TY - JOUR T1 - Building back fairer in public health policy requires collective action with and for the most vulnerable in society JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-005555 VL - 6 IS - 3 SP - e005555 AU - Lucia D'Ambruoso AU - Pamela Abbott AU - Agnes Binagwaho Y1 - 2021/03/01 UR - http://gh.bmj.com/content/6/3/e005555.abstract N2 - Summary boxThe COVID-19 pandemic reveals how public policy is shaped by a ‘competition for ideas’, where problems are raised and framed differently by different actors located within hierarchies of power, networks and resources.Despite statistical data revealing inequalities in the distribution of burden and risk, it remains relatively uncommon to amplify the voices of those most directly affected.The pandemic has also revealed monopolies of knowledge production, with global burdens estimated by institutions in the global north developed through methodologies that lack transparency, this disempowers low-income and middle-income countries.In many so-called developed democracies, the responses to the pandemic have been inadequate with cutbacks to health and social services limited commitment to equity in leadership and poor governance, ensuring some issues make it onto policy agendas while others are suppressed.Building and maintaining equitable and resilient health systems reconciling COVID-19 with high-quality, timely care for all people, with and without COVID-19, and particularly vulnerable groups requires community voices to be regarded as critical sources of evidence for policy learning.During the COVID-19 pandemic, politicians have repeatedly used rhetoric that ‘we’ (they) have to ‘follow the science’, justifying their actions as rational. Political science provides a more complex picture, in which public policy is shaped by a ‘competition for ideas’, with problems raised and framed differently by different actors located within networks of power, interests and resources.1 From this perspective, it is possible to appreciate why alternative arguments get little attention.In this commentary, we argue that community intelligence has not featured sufficiently in state responses to COVID-19, and that building resilient health systems with high-quality, timely care for all people, with and without COVID-19 must incorporate the voices of those most disproportionately affected as legitimate sources of knowledge and action.COVID-19 reflects and exacerbates existing social inequalities. Within and between … ER -