Risk governance in the response to global health emergencies: Understanding the governance of chaos in Brazil’s handling of the Covid-19 pandemic

Gabriela di Giulio; João Nunes; Ione Mendes; Felipe Reis Campos

doi:https://doi.org/10.1093/heapol/czad016

Risk governance in the response to global health emergencies: Understanding the governance of chaos in Brazil’s handling of the Covid-19 pandemic

Gabriela di Giulio^*, João Nunes, Ione Mendes, Felipe Reis Campos

^*Corresponding author for this work

Politics

Research output: Contribution to journal › Article › peer-review

Abstract

Covid-19 has shown how inadequate institutional strategies interact with, and exacerbate, social inequalities, thus impacting upon the intensity of the harm produced and amplifying negative consequences. One of the lessons from this pandemic, which happens against the background of other, interconnected systemic crises, is the urgency of adopting a “whole-of-society” approach to determining what works and what does not work in the context of a health emergency response. But how can institutional performance in health emergency response be assessed? How to make sense of success or failure? We argue that the adoption of a risk governance approach sheds light on institutional performance in the response to health emergencies. Risk governance is particularly pertinent in situations where the potential for extreme consequences is considered high, where there are enormous uncertainties regarding the consequences, and where different values are present and in dispute. Based on a documentary evidence review, we analyse the Brazilian response to Covid-19 by considering: 1) how the Brazilian federal government performed on its central role of managing the national response, 2) the reactions from other actors prompted by this performance, and 3) the main observed effects emerging from this scenario. We argue that the Brazilian federal government response was weak in five risk governance parameters that are essential in a health crisis response: risk communication; transparency and accessibility of data; negotiation between actors; social cohesion and public participation; decisions based on technical and scientific evidence, resources and contexts. The neglect of risk governance parameters, combined with an attempt to spread doubt, confusion, and disinformation – which could be termed a ‘governance by chaos’ – is an important element for making sense of the effects and controversies surrounding Covid-19 in Brazil.

Original language	English
Number of pages	16
Journal	Health Policy and Planning
Early online date	19 Apr 2023
DOIs	https://doi.org/10.1093/heapol/czad016
Publication status	E-pub ahead of print - 19 Apr 2023

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© The Author(s) 2023. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

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Cite this

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title = "Risk governance in the response to global health emergencies: Understanding the governance of chaos in Brazil{\textquoteright}s handling of the Covid-19 pandemic",

abstract = "Covid-19 has shown how inadequate institutional strategies interact with, and exacerbate, social inequalities, thus impacting upon the intensity of the harm produced and amplifying negative consequences. One of the lessons from this pandemic, which happens against the background of other, interconnected systemic crises, is the urgency of adopting a “whole-of-society” approach to determining what works and what does not work in the context of a health emergency response. But how can institutional performance in health emergency response be assessed? How to make sense of success or failure? We argue that the adoption of a risk governance approach sheds light on institutional performance in the response to health emergencies. Risk governance is particularly pertinent in situations where the potential for extreme consequences is considered high, where there are enormous uncertainties regarding the consequences, and where different values are present and in dispute. Based on a documentary evidence review, we analyse the Brazilian response to Covid-19 by considering: 1) how the Brazilian federal government performed on its central role of managing the national response, 2) the reactions from other actors prompted by this performance, and 3) the main observed effects emerging from this scenario. We argue that the Brazilian federal government response was weak in five risk governance parameters that are essential in a health crisis response: risk communication; transparency and accessibility of data; negotiation between actors; social cohesion and public participation; decisions based on technical and scientific evidence, resources and contexts. The neglect of risk governance parameters, combined with an attempt to spread doubt, confusion, and disinformation – which could be termed a {\textquoteleft}governance by chaos{\textquoteright} – is an important element for making sense of the effects and controversies surrounding Covid-19 in Brazil.",

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