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The COVID-19 pandemic has shown how vulnerabilities in health systems can have profound implications for health, economic progress, trust in governments, and social cohesion.

Containing and mitigating the spread and infection rate of the virus continue to be essential. But so is strengthening the capacity of health systems to respond swiftly and effectively. This includes administering COVID-19 vaccines. After lightning speed development and testing, vaccine campaigns are rolling out in many countries. But questions about production, delivery and equitable access remain, not least for low and middle-income countries.

This page features the latest OECD work on the impact of COVID-19 on health and health systems, along with OECD recommendations and policy advice on how to boost health systems’ resiliency. It also features a curated collection of earlier OECD health content.

The race to vaccinate

Imagine a future where everyone has been inoculated against COVID-19.

This is the horizon we are all looking towards, but before this becomes a reality, there are many challenges we must address.

A global economic recovery is in sight. For it to succeed, we need faster, more effective vaccination rollout across the world.

Discover the vaccines story

Spotlight: The hidden pandemic

What do we know about how people feel?

The COVID-19 pandemic has profoundly changed our world and the past year has been challenging for many.

Today, although vaccines are bringing hope, the pandemic and its challenges are far from over.

People are struggling with mental health issues and with worries about their jobs, finances, loved ones and the future.

A heavy toll on mental health

Around the world, reported levels of anxiety and depression have increased significantly, even doubling in some countries. This has been driven both by the pandemic itself – the deaths caused by the virus, strict public health measures – and by the economic crisis it has triggered.

Young people hit hard

The pandemic has been especially hard for children, teens and young adults. Those aged 18-30 were already at above-average risk of loneliness before COVID-19, but school and university disruptions and closures, along with limits on social interaction, have made things worse.

Reduced social contact and lost hours of schooling can have a lasting effect on children’s and young adults’plans and prospects and their mental health, to their detriment and that of their communities and countries.

> Supporting young people’s mental health through the COVID-19 crisis | Policy response
> The state of school education: One year into the COVID pandemic | Report

People are worried about jobs, finances & the future

In a recent OECD survey, 44% of households report having at least one member whose work had been disrupted by the crisis – such as by a job loss, a lay-off, a retention scheme, reduced working hours, unpaid leave or resignation.

People are concerned about their overall financial, social and economic well-being and that of their families. Many say they haven’t been able to cover usual expenses, such as rent, mortgage, utilities or credit card bills. Many are unsure if they have the right skills and knowledge to secure a good quality job in the next decade.

People are also worried about adequate long-term care for their elderly relatives and about whether they themselves will be able to afford to retire one day.

> Risks that matter: The long reach of COVID-19 | Policy response

> Addressing the hidden pandemic: The impact of the COVID-19 crisis on mental health, by Anthony Gooch & Francesca Colombo | Blog

How can governments help?

OECD countries have taken steps to increase mental health support, including more resources for phone support lines or flyers, better access to mental health services, and more mental health funding.

Beyond such crisis measures, governments should:

  • foster an integrated, whole-of-society approach to mental health that involves both the public sector and employers

  • adapt mental health policies to support young people

  • assure continued access to existing mental health services and add new services or entitlements as needed

  • raise awareness of how the workplace – including remote working – impacts mental health and promote mental health training for line managers and executives

  • consider increasing mental health support for jobseekers through public employment services.

As the pandemic continues, nearly 70% of people in OECD countries say their government should be doing more to help. Governments have already put into place unprecedented support measures.

Today, they should continue to use all resources necessary to maintain income support for people and firms until economies can fully reopen. Going forward, countries can also turn to the OECD framework for benchmarking mental health systems performance, to help them ease the burden of mental ill health on individuals, societies and economies.

Discover more about inclusive recovery

Key insights

24/03/2021

Water Governance in African Cities

Every hour in Africa, an estimated 115 people die from diseases related to improper hygiene, poor sanitation or contaminated water. The COVID-19 pandemic has acted as a magnifying glass on pressing water and sanitation challenges in African cities, stressing and widening inequalities, especially for the 56% of the urban population living in informal settlements, lacking basic handwashing facilities, and relying on public water points and shared toilets.

