Introduction and methodology

4.1

Introduction and methodology

This Section analyses local and regional government contributions towards the recovery from COVID-19. It adopts an approach based on the concept of “Health in All Policies” (HiAP). This provides a powerful and operational lens through which to conduct public policy across different sectors and to systematically consider the health implications of different decisions, detect synergies, and avoid harmful impacts on heath (see Box 4.1). This Section therefore particularly focuses on health (SDG 3), looking for interlinkages with poverty (SDG 1), hunger (SDG 2), employment and decent jobs (SDG 8), inequalities (SDG 10), addressing climate change and building up resilience (SDG 13), sustainable consumption and production (SDG 12), effective institutions (SDG 16) and

partnerships for the SDGs (SDG 17).1

The analysis of the initiatives implemented by LRGs is structured around 4 “pillars”, which have been inspired by the “5 Ps” of the 2030 Agenda: People, Prosperity, Planet, Peace and Partnerships. All the pillars follow the same structure. Firstly, they introduce a brief explanation of the pillar and the main impacts that COVID-19 has had on the SDGs concerned. Secondly, COVID-19 responses are presented by type and are related to concrete experiences from LRGs around the world. The analysis takes into account the wide variety in the distribution of responsibilities across different LRG levels (also called “subnational government levels” or “SNG levels”; see Table 4.1) and the fact that responses may not necessarily apply to all the different levels of subnational government. The majority of countries have either one level or two levels of subnational government (approximately 30% and 48% of countries, respectively), whereas a minority of countries (28%) also have a third level (departments, districts, counties, etc.).2 Furthermore, complexity in the distribution of responsibilities can also lead to competing and overlapping competences. For instance, in most federal countries, state governments (provinces, regions, Länder) have wider responsibilities than lower tiers of government. In general, state constitutions or laws, decide on the responsibilities devolved to, or shared with, municipal levels. In contrast, in unitary countries, the assignment of responsibilities is decided by national laws. Some of the responsibilities devolved to subnational governments may be mandatory, while others are optional. All these considerations are key factors to bear in mind, as they have a direct impact on how LRGs are responding to the pandemic and promoting sustainable responses and just recovery.

TABLE 4.1

Breakdown of responsibilities across subnational government levels: a general scheme

MUNICIPAL LEVEL INTERMEDIARY LEVEL REGIONAL LEVEL

A wide range of responsibilities: • General clause of competence • Eventually, additional allocations by the law

Community services: • Education (nursery, schools, pre-elementary and primary education) • Urban planning & management • Local utility networks (water, sewerage, waste, hygiene, etc.) • Local roads and city public transport • Social affairs (support for families and children, elderly, disabled, poverty, social benefits, etc.) • Primary and preventive healthcare • Public order and safety (municipal police, fire brigades) • Local economic development, tourism, trade fairs • Environment (green areas) • Social housing • Administrative and permit services Specialised and more limited responsibilities of supramunicipal interest

An important role of assistance towards small municipalities

May exercise responsibilities delegated by the regions and central government

Responsibilities determined by the functional level and the geographic area: • Secondary or specialised education • Supra-municipal social and youth welfare • Secondary hospitals • Waste collection and treatment • Secondary roads and public transport • Environment Heterogeneous and more or less extensive responsibilities depending on countries (in particular, federal vs unitary)

Services of regional interest: • Secondary/higher education and professional training • Spatial planning • Regional economic development and innovation • Health (secondary care and hospitals) • Social affairs, e.g. employment services, training, inclusion, support to special groups, etc. • Regional roads and public transport • Culture, heritage and tourism • Environmental protection • Social housing • Public order and safety (e.g. regional police, civil protection) • Local government supervision (in federal countries)

Source: OECD/UCLG (2019)

Cities and regions have reported that they are implementing a mixture of relief and recovery measures, while gradually restoring the capacity of local economies to transition to the postCOVID-19 phase in the medium-to-long term. However, in general, there is no clear division

between immediate responses (i.e. providing relief or emergency assistance) and recovery/

rebuilding measures. In fact, the immediate response phase is lasting longer in some countries than was initially expected. In turn, this is holding back many measures specifically related to the recovery phase. It may therefore be more appropriate to discuss the overall response in terms of “early recovery”3. This involves providing support or relief measures as well as help with medium-to-long-term recovery. This entails policy measures that foster both human and economic resilience among other dimensions of sustainable development.

BOX 4.1

Health in All Policies

While health and well-being are explicitly addressed in SDG 3, health is also present as either a pre-condition, or a collateral endpoint, in other SDGs. Understanding the interlinkages between SDGs therefore remains critical for sustainable development and if societies are to address the current pandemic and recover from it. SDGs can be used to draw attention to the need to close gaps in the distribution of health impacts as well as to promote health gains. The Health in All Policies (HiAP) approach relies heavily on the use of scientific evidence and evaluation tools, such as health impact assessments. These assessments may include local-level quantitative analyses of disease estimates, health economic assessments, and the involvement of citizens and other stakeholders in integrating health recommendations into other sector-specific policies.4 The

term “SDG 3+” promotes the permeability of health and well-being as both a means and an end in the 2030 Agenda, looking beyond SDG 3. It considers health holistically and explicitly

establishes connections with the other SDGs. 5 Nevertheless, only a few cities have adopted this approach so far. Although its potential is significant, it requires using tools such as health impact assessment planning and management. These, in turn, require adequately resourced and skilled LRG staff capable of effectively implementing the HiAP approach.

Example of a HiAP approach. Source: Department of Health and Human Services (DHHS), Humboldt County (USA)