Joseph Harris

Moving towards universal health coverage: lessons from 11 country studies

In recent years, many countries have adopted universal health coverage (UHC) as a national aspiration. In response to increasing demand for a systematic assessment of global experiences with UHC, the Government of Japan and the World Bank collaborated on a 2-year multicountry research programme to analyse the processes of moving towards UHC. The programme included 11 countries (Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam), representing diverse geographical, economic, and historical contexts. The study identified common challenges and opportunities and useful insights for how to move towards UHC. The study showed that UHC is a complex process, fraught with challenges, many possible pathways, and various pitfalls--but is also feasible and achievable. Movement towards UHC is a long-term policy engagement that needs both technical knowledge and political know-how. Technical solutions need to be accompanied by pragmatic and innovative strategies that address the national political economy context.

Who Governs? Autonomous Political Networks as a Challenge to Power in Thailand

Abstract Recent scholarship examining political contestation in Thailand has emphasised concepts such as “network monarchy,” while pointing to the populism and enduring political influence of Thaksin Shinawatra. While this descriptive work has helped shed light on the architecture of governance in Thailand, it has not been embedded in a broader theoretical approach that might help to train our attention on other powerful actors that play important roles in shaping Thailand’s political and institutional landscape. In this article, I outline one such approach and advance the term “autonomous political networks,” to refer to collections of people who share strong value commitments and political goals and who operate in the space between the country’s dominant political institutions – often straddling positions in the state and civil society simultaneously. This theoretical discussion is grounded empirically in a description of one such network whose power is derived from sources other than electoral legitimacy or long-standing historical tradition. The article discusses the enormous influence this network has exercised in reshaping Thailand’s political order, all while remaining largely invisible to the public eye. It suggests the need to use this approach to elaborate other hidden political networks that play important roles in governance in Thailand and beyond.

Uneven inclusion: consequences of universal healthcare in Thailand

‘Post-national’ scholars have taken the extension of social rights to migrants that are normally accorded to citizens as evidence of the growing importance of norms of ‘universal personhood’ and the declining importance of the nation-state. However, the distinct approach taken by the state toward another understudied category of non-citizen – stateless people – complicates these theories by demonstrating that the state makes decisions about groups on different bases than theory would suggest. These findings suggest the need to pay more attention to how the state treats other categories of ‘semi-citizens’. This article examines the differential effects of universal healthcare reforms in Thailand on citizens, migrants, and stateless people and explores their ramifications on theories of citizenship and social rights. While the state has expanded its healthcare obligations toward people living within its borders, it has taken a variegated approach toward different groups. Citizens have been extended ‘differentiated but unambiguous rights’. Migrants have been granted ‘conditional rights’ to healthcare coverage, dependent on their status as registered workers who pay mandatory contributions. Large numbers of stateless people, however, saw their right to state welfare programs disenfranchised following passage of the new universal healthcare law before later being granted ‘contingent rights’ through a new program.

The Nuts and Bolts of Post-Conflict Capacity Building: Practicable Lessons from East Timor

‘Capacity building’ has become a ubiquitous term in the international peacebuilding community. While the need for capacity building in post-conflict contexts is widely accepted, discussions rarely venture into what it is in practical and operational terms, and how it ought to be done. This article 1 examines a major capacity building project in East Timor, focusing on capacity building as it occurs day to day and on the ground. Following a brief overview of the concept of capacity building, it identifies a number of key challenges that arise in initiatives in which internationals work directly with local actors to build their capacity. It then offers a set of concrete proposals, targeted at capacity builders and their managing institutions, for improved practice.

Achieving Access: Professional Movements and the Politics of Health Universalism

Excerpt] This book examines efforts to expand access to health care and AIDS medicine in Thailand, Brazil, and South Africa. Although these countries are geographically far apart, they share many similarities as newly industrializing countries engaged in processes of democratic opening. Scholars have often suggested that expansionary social policy is the product of left-wing parties and labor unions or bottom-up people’s movements. From a strictly rational perspective, that these groups would be at the forefront of such change makes perfect sense. After all, expanding access to health care and medicine would seem to be in their interest, and they would appear to have a lot to gain. While this book recognizes the role they often play, it focuses on a different, more puzzling set of actors whose actions are sometimes even more decisive in expanding access to health care and medicine: elites from esteemed professions who, rationally speaking, aren’t in need of health care or medicine themselves and who would otherwise seem to have little to gain from such policies. This group includes doctors like Sanguan Nitayarumphong and Paulo Teixeira, whose work with the poor and needy informed their advocacy for universal health care in Thailand and Brazil while also putting them into conflict with the medical profession of which they were a part. How is it that these people would play such an important and active role in making change happen?

Joel Sawat Selway, Coalitions of the Well-Being: How Electoral Rules and Ethnic Politics Shape Health Policy in Developing Countries

In pointing to the importance of both electoral rules and social structure (read “ethnicity”) in public goods provision, Joel Sawat Selway makes an important contribution aimed at helping understan...

Une couverture sanitaire universelle pour un développement durable inclusive : une synthèse de 11 études de cas pays

The goals of Universal Health Coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey that have achieved UHC are showing how these programs can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low income and middle-income countries (LMICs), where most of the world s poor live.

Heart-Sick: The Politics of Risk, Inequality, and Heart DiseaseHeart-Sick: The Politics of Risk, Inequality, and Heart Disease, by ShimJanet K.New York: New York University Press, 2014. 277 pp.

al North (p. 224). In all, this book problematizes Western hegemonic ways of knowing and outlines revolutionary ‘‘epistemologies of the South,’’ premised on the idea that global social justice is not possible without global cognitive justice. Though a dense epistemological and philosophical sojourn, this book illuminates a tangible way of knowing that connects theory and praxis. Therefore, this book warrants urgency and makes important contributions to the field of sociology specifically, and our ways of knowing generally, as well as the praxis of social justice.