Despite MOUD being the standard of care for opioid use disorder, access remains severely limited in Community Mental Health Centers (CMHCs), which serve the primary population with co-occurring disorders. A Design Lab pilot identified payment limitations and regulatory complexity as the chief barriers to implementation. The most feasible and high-impact strategy identified was establishing a structured learning exchange between CMHC leaders and insurers to improve reimbursement understanding. Policymakers and payers are therefore advised to pilot this learning exchange model to initiate broader payment reform and expand evidence-based care for this vulnerable population.
South Asia’s Gen Z revolutions now face difficult realities
English Summary
Youth-led protest movements that toppled governments in Sri Lanka (2022), Bangladesh (2024), and Nepal (2025) have produced new administrations with strong mandates but mounting governance challenges. All three countries face economic strain from IMF bailouts compounded by the Iran war's inflationary pressures and fuel shortages, while inexperienced leaders are struggling to deliver on anti-corruption and reform promises. Relations with India present both opportunities—particularly in energy and humanitarian aid—and risks from border tensions and identity politics under the BJP's expanding regional footprint. The convergence of internal fragility and external shocks means these post-revolutionary governments could squander their democratic renewal windows if structural reforms stall.
中文摘要
青年主導的抗議運動先後推翻了斯里蘭卡(2022年)、孟加拉(2024年)及尼泊爾(2025年)的政府,催生了擁有強大民意授權但面臨日益嚴峻治理挑戰的新政權。三國均承受國際貨幣基金組織紓困方案帶來的經濟壓力,加上伊朗戰爭引發的通膨壓力與燃料短缺,使局勢雪上加霜;與此同時,缺乏經驗的領導人正艱難地兌現反腐與改革承諾。與印度的關係既帶來機遇——特別是在能源與人道援助領域——也因邊境緊張局勢及印度人民黨擴大區域影響力下的身分政治而存在風險。內部脆弱性與外部衝擊的交匯意味著,若結構性改革停滯不前,這些後革命政府可能將錯失民主更新的窗口期。
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