> Read the report

OECD Forum Virtual Events on vaccines

  • International co-operation & vaccines (24/11/2020)

> WATCH THE REPLAY

  • Communicating on public health & vaccines in a climate of disinformation (19/11/2020)

> WATCH THE REPLAY

OECD Forum Virtual Events on vaccines

22/12/2020

Development Co-operation Report 2020

The devastating impacts of COVID-19 on developing countries have tested the limits, ingenuity and flexibility of development co-operation while also uncovering best practices.

This 58th edition of the Development Co-operation Report draws out early insights from leaders, OECD members, experts and civil society on the implications of coronavirus (COVID-19) for global solidarity and international co-operation for development in 2021 and beyond.

> READ THE REPORT

Development Co-operation Report 2020

Latest policy advice

This new series brings together data, analysis and recommendations on a range of topics related to the impacts of the coronavirus (COVID-19) on health, healthcare systems and workers.

Access to all policy responses

OECD initiative for safe international mobility during the COVID-19 pandemic (including blueprint)

OECD Ministers have endorsed a new initiative to promote safe international travel during the COVID-19 pandemic at the OECD’s annual Ministerial meeting in Paris. The Initiative involves a safe travel blueprint and a temporary international...
31/05/2021
> read

The effect of COVID-19 on alcohol consumption, and policy responses to prevent harmful alcohol consumption

The COVID‑19 pandemic and its associated government measures to limit mobility impacted patterns and places of alcohol consumption. While the path to recovery remains long and difficult, this crisis also increases the risk that individuals...
19/05/2021
> read

Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society response

The COVID‑19 crisis has heightened the risk factors generally associated with poor mental health – financial insecurity, unemployment, fear – while protective factors – social connection, employment and educational engagement, access to physical exercise, daily...
12/05/2021
> read

Supporting young people’s mental health through the COVID-19 crisis

The mental health of young people has been significantly impacted by the COVID‑19 crisis. Prevalence of symptoms of anxiety and depression has risen dramatically among young people and remains higher than pre‑crisis levels even with...
12/05/2021
> read

Perspectives

What we must do next

The lightning-speed development of the new COVID-19 vaccines could not have happened without an extraordinary level of international co-operation, but there are many challenges ahead. How can policy makers succeed?

 

Anthony Gooch, Director, Public Affairs and Communications, OECD

| Co-operation and vaccines |
> READ

Mobilising a Comprehensive, Rapid and Equitable Response

The pandemic has exposed many areas in need of continued and increased investment. Innovating and strengthening systems and infrastructure are vital to enable equitable access. Here’s why.

 

Paul Stoffels, Chief Scientific Officer, Johnson & Johnson

| Cross-sector collaboration |
> READ

Haves and Have-Nots: the geopolitical dilemma

For many of the world’s poorest people there there is little propect of inoculation in the immediate future. We must act together and act now.

 

Dr Ayoade Olatunbosun-Alkija, Chief Strategist, CONVINCE Africa

| Vaccine access|
> READ

Discover other original data visualisations related to the COVID-19 crisis in Data Insights

COVID vaccination tracker

by Our World in Data

In less than one year, the world made incredible strides to develop vaccines that protect us from SARS-CoV-2, the virus that causes COVID-19.

Now the challenge is to make these vaccines available to people all around the world.

Today, only 10 countries account for 90% of all vaccinations administered so far, and many less-well-off countries struggle to get any kind of access to vaccinations at all.

We must work together and invest in rolling vaccines out much faster and more globally than we are doing now.

Click to access the tracker

Our World in Data are building a COVID-19 vaccination dataset that we are making available on this page to support international tracking efforts.

