The COVID-19 pandemic has brought uncertainties of various kinds to the African continent. Apart from the public health impact and associated economic shocks, many countries had to deal with an increasing phenomenon of misinformation. State agencies and public institutions were stretched beyond their limits. But how does a society like Ghana navigate these issues without inadvertently creating opportunities for further confusion and instability, particularly in an election year when political capital was at stake?
As part of its initiative to support future pandemic planning and response, the Ghana–Togo–Southampton pandemic partnership held conversations with pandemic stakeholders across central and local government, civil society and international organisations to explore the issues around the management of the pandemic in the country. ‘Political decisions’ emerged as a major theme.
In evaluating pandemic management within a political year, the study discussed decisions of government, to which there was sometimes widespread popular resistance, but on which the position of government prevailed. Although the government in Ghana introduced many interventions that seemed to be informed by available evidence, some difficult policy situations created room for these ‘political decisions’.
For instance, in March 2020, the need for a national lockdown was supported by many health experts and the Ghana Medical Association (GMA) as an effective measure to contain viral spread. But this policy decision was not taken, as demographic data suggested otherwise, with poverty perceived to be more important to many people than the health consequences of being infected with the virus. To avert the ill-effects of poverty, another intervention sought to distribute food to vulnerable populations; however, this led to public disorder, which appeared not to have been pre-empted. Finally on 30 March 2020, a lockdown was announced, but it was only in place for 3 weeks, which equally provoked feelings of disappointment among sections of the public.
Some stakeholders defended these decisions, arguing that negative outcomes were due to imperfections in science. This position assumes that decisions by political actors are sacrosanct; in reality the weaknesses in science alluded to can be addressed and minimised by consulting a wide variety of evidence for policy decisions. Consulting a mix of evidence types before taking policy decisions allows for the weaknesses in one type of evidence to be counteracted by another.
In the dilemma of difficult policy situations, governments have the choice to proceed with a political decision or to allow for a wider consultation of evidence. Very often, as in the case of the lockdown, there is limited time for this. Political decisions may be convenient; various stakeholders in our study agreed that the occasional lapses in policy response were not enough to derail the government’s effort to control the effects of the virus, while simultaneously protecting the economy.
But managed poorly, political decisions may derail the positive outcomes desired. Other instances of political decision were the reopening of airports for international travel, but not land borders; proceeding with fresh biometric registrations for the December 2020 elections; and holding national elections despite the threats posed by the pandemic. In the case of Ghana, and many other African societies, ethnic communities are spread across demarcations of national territory. Without a clearly communicated public health justification, any decision to selectively reopen borders could easily be misconstrued as being for political advantage (especially in an election year). This has the potential to intensify polarisation, and undermine opportunities for national cohesion, convergence and collaboration, especially needed in times of pandemic. It was not surprising that daily records of positive coronavirus cases begun to rise by the end of the 2020 elections. Similar circumstances have been observed in many countries that have held elections during the pandemic, with rallies and mass gatherings associated with subsequent increases in COVID-19 cases.
With incidents like these, a population can lose respect for decisions by political actors, who are entrusted with significant responsibility for providing direction in such crucial times. The spread of fake news and conspiracy theories gain momentum, and as other studies we conducted on vaccine acceptance suggest, people make decisions, such as whether to accept vaccines, based on their political affiliation, along with other traditional demographic lines.
Ghana has a long history of peace, and perhaps this pre-existing political consciousness may have worked in favour of political stability during the pandemic, despite the potential for polarisation and animosity during an election year. It is also plausible that trust in state institutions has diminished following these decisions. As one stakeholder said, “People [across different communities in the country] have become enemies… but this has got nothing to do with the outbreak, it is [fuelled by] personal interest – [it is] selfish interest that is culminating to make things so complicated”.
Training in public health policy may not prepare students for situations as these, but a better awareness of evidence-informed decision making (EIDM) will help decision makers to prioritise the general good over interests of the self.
Kirchuffs Atengble is Executive Director of PACKS Africa. Michael Head is a Senior Research Fellow at the University of Southampton.
Image credit: World Health Organization, CC BY-SA 3.0 IGO, CC BY-SA 3.0 IGO, via Wikimedia Commons
