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The clinical foreground and industrial background: Customizing national strategy for COVID-19 testing

Smita Srinivas, Ramakrishna Prasad and Pritika Rao

October 2020

The WHO’s exhortation to countries to “Test, Test, Test!” in the light of the COVID-19 pandemic has led to an unprecedented global effort to increase testing capacity for SARS–CoV-2 infection. However, there exists a notable absence of debate about national industrial customization of this testing capacity. The paper contributes a conceptual integration of economics with public health to illustrate the vital industrial organization of health systems. The paper comprises an analysis using a five-layered approach to the industrial complexity involved with building technological capabilities and policy instruments to accelerate Covid-19 testing. A unique combination of systems literature gaps in economics and public health, intelligence gleaned from active pandemic policy-public health action networks, and cross-national analyses of industrial capabilities in firms using a qualitative heuristic along with a review of observational testing data. The focus on accelerated testing points to unspecified assumptions and specific assumptions of technological capabilities. The results show that there are idiosyncracies in local production capabilities (supplier versus non-suppliers) and export abilities that are mixed between and within Low Middle Income Countries (LMICs) and Higher Income Countries (HIC) countries, which makes them less easy to differentiate solely by their industrialized status. Early analysis provides confirmation of the importance and localized devolution and policy contexts for industrial supply chains. The disproportionate focus on diagnostic kits production as opposed to potential economic development interventions has missed important opportunities thus far. The next steps for extending this research include evaluating how those in different national industrial supplier categories adapt to global markets, constraints, and demand-side uncertainties.

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