Global health leaders must look beyond technological solutions says a new report published today by the Institute of Development Studies.
Three years on from the declaration of the Covid-19 pandemic, experts are warning the global health community to think beyond vaccines and lockdowns, proposing investment in a radical, five-point action framework for pandemic preparedness which responds to people’s experiences, knowledge and needs.
Growing body of social science research
Based on a large and growing body of social science research undertaken during and since Covid-19, in locations from urban Northwest London to rural Zimbabwe, the Pandemic Preparedness for the Real World report reveals failures in the conventional approaches to pandemic preparedness.
Lurching from crisis to crisis, top-down in delivery and reliant largely on technological ‘solutions’, these approaches failed to protect the most vulnerable during the Covid-19 pandemic, including those marginalised by geography, poverty, religion, ethnicity and gender.
Team of senior academic authors
The report, co-authored by a team of senior academics from the Institute of Development Studies, including former World Health Organization (WHO) and UK Government advisers, calls on world leaders to look beyond the conventional staples of the public health toolkit as they draw up a new WHO global treaty on pandemics.
It identifies a better way forward for preparedness rooted in community initiatives from Brighton to Brazil which are tailored to local contexts and inclusive of diverse people.
Professor Melissa Leach, Director of the Institute of Development Studies and co-author of the report, said:
“Pandemics are as much social as they are biomedical in origin. They are about how people act and react, their relationships with their communities and health workers, and trust in political leaders.
“The uncertainty of disease outbreaks and the often-unpredictable nature of the settings in which they take place mean we need a new approach to preparing for pandemics which recognises and acts on this basic point.
“The world’s response to Covid-19 resulted in huge differences in outcomes, such as an uneven global distribution of vaccines and increased death rates among the most marginalised. Pandemic Preparedness for the Real World argues that a reoccurrence of such vastly inequitable outcomes can be guarded against in future diseases crises. But it is necessary to act now.”
Five action points
The report’s authors argue that social, economic and political issues must be as core to the pandemic preparedness agenda as biological ones. They call for investment across five key action areas:
- Professionals. Investment in ‘reliability’ capacity of health professionals and others working in critical infrastructures in health, such as nurses.
- Knowledge. Mechanisms such as citizens’ panels to ensure diverse knowledge, expertise and perspectives are prioritised and integrated.
- Resilience. Reform of health, social and other systems and structures to be accessible to all and support people’s resilience to disease crises.
- Institutions. Decentralising decision making, empowering local authorities and challenging entrenched interests so people’s trust in politics and state institutions can be renewed.
- Ethics. Embedding social justice and equity throughout preparedness.
Such measures would ensure more equitable, ethical and effective preparedness and thus response. They would also contribute to addressing some of the major social injustices in the world today.
The report includes examples of the failures of pandemic planning ahead of Covid-19, including in the UK where outbreak modelling and planning assumed wrongly that influenza would be the next big disease outbreak.
Stories of success to learn from include a community-based monitoring system in Brazil which demonstrated that recently contacted indigenous peoples needed a differentiated approach to health service delivery, and a surplus food distributor in Brighton whose extensive local networks and knowledge enabled it to scale up effectively during the pandemic period.
One organisation in Mumbai was able to offer prevention information and food provision during Covid-19 by incorporating these pandemic responses only thanks to its existing women’s and children’s health programme.
Professor Leach continued:
“The IDS team has identified how preparing for future pandemics in a fairer way converges with broader development aims, such as reducing poverty and inequalities and peacebuilding. If global leaders take note, we can go some way towards building not just a world better able to handle future disease shocks, but also a better world.”