Abstract

Over the past several decades, the governance of public health and infectious disease in South Asia has been a crowded space. In addition to the efforts of national, state, and local governments, powerful non-state entities like the World Health Organization and the Bill and Melinda Gates Foundation have also shaped responses to various infectious disease efforts. This system of polycentric governance—namely a situation where the state and multiple non-state entities work together on the same development projects—was widespread, not just in the South Asian region but could be found across the public health domain in the developing world. Beginning in March 2019, however, many of the states of South Asia quickly and forcefully ensured that they would control the governance response to the COVID-19 pandemic. Previously, powerful non-state entities as well as what seemed to be strong technocratic public health networks were marginalized. This sudden transition not only affected how states have responded to the COVID-19 pandemic but is also likely to affect the governance of public health and infectious disease going forward.