This blogpost is part of the Covid-19 Governance Mapping initiative, a collective effort to document the structures of national decision-making in the world’s Covid-19 response, and the actors involved. Together with experts from The Collectivity and a team of researchers, the project gathered data on over 20 countries, mostly for the period between April and July 2020. That data is public, and the blog series provides a first analysis of the findings.
Advisory committees to governments exist on all levels, from international, to national and regional levels. At the international level the World Health Organisation (WHO) provides guidelines that are taken into consideration by the majority of countries. Besides this advice, many governments have sought technical, scientific and expert advice from within as well as outside of the government. Often these actors are directly appointed by heads of state. Who is considered valuable for advice illuminates whose voices are heard and taken into consideration when making decisions and shaping regulation.
Our data from April to July 2020 shows that government advisory groups differ in their make-up, depending on the context of the country. In most countries advisory groups include health experts advising on public health decisions. In the Netherlands, the Outbreak Management Team consists solely of health experts, and is convened by the Centre for the Control of Infectious Disease (RIVM) to advise the Ministry of Health, Welfare and Sport on national policy-making. In Turkey, the Ministry of Health set up a group of medical scientists to come together on the Coronavirus Scientific Advisory Board. The board reports to the Health Minister, and policy measures are carried out by the government. In Germany the Covid-19 advisory team consists of actors beyond the health sector: members come from six different ministries and hence advice is sought on the pandemic’s impact beyond health. However, noteworthy is that all members come from within the government.
Not all countries have appointed advisory committees. This is important to be cognisant of, as we are increasingly seeing that decisions made to address Covid-19 have far-reaching consequences for societies at large, and some parts of the population are not represented well enough. As such, the outcome of these policies can be traced back to who was consulted or not during decision-making processes. This will offer lessons for future crises on whose voices need to be heard to respond in a comprehensive manner. Our data shows that the governments of Malawi, Mauritius, and Thailand, among other countries, had not taken advice from special committees during decision-making processes during that April-July 2020 period. This sheds light on the exclusive nature of the government and the lack of opportunities for external actors to have a seat at the table to shape and influence regulations in an emergency context.
The majority of countries have established or activated special task forces to respond to the pandemic. These are often set up temporarily for emergency reasons to study the issue at hand. Our data shows that these committees primarily comprise a selection of ministers or their representatives, often appointed by the president or prime minister, to enable intersectoral dialogue and decision-making. Health ministers are often included in these groups, but they are not necessarily leading the decisions. It is not entirely clear how these members are appointed, and there seems to be a lack of transparency on the selection criteria of members. Interestingly, oftentimes task forces especially established for the Covid-19 crisis are not organised by law. Given the urgency of action required in current conditions, this means that these entities have in the majority of cases been granted emergency powers without a legal basis. If committees are not organised by law, interesting questions come up on if legal frameworks are taken into consideration at all, and what systems of checks and balances are in place to forego the potential exploitation of emergency powers.
We’ve also seen some challenges to the existence and capacities of Covid-19 committees and task forces. In Sudan, whose government was in transition, many health professionals called for the Minister of Health to resign due to his mismanagement of the pandemic response. In the timespan of one month, the Minister of Health fired the majority of his senior staff, including several directors of professional health entities, on the basis of insubordination and incompetence. An ensuing internal conflict between the Minister of Health and his opponents has led to the near removal of the Ministry of Health from the taskforce (submitted by the Representative of Sovereignty Council), as well as a string of resignations of the Federal Ministry of Health in May 2020, due to a lack of structured decision-making and the absence of democracy.
In Malawi, growing critiques led to a reshuffling of the committee. The Special Cabinet Committee on Covid-19, established in March 2020 by President Mutharika, was formed to circulate recommendations on proactive health measures to mitigate the virus. The committee comprised eight cabinet ministers and was chaired by the Minister of Health, who lacked training and experience in the health sector. Increasing criticism over its handling of the pandemic, the committee was dissolved by Mutharika and replaced with a Presidential Task Force consisting of 21 members, including public health experts as well as various other key stakeholders such as the influential Christian Health Association of Malawi (CHAM), and the Chief’s Council.
In some exceptional cases, less typical government councils are taking crisis decisions. In Lebanon, the Higher Defense Council recommends measures to the cabinet regarding the health crisis. This of course has to be viewed against the backdrop of a combination of economic, political and humanitarian crises and the resulting security risks during which the pandemic arrived.
Some governments have reinvigorated pre-existing entities to deal with the emergency. These committees pre-date the crisis and were set up to deal either with emergency situations in general, or health crises in particular. In Mexico, the National Committee for Health Security already existed before the Covid-19 virus broke out. It has dealt with pandemic influenza before (H1N1 in 2009) and is now in charge of the analysis, definition, coordination, monitoring and evaluation of policies, strategies and actions in facing Covid-19. Preceding conditions of the Covid-19 emergency, this Committee had been organised by law which allowed a legal mechanism to dictate measures at a national level to manage and investigate the Covid-19 outbreak. Similarly, in Uganda, besides the creation of the National Task Force on Covid-19, consisting of representatives of multiple ministries, pre-existing district task forces that played a significant role in coordinating support during the 2001 Ebola outbreak were called into play to respond to Covid-19. In both countries, these forces were relatively better prepared to address a sudden health emergency.
In short, our data shows that a range of different actors are engaged globally to seek advice from, both within and outside of the government. We also see that special task forces typically unite (some) politicians on a ministerial level, but are (almost by definition) not a democratic representation of the people, meaning powers of decision-making remain centralised. Sometimes the task forces that came into being due to the Covid-19 crisis even lack legal justification. More transparency on who has been selected to be included in advisory boards or task forces and on what grounds would give us more insight into processes of inclusion. A key question as the pandemic may be with us for a long time is what will happen with the task forces, will they become embedded in the democratic fabric of societies or will the exception become the rule?