Production for export: the role of the state in the development and operation of global care chains

In its focus on different forms of public and private agency within the global (care) economy, global care chains (GCC) analysis has tended to neglect the role of the state in the development of GCCs. Through a focus on GCCs involving nurses – global nursing care chains (GNCCs) – this article aims to contribute to bridging that analytical deficit. It argues that state strategies to develop an export industry in healthcare labour constitute a major input into the formation and operation of GNCCs. Proceeding through a review of state export‐oriented production strategies across Asia, it explores key aspects of states' emphasis on nurse labour export as an economic development strategy, and demonstrates the importance of the state in three main ways: firstly, through the management and promotion of female migration; secondly, through the development of nurse education involving public‐private partnerships, and thirdly, through a concern to ensure the ‘product quality’ of the nursing labour it exports. In promoting the export of nurses, Asian states are not only prioritising dubious economic development policies over national health development policies, but they are also implicitly prioritising the health systems of foreign countries over their own health systems and their population's health.