Open letter to the Bureau of the Intergovernmental Negotiating Body to strengthen pandemic prevention, preparedness and response.
Dear Bureau of the Intergovernmental Negotiating Body,
We, the members of the World Health Organization (WHO) Technical Advisory Group on Behavioural Insights and Sciences for Health,
write to ask you to explicitly include the behavioural and social sciences in the new international instrument as they are critical for pandemic prevention, preparedness and response.
COVID-19 has confirmed that the behavioural and social sciences have guided our understanding of the drivers of transmission and how to design and deliver effective interventions. Changing behaviours is complex and may not happen even when life is at
stake – it requires more than clinical and epidemiological expertise.
To ensure a robust international instrument, our first suggestion is that you consider including uses of behavioural and social sciences in pandemic prevention, preparedness and response at relevant places in the international instrument.
This ranges from informed political and public health leadership, the choice of legislation for mandatory vaccination, financial measures to support self-isolation, guidance and scripts for contact tracing, and tailored communications for vulnerable
communities to minimize health inequalities (explained well in this article).
Second, we propose the inclusion of at least one article focusing on critical behavioural and social actions for pandemic prevention, preparedness and response. One
example of this is “intensify and target risk communication, strengthen community engagement, empowerment and support, addressing community concerns, combating misinformation and building trust” as highlighted by the WHO Director-General
in his charge to countries at the World Health Assembly in 2021.
Finally, to facilitate the appropriate integration of behavioural and social sciences in the new international instrument, we propose that experts in behavioural and social sciences should be included as members of the Intergovernmental Negotiating Body or as advisors. We, together with WHO Headquarters’ behavioural sciences team, can help source these experts.
World Health Assembly resolutions related to COVID-19 that may be reflected in the new instrument, and which cannot be successfully implemented without the contribution of behavioural and social sciences, include:
- Community engagement, rapid investigation, risk assessment, rapid response and public information and risk communication: rapid and customized engagement and agile data collection with target audiences, synthesis and interpretation of their responses, and co-design of appropriate and acceptable responses from credible messengers, which can cause reactance and loss of trust in public health and government if poorly designed.
- Equitable access to healthcare services: explaining both public and healthcare professional barriers to equitable access and designing and evaluating solutions.
- International health regulations implementation/compliance and policies/norms/guidance: specification of behaviours for compliance; determining barriers to compliance through the science behind comprehension, intention and behaviour; and the expertise to optimize international health regulations and supportive resources for maximum impact.
Behavioural and social sciences use evidence, theory, frameworks, and methods drawn from anthropology, psychology, health promotion, behavioural economics, sociology, marketing, design thinking and more. These are used for the design, implementation and evaluation of policies and programmes for greater public health impact, reduced inequalities and greater value for the public purse. WHO needs to create mechanisms for capacity building in this area and for the rapid exchange of behavioural evidence and data and resources across countries.
The Intergovernmental Negotiating Body has a critical task ahead, with the responsibility of building on the lessons learned from the COVID-19 pandemic. One of the lessons learned is that we must improve how we use the behavioural and social sciences. We wish you the best as your work will help to enhance global health and protect lives and hope we can be of further assistance.
Sincerely,
Professor Cass Sunstein, Harvard University, United States of America (USA) – Chair; Dr Maria Augusta Carrasco, Public Health Institute, USA; Dr Varun Gauri, Princeton University, USA; Dr Gavin George, University of KwaZulu-Natal, South Africa; Professor Ross Gordon, Queensland University of Technology, Australia; Professor David Houeto, University of Parakou, Benin; Professor Ruth Kutalek, Medical University of Vienna, Austria; Dr Glenn Laverack, University of Trento, Italy; Dr Fadi Makki, B4Development, Qatar; Ms Ammaarah Martinus, South Africa; Dr Shahinaz Ibrahim Mekheimar, Theodor Bilharz Research Institute, Egypt; Professor Susan Michie, University College London, United Kingdom; Dr Iveta Nagyova, Pavol Jozef Safarik University, Slovakia; Professor Saad Omer, Yale University, USA; Professor Rajiv Rimal, Johns Hopkins Bloomberg School of Public Health, USA; Ms Jana Smith, ideas42, USA; Dr Beena E. Thomas, National Institute for Research in Tuberculosis, India; Dr Chiara Varazzani, Organisation for Economic Cooperation and Development, France; Ms Archna Vyas, Bill & Melinda Gates Foundation, India; and Dr Joyce Wamoyi, National Institute for Medical Research, United Republic of Tanzania.
Members of the WHO Technical Advisory Group on Behavioral Insights and Sciences for Health.