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Institutions and the politics of agency in COVID-19 response: Federalism, executive power, and public health policy in Brazil, India, and the U.S.

Published online by Cambridge University Press:  10 October 2022

SCOTT L. GREER
Affiliation:
Professor, Department of Health Management and Policy, University of Michigan School of Public Health, USA email: slgreer@umich.edu
ELIZE MASSARD FONSECA
Affiliation:
Associate Professor, Sao Paulo School of Business Administration, Fundação Getúlio Vargas, Brazil email: elize.fonseca@fgv.br
MINAKSHI RAJ
Affiliation:
Assistant Professor, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, USA email: mraj@illinois.edu
CHARLEY E. WILLISON*
Affiliation:
Assistant Professor, Department of Public and Ecosystem Health, Cornell University, USA email: cew253@cornell.edu
*
Corresponding author, email: cew253@cornell.edu
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Abstract

The COVID-19 pandemic of 2020 was one of the rare events that shocked almost every world government simultaneously, thus creating an unusual opportunity to understand how political institutions shape policy decisions. There have been many analyses of what governments did. We focus instead on what they could do, focusing on the institutional politics of agency – how institutions empower rather than how they constrain, and how they affect public policy decisions. We examine public health measures in the first wave (March-September 2020) in Brazil, India, and the U.S. to understand how the interplay of institutions in a complex federal context shaped COVID-19 policy-responses. We find similar patterns of concentrated federal executive agency with limited constraints. In each case, when federal leadership failed public health policy responses, federated, subnational states were left to compensate for these inefficiencies without necessary resources.

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Type
Article
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press