Chapter 3.5 reflects on how to use payment mechanisms to support the integration of care. Integrated care is about better management of the care patients receive in different settings (primary, secondary) and from different specialists and teams. It is particularly important for patients with multi-morbidity and chronic long-term needs, and as populations age. Key learning includes that

• Health systems’ payment models can play an important role in incentivizing integrated care.

• Purchasers are now testing innovative payment models (e.g. pay-for-coordination or P4C) which explore how to foster better coordination. These models include

• – Appointing a ‘budget holder’ for a patient so a case manager and /or multidisciplinary team has oversight of all care

• – Bundling payments to single providers so that the multiple services a patient uses are better linked and

• – Bundling payments for patients being treated by multiple providers, creating joint budget responsibility and a need to work together and avoid duplication.

• Policy-makers would do well to focus on careful design of information systems to underpin payment schemes because

• – Information sharing supports clinical effectiveness

• – Quality indicators allow purchasers to tie bonuses or penalties to integration

• – Monitoring activity and health outcomes helps assess value for money

• – Tracking the distributional consequences of incentive schemes is crucial in protecting equity

• – Robust evaluation tools allow immediate lessons to be shared and will capture changes over time and across the healthcare system.

• Health systems need to embed financial incentives as part of a broader system approach. Critical elements include

• – Committed leadership

• – Effective communication among providers

• – Structural integration, either through coordinating mechanisms that link provider roles or by the formation of new entities with single management teams.

Chapter 3.8 highlights the importance of funding as a tool for preparing for and responding to pandemics. A pandemic can wreak health, societal and economic havoc. Prioritizing common and global public goods for health and specifically for pandemic planning is complex and requires financing mechanisms at national, regional and supranational levels. Key learning, including from COVID-19, is that

• – Pandemic preparedness is subject to inherent market and collective action failures and is often underfunded.

• – Governments need clear strategies for funding preparedness.

• – Preparedness depends on strong health system foundations and contingency funding mechanisms that go beyond simply setting funds aside. It is crucial that funds can be mobilized quickly and in a coordinated fashion.

• – Key steps for planning responses include

• Assessing existing activities and mapping value for money

• Agreeing the need for public financing for population-based functions (i.e. common goods)

• Identifying appropriate types of financing that reflect the complexity of determining resource needs and allow for nuanced cost estimation

• Developing context-specific financing tools that include flexible funds and address accountability

• Holding transparent discussions about trade-offs

• Improving budget transfer mechanisms

• Integrating domestic finance into multiyear budgets, and

• Managing and strengthening international collaboration

• International guidance and learning from COVID-19 can help inform preparations. Organizations including the WHO and World Bank offer tools to help decision-makers. It is crucial that these are assessed for suitability to context and customized to the national and local setting.

El recurso del método (Reasons of State), published in 1974 by Cuban writer Alejo Carpentier, has often been analyzed along with other dictatorship novels focusing on recurring themes, such as violence, rebellion, US imperialism or the dictator’s solitude. This essay introduces a “sensory approach” arguing that Carpentier revisits the traditional hierarchy of the five senses. Thematically, the novel emphasizes the “spectacular” and panoptical dimension of the dictator’s regime; however, this visual (and aural) domination is questioned by the Marxist opposition embodied in the character of the Student. From an intertextual perspective, Carpentier’s use of quotations from Descartes paradoxically undermines the Cartesian cogito, and the protagonist’s behavior ultimately evolves toward an anti-Cartesian and anti-ocularcentric stance, as epitomized by the figure of Mayorala Elmira. Reflecting on these two dimensions of the novel from a sensorial point of view contributes to a more nuanced understanding of Carpentier’s poetics.

Allen Ginsberg’s fastidiousness about retroactively dating three decades of his own photographs in the 1980s is a significant part of a historiographical project. Ginsberg strives to document his role in the creation of a movement that enables viewers to perceive self-portraits and individual portraits of other key Beat figures such as Kerouac as communal objects. Ginsberg’s inscriptions couple the author’s penchant for mythmaking with his interest in narrating events that are made significant through their incorporation into a composition that suggests a heightened meaning for each individual image. Collecting the ninety-one portraits in Allen Ginsberg: Photographs, placing them in a roughly chronological order, and providing information about each image through captions that feature the date of composition, the place in which the image was taken, and how each subject contributed to the Beat movement or to subsequent countercultural movements such as hippie and punk that Ginsberg regards as part of the Beat legacy, the poet displays his interest in what Yosef Hayim Yerushalmi in Zakhor: Jewish History and Jewish Memory regards as the creation of “collective memory.”

