The COVID-19 pandemic led to unprecedented challengesand political creativity worldwide. In governance, this often led to unexpected centralisation and decentralisation in response to case surges. Changes in the distribution of power and responsibility throughout governments changed quickly as the pandemic progressed. Centralisation and decentralisation occurred within governments and between governments, as power shifted. The main explanation for the patterns of centralisation and decentralisation is the politics of credit and blame. Politicians at all levels seek to centralise when there is credit to be had from forceful action and decentralise when there are unpopular policies or bad news coming.
No-one is safe until everyone is safe. But what can be donewhen a country fails to take measures to control a pandemic virus? It poses a threat to its own people but also to its neighbours and beyond. Countries do pool sovereignty, working through supra-national structures, such as international agencies, or using processes set out in treaties, recognising the mutual benefits of the international rules-based system. Here we review the ways in which governments have, or have not worked together on other issues that pose a threat to global health and discuss the implications for pandemic responses.
The COVID-19 pandemic has taught us that preparednessfor and resilience against health emergencies is critical. To improve preparedness for health emergencies, the emergency preparedness and response governance architecture at all levels should be strengthened. It should be based on cross-cutting, whole-of-government, and whole-of-society approaches, moving away from siloed perspectives. Moreover, resilience against health emergencies should be based on universal health coverage and anchored in the International Health Regulations (IHR) 2005 core capacities implementation. Capacities and capabilities that are required to improve health services for national and global health security should also be strengthened.
The impact of the COVID-19 pandemic on countries in theEuropean Region has been devastating with substantial morbidity and mortality and broader societal and economic effects. This in part reflects poor public health leadership and politicised responses but more importantly, a failure to account for social disparities. The stop- start pattern of Public Health and Social Measures further exacerbates the disproportionate impact on those most vulnerable. A Health in All Policies lens offers an indication of the type of coherent multisectoral thinking needed to address these social disparities in the COVID-19 context as well as in pandemic planning measures going forwards.
No-one is safe until everyone is safe. But what can be done when a country fails to take measures to control a pandemic virus? It poses a threat to its own people but also to its neighbours and beyond. Countries do pool sovereignty, working through supra-national structures, such as international agencies, or using processes set out in treaties, recognising the mutual benefits of the international rules-based system. Here we review the ways in which governments have, or have not worked together on other issues that pose a threat to global health and discuss the implications for pandemic responses.
