Global Health Policy Unit, Edinburgh

Our new article in Health Policy and Planning examines health system disruption, adaptation, and recovery in Ukraine after Russia’s full-scale invasion in February 2022, drawing on the experiences of patients and health workers in three front-line areas, as well as internally displaced persons. At a time when attacks on health care are an increasingly prominent feature of war - in Ukraine and elsewhere - the study brings community perspectives clearly into view. The findings point to the effects of insecurity, workforce shortages, and infrastructure damage on service availability. At the same time, many respondents saw health sector reforms - including the Program of Medical Guarantees, Ukraine’s publicly financed package of health service entitlements - as important mitigating factors. Internally displaced persons generally reported positive experiences of care in host communities, though administrative, information-related, and capacity constraints (e.g., imbalances in health care capacity vs. need in high-influx areas) continue to limit access for some. Respondents emphasized the importance of both short-term emergency responses and longer-term recovery, identifying workforce strengthening, integration of humanitarian efforts, and financial protection as critical priorities. I’m grateful to the study's co-authors, Kateryna Kalendruz, Tetiana Bondar, Oleksiy Ganyukov, and Jarno Habicht; to the patients, health workers, local officials, and civil society representatives who contributed to the research; to World Health Organization Ukraine for supporting this work; and to Sviatoslav Linnikov, Oleksandr Vovruk, Nam-Mykhailo Nguien, Denys Dmytriiev, Alona Goroshko, Triin Habicht, Solomiya Kasyanchuk, Galyna Gorodetska, and Dene Cairns for their contributions to the wider development of the study. https://lnkd.in/d-aFis-X

Had a fantastic time at Livestock, Environment and People (LEAP) Conference yesterday! 🐄🥕🌱 I met so many great people and participated in a panel with brilliant contributions on bottom-up costs of downscaling ruminant herds from Stephanie Walton, divergent assumptions in 1.5˚C roadmaps from Anniek Kortleve, and evidence needs for dietary tramsformation from Rachel Headings (TABLE), expertly chaired by Cleo Verkuijl. Feeling very lucky and grateful to have been awarded ‘best presentation’ for my work on strategic ignorance and the FAO Sustainable Livestock Transformation agenda (from my The Leverhulme Trust fellowship). Thanks so much to the organisers and well done on another great conference - see you next year! 🌱

A new study by HSIL leaders Che L Reddy and Rifat Atun, together with Amrit Virk and colleagues, published in the Journal of Global Health, explores a frugal, scalable model for expanding cancer care in India. Rather than relying on costly new infrastructure, the model repurposes existing district hospitals, rapidly upskills general physicians and nurses in oncology, and connects them with specialists through simple smartphone messaging platforms for real-time clinical support. This “low-friction” approach has already been adopted across six Indian states, potentially expanding access to cancer services for ~380 million people. This study demonstrates how service delivery innovation (not just new technologies) can transform cancer care at scale. https://lnkd.in/eHDTwq-s

New Special Issue – Journal of Critical Public Health Vol. 3 No. 1 (2026) "Competing Narratives in Decentred Health Systems" Guest Editors: Katherine Smith, Justin Waring, Mark Bevir Published: 23 January 2026 The concept of ‘health systems’ is pervasive in contemporary public health policy and scholarship. Health systems are invoked as objects that can be strengthened, made resilient or reformed through better design, improved governance arrangements or more rational use of evidence. Yet, as much work in critical public health has shown, health systems are not neutral, coherent or stable entities. They are made and remade through the actions of situated actors, drawing on particular historical trajectories, ideas and interests, and they routinely reproduce social and health inequalities (e.g. Asefa 2023, Bambra et al. 2021, Stewart & Dodworth 2023, Wiltshire et al. 2017). This Special Issue of Journal of Critical Public Health brings interpretive and decentred approaches on public governance to bear on a set of empirical cases that span European economic governance, European Union (EU) meta-regulation, multistakeholder food policy partnerships, housing policy, place-based public health, integrated care reforms and healthcare within prisons. Collectively, the papers ask: what happens when we stop treating health systems as unitary structures or technocratic projects and instead treat them as contingent, contested practices? In doing so, they invite us to rethink how we conceptualise ‘systems’, and what it might mean to pursue more just and inclusive forms of public health. Articles in the issue: • An interpretive discourse network analysis of post-pandemic economic recovery across EU institutions – Charlotte Godziewski, Tim Henrichsen • Unpacking the ideas that shape the health policy process: A genealogy of the EU’s Better Regulation agenda – Eleanor Brooks • The post-politics of partnership: Understanding corporate power in multistakeholder governance – Robert Ralston • Negotiating the dilemmas of health system governance: A decentred analysis of integrating care systems – Justin Waring, Simon Bishop, Dr Bridget Roe • Disrupted rituals and relational ruptures: A decentred approach to integrated working in the English National Health Service – Jenelle Clarke, PhD • ‘You tried your best, but we suffered enormously’: A decentred analysis of the contested narratives surrounding COVID-19 policy implementation in the British prison system – Laura Sheard, Lucy Wainwright, Sarah Senker, Paula Harriott, Krysia Canvin • Housing as a social determinant of health: System perspectives from lived experience, policy and evidence – Lisa Garnham, Katherine Smith, Ellen Stewart, Clementine Hill O'Connor • Articulating place: Towards a conjunctural analysis of public health – Colin Lorne, Michael Lambert Explore the full issue here: https://lnkd.in/eXJe3n9G

