On Monday 5th June 2023, delegates from across health, community and academic sectors and UK/EU contexts came together for the LSE Commission for Pandemic Governance and Inequalities, hosted as part of the Horizon-2020 funded Periscope project. This marked the launch of a policy report based on 3 years of cross-disciplinary research on multi-level governance in pandemic preparedness and response, which will be published later this month.

“Act from the new normal, not the past”. This was one of the many policy recommendations highlighted by a group of young leaders engaged in policy conversations as part of a collaboration between Leaders Unlocked and the LSE/Periscope Commission for Pandemic Governance and Inequalities. They argued that at this stage of the pandemic, we should be thinking creatively and collaboratively in order to build from existing social realities, to address the unacceptable failures of the Covid-19 response in the UK and beyond, and to prevent them from happening again in future.

This was part of the ‘future fit for young people’ that the young researchers defined in their inspiring plenary session closing the LSE event on Monday 5th June. Their testimonials and forward-thinking policy ideas concluded a day of panel discussions around Covid-19 policy and inequalities. Following on from the methodology of the LSE Covid Commission, our event brought the people most crucial to the pandemic response at community level to the forefront of conversations. Our aim is to counter the inequalities faced by marginalised communities related to pandemic governance and to propose new approaches.

During the event, which involved over 50 speakers across 13 panel sessions and interactive workshops, we discussed a range of issues; from trust in health policymaking, to EU institution-building, to ‘recognising and supporting carers’, in line with the theme of Carers Week 2023. Throughout the day, participants reflected on experiences of the pandemic from their various positions as practitioners and community activists, academic experts and public health decision-makers.

Periscope partners from across Europe attended, including behavioural, political, psychological and social scientists from the Karolinska Institute, the Federation of European Academies of Medicine, and the Centre for European Policy Studies and the London School of Economics. This brought a multidisciplinary, multi-level and global perspective to discussions at the event, crucial in responding to trans-boundary crises like Covid-19, as highlighted across the Periscope project.

What are the possibilities for governing effectively and equitably under interdependent, cross-border, ‘transboundary’ crises? And what kind of evidence and data can have an impact in informing policy during health emergencies? Professor Walter Osika, Phoebe Tickell and colleagues at KI lead an interactive ‘circle’ session thinking through the interconnectedness between humans, animals and the natural/built environment, and the significance of this for best practice policy in responding to zoonotic health emergencies like Covid-19. Their research on One Health policy, its limits and possibilities, informs the commission report and to ensure we overcome a limiting anthropocentric perspective in our policy recommendations.

Expert discussions included a panel involving Professors Tim Allen, Melissa Leach, Melissa Parker, Clare Wenham and Hayley Macgregor, on Covid-19, global health and security, based on their extensive research on the unequal impact of the securitisation of public health in pandemics in various contexts. This discussion looked at pandemic governance from a global health perspective, considering the legitimised securitisation, politicisation and militarisation of pandemic responses in recent years.  

Professor Barbara Fasolo ran a session on behavioural aspects of the pandemic response, joined by WHO Regional Officer Martha Scherzer. This session offered a behavioural science and ‘gamified’ approach to reflecting on the pandemic period and the lockdowns, led by Professor Marco Brambilla.

Colleagues at CEPs, including Dr. Timothy Yeung, Jane Arroyo, Hien Vu and Paula Gurtler, were accompanied by Professor Erika Vlieghe, professor of infectious diseases who has played a significant role advising the Belgian government during the pandemic. Based on their research, they focused on the role of EU institutions in pandemic governance from a macro-governance perspective.

Professor Laura Bear also chaired a panel on the role of macro-data and evidence in Covid-19, which involved experts on various data modelling approaches used to inform national and global-level decision making, including UK economic advisor Dr. Tony Curzon-Price, agent-based modelling expert Dr. Maria del Rio Chanona, Periscope computer scientist behind the data atlas Dr. Enea Parimbelli, and Professor Gedion Onyango, expert in evidence for public policy and the Afrobarometer. Participants discussed the complexities around balancing data privacy and access during health emergencies, also interrogated during a brown-bag session on data-driven technologies during pandemics led by Dr. Melis Mevsimler of the Ada Lovelace Institute.

Our research in the UK-based commission has involved various LSE anthropologists and builds from a legacy of the LSE Covid & Care programme and Periscope research, engaging with key figures in the pandemic response in the UK who have extensive expertise in mediating between their communities and the formal public health system. The UK policy report leads from the knowledge of these key figures. Many of them have extensive experience in the community and voluntary sector. Their perspectives are at the centre of our approach to pandemic governance and recovery. We argue in our forthcoming LSE Commission report that their work needs to be better recognised and resourced as crucial in pandemic preparedness, response and recovery.  They carry out crucial ‘relational work’, which requires effective communication, unpaid emotional/ care labour. Through this, the voluntary, community and social enterprise sector (VCSE) and community activists build trust and social networks over the long term. Several panels on the day explored the barriers and enablers of this work. 

Trust-building was examined in the ‘trust lab’, an interactive session chaired by Dr Liz Storer. This involving an interdisciplinary team of researchers, including Dr. Nikita Simpson, Dr. Iliana Storer, Milena Wuerth and Suad Duale, who have all been involved in a project which sought to re-define trust in health policymaking. This included a trust walk, in which participants reflected on the inequalities in health access, housing and pandemic outcomes different individuals in the group had experienced. The key message was that trust is undermined by policy action. Particularly if you are from a group that is unsupported by long-term economic and social policies. 

Professor Laura Bear chaired a panel which engaged leaders in the third and voluntary community sector with lived experience as paid care workers and unpaid carers, including the Tower Hamlets Carer Wellbeing Academy and the Equal Care Co-op. This was an important conversation for making the care work underpinning the pandemic response visible and thinking about ideas for more equitable pandemic policy on this basis. The conclusion was that the VCSE sector is a vital social infrastructure that needed to be provisioned by central funding rather than starved of resources. And Isaac Stanley led a discussion on the role of diaspora communities in the pandemic response, engaging with experts of Ugandan, Latin American, South Asian and Somali diasporas in the UK, including Grace Romero, Dr Moses Mulimira, Professor Kaveri Quereshi and Professor Joanna Lewis.

Anne Bowers, Head of Community Health for the London Borough of Newham co-ordinated a radio 4 ‘reunion style’ discussion across levels of public health governance, engaging with Community Champions, local authority and public health officials, and NHS staff from Newham. This offered an engaging, a place-based discussion of community collaboration during the Covid-19 pandemic. As across the commission, the panel took a retrospective look at what worked well and what could be better for future pandemics, particularly for addressing inequalities in the borough. A key finding from this reflection was that networks across communities had been built through Community Champions policies. And that it is vital to keep these efforts going to combat the cost-of-living crisis and other current issues.

The cross-disciplinarity of the event made it a particularly unique and rich discussion, collapsing traditional boundaries between academic and policy discussions. At its core was the expertise and relational work of leaders within the community and voluntary sector. We argue that their unique knowledge should be at the centre of all discussions about how to prepare, respond and recover from complex global health emergencies such as Covid-19. Communities and trust do not exist ‘out there’ to be tapped into for pandemic response and preparedness; they need to be built and invested in as essential social infrastructures.

In case of any questions about the commission, please contact Charlotte Hawkins (C.Hawkins2@lse.ac.uk) or Laura Bear (l.bear@lse.ac.uk).

Links to event recordings: bit.ly/43ZcmgP