Policy piloting has become a popular form of organization in implementing public policies. However, the current literature surprisingly discusses little about its management. This study investigates how two policy-pilot attributes – ambiguity and compatibility – shape policy-pilot management. To accomplish this, we developed an analytic framework consisting of four management strategies: experimentation, refinement, upscaling, and institutionalization. We chose a representative policy pilot in Chinese health governance, the New Rural Cooperative Medical Scheme, to examine the adoption of these four strategies. Our finding that, at various junctures, the Chinese state adopted these four strategies to manage policy piloting demonstrates the applicability of the analytic framework constructed in this study. This study contributes to the existing public policy literature by providing new insights into policy implementation in temporary organizing settings.

The spread of COVID-19 has seen a contest over health governance and sovereignty in Global South states, with a focus on two radically distinct modes: (1) indicators and metrics and (2) securitisation. Indicators have been a vehicle for the government of states through the external imposition and internal self-application of standards and benchmarks. Securitisation refers to the calling-into-being of emergencies in the face of existential threats to the nation. This paper contextualises both historically with reference to the trajectory of Global South states in the decades after decolonisation, which saw the rise and decline of Third-World solidarity and its replacement by neoliberalism and global governance mechanisms in health, as in other sectors. The interaction between these modes and their relative prominence during COVID-19 is studied through a brief case-study of developments in Kenya during the early months of the pandemic. The paper closes with suggestions for further research and a reflection on parallel trends within Global North states.

France is one of the European countries hardest hit by the Covid-19 pandemic. The pandemic brought into light structural weaknesses of the health system, including its governance and decision-making process, but also provoked changes that helped to improve its resilience. We analyse the French experience of Covid-19 in 2020 by critically reviewing major policy measures implemented during the first two waves of the pandemic. France has struggled to find the right balance between the rock of economic and social damage caused by containment measures and the hard alternative of a rapidly spreading pandemic. The response to the first wave, including a full lock-down, was an emergency response that revealed the low level of preparedness for pandemics and the overly hospital-centred provision of health care in France. During the second wave, this response evolved into a more level strategy trying to reconcile health needs in a broader perspective integrating socio-economic considerations, but without fully managing to put in place an effective health strategy. We conclude that to achieve the right balance, France will have to strengthen health system capacity and improve the cooperation between actors at central and local levels with greater participatory decision-making that takes into account local-level realities and the diversity of needs.

Currently, a mass media campaign is underway in Turkey using a new communication means called the “public spot” (kamu spotu). This article concentrates on the public spots produced by Turkey’s Ministry of Health, and more specifically on those that advocate quitting smoking and preventing obesity. Drawing on interviews with Ministry of Health personnel and analyzing the content of these spots, we suggest that they operate as risk caveats. They caution individuals against smoking and obesity’s potential harms and guide her/him towards self-health governance by encouraging the maintenance of a particular lifestyle that embraces a balanced diet, regular activity, and no smoking. As such, we read these spots as a technique of neoliberal governmentality. This technique works primarily by responsibilizing individuals as health entrepreneurs investing in risk free lifestyles; that is, by conceptualizing health as a matter of self-conduct where personal responsibilities are emphasized.