A few months ago following a wonderful conference we (virtually) sat down with Sibylle Herzig van Wees Ben Kasstan-Dabush Michael J. Deml sandra mounier-jack and Ifrah Mohamed Ibrahim to think: what do we mean when we talk about underserved in the context of #vaccination? is the access/hesitancy dichotomy helping us? are we stripping individuals and communities of agency when we assume the system is the sole function of their vaccination status? and does the term fully encompass the reality of undervaccination? this is the result in The Lancet Group Regional Health-Europe. So the bottom line? -We suggest abandoning terminology that highlights only one of the numerous drivers of vaccination disparities -We propose the term undervaccinated to describe individuals or groups in high-income settings who are un- or partly vaccinated: The term focuses on vaccination status without assuming the relative influence of individual or systemic factors. -As a value-free term, it makes no assumptions about the causes of non-vaccination and is thus applicable across contexts where factors, from access barriers to confidence, vary. read more in the full paper: https://lnkd.in/eNpt_aZG

New in The BMJ: Harnessing wartime recovery to transform healthcare in Ukraine - co-authored with WHO colleagues Solomiya Kasyanchuk, Triin Habicht, Natasha Azzopardi Muscat, and Jarno Habicht. Amid the damage, destruction, and displacement caused by the war, Ukraine's health system continues to operate. Reforms launched in 2017 - including creation of the single payer National Health Service of Ukraine (NHSU) and universal access to a defined package of care - are still moving forward. And recovery is already underway – creating an opportunity not only to rebuild, but to redesign the system around efficiency, equity, and people-centred care. In the article, we argue for a clear strategic course for capital investment in health sector recovery, focused on: ✅ addressing hospital centrism through network consolidation and avoiding duplication ✅ expanding the scope of primary care – including in larger centres that can sustain multidisciplinary teams and diagnostics - so more essential services can be delivered closer to communities ✅ strengthening oversight through transparent, data-driven appraisal and publication of decisions and progress (linked to the innovative DREAM platform and ProZorro, Ukraine’s internationally recognised e-procurement system) With strong ministry of health leadership, clear priorities, and transparent appraisal, investments in health system recovery can accelerate reform, sustain donor confidence, and prepare the ground for EU membership. https://lnkd.in/eVcAScqC

Debates about private ownership in healthcare often focus on ‘public vs private’. Our new paper in Health Economics, Policy and Law - co-authored with Chiara Berardi (UCL Global Business School for Health) and Marco Varkevisser (Erasmus School of Health Policy & Management (ESHPM)) - proposes a different way to think about investor-ownership and why it matters for policy. https://lnkd.in/eVgW-DfY In the article, we present a typology of private investor-ownership in health service provision - covering non-profits, sole proprietors/partnerships, shareholder-owned public corporations, venture capital, and private equity. We set out the main policy-relevant characteristics of each, including: capital structure, investment horizons, investor roles in operational management, financial leverage, growth orientation, approaches to profit extraction, and the degree of financial transparency. We argue that these characteristics give rise to different organisational objectives and incentives, shaping their conduct and performance - with important implications for health system goals such as equity, efficiency, and quality of care. Ownership clearly matters for policymakers, regulators and purchasers; yet our analysis suggests that, across countries, policy frameworks rarely acknowledge or address variation in private ownership. We hope the article will stimulate discussion about how policy can respond more effectively to the diverse challenges and opportunities associated with different forms of private investor-ownership. We also intend to pursue further country-specific empirical work to refine and extend the typology, and to examine how different ownership forms operate across contexts - shaping organisational behaviour and health system outcomes. We would welcome opportunities to collaborate with others interested in building this still-emerging area of inquiry. #HealthPolicy #HealthEconomics #Regulation #ProviderMarkets #PrivateEquity #VentureCapital #HealthSystemGovernance #Transparency