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COVID-19 is the most significant public health emergency in more than a century, causing a global economic crisis, and with long-term repercussions across society. COVID-19 continues to claim lives, many are suffering ill health (physical and/or mental) due to the virus, and health systems struggle to recover from the massive disruption. This unprecedented crisis has highlighted the urgent need for smart investments to strengthen health system resilience – to protect people’s underlying health, through enhanced preventive care and the ability to reinforce defences in acute times, to fortify the foundations of health systems by ensuring adequate core equipment and exploiting the potential of health information, and to bolster health professionals working on the frontline by building and maintaining sufficient numbers of doctors and nurses – thereby providing countries with the agility to respond not only to evolving pandemics but also to other health and societal shocks. This report identifies a set of priority investment areas needed to strengthen health system resilience. It then produces order-of-magnitude estimates of the expected costs of such investments, drawing extensively from existing OECD data and analytical studies.

This report explores ways in which regional trade agreements (RTAs) can incorporate environmental objectives in chapters and articles related to trade in services. In particular, the analysis builds on a review of existing provisions in recent RTAs aiming at fostering deep economic integration. The report identifies a range of possible options as a way forward, from general commitments to co-operate on environmental goods and services, through horizontal provisions guaranteeing the right to regulate or to protect the environment, to specific commitments on market access and national treatment, or disciplines designed to promote regulatory cooperation and good regulatory practices. These different avenues point to the need for a holistic approach in incorporating environmental considerations in services related provisions. Parties interested in promoting and facilitating trade in environmental services through RTAs would not only need to look at environment and sustainability chapters, but may also wish to do it through specific commitments on market access and national treatment as well as sectoral provisions or annexes on regulatory co-operation.

Income inequality is low in Belgium, and intergenerational income mobility is on par with the average OECD economy. However, as in other OECD countries, there is scope to improve equal access to opportunities across the population. Poverty risks are high for the unemployed and the low-skilled. Vulnerable socio-demographics, in particular the low educated, single mothers and people with a migrant background and with disabilities have persistently low incomes. Moreover, low-income households are overburdened by housing costs. To foster upward income mobility, employment should be increased among vulnerable groups by enhancing skills through life-long learning, effective career guidance and continuing to strengthen work incentives. To prevent the transmission of disadvantages across generations, social segregation in compulsory education should be addressed, in particular through better-designed school choice policies, higher mobility between general and vocational tracks, and stronger incentives and training for teachers. Promoting quality and affordable housing is also necessary to reduce spatial segregation and mitigate barriers to opportunity.

Public procurement represents a major share of government spending. Even though adequate regulatory and strategic frameworks exist, the uptake of responsible business conduct considerations in public procurement is relatively low. Given the relevance of the economic argument for governments, this paper provides insights for policy makers and practitioners on the economic benefits of integrating responsible business conduct in public procurement supply chains. It analyses both direct and indirect economic benefits, and looks into the broader impact on businesses and individuals beyond national borders.

The COVID-19 pandemic has had devastating effects on lives, the economy, and the public finances worldwide, drawing attention to the need to enhance resilience to future shocks. This paper focuses on subnational governments, given their important and growing role in the provision of essential public goods and services worldwide. The paper discusses key aspects of subnational resilience, in particular the sensitivity of subnational finances to macroeconomic cycles and shocks and the availability of fiscal buffers; the main factors influencing subnational governments’ ability to provide essential services during crises; and their ability to anticipate and prepare for future shocks, especially those related to climate change. The paper also discusses policy and institutional reform options for both national and the subnational governments to strengthen subnational resilience.

Before the pandemic hit, the city of Bilbao had the highest economic growth in Spain from 2000 to 2018, driven by a shift from heavy industry to a service-based economy. It also benefitted from a burgeoning tourism and culture sector, thanks to developments such as the Guggenheim Museum in 1998. Plagued with high unemployment in the late 90s, unemployment started to drop until 2008. However, such promising trends were unable to shield the city from the 2008 global financial and later COVID-19 crisis. This study assesses inequality in Bilbao and how the COVID-19 pandemic and the city’s response and recovery measures have affected its inclusive growth agenda. It also examines how Bilbao’s approach to deploying a smart city strategy and localising the SDGs contributes to the city’s overall resilience and inclusive growth objectives.

