The COVID-19 pandemic has exposed massive failures of governance at the global and national levels. Global health governance failed rapidly, with action quickly becoming nationally based, uncoordinated, and often zero-sum. However, domestic health governance also often fared very poorly, even in some of the wealthiest countries, which were ostensibly best-prepared to deal with a pandemic. Why? We argue that this reflects the inherent pathologies of the shift from‘government to governance’ and of the‘regulatory state’ it had spawned. This has resulted in the hollowing-out of effective state capacities, the dangerous diffusion of responsibility,and de facto reliance on ad hoc emergency measures to contain crises. We demonstrate this through a detailed case study of Britain, where regulatory governance and corporate outsourcing failed miserably, contrasting this with the experience of South Korea, where the regulatory state form was less well established and even partially reversed.
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