TY - JOUR

T1 - Thinking politically about intersectoral action

T2 - Ideas, Interests and Institutions shaping political dimensions of governing during COVID-19

AU - Baum, Fran

AU - Musolino, Connie

AU - Freeman, Toby

AU - Flavel, Joanne

AU - Ceukelaire, Wim De

AU - Chi, Chunhuei

AU - Dardet, Carlos Alvarez

AU - Falcão, Matheus Zuliane

AU - Friel, Sharon

AU - Gesesew, Hailay Abrha

AU - Giugliani, Camila

AU - Howden-Chapman, Philippa

AU - Huong, Nguyen Thanh

AU - Kim, Sun

AU - London, Leslie

AU - McKee, Martin

AU - Nandi, Sulakshana

AU - Paremoer, Lauren

AU - Popay, Jennie

AU - Serag, Hani

AU - Thiagarajan, Sundararaman

AU - Tangcharoensathien, Viroj

AU - Villar, Eugenio

PY - 2024/11/18

Y1 - 2024/11/18

N2 - 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.

AB - 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.

KW - Politics

KW - Social Determinants

KW - Health Policy

KW - Equity

KW - Social Inequality

KW - Governance

KW - Policy Analysis

KW - Evidence-based Policy

KW - Institutional Theory

KW - Covid-19

KW - Humans

KW - Public Health

KW - Government

KW - Pandemics

KW - Global Health

KW - COVID-19

KW - SARS-CoV-2

U2 - 10.1093/heapol/czae047

DO - 10.1093/heapol/czae047

M3 - Journal article

VL - 39

SP - i75-i92

JO - Health Policy and Planning

JF - Health Policy and Planning

SN - 0268-1080

IS - Supplement_2

ER -