Ginsberg was famous for chronicling every facet of his life, and his last poems in the mid 1990s frequently reflect an intense self-consciousness about his final illnesses. While earlier in his career, the body was an important site for Ginsberg’s poetics of candor, confrontation, and erotic epiphanies, he remained equally adamant as his health faltered in ascertaining his physical deterioration in poems such as “Here We Go Round the Mulberry Bush” and “Sphincter.” Even during his final period, however, Ginsberg’s level of literary fame provided him access to figures in popular music that amplified his cultural prominence and enabled him to retain a sense of artistic relevance. Simultaneously with his meditations on death, Ginsberg’s culminating poems maintained his renowned sly humor about his social status as a writer whose expansive cultural reputation included the continuity of radical political critique. This chapter on his posthumous volume Death and Fame: Last Poems 1993–1997 (1999) explores Ginsberg’s attempts to reconcile the problematic contexts of fame’s durability while struggling to find succor, in both Buddhist and poetic terms, with his accelerating disability and terminal departure.

Alejo Carpentier combines history and literature to compose his novel El arpa y la sombra (The Harp and the Shadow). On the one hand, he uses historical facts to create a fictional story that reveals a human Christopher Columbus, far removed from stereotypes, myths and ideological designs. On the other hand, he draws on a vast wealth of literary works and authors from the Hispanic world to complement, through intertextualities and cultured references, the image he wishes to present of the Admiral. Relevant examples include quotations from Cervantes’ interlude Retablo de las maravillas (The Stage of Wonders) and Federico García Lorca’s poem “La casada infiel” (“The Unfaithful Wife”), as well as other more general texts such as Juan de Mandavila’s Libro de las maravillas del mundo (Book of the Wonders of the World) and various passages from the Bible. All of this is made possible, despite the anachronisms that appear in the text, thanks to the integration of the novel into the realm of freedoms of the postmodern historical novel.

This chapter asks how two subjects defined in the terms of ‘religion’ – the ‘Muslim’ and the ‘Jewish’ subject – became recognizable as such in the decades prior to the independence of the ‘Islamic Republic’ of Pakistan and the ‘Jewish National Home’ of Israel, which aligned the recognition and formation of the religious minority, the nation, and the state. It addresses the recognition of Israel and Pakistan in the contexts of their colonial pasts and analyses the role of demography, the claim for political representation, and the work of two international commissions that shaped the borders of their statehood. It shows how emerging modes of cultural recognition built on and cemented very particular understandings of ‘religion’ and funnelled certain aspects of social, political, and cultural life into coherent, representable, and recognizable forms of religious difference. By looking in detail at the epistemological politics of religious difference, the chapter illustrates the costs that come with the recognition of ‘religion’ and ‘religious difference’ in the transition from empire to state. The double face of the imperial recognition of the ‘Indian Muslims’ and the ‘Palestinian Jews’, in other words, worked both as a condition for legitimate government and power and as a resource for the future challenge against them.

This chapter analyses the WTO’s institutional features, focusing on rule-making and dispute settlement. It describes the creation of the GATT and the shift to the WTO, analysing salient aspects of the WTO’s structure. It reviews how WTO institutions have operated, highlighting problematic features and identifying potential reforms. The WTO is widely viewed as a seriously flawed institution. Despite its goal of promoting liberalised trade, members have found it virtually impossible to conclude new agreements. The dispute settlement system, once viewed as its crown jewel, now lies in tatters. While many factors have contributed to the current situation, the multilateral trading system’s institutional architecture is deeply implicated.

Chapter 3.4 explores how pharmaceutical care is financed. Paying for medicines includes how the end-purchase of existing medicines is managed but also the way investment in research and development (R&D) is handled. Key learning includes that

• Pharmaceutical innovation draws on substantial public and private resources.

• – The public sector primarily supports early-stage research, regulates the industry and incentivizes development.

• – The private sector is typically central to development, commercialization, manufacture and marketing. It seeks high profit margins and is not always transparent or responsive to policy priorities.

• Novel and specialized therapeutics as well as population ageing are likely to accelerate medicines expenditures. This requires careful management of pricing and reimbursement.

• Policy-makers can leverage a mix of push and pull strategies to align industry efforts with societal need including through

• – Clear communication of health system priorities

• – Transparent incentive and pricing systems and measures to enhance R&D efficiency

• – Payment mechanisms that foster equity and sustainability

• – Cross-country collaboration including on preparedness, procurement and pricing transparency.

