised sections of the population tend to have access difficulties and therefore the most limited contact with health services, lower levels of education and health literacy, and suffer poorer health for many conditions.

Second, we need to go beyond rolling out standard technical, vertical approaches and carry out a review of all demand- and supply-side factors. We need to understand better the social and cultural factors shaping health behaviours in communities, the role of community organisations and networks in providing trusted advice, and community perceptions of the health system. We need to reflect on shortfalls in current program implementation, including reviewing important policy barriers.

Third, we need to mainstream public health services and integrate better with the rest of the health system in order to tackle the elimination task. This approach should emphasise integrated, people-centred services, delivered where people live. Primary health care is the pivotal point for individual and community services, where case identification and treatment can occur for individuals, health education can be done for patients and for the community, and population outreach and environmental interventions can be carried out.

Fourth, we need to keep our minds open to new innovations which can help us achieve the elimination goal, including the potentially important results of recent vaccine trials and new therapeutic agents.

Finally, and importantly, we need to sustain political will and commitment in the face of competing priorities and reduced resources as countries continue to grapple with the COVID-19 pandemic. In the initial period of the pandemic, many countries focused their scarce resources on COVID-19 services, even to the neglect of other health issues. With t

This article explains how making a disease notifiable by law is a core component of a robust and well-functioning health system. Mechanisms to rapidly detect and report existing or emerging infectious diseases in a timely manner are key to disease control and elimination. Using malaria in Asia-Pacific as a case in point, we explore different policy considerations involved in making malaria a notifiable disease. These include the timing of legislative changes at different stages of elimination, investing in adequate infrastructure for a robust surveillance system that can support targeted interventions, and the importance of involving all sectors in the delivery of malaria services to detect, report and respond to every case. The article explains how frameworks to report on notifiable diseases, in this case malaria, contribute to improved regional health security.

This article explores the child protection actors, processes and child maltreatment issues in a regional Local Government Unit in the Philippines. Utilising a qualitative case study design, it engages with 14 young people with histories of child maltreatment and 13 key child protection actors, exploring their views and experiences of child protection actions, processes and outcomes. The findings highlight informal community-based actors, including neighbours, family, friends and non-government organisations in initial responses to child maltreatment, compared to formal child protection actors, who respond to severe maltreatment utilising a legal framework. Actors are constrained by limited government capacity and community reach, revealing misalignment between formal child protection activities and breadth of risks for children. Non-government organisations assist child protection efforts through the provision of residential care. Policy recommendations include strengthening relationships between formal actors and communities, expanding early intervention activities, and developing the capacity of community-based child protection actors.

While the effect of land fragmentation on farm efficiency and production diversification in Vietnam has been well established, no evidence exists for its effect on household food security. Using a unique dataset from household surveys in combination with micro-econometric models, the current study examines the impact of land fragmentation on food security in the poorest districts of Vietnam’s North Central Coast. Even after controlling for other factors in the models, we provide the first evidence that in Vietnam, ethnic minority households whose land holdings are fragmented are more likely to suffer from food insecurity. A higher likelihood of achieving food security is found for households whose members have better education and non-farm self-employment. The findings suggest that land policies that encourage land consolidation and improve the access of ethnic minorities to better education and non-farm self-employment would help them improve their food security. Such policies should be promoted in the study area.