Health and Healthcare Systems

How the institutional response to COVID-19 can prepare us for climate change

Women gesture as Fridays for Future activists protest calling for a "Global Day of Climate Action" in Warsaw, Poland, September 25, 2020. REUTERS/Kacper Pempel - RC2L5J9OO4RQ

How do we confront problems that are defined scientifically, yet solve them through political systems? Image: REUTERS/Kacper Pempel

  • Political institutions' response to the pandemic could be a crucial dress-rehearsal for a transition to a different economic model in the face of climate change;
  • How national institutions work with the individual to build enough trust to guide the transition will be crucial;
  • Efforts towards a climate-secure world need to graduate from technical discussions to the conception of the right institutional architecture to support this change.

When Hannah Arendt, the German-American philosopher, reflected on the dawn of the nuclear age, she observed that a world that relegates existential questions to technical and scientific language alone is a world in which people have lost the ability to author their own life.

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Arendt’s concern with the technocratic state was extreme, the product of her life experience and the times in which she lived. Nonetheless, she was pointing to a fundamental challenge: if there is no trusted language that can subject choices to political debate, political institutions are unlikely to create spaces in which all individuals participate and which produce politically legitimate solutions to real-life problems.

How do we confront problems that are defined scientifically, yet solve them through political systems that are designed to offer a space in which everyone can author their life and contribute to collective action? The COVID-19 pandemic has laid bare the complexity of such scientifically driven policy responses and raised profound political issues.

An effective track-and-trace system or localized draconian lockdowns, for example, enable a surgical containment of the epidemic but require a significant breach of individual privacy and freedom – rights that have deep roots in the political history of many countries.

Despite these complexities, and with some notable outliers, the response of most countries has been impressive in both scale and scope. At a minimum, it is remarkable that, even without any previous experience, many countries have chosen to shut down their economies at unprecedented cost in order to protect the most vulnerable in society.

Some have observed that such a response to the pandemic has provided a crucial dress-rehearsal for how political institutions might fare in sustaining a transition guided by science to a different economic model in the face of climate change. Countless reports describe technologies that might help avoid the worst effects of climate change, from solar power, sea walls and wind farms to drought-resistant crops and forest restoration. These all form part of a growing list of ingredients in the most substantial technical transition plan ever conceived.

But as with the pandemic, the transition, while science-informed, will result in a distribution of impacts and costs that will be uneven at best and very significant political challenges if poorly governed. Individuals will experience these events in very different ways and with different material consequences. Those material consequences may or may not be economically significant, but they will be politically salient.

To ensure politics is fully mobilized towards implementation, individuals will need trustworthy national institutions to help them understand it, especially if they are to bear some of these costs. This is where the pandemic holds an important lesson. In countries that have successfully implemented lockdowns, public health institutions have earned sufficient trust to guide those decisions and that trust did not arise simply from being scientific institutions.

The privileged role of medical science in contemporary politics is the result of decades of frontline work. Health is the largest expenditure in most country’s national accounts amounting to close to 10% of GDP in OECD countries. In many of these countries, much of that expenditure is public, part of the post-World-War welfare promises that have led the state to become the biggest economic actor in the modern economy. It coordinates and delivers myriad services that individuals experience in the course of their lifetime. It also motivates an enormous private sector which shares the same basic scientific framework.

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Health is also highly bureaucratized: all countries have a ministry of health, which coordinates the expenditures of the state; scientific advisory structures, institutions staffed by medical and health experts; and, crucially, vast delivery organizations – hospitals, clinics – with capillary territorial reach. These elements are all united by a common body of knowledge and epistemological framework.

The fact that the family doctor belongs to the same institutional architecture as government advisors and pharmaceutical research ensures medical language is not entirely lost to the public and that individual health can be part of the story of individual political agency. It is that complex architecture that has built the trust health officials enjoy to legitimately influence policy.

As a dress rehearsal for disruptive change, the response to the COVID-19 crisis is, therefore, instructive. Sufficiently radical changes to the nature of our built and natural environment and to our economy will pose a fundamental challenge to how we govern the landscape and to who does what, where and for whose benefit. For those challenges to be resolved in service of a commonwealth, politics and political principles matter even more than detailed technical recipes. The quality of the national institutions that are supposed to both advise the state and give voice to the experience of the individual will matter a great deal.

Trust in OECD governments has been going down in recent years
Trust in OECD governments has been going down in recent years Image: Our World in Data

While there is ample international architecture for dealing with climate change, a common theory for national institutions is missing. What is the equivalent of the 20th-century public health institution that will help societies and individuals cope with the challenges posed by the largest economic and landscape transition in human history?

It is unlikely that the answer will depend on creating entirely new institutions; there is not enough time for that. Existing institutions offer building blocks that may need to be rearranged to face what is to come. Educational institutions, for example, are important delivery vehicles for general literacy and may have to play a far more consistent role in helping individuals understand their experience in a changing world. Universities are the training grounds for the generation of professionals who will guide the transition and who must share a basic language and epistemology.

Public institutions that deal with the landscape (agricultural ministries, environment ministries, energy ministries, water ministries) are currently organized to reflect economic categories but will need to coordinate across their domains to deliver a national landscape that is resilient to a different planetary environment. Consistent advice on the state of the environment and the effectiveness of policy interventions will need a disciplinary approach akin to what epidemiology does for public health.

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The political institutions that mediate individual experience into collective agency are crucial to our social life. But in order to build trust, a robust, capillary and reputable institutional architecture, which can both advise political processes and reassure individual citizens of the legitimacy of their knowledge, is also needed.

In the end, a crucial lesson from the pandemic is this: efforts to bring about the transition to a climate-secure world need to graduate from technical discussions about what ought to happen to the conception of the institutional architecture that will place the individual citizen and their political agency at the heart of a science-based transition.

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