Politics and distrust undermined public health responses in the U.S. and the UK. Why was the response of each nation's scientists so different?
It's easy to look to the 2019 Johns Hopkins Global Health Security Index and cringe. The pandemic-torn U.S. and UK were ranked number one and number two for overall preparedness, yet both nations proved that no amount of planning, no amount of elite research institutions, and no amount of private industry excellence can compensate for volatile leadership.
The Index does have a "Political and Security Risk" indicator but clearly underestimated its impact. For instance, the U.S. ranked 59th out of 195 countries in that risk indicator, with a score of 75.0. But because its overall scores in other categories were so high, even if its Political and Security Risk score was adjusted to put the U.S. in last place, it would still be ranked first in overall preparedness.
Yet no pre-COVID-19 assessment of preparation could have anticipated U.S. leaders' willingness to ignore (or even flout) recommendations from scientists in a public health crisis and instead embrace the politics of perceived personal freedoms. And in the UK, science itself became the issue, as misconceptions of malpractice caused by a lack of transparency from policymakers led to a thirst for independent science. Unnecessary divisions were created in that nation's public health community as well--to the detriment of public discourse.
Best practices in public health--and overall science policy--argue for two key elements: sufficient funding and independence from partisan infighting. These things are essential because good science aids in policy formulation (Science for Policy), yet science itself is a sector within government that needs regulation and oversight as well as funding (Policy for Science). Public trust requires that science (and government-funded science, especially) be seen as free of corrupting influence.
In conflicts between science and commerce (such as climate change, or Big Tobacco), corporations often attempt to erode trust through marketing campaigns, or by finding a champion within government to take up their cause.
But when a refutation of the science behind public health comes directly from those in power, the public is offered a nefarious binary: Believe the politician or the scientist. This binary then can split along party lines. False and true are boiled down to red and blue, to the detriment of the public.
So perhaps the Global Health Security Index is a site for questions, and not answers. The U.S. and the UK had the science, the policies, the plans, and the expertise to effectively respond, relatively speaking, to a pandemic. Why didn't it matter? And, now, as both nations reap the bounty of scientific advances to leap ahead of the world in effective vaccinations, can we find our way again?
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