In fighting the spread of COVID-19, the drastic measures undertaken by governments worldwide demonstrate a trade-off between public health and fundamental democratic principles. Yet this behaviour is not consistent across democracies, which motivates this paper to examine why some democracies were willing to constrain individual freedoms and concentrate power more than others during the pandemic's first wave. Creating two indices to measure the degree to which COVID-19 policies interfere with these democratic principles in 34 European countries, the analyses show that the large variation cannot be solely explained by pandemic-related factors. It is argued that the strong protection of democratic principles already established in 'normal' times makes governments more reluctant to opt for restrictive policies. By highlighting how differences in policy responses are attributed to provisions guaranteeing individual liberties, this paper contributes to a better understanding of how democracies handle the democratic dilemma in times of crises. KEYWORDS COVID-19; public health policies; democracy; fundamental rights; state of emergency; public health crisis The COVID-19 pandemic came fast and hit hard. After the virus spread in China in early 2020, it did not take long until Italy, as the first European country, had to deal with a strong rise in daily SARS-CoV-2 infections. When the situation got out of control, Italy's Prime Minister Giuseppe Conte proclaimed a nation-wide lockdown. Most European CONTACT Sarah Engler
The purpose of this scoping review is to establish the state of the art on economic evaluations in the field of HIV/STI prevention in high-income countries with concentrated epidemic settings and to assess what we know about the cost-effectiveness of different measures. We reviewed economic evaluations of HIV/STI prevention measures published in the Web of Science and Cost-Effectiveness Registry databases. We included a total of 157 studies focusing on structural, behavioural, and biomedical interventions, covering a variety of contexts, target populations and approaches. The majority of studies are based on mathematical modelling and demonstrate that the preventive measures under scrutiny are cost-effective. Interventions targeted at high-risk populations yield the most favourable results. The generalisability and transferability of the study results are limited due to the heterogeneity of the populations, settings and methods involved. Furthermore, the results depend heavily on modelling assumptions. Since evidence is unequally distributed, we discuss implications for future research.
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