Browse all related resources

This inventory pulls together OECD analysis and data on healthcare systems and workers. It covers topics both directly and indirectly related to many of the issues arising in the context of the global coronavirus (COVID-19) crisis, from the resilience of health systems to the public health threats caused by pandemics or fake pharmaceuticals,

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19/07/2021
Paper
Empowering the health workforce to make the most of the digital revolution
Digital technologies offer unique opportunities to strengthen health systems. However, the digital infrastructure only provide the tools, which on their own cannot transform the health systems, but need to be put to productive use by health workers. This report discusses how to engage and empower the health workforce to make the most of the digital revolution. While many health workers already use some digital tools and perceive the benefits that they bring to them and to patients, many also question the value digital technologies produce in health care or complain about technology getting in the way of work. Moreover, health workers often report not having sufficient opportunities for the up-skilling required to fully use new technologies or that the legal, financial, and organisational aspects of work – designed in the pre-digital era – do not enable them to reap the full benefits of these new technologies. Health workers and patients also demand appropriate safeguards against possible lack of transparency or threats to data privacy.
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30/06/2021
Report
Access and Cost of Education and Health Services
Current population trends and the COVID-19 pandemic reinforce the need for efficient public service provision while guaranteeing good access to all. Population decline and ageing in rural regions affect the provision of services through lower economies of scale and scope, professional shortages and longer distances. Reliable estimates of the costs and access arising from demographic and geographical differences can help adapt the provision of services to different territorial realities. This report provides internationally comparable fine-grained present and future estimates of the cost and physical access to education (primary and secondary) and health services (cardiology, maternity and obstetrics) in European countries. The report finds that demographic change in the next decades will likely further strain the trade-off between costs and access, especially in remote rural areas. Adapting to changes in demand following lower fertility rates and ageing implies that services will need to become more widely available, while others will have to concentrate more. This report aims to support evidence-based policy decisions to ensure service provision allows for both cost efficiency and a sufficient level of access in all territories.
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11/06/2021
Paper
The tortoise and the hare: The race between vaccine rollout and new COVID variants
New variants of the virus are spreading which, together with seasonal effects, are estimated to be able to raise effective reproduction numbers by up to 90%. Meanwhile, many countries are rolling out vaccination programmes, but at varying speeds. Hence the race is on to beat the variants with the vaccines. Vaccination is very powerful at reducing virus transmission: fully vaccinating 20% of the population is estimated to have the same effect as closing down public transport and all-but-essential workplaces; fully vaccinating 50% of the population would have a larger effect than simultaneously applying all forms of containment policies in their most extreme form (closure of workplaces, public transport and schools, restrictions on travel and gatherings and stay-at-home requirements). For a typical OECD country, relaxing existing containment policies would be expected to raise GDP by about 4-5%. Quick vaccination would thus help limit the extent to which containment policies need to be escalated in future epidemic waves, providing huge welfare benefits both in terms of fewer infections and stronger economic activity.
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11/06/2021
Paper
Laying the foundations for artificial intelligence in health
Artificial intelligence (AI) has the potential to make health care more effective, efficient and equitable. AI applications are on the rise, from clinical decision-making and public health, to biomedical research and drug development, to health system administration and service redesign. The COVID-19 pandemic is serving as a catalyst, yet it is also a reality check, highlighting the limits of existing AI systems. Most AI in health is actually artificial narrow intelligence, designed to accomplish very specific tasks on previously curated data from single settings. In the real world, health data are not always available, standardised, or easily shared. Limited data hinders the ability of AI tools to generate accurate information for diverse populations with potentially very complex conditions. Having appropriate patient data is critical for AI tools because decisions based on models with skewed or incomplete data can put patients at risk. Policy makers should beware of the hype surrounding AI and identify and focus on real problems and opportunities that AI can help address. In setting the foundations for AI to help achieve health policy objectives, one key priority is to improve data quality, interoperability and access in a secure way through better data governance. More broadly, policy makers should work towards implementing and operationalising the OECD AI Principles, as well as investing in technology and human capital. Strong policy frameworks based on inclusive and extensive dialogue among all stakeholders are also key to ensure AI adds value to patients and to societies. AI that influences clinical and public health decisions should be introduced with care. Ultimately, high expectations must be managed, but real opportunities should be pursued.
