6 - All-of-government preparations and response Ngā whakaritenga me te urupare a te kāwanatanga whānui
Introduction | Kupu whakataki
At the start of 2020, the scale of the threat presented by COVID-19 and its possible implications for Aotearoa New Zealand were becoming apparent. This chapter is focused on the plans, systems, governance mechanisms, decision-making structures and strategiesiii that were central to the Government’s pandemic response over the next two years, and how they were communicated to the public.
National and international preparedness for pandemics has been a high-profile public health issue in recent decades as potent infectious diseases (such as Ebola, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and various influenza viruses) have emerged or re-emerged with increasing frequency.
Across the world, numerous pandemic strategies and plans have been drafted, enhanced surveillance and testing regimes adopted, and simulation exercises conducted.6
Yet the Director-General of the World Health Organization, Tedros Adhanom Ghebreyesus, was frank in his appraisal of what the ’preparedness project’ had achieved by 2020:7
“Over the years we have had many reports, reviews and recommendations all saying the same thing: the world is not prepared for a pandemic. COVID-19 has laid bare the truth: when the time came, the world was still not ready.”8
Tedros Adhanom Ghebreyesus,
Director-General, World Health Organization
Faced with a pandemic of this scale and a virus about which so little was known, it was impossible for any country to have made infallible preparations. Quite simply, as the World Bank noted, ’there are limits to preparedness’.9 Any assessment of Aotearoa New Zealand’s readiness to respond to the COVID-19 pandemic needs to place it in this global context.
Before COVID-19, Aotearoa New Zealand had in fact scored well relative to other countries in a World Health Organization assessment of its capacity to respond to health security threats.10 Another assessment of international pandemic preparedness, the Global Health Security Index, had scored Aotearoa New Zealand slightly above the average for high-income countries.11 But that assessment also revealed that, collectively, international preparedness was weak.iv
iii A more detailed description of the legislation, emergency plans, systems and structures supporting the COVID-19 response is provided in Appendix A of the Inquiry's main report.
iv To assess overall preparedness, the Global Health Security Index 2019 studied 195 countries’ pandemic readiness across six dimensions/categories – prevention of the emergence of pathogens, early detection, rapid response and mitigation, sufficiency and robustness of the health system, commitment to improving national capacity and financing and a country’s overall risk environment and vulnerability to biological threats. However, a major gap has been identified between countries’ preparedness levels – as measured in the Index – and COVID-19 death rates. For example, the top-ranked country in the Index was the United States of America whose death rate as at March 2023 was 341 per 100,000 people (according to Johns Hopkins University: see https://coronavirus.jhu.edu/data/mortality). Health researchers say this suggests more accurate ways to measure countries’ pandemic preparedness and response capabilities are needed: see Crosby, S, Dieleman, JL, Kiernan, S and Bollyky TJ (2020), All Bets Are Off for Measuring Pandemic Preparedness, Think Global Health, 30 June 2020, https://www.thinkglobalhealth.org/article/all-bets-are-measuring-pandemic-preparedness