14
Jan

The COVID-19 pandemic affects societies at all levels – it is not unique to health. It has highlighted the need for specific governance patterns to ensure an efficient response to the epidemic while minimizing the collateral effects on other segments of society or the economy. Many countries are now thinking about the “after”, about building back better. We must reflect on what types of governance mechanisms are needed for pandemic preparedness and resilience at all levels: global, national and subnational – drawing the lessons from current structures, frameworks, responses and solutions. Identifying lessons learned from the first months of the pandemic is the first step before being able to think about creative innovative mechanisms for health and pandemic preparedness governance.

At the global level, the pandemic has highlighted the need for specific mechanisms such as public-private partnerships for the equitable access to essential supplies, diagnostics, treatments and vaccines. Questions are raised around emergence of nationalisms, limiting multilateralism approaches and the power given by States Parties to multilateral organizations. Another issue is that some recommendations by international organisations (such as the WHO) are not followed in times of emergencies, which could undermine trust and legitimacy of such organizations.

At national level, we witnessed lack of preparedness and ad-hoc nature of decision, even for countries with high preparedness index score. In times of unknowns and uncertainties, balancing health objectives and socio-economic impacts was difficult for many countries, of which some tried to “buy time” to strengthen readiness. There were some gaps in protecting some specific vulnerable populations and taking into consideration their needs and the disproportionate impact of the disease on them. This makes us reflect on what would be the appropriate levels of inclusiveness and multi-disciplinary needed for decision-making. Crises and emergency times may also be opportunities for governments to justify extreme measures and strong mechanisms must exist to fight corruption or abuse of authority.  Ensuring state continuity is also often at stake during emergencies.

At subnational level, it would be important to understand what governance is most efficient to implement a whole of society approach at local level, including communities and private sector, and what would be ideal relationships between rural and urban areas. Regional cooperation mechanisms are also important to study.

At all levels, questions are raised around evidence-based policies, processes, systems, regulations and operations. Key recurring themes are inclusiveness, accountability, transparency, flexibility, effectiveness, trust and resilience. Another recurring issue we face at all levels is financing and the chronic underfunding and underinvestment in global health and pandemic preparedness.

The COVID-19 pandemic affects societies at all levels – it is not unique to health. It has highlighted the need for specific governance patterns to ensure an efficient response to the epidemic while minimizing the collateral effects on other segments of society or the economy. Many countries are now thinking about the “after”, about building back better. We must reflect on what types of governance mechanisms are needed for pandemic preparedness and resilience at all levels: global, national and subnational – drawing the lessons from current structures, frameworks, responses and solutions. Identifying lessons learned from the first months of the pandemic is the first step before being able to think about creative innovative mechanisms for health and pandemic preparedness governance.

At the global level, the pandemic has highlighted the need for specific mechanisms such as public-private partnerships for the equitable access to essential supplies, diagnostics, treatments and vaccines. Questions are raised around emergence of nationalisms, limiting multilateralism approaches and the power given by States Parties to multilateral organizations. Another issue is that some recommendations by international organisations (such as the WHO) are not followed in times of emergencies, which could undermine trust and legitimacy of such organizations.

At national level, we witnessed lack of preparedness and ad-hoc nature of decision, even for countries with high preparedness index score. In times of unknowns and uncertainties, balancing health objectives and socio-economic impacts was difficult for many countries, of which some tried to “buy time” to strengthen readiness. There were some gaps in protecting some specific vulnerable populations and taking into consideration their needs and the disproportionate impact of the disease on them. This makes us reflect on what would be the appropriate levels of inclusiveness and multi-disciplinary needed for decision-making. Crises and emergency times may also be opportunities for governments to justify extreme measures and strong mechanisms must exist to fight corruption or abuse of authority.  Ensuring state continuity is also often at stake during emergencies.

At subnational level, it would be important to understand what governance is most efficient to implement a whole of society approach at local level, including communities and private sector, and what would be ideal relationships between rural and urban areas. Regional cooperation mechanisms are also important to study.

At all levels, questions are raised around evidence-based policies, processes, systems, regulations and operations. Key recurring themes are inclusiveness, accountability, transparency, flexibility, effectiveness, trust and resilience. Another recurring issue we face at all levels is financing and the chronic underfunding and underinvestment in global health and pandemic preparedness.