BRICS countries and the global movement for universal health coverage

Abstract

This article explores BRICS' engagement in the global movement for Universal Health Coverage (UHC) and the implications for global health governance. It is based on primary data collected from 43 key informant interviews, complemented by a review of BRICS' global commitments supporting UHC. Interviews were conducted using a semi-structured questionnaire that included both closed- and open-ended questions. Question development was informed by insights from the literature on UHC, Cox's framework for action, and Kingdon's multiple-stream theory of policy formation. The closed questions were analysed with simple descriptive statistics and the open-ended questions using grounded theory approach. The analysis demonstrates that most BRICS countries implicitly supported the global movement for UHC, and that they share an active engagement in promoting UHC. However, only Brazil, China and to some extent South Africa, were recognized as proactively pushing UHC in the global agenda. In addition, despite some concerted actions, BRICS countries seem to act more as individual countries rather that as an allied group. These findings suggest that BRICS are unlikely to be a unified political block that will transform global health governance. Yet the documented involvement of BRICS in the global movement supporting UHC, and their focus on domestic challenges, shows that BRICS individually are increasingly influential players in global health. So if BRICS countries should probably not be portrayed as the centre of future political community that will transform global health governance, their individual involvement in global health, and their documented concerted actions, may give greater voice to low- and middle-income countries supporting the emergence of multiple centres of powers in global health.

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China

“…Despite substantial improvements in access to health services and the dramatic reductions in poverty, inequalities still exist. Urban–rural disparities in financing and health services access are major issues in China when promoting UHC 79. Given China’s urban–rural dualistic economic structure, uncoordinated development in the healthcare system has led to more and better healthcare resources in urban areas,80 especially with regard to health personnel, and the differences in regional economic development tend to be the cause of the regional inequity.…”

China engages with the global intellectual property governance: The recent trend

“…The BRICS also began to engage in global energy governance (Downie, ). Yet in other areas like health, the BRICS are unlikely to be a unified political bloc that will transform global health governance (Tediosi, Finch, Procacci, Marten, & Missoni, ).…”

“…The BRICS also began to engage in global energy governance (Downie, 2015). Yet in other areas like health, the BRICS are unlikely to be a unified political bloc that will transform global health governance (Tediosi, Finch, Procacci, Marten, & Missoni, 2016). According to an interview with Zhang Shaogang, the head of the International Department of MOFCOM, "China seeks to use this cooperation mechanism to coordinate IP cooperation with other BRICS countries at both multilateral and plurilateral levels, increase the discursive power and influences of the emerging economies in international IP rulemaking, and promote a more balanced, fair, and reasonable international IP system" (Zhang & Hu, 2017).…”

International Health Development Assistance of BRICS Countries

“…[6] BRICS countries implicitly supported the international health development assistance even though they seem to act more as individual countries rather that as an allied group, their individual involvement in international health development assistance may give greater voice to low-and middle-income countries supporting the emergence of multiple centres of powers in international health development assistance. [7] In addition, on the basis of comparative advantages, cooperation among BRICS countries has the potential to bring about global changes and make a positive contribution to the health of the population, not only in BRICS but also in the rest of the world. [8] The policies and practices of international health assistance have also received more and more attention.…”