The global COVID-19 crisis has emphasized the close relationship between health and governance. Countries’ experiences with the disease during the previous several months have been shaped not just by the capacity of hospitals, the sophistication of contact tracing technology, or the effectiveness of test kits, but also by the decisions of local and national government officials, the responses of citizens, private sector and media, as well as the level of coordination and cooperation between all those governance system actors.
At the same time, the pandemic is testing the resilience of governance systems to crisis and conflict. It is sparking violence along pre-existing fault lines, triggering political upheaval and exacerbating economic and social inequalities. It is also activating formal and informal community networks, mobilizing individuals and organizations to serve those in need and uniting people around a common purpose.
Health and governance influence each other in many ways, but the COVID-19 pandemic has highlighted some important factors in resilience: trust, inclusion, social cohesion and local autonomy.
Trust
Whether or not people cooperate with public health directives such as physical distancing is related to the degree by which they trust the heath institutions, media outlets, government agencies or political leaders delivering the message, especially when there are multiple conflicting messages about the virus.
For example, the government of Sudan, in the midst of a tenuous political transition, is struggling to counter misinformation about unproven remedies like acacia seeds, and messages from opposition figures who call for defiance against physical distancing and claim the government has fabricated the crisis.
While trust influences the epidemiology of COVID-19, the pandemic is in turn shaping affected communities’ trust in the government, private sector, health care sector and fellow citizens.
South Korean officials made a commitment to transparency and regular information-sharing with citizens, and, as evidenced by the recent landslide victory of the ruling Democratic Party, fostered trust in the government. In other countries we are seeing public trust erode in the face of ineffective responses, whether in government institutions directing the response or businesses that fail to adequately protect their employees.
Inclusion
Exclusion and inequality are exacerbating the severity and the spread of COVID-19. Where access to health care, running water and safe places to isolate are limited to the elite, the disease will continue to spread among the population.
While San Francisco has a relatively low caseload in comparison to other U.S. cities, it saw an outbreak of 70 new cases at a homeless shelter. With a large homeless population and fewer places for them to shelter, the city may see its number of COVID-19 cases increase regardless of the physical distancing directives in place.
Social and economic disparities are likely to widen in the wake of COVID-19. In countries like Cameroon or cities like Lagos, where the governments instituted strict lockdowns, small business owners are at particular risk of economic loss—many of these micro-entrepreneurs are unregistered and unlikely to receive any support from relief packages or tax benefits.
Social Cohesion
The pandemic has provided numerous examples of communities coming together to provide support to people in need.
In the United Kingdom, mutual aid groups have come together to deliver meals to health professionals, help neighbors get groceries or medicine, or provide entertainment to families trapped in their homes. In Brazil, volunteers are working to raise awareness of hygiene and distancing in the favelas, and others are distributing cleaning supplies.
This kind of cooperation results in better distribution of services to people in need and also has helped bolster morale and build trust.
However, in other communities COVID-19 is exacerbating conflict and xenophobia. Instances of incendiary anti-Muslim rhetoric are rising in India amid growing Hindu nationalism. Chinese immigrants, and people of Asian descent more broadly, are being blamed for carrying the virus and have been subjected to heightened discrimination and violence in Italy, the United States and other countries.
Local Autonomy
The COVID-19 crisis has also highlighted the importance of local government, and of effective coordination among local, regional and national government agencies.
Until late March, President Andrés Manuel López Obrador encouraged Mexicans to continue their normal lives, while concurrently states and cities instituted a variety of physical distancing and control measures of their own, contributing to an uneven response to the crisis and conflicting public health messages for citizens. In the United States, poor intra-government coordination has exacerbated competition over personal protective equipment and ventilators between states, cities, and the federal government.
Local leaders have also demonstrated their key role in mounting an effective and timely response to the pandemic. In decentralized or federalist countries, like the United States, Mexico and Nigeria, municipal governments and state governors have often been ahead of their central governments in instituting quarantines, lockdowns or other control measures.
Being closer to their communities, these leaders are more immediately aware of the threat the disease poses to their constituents, and they are also more directly accountable to their constituents for a slow or inadequate response to the pandemic.
Maggie Proctor is a Program Manager, Governance and Community Resilience Practice Area, at Creative Associates International.