Author: Aleem Walji, Former Chief Executive Officer at Aga Khan Foundation U.S.A. Aleem has also held senior leadership roles at the World Bank and Google.org.
While it’s too early to develop definitive policy prescriptions in the face of an unfolding global pandemic, there are things we can learn in real time from COVID-19 and our response to date.
Here are 11 that come to mind for policy makers, the private sector and civil society:
- The world is so interdependent that disease anywhere can create dis-ease everywhere. Go-it alone approaches don’t work and are dangerous in the face of a global scourge that transcends geographic boundaries, social and economic divides. Germs level the playing field and remind us that ensuring the health and wellbeing of every person is both morally right and in our collective self interest. His Highness the Aga Khan in 2010 remarked, “Almost everything now seems to ‘flow’ globally – people and images, money and credit, goods and services, microbes and viruses, pollution and armaments, crime and terror”. He alerted us then that none of us live on an island.
An effective response to COVID-19 anywhere has to involve multiple stakeholders including Government, the private sector, civil society, faith-based groups, and multilateral organizations for starters. A coalition has to be multi-country, multi-sector and multi-year. While governance of such an alliance will not be easy, this is the moment to strengthen coordination and demonstrate how collaboration builds more resilient systems.
National and International institutions like the Center for Disease Control (CDC), the World Health Organization (WHO) and the United Nations High Commission for Refugees (UNHCR) have an outsized role to play at times of crisis precisely because their role is to share information and provide support as widely and quickly as possible in the interest of communities everywhere.
- Pre-emptive planning and disaster preparedness is the best medicine. Investing in strong health systems is a precondition to saving lives in the face of a health crisis. This means investing in epidemiology, early warning systems, data collection, analytics, and securing access to emergency supplies before they are needed. It means training doctors, nurses, and community health workers to respond to crises and building surge capacity when demand exceeds supply. Strong public health systems in Nigeria are just as important as Louisiana in a globalized world. We need to invest in both. While we shore-up expertise and strengthen local supply chains, we must also resource transnational institutions so they can respond quickly wherever they are needed. While we cannot prevent low-probability, high-impact events from happening, we can plan for them and minimize damage when they occur.
- Consistent messaging from leaders is critical to behavior change. At times of crisis, people understand the need for directive leadership and expect their leaders to level with them and make decisions based on the best information they have. It’s equally important to be clear on what we don’t know and not pretend to know all the answers and repeatedly change course. Crises are times to draw upon the best expertise we have wherever it lies and put aside divisive politics and grandstanding. This is when we put people above party and parochial interests. Behavior change is hard but citizens respond to clear and consistent messaging when so much is at stake. Our new normal will require new models to increase connectivity, retain human connection and protect our health. The potential for misinformation to spread as fast if not faster than the virus is real. Civil society, government, news and social media platforms need to work together to counter false narratives and ensure all people have access to timely and trustworthy information to inform their attitudes and behavior.
- Civil society institutions step up at times of crises. Necessity unlocks human innovation, creativity and the ability to develop local solutions to local problems. The most powerful lever a government can pull is enabling people-led institutions to problem-solve alongside public and private actors. Examples range from setting-up neighborhood food pantries to retrofitting scuba gear as ventilators to 3D printing masks, face shields, and emergency medical equipment. When people know what is needed, they step-up, innovate and bootstrap with the resources they have. Sometimes the best thing governments and funders can do is to frame problems clearly, set targets and invite solutions from anyone anywhere to be tested, adapted and scaled if they work.
- Government, business and civil society must work together to achieve what is best for society rather than narrow self-interests. Profit drives business behavior in capitalist societies but businesses led by enlightened self-interest realize that when citizens and societies falter, businesses lose customers, markets crash and long-term profits decline. Today, factories across the world are being repurposed to manufacture personal protective equipment, pharmaceuticals are collaborating to fast-track a vaccine, and philanthropies are working with the private sector to launch a therapeutic accelerator. In these moments, we pull together around total societal impact rather than parochial interests. Each group has a role to play in building a more resilient and inclusive society. The challenge is how to remember that lesson when we move to a new normal.
- Technology and Data are Enablers Not Solutions. Epidemiologists, immunologists, and data scientists are modeling the spread of the virus in real time: what’s happening, where it’s happening, and what we must do to save lives by ‘flattening the curve’. Tech companies are deploying geospatial data and machine learning to ‘contact trace’ the virus and determine where it’s speeding-up and where it’s slowing down. But algorithms are only as good as the data they ingest. Data gaps and inaccurate assumptions limit our predictive capacity: think of the number of people not tested for COVID-19 globally, the challenge of testing in low-resource settings and what happens if recovery does not mean permanent immunity. Privacy concerns around sharing location-based information and developing disease registries are serious. Ethical considerations abound because technologies are embedded within broader systems of power. Our ability to channel them for good depends on the incentives and motivations of those who control them. Global and local civil society institutions must have a voice in determining what data is permissible to share in emergency situations and what constitutes overreach and intrusion now and in the future.
