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Governance of the Covid-19 response: a call for more inclusive and transparent decision-making
  1. Dheepa Rajan1,
  2. Kira Koch1,
  3. Katja Rohrer1,
  4. Csongor Bajnoczki1,
  5. Anna Socha2,
  6. Maike Voss3,
  7. Marjolaine Nicod2,
  8. Valery Ridde4,
  9. Justin Koonin5
  1. 1 UHC2030 Partnership and Health Systems Governance Collaborative, World Health Organization, Geneva, Switzerland
  2. 2 UHC2030 Partnership, Geneva, Switzerland
  3. 3 German Institute for International and Security Affairs (SWP), Berlin, Germany
  4. 4 CEPED, Institute for Research on Sustainable Development, IRD-Université de Paris, ERL INSERM SAGESUD, Paris, France
  5. 5 AIDS Council of New South Wales (ACON), Surry Hills, New South Wales, Australia
  1. Correspondence to Dr Dheepa Rajan; rajand{at}who.int

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Summary box

  • Not all countries make their Covid-19 task force membership list public—the available information varies by country.

  • There is currently a predominance of politicians, virologists and epidemiologists in the Covid-19 response at the country level.

  • Experts on non-Covid-19 health, social and societal consequences of Covid-19 response measures are, for the most part, not included in Covid-19 decision-making bodies.

  • There is little transparency regarding whom decision-making bodies are consulting as their source of advice and information.

  • From the available data on Covid-19 decision-making entities, female representation is particularly paltry.

  • In addition, civil society is hardly involved in national government decision-making nor its response efforts, barring some exceptions.

  • We need to be more inclusive and multidisciplinary: the Covid-19 crisis is not simply a health problem but a societal one—it impacts every single person in society one way or another.

  • Decision makers need to address more systematically the suffering from mental illness exacerbations, domestic violence, child abuse, child development delays, chronic diseases and so on, during lockdown.

Introduction

As SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) ravages the globe, heads of state are making swift decisions to put large swathes of the world’s population under mass isolation in the race to heed off Covid-19’s lethality, particularly in certain population subgroups. How are these decisions—that affect each and every one of us, some groups disproportionately and regardless of Covid-19 status—made? How far have policy makers and politicians consulted those who have experience and expertise on the secondary effects of lockdowns, social isolation measures and movement restrictions?

We attempted to address these questions with a rapid analysis of 24 countries’ Covid-19 task force compositions. The countries were selected to represent a range of geographies and income levels. As far as possible, we focused on governance bodies set up or activated to give scientific, or evidence-based, advice to …

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