The Implementation Toolkit of the OECD Principles on Urban Policy aims to facilitate and accelerate the uptake of the OECD Principles on Urban Policy (2019) as a driver of policy reform and improvement in diverse urban policy contexts. It consists of two interlinked and complementary components. First, a self-assessment framework provides governments with a user-friendly four-step guide and a series of questions and indicators to assess the state of play of their urban policy frameworks (“what”), and operational mechanisms (“how”) as well as the outcomes. Second, a policy database offers a selection of 60+ leading examples from around the globe on how national and subnational governments are using the OECD Principles on Urban Policy on the ground to reshape their urban policy. Against the backdrop of current challenges surrounding cities, the Toolkit seeks to support national and subnational governments in making cities fit to face current and future shocks and opportunities.

Responsibilities for research integrity and security are distributed across multiple actors in the international research ecosystem. These include, national governments, research funding agencies, research institutions, universities, academic associations, and intergovernmental organisations. This report describes policy initiatives and actions to safeguard national and economic security whilst protecting freedom of enquiry, promoting international research cooperation, and ensuring openness and non-discrimination. It includes examples of actions that are being taking to prevent foreign interference, manage risks, and help ensure trust in science in the future, and offers recommendations to help countries develop effective policies to strengthen research security as part of a broader framework of research integrity.

Across OECD countries, two in three people aged over 65 years live with at least one chronic condition often requiring multiple interactions with different providers, making them more susceptible to poor and fragmented care. This has prompted calls for making health systems more people-centred, capable of delivering high-quality integrated care. Despite promising, mostly local-level, experiences, systems remain fragmented, focused on acute care and unsuitable to solve complex needs. Moreover, assessing and comparing the benefits of integrated care remains difficult given the lack of technically sound, policy-relevant indicators. This report presents the results of the first OECD pilot of a new generation of indicators to support international benchmarking of quality of integrated care. Lessons from the pilot call for further work on: (1) expanding work on indicator development; (2) performing policy analysis to understand cross-country variations on governance models and health financing; (3) upscaling data linkage; and (4) measuring care fragmentation.

Russia’s war against Ukraine has triggered unprecedented policy responses around the globe, raising manifold implications for international investment policy, both immediate and longer term.

As a key component of health care, a full understanding of how much is spent on prescription medicines is increasingly important. Only a partial understanding of total expenditures across health systems is currently possible, as reporting is often limited to medicines dispensed in community pharmacies. However, spending on pharmaceuticals used elsewhere in the health sector, particularly in hospitals, constitutes a significant and growing proportion of the overall resources allocated to medicines. This report aims to improve the coverage and quality of data on total pharmaceutical spending across the whole health sector, by reviewing current practices, and recommending a set of definitions, concepts and guidance under the framework of A System of Health Accounts 2011. Countries are encouraged to apply these guidelines in their future reporting of pharmaceutical expenditures, as part of their annual health accounts data production.

Public sector innovation is about finding new and better ways to achieve positive public outcomes. The increased complexity of the challenges faced by governments has made enhancing the innovative capacity of governments and public sector systems an imperative. But for innovative approaches or solutions to create lasting impact, they must be embedded as part of existing systems. In the same way, a public sector’s capacity to innovate depends on whether innovation is embedded in the functions and mechanisms of government. To assist governments in achieving this this, the OECD Observatory of Public Sector Innovation (OPSI) developed the Innovative Capacity Framework. It focuses on the innovative capacity of existing public sector systems and their governing mechanisms, rules, processes, norms and other factors. The Framework includes guidelines for making innovation an integral part of policy making and administration and for improving the capacity of governments to quickly adapt to changing environments and, ultimately, build more robust and sustainable solutions.

This report explores how ASEAN member states can mitigate the negative impacts of the rapidly growing number of cars on the region’s roads. More, increasingly larger vehicles consume more energy, emit more CO2 and cause more local air pollution. Among the policies to counter these trends and make mobility in the region more sustainable is the ASEAN Fuel Economy Roadmap. This study provides support for implementing the roadmap. It looks specifically at policies for making light-duty vehicles more efficient and less emitting but also provides insights for other motorised road vehicles. The report explores opportunities for aligning policies across ASEAN, considers the role of trade agreements and recommends measures for a transition towards electrification.