- Savings lives and saving livelihoods both matter. Choosing between lives and the economy is a false choice. We need both to survive and thrive. The first order of business has to be the preservation of life. It is both a moral imperative and essential for long-term economic and social well being. But livelihoods matter and people without jobs and income, without health insurance, benefits, and social safety nets cannot contribute to economic health. The Prime Minister of Pakistan recently warned, ‘we might save our people from Corona today but they will die of hunger tomorrow’. Public, private and social institutions need to strengthen safety nets while reigniting local enterprises and resuscitating businesses on life support. Small businesses create millions of jobs and urgently need financial assistance to weather the storm and strengthen their economic foundations. Further investment in health, education, livelihoods and civic institutions will be needed in the medium to long term as they are the surest pathway to prosperity over the long haul.
- Low paid workers are not low-skilled workers. The quiet heroes of this crisis are front line health workers but also grocery store, warehouse, and pharmacy staff, food delivery people, trash collectors, cleaners, mailmen and women, law enforcement officers, elderly caregivers, the list goes on. They are a fundamental rubric of our society. How do we ensure their health and wellness after the crisis passes? More than ever we appreciate teachers and how they shape the future of our children and our societies. As we all juggle work, childcare, and our children’s education directly, we can appreciate how the most vulnerable in our society do this everyday and have the fewest resources to do so. Building safety nets is essential to counter glaring inequality, vulnerability and exclusion in a post COVID world.
- Our challenges are interrelated and require systems approaches to solve them. Disease, climate, health and the economy are not discrete phenomena: they are interrelated. Biodiversity saves species but also enhances human health and quality of life. As more of our world is susceptible to drought, loss of land due to sea level rise and snowmelt, the spread of disease is accelerated and impacts our economic health. To fight pandemics, we need to understand the social, economic, and political consequences of the decisions we make, directly and indirectly, and the price we pay for short-term wins over long-term gains. Complex systems create interdependencies that are under-appreciated until crises strike. This is why we need integrated approaches and systems thinking to address our most complex problems.
- Fast-moving crises should remind us of the importance of countering long-term and slower-burning crises. Crises create new vulnerabilities but they also highlight and exacerbate existing vulnerabilities. Millions of New Yorkers will get food from more than 800 pantries in the months to come but 1.4m people depended on food assistance before the virus. Crises bring into high relief inequities in our society and provide fresh perspective on broken systems. We are already seeing the disproportionate impact on Black and Hispanic communities in the US. We live in a world where a $400 unexpected expense in the richest country on earth can plunge 100m people into poverty. More than 500m people may fall into poverty across the globe this year. Few governments can inject millions let alone trillion dollars of economic relief into their economies. What happens to our safety and security if COVID-19 overwhelms parts of Africa, Asia and Latin America preying upon weak health systems, poor governance, high population density and high rates of poverty? Unless we support these countries, the threat of viral rebound remains. Rapid, low cost and early testing comes to mind, self-triage, access to water and hand washing stations and thinking through what physical distancing and isolation looks like in slums and refugee camps. The fate of more than 70m refugees and internally displaced people will be impacted by how we prepare now. This is not a time for fiscal distancing as the virus will boomerang if we’re not vigilant.
- Crises give us permission to rethink and reshape our societies. The eruption we call COVID-19 presents an opportunity to reshape institutions and redirect resources with broader societal interests in mind. We can make different choices about the kind of world we want to live in. What are public goods and what happens when we define them too narrowly (eg who gets health insurance, paid leave or access to job retraining)? When it comes to public health, how much should we invest in preventative care and what resources should flow to the federal, state and local levels? What personal data should governments and the private sector control and under what conditions? Google recently made aggregate data related to human mobility publicly available for more than 100 countries. Should this continue post COVID and who decides? Are we prepared to confront the indirect costs of climate change given its health and economic consequences? When do global supply chains serve us and what are the strategic goods and services that we must be available quickly and locally (think PPEs, medical equipment, medicine and food)? Exponential technologies like 3D printing and blockchain can help secure local supply chains but how do we mitigate the risk of ‘un-infectable’ robots and AI displacing workers not equipped for a digital economy? These are fundamental questions to debate today and in the months ahead. Time and tragedy create rare opportunities to make different choices with the benefit of real life experience. Are governments, corporates and the social sector up to the challenge?
Our shared goal must be to build a more resilient global system composed of resilient nations and communities. That will require investing in emergency preparedness and response, building stronger civic-minded institutions to accelerate recovery, and recognizing the interrelated nature of the environment, health systems, social systems, and economic well being.
We are only as strong as the most vulnerable amongst us. We have to work across divides to build local and global systems that are more inclusive, flexible, and fair.