Thinking politically about intersectoral action: Ideas, Interests and Institutions shaping political dimensions of governing during COVID-19
This research article analyzes the political factors influencing 16 nations' responses to the COVID-19 pandemic. Utilizing a qualitative case study approach and a "three Is" framework (institutions, ideas, interests), the study examines how political systems, ideologies, and the interests of various actors shaped pandemic management.
College of Health researcher(s)
College unit(s)
Abstract
Our paper examines the political considerations in the intersectoral action that was evident during the SAR-COV-2 virus (COVID-19) pandemic through case studies of political and institutional responses in 16 nations (Australia, Belgium, Brazil, Ethiopia, India, New Zealand, Nigeria, Peru, South Africa, South Korea, Spain, Taiwan, Thailand, Vietnam, UK, and USA). Our qualitative case study approach involved an iterative process of data gathering and interpretation through the three Is (institutions, ideas and interests) lens, which we used to shape our understanding of political and intersectoral factors affecting pandemic responses. The institutional factors examined were: national economic and political context; influence of the global economic order; structural inequities; and public health structures and legislation, including intersectoral action. The ideas explored were: orientation of governments; political actors’ views on science; willingness to challenge neoliberal policies; previous pandemic experiences. We examined the interests of political leaders and civil society and the extent of public trust. We derived five elements that predict effective and equity-sensitive political responses to a pandemic. Firstly, effective responses have to be intersectoral and led from the head of government with technical support from health agencies. Secondly, we found that political leaders’ willingness to accept science, communicate empathetically and avoid ‘othering’ population groups was vital. The lack of political will was found in those countries stressing individualistic values. Thirdly, a supportive civil society which questions governments about excessive infringement of human rights without adopting populist anti-science views, and is free to express opposition to the government encourages effective political action in the interests of the population. Fourthly, citizen trust is vital in times of uncertainty and fear. Fifthly, evidence of consideration is needed regarding when people’s health must be prioritized over the needs of the economy. All these factors are unlikely to be present in any one country. Recognizing the political aspects of pandemic preparedness is vital for effective responses to future pandemics and while intersectoral action is vital, it is not enough in isolation to improve pandemic outcomes.
FAQ: Political Factors in COVID-19 Pandemic Response
What were the primary political factors affecting intersectoral action during the COVID-19 pandemic?
The study examined political dimensions across 16 nations using Hall's (1997) three Is framework:
- Institutions: Countries like Taiwan and South Korea with strong CDCs and past epidemic experience responded more effectively. Federalism had varied impacts - positive in Australia, negative in Brazil and USA.
- Ideas: The pandemic challenged neoliberal ideologies, leading to extensive welfare measures. Countries embracing collective values and scientific evidence fared better.
- Interests: Trust in government and effective communication were vital. Populist leaders who contested scientific consensus undermined responses, while civil society played significant roles in advocacy and support.
Did pre-existing public health frameworks influence a country's pandemic response?
Yes, countries with established public health institutions and legislation, particularly those updated after previous epidemics, like Taiwan and South Korea, were better prepared to respond quickly and effectively. They had the infrastructure, legal tools, and experience to implement measures like contact tracing, testing, and isolation. However, the presence of a CDC did not guarantee success if political leadership disregarded or undermined its advice, as seen in the USA and Brazil.
How did federalism affect pandemic responses?
The impact of federalism varied. In some countries like Australia, the division of powers between federal and state/territory governments facilitated localized responses, while a National Cabinet ensured coordination across sectors. In contrast, Brazil and the USA saw tensions between federal guidelines and state practices, hindering a unified response. South Africa experienced inconsistencies between provinces, reflecting historical inequalities. Federalism's effectiveness depended on the level of cooperation and clarity in responsibilities between different levels of government.
How did global economic inequities affect responses, particularly regarding vaccine access?
Wealthy nations secured vaccine supplies in excess of their needs, while poorer countries faced significant delays and shortages. This inequity reflected existing global power imbalances and the influence of transnational corporations prioritizing profit over global health. The retention of intellectual property rights by vaccine manufacturers inflated prices and restricted access for low-income countries. COVAX, the initiative aimed at equitable vaccine distribution, faced criticism for prioritizing pharmaceutical company interests.
What role did civil society play in pandemic responses?
Civil society organizations played crucial roles in advocating for global vaccine equity, providing direct support to communities, addressing issues like gender-based violence, and pressing for transparency in government actions. Their impact varied based on a country's openness to civil society engagement. In countries with vibrant and active civil societies (e.g., South Africa, India, Brazil), advocacy efforts led to policy changes and increased support for vulnerable groups. However, some governments, like those in Nigeria and Ethiopia, used the pandemic as a pretext to restrict civil liberties and curtail civil society activities.
How did the pandemic affect public trust, and why was trust important?
Trust in government and effective communication from leaders were crucial for public adherence to pandemic measures. Countries with high levels of trust generally saw better compliance with restrictions and uptake of public health advice. Clear, empathetic communication from leaders like Jacinda Arden in New Zealand fostered a sense of unity and collective responsibility. Conversely, leaders who downplayed the severity of the virus or spread misinformation eroded public trust. Low trust, as seen in Brazil and Peru, made it challenging to implement effective measures.
How did political ideologies, particularly neoliberalism, influence responses?
The pandemic challenged neoliberal ideologies that emphasized individual responsibility and limited government intervention. Many countries, including those with traditionally strong neoliberal stances, implemented unprecedented social welfare measures and economic support packages. This shift suggests a growing recognition that a solely market-driven approach was insufficient to address a public health crisis of this magnitude.
Did pre-existing socioeconomic inequities within countries affect pandemic outcomes?
Pre-existing inequalities significantly impacted pandemic outcomes. Disadvantaged groups, including those living in poverty, ethnic minorities, and migrants, consistently experienced higher infection and mortality rates across various countries. Factors such as crowded living conditions, limited access to healthcare, and job insecurity heightened their vulnerability. The pandemic exposed and exacerbated these existing disparities, highlighting the urgent need for policies addressing social determinants of health.