Learning from past pandemic governance: Early response and Public-Private Partnerships in testing of COVID-19 in South Korea

Abstract

How can political elites learn from the past to enhance sustainability of their leadership in a pandemic situation? In this article, we develop a theoretical framework of policy implementation that combines collaboration from public and private sectors ("Public-Private Partnership," or PPP) to efficiently deal with urgent crises such as COVID-19. We explain the role of new institutions prompted by policy failure precedence (Time 1) that at a later time period (Time 2) allow for the activation of PPPs with the aim to extend the political life of incumbent leaderships. Specifically, we examine the case of South Korea, a country in which a prior case of MERS in 2015 (Time 1) had established new policies for pandemic governance. In 2020, such policies were activated by the incumbent leadership in order to contain COVID-19 (Time 2). In particular, for swift and effective management of the pandemic, the South Korean government utilized partnerships with the private sector to exponentially increase the amount of Real-Time Polymerase Chain Reaction (RT-PCR) testing. We apply Policy Feedback Theory to demonstrate the political effects of failed policy precedents and how the political outcomes again shape new policies in a dynamic and cyclical manner. Empirically, we conduct a content analysis of South Korea's pharmaceutical sector in government procurement and exports of test-kits during the COVID-19 pandemic. We show that as the pandemic situation progressed, South Korea's leader, who had been in danger of plummeting support to the extent that impeachment was discussed as a viable option, drastically shifted public opinion to achieve a landslide victory in general elections in April 2020. Our findings suggest that democratic governments, aware of precedents and wary of their fate in elections, are pressured to perform well in crisis management, and thus turn to rapidly mobilizing public and private means for survival. Such means are evidenced by the case of emergency use authorization (EUA) process for test-kits, in which "leapfrogging players" - up-and-coming innovators - that contribute to turning a pandemic crisis into an opportunity for sustainable leadership and for themselves.

Keywords: COVID-19; In Vitro Diagnostics (IVD); Policy feedback theory; Public-Private Partnership; RT-PCR testing; South Korea.

Fig. 1

Conceptual Framework of PPPs for Pandemic Governance in a Policy Feedback Mechanism Note: Developed based on Auzzir et al., ‘Public-private partnerships (PPP) in disaster management in developing countries: a conceptual framework,’ Procedia Economics and Finance, 18 (2014) 807–814. We combine this conceptual framework with the core elements of Mettler and SoRelle, ‘Policy Feedback Theory,’ in M. Weible, Christopher, and Paul A. Sabatier. eds.. Theories of the Policy Process. Westview Press, 2017.

Fig. 2

PPP Implementation 1 in Early Response to COVID-19: EUA Process by KCDC and MFDS. Source: Developed and updated based on Press Release, ‘64 Applications for EUA of COVID-19 Diagnostic Test-kits from 42 entities, of which 19 were reviewed, 4 authorized for EUA, 45 under review (Translated),’ Ministry of Food and Drug Safety (MFDS), March 10, 2020. https://www.mfds.go.kr/brd/m_99/view.do?seq=44010&srchFr=&srchTo=&srchWord=&srchTp=&itm_seq_1=0&itm_seq_2=0&multi_itm_seq=0&company_cd=&company_nm=&page=1.

Fig. 3

PPP Implementation 2 in Early Response to COVID-19: Exports of Excess RT-PCR Test-Kits by South Korea from January to April 2020 (HS Code: 3822.00, Amount: Millions of $USD, Weight Unit: Tons) Source: ‘Exports of Made in Korea RT-PCR diagnostic test-kits for COVID-19: to 103 country destinations, totalling $0.26 billion between January to APril 2020 (Translated)', Korea Customs News, May 9, 2020. http://www.kcnews.org/news/articleView.html?idxno=2646.

Fig. 4

PPP Implementation 2 in Early Response to COVID-19: Exports of Excess RT-PCR Test-Kits by Destination from January to April 2020 (HS Code: 3822.00, Amount: Thousands of $USD) Source: ‘Exports of Made in Korea RT-PCR diagnostic test-kits for COVID-19: to 103 country destinations, totalling $0.26 billion between January to APril 2020 (Translated)', Korea Customs News, May 9, 2020. http://www.kcnews.org/news/articleView.html?idxno=2646.

Fig. 5

COVID-19 testing in South Korea exceeded other countries in February and March 2020

Fig. 6

Deaths from COVID-19 in South Korea drop in late March, and further decrease in April and May 2020

Fig. 7

Positive and negative public evaluations of President Park Geun-hye (Time 1), and percentage of respondents attributing to policy failure in MERS for negative evaluation Source: Compiled and created based on Gallup Korea data (2015)

Fig. 8

Positive and negative public evaluations of President Moon Jae-in (Time 2), and percentage of respondents attributing to policy response to COVID-19 for positive or negative evaluation Source: Compiled and created based on Gallup Korea data (2020)