Political Capacity for Pandemic Response

• In Event: Pandemic Politics, Vaccine Polities: Comparing Outbreaks, Eras, and Geographies

Abstract

A pandemic similar to COVID-19 has been predicted for years—by everyone from the World Health Organization to the U.S. National Academy of Medicines to Bill Gates. This has led to extensive analysis about which countries have the greatest capacity to respond to a pandemic. Public health, social science, and international organization have offered clear answers, with multiple high-profile measures to compare countries on their “preparedness” to respond to disease outbreaks. During COVID-19, however, all of these measures failed to predict the countries that responded most effectively and those that failed to do so. We argue this stems from measures and discussions about global health security and preparedness that fail to take account of critical comparative political factors.

We look at COVID-19, AIDS, Ebola, and Zika to construct a definition and model for “political capacity” in pandemic response which might better predict and explain the effectiveness of government response. We build on qualitative data from case-studies in South Africa, Brazil, South Korea, Thailand, the US and UK to understand the factors that drove government responsiveness or lack thereof in the face of cross-national infectious disease outbreaks. We include in this framework exploration of factors often suggested as variables in quantitative study (e.g. regime type) as well as more granular exploration of historical and institutional factors such as racism and economic inequality, recent experience with infectious diseases, relative political power of health-sector actors, and relationships between national governments and international institutions.

This work brings key insights from comparative politics and international relations to fill a surprising gap in global public health understanding. Following the SARS outbreak in 2003, UN member states revised the International Health Regulations in numerous ways, including a commitment by all to strengthen eight core public health and disease response capacities. Official Joint External Evaluations (JEEs), academic-think tank collaborations like the Global Health Security Index, and various World Bank and World Health Organization efforts have all sought to explain capacity. With none succeeding in explaining COVID-19 we argue a new concept of “capacity” is needed for both scholarship and practical purposes.

Authors

• Matthew Kavanagh, Georgetown University

• Renu Singh, Hong Kong University of Science and Technology