Chapter 3.10 evaluates innovative financing for neglected diseases. Neglected diseases (NDs) account for about a fifth of the global burden of disease and affect over a billion people. They are neglected because the pharmaceutical sector does not consider it profitable to develop treatments for them. This reflects that fact that NDs are most prevalent in low- and middle-income countries with relatively low purchasing potential. Key learning includes that

• Global pharmaceutical research and development (R&D) invests a disproportionate share of innovation, activity and resources in low burden diseases and fosters significant inequities.

• A range of push and pull incentive mechanisms have been developed to delink the cost of research from market profitability and promote innovation in areas of need.

• – Reduce the upfront costs by subsidizing R&D pre-discovery (push incentives) and

• – Offer a reward post-discovery (pull incentives)

• The evidence on the effectiveness and reach of incentive schemes is scant and more needs to be done to understand the relative cost-effectiveness of the different incentive mechanisms and the extent to which they mitigate inequalities in innovation and access to new medicines.

• A global, unified governance framework for needs assessment and resource allocation could usefully

• – Carry out systematic comparison of the relative needs associated with NDs globally

• – Assess the costs and benefits of addressing these

• – Set priorities for the coordinated global allocation of funding and targeted incentive mechanisms, and

• – Consider payment mechanisms that will translate research into market launches.

This chapter examines the Story of Apollonius, King of Tyre as a revisionist shipwreck fiction that repurposes epic paradigms. The chapter reads the Cyrenean episode (chs. 11–24) as a sustained imitation – and critique – of Homer’s Phaeacia and Vergil’s Carthage. Unlike Odysseus or Aeneas, Apollonius resists narrative concealment and erotic distraction, instead reasserting his identity through skill, performance, and pedagogy. His learned character transforms a Phaeacian paradise into a classroom and converts a Didonian princess into a regina docta. The chapter argues that the novel appropriates the tropes of “bad” fiction to redefine the genre as morally and intellectually edifying. The text enacts a metaliterary defense of fiction, presenting Apollonius as an alternative heroic model who surpasses canonical predecessors in virtue and wisdom. The novel thereby mounts a serious challenge to the status of canonical epic, reimagining prose narrative as a vehicle for paideia. In this reading, the Story of Apollonius emerges not as an escapist tale but as a learned fiction that invites its readers to decode, critique, and ultimately embrace the educative potential of prose romance.

This chapter foregrounds recent studies on race and religion as analytic categories in the study of the ancient world. Conventional scholarly analysis of the late-antique Mediterranean world often assumes that uses of the terms race and racism are anachronistic in studies of premodern societies. By contrast, religion is often taken for granted as an unproblematic category of analysis across both modern and premodern social contexts. More recently, critical studies of race and religion have illustrated the shortcomings in the basic assumptions that undergird the uses and disuses of terms like race, racism, religion, and ethnicity in studies of premodernity. Drawing on these recent works, this chapter demonstrates the entanglements between religious and racialised conceptions of group identities and hierarchies. Race and religion are conceptually intertwined to the extent that religious ideas have been instrumental in processes of racialisation and religious groups have been targets of racialisation. The chapter concludes with examples of how theories of environmental determinism and anti-Semitism manifest in Christian ideologies and imperial policies in late antiquity.

This chapter examines the political economy of international trade policy, exploring the evolution of the international trading system from the GATT to the WTO. It analyses the fault lines between free trade and fair trade and winners and losers, and the role of labour market policies in addressing transition costs. It also discusses the challenges facing the WTO, including institutional dysfunction and an expanding mandate. It proposes potential solutions, such as plurilateral agreements and improved institutional arrangements, while emphasising the need for collaboration with other international agencies. The chapter concludes by stressing the urgency of recovering the aspirations of the post-war international order to address current global challenges.

The distinctiveness of Neandertals’ leg bones results from a complex set of environmental, evolutionary, and anatomical factors. Their lower limb morphology includes robust bones with hypertrophied muscle attachments and thick cortices, anteriorly curved femoral diaphyses, absence of pilaster, low femoral neck-shaft angle, large joints, and low crural indices. Although some of these features reflect their massive bodies and high activity levels, few aspects of Neandertal lower limb morphology can be considered separately from their cold-adapted body proportions. However, although cold adaptation can explain European Neandertal intralimb proportions, it fails to account for the same limb proportions in West Asian Neandertals, suggesting additional factors shaped their limb proportions. Their lower limb anatomy may represent a model of morphological integration, a balance between elevated activity levels and adaptation to the rigorous demands of an ice age climate, all superimposed on the expression of more canalized traits controlling rates of bone remodeling.