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This paper explores some of the key features of the ‘second’ global shift or offshoring of a range of service functions from America and Europe to countries like India and China. Service offshoring or global sourcing is perceived by the media, policy-making communities and trade unions as a significant threat to existing and future service employment in developed market economies. This paper explores two issues. First, it explores the growth of call centres and data-processing warehouses in India and elsewhere as strategies that are being used to develop a new international spatial division of service labour based on blended delivery systems. Second, it explores the impact that the second global shift is having on service operators living in India. Service work is a hybrid form of work that contains within it various types of emotional labour. Emotional labour is usually understood to be implicated in face-to-face encounters between service producers and consumers. The second global shift, however, involves distanciated emotional labour in which firms located in developed market economies encourage foreign workers to alter the ways in which they project their identities. The offshoring of services to India and China encourages call centre operators based in India and China to become American or English at night and Indian or Chinese during the day. Unlike the first global shift, the geographies of the second global shift are partially determined by a country's colonial heritage. [ABSTRACT FROM AUTHOR]

Background: Resource allocation in health is universally challenging, but especially so in resource-constrained contexts in the Global South. Pursuing a strategy of evidence-based decision-making and using tools such as Health Technology Assessment (HTA), can help address issues relating to both affordability and equity when allocating resources. Three BRICS and Global South countries, China, India and South Africa have committed to strengthening HTA capacity and developing their domestic HTA systems, with the goal of getting evidence translated into policy. Through assessing and comparing the HTA journey of each country it may be possible to identify common problems and shareable insights. Objectives: This collaborative paper aimed to share knowledge on strengthening HTA systems to enable enhanced evidence-based decision-making in the Global South by: Identifying common barriers and enablers in three BRICS countries in the Global South; and Exploring how South-South collaboration can strengthen HTA capacity and utilisation for better healthcare decision-making. Methods: A descriptive and explorative comparative analysis was conducted comprising a Within-Case analysis to produce a narrative of the HTA journey in each country and an Across-Case analysis to explore both knowledge that could be shared and any potential knowledge gaps. Results: Analyses revealed that China, India and South Africa share many barriers to strengthening and developing HTA systems such as: (1) Minimal HTA expertise; (2) Weak health data infrastructure; (3) Rising healthcare costs; (4) Fragmented healthcare systems; and (5) Significant growth in non-communicable diseases. Stakeholder engagement and institutionalisation of HTA were identified as two conducive factors for strengthening HTA systems. Conclusion: China, India and South Africa have all committed to establishing robust HTA systems to inform evidence-based priority setting and have experienced similar challenges. Engagement among countries of the Global South can provide a supportive platform to share knowledge that is more applicable and pragmatic. [ABSTRACT FROM AUTHOR]