Box 4.5: Applying lessons from previous health emergencies to COVID-19 in Vietnam

swift repurposing of buildings and infrastructure to serve as emergency hospitals and homeless shelters.121

While governance institutions played a huge role in facilitating an effective COVID-19 response, governance practices were just as relevant. Practices such as public participation and principles such as social cohesion, communal solidarity, transparency and trust in public institutions have been credited with positive outcomes in a number of countries. For example, in Uruguay, pre-existing governance modes of

Box 4.5: Applying lessons from previous health emergencies to COVID-19 in Vietnam

Vietnam’s response to the pandemic has been remarkably successful, as the previous health emergencies experienced (SARS in 2003 and Avian influenza between 2004 and 2010) made the response to COVID-19 quicker and easier for the country: it had already a welldeveloped public health system, as well as the infrastructures (such as emergency operations centres and surveillance systems) and the experience to manage such a crisis, resulting in an effective early detection and containment strategy.122 The response consisted of a “whole of government” strategy, with strong central coordination and reinforcement of neighbourhoods, but also a “whole of society” approach, engaging multi-sectoral stakeholders in decision-making processes: a committed multi-level governance approach. Although some of the actions undertaken by Vietnam are not replicable in other countries (the country has a one-party government that facilitated a highly centralized action strategy), some lessons learnt could be applicable to other countries: investment in public health infrastructures, clear and consistent communication since the very first stages of the crisis, community engagement and participation, as well as early action and the different methods used for contact tracing and for quarantines. hierarchy and collective decision-making ensured widespread support for containment measures. Indeed, although many of the initial containment measures were not mandatory, business associations and unions made voluntary agreements to halt activities and supported government prevention campaigns. Longstanding institutional strength and an emphasis on welfare economics and social responsibility underlined the country’s management of the pandemic.123 Elsewhere, too, pre-existing governance instruments on disaster prevention and management were effectively deployed during the pandemic. Some of them had a broad focus while others had been specifically formulated for health emergencies. For example, as a result of Colombia’s 2012 Law 1523 adopting the national disaster risk management policy, the country had already created the National Disaster Risk Management System, used by several cities to quickly establish local disaster management strategies that helped guide their response to COVID-19.124 Another example is Peru and the approval in 2019 of Regulation No. 30895, strengthening the Ministry of Health’s capacity to respond to a potential health crisis: as a result of this measure, when the pandemic first hit Latin America Peru was one of the first countries in the region to impose restrictions and approve a national plan for addressing the pandemic, even before the country registered its first case of COVID-19.125

The utility and relative success of pre-existing governance mechanisms in responding to COVID-19 in cities supports the contention that institutionalized governance mechanisms may hold certain advantages over ad hoc bodies formed for emergency purposes and limited durations in that in the latter case, learning and capacities are not built and preserved for the next crisis but are lost after the body is disbanded. Nonetheless, it has been observed that in many countries existing structures were not fully utilized even as parallel new structures were put in place. This led to a risk of confusion and institutional division that could undermine a coordinated response strategy. Practices such as public participation and principles such as social cohesion, communal solidarity, transparency and trust in public institutions have been credited with positive outcomes in a number of countries