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08/06/2021
Report
A New Benchmark for Mental Health Systems
Mental ill-health affects millions of people, and drives economic costs of more than 4% of GDP. A good mental health system helps people stay in good mental health, and connects those in need to appropriate support to manage their mental health condition or even fully recover from it. However, mental health care has long been neglected and under-funded, and unmet need for care is still high. The long-lasting COVID-19 crisis and the toll it is taking on mental health has made mental health systems more important than ever. This timely report provides an in-depth analysis of how well countries are delivering the policies and services that matter for mental health system performance. The report highlights recent reforms countries have taken to strengthen mental health performance, including by increasing access to mental health care, ensuring that service users take the lead in planning and even delivering services, and prioritising integration and mental health promotion. The report also identifies promising approaches countries should pursue to better meet their populations’ mental health needs. This report sets up a framework for understanding mental health performance through internationally comparable indicators, an approach set to grow stronger still in the coming years as more data become available.
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31/05/2021
Policy response
OECD initiative for safe international mobility during the COVID-19 pandemic (including blueprint)
OECD Ministers have endorsed a new initiative to promote safe international travel during the COVID-19 pandemic at the OECD’s annual Ministerial meeting in Paris. The Initiative involves a safe travel blueprint and a temporary international cross-sectoral forum for knowledge sharing. The forum will allow governments and stakeholders to share information in real time on plans and approaches facilitating travel. The blueprint promotes greater certainty, safety and security in travel as re-opening takes place. It builds on existing initiatives and aims to increase interoperability amongst travel regimes. It will be implemented by countries on a voluntary basis.
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19/05/2021
Report
Preventing Harmful Alcohol Use
One in three adults has engaged in binge drinking at least once in the previous month, and one in five teenagers has experienced drunkenness by age 15. Harmful patterns of alcohol consumption have far-reaching consequences for individuals, society and the economy. Using microsimulation modelling, this book analyses the cost of alcohol consumption in 52 countries (including OECD, European Union and G20 countries), showing how alcohol-related diseases reduce life expectancy, increase health care costs, decrease workers’ productivity and lower GDP. While recognising the importance of the alcohol industry in many countries, the report makes a strong economic case for enhancing policies to tackle harmful alcohol consumption.
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19/05/2021
Policy response
The effect of COVID-19 on alcohol consumption, and policy responses to prevent harmful alcohol consumption
The COVID‑19 pandemic and its associated government measures to limit mobility impacted patterns and places of alcohol consumption. While the path to recovery remains long and difficult, this crisis also increases the risk that individuals engage in harmful drinking to cope with stress. During the COVID‑19 pandemic, there has been an increase in domestic violence, for which harmful alcohol consumption is a risk factor.Harmful alcohol consumption damages health, causes diseases and injuries, weakens response to COVID‑19, and leads to significant economic and societal costs. Comprehensive policy packages built on a PPPP approach including Pricing policies, Policing to counter drink-driving, Primary care‑based counselling for heavy drinkers, and regulating alcohol Promotion activities, improve health, and support a stronger economic and social recovery in the aftermath of the pandemic.
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12/05/2021
Policy response
Tackling the mental health impact of the COVID-19 crisis: An integrated, whole-of-society response
The COVID‑19 crisis has heightened the risk factors generally associated with poor mental health – financial insecurity, unemployment, fear – while protective factors – social connection, employment and educational engagement, access to physical exercise, daily routine, access to health services – fell dramatically. This has led to a significant and unprecedented worsening of population mental health. Across countries, the mental health of unemployed people and those experiencing financial insecurity was worse than that of the general population – a trend that pre‑dates the pandemic, but seems to have accelerated in some cases. OECD countries have responded with decisive efforts to scale‑up mental health services, and put into place measures to protect jobs and incomes, thereby reducing mental distress for some. However, the scale of mental distress since the start of the pandemic requires more integrated, whole‑of-society mental health support if it is not to lead to permanent scarring.
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12/05/2021
Policy response
Supporting young people’s mental health through the COVID-19 crisis
The mental health of young people has been significantly impacted by the COVID‑19 crisis. Prevalence of symptoms of anxiety and depression has risen dramatically among young people and remains higher than pre‑crisis levels even with the partial re‑opening of the economy, and compared to other age groups, even as economies partially re-open. The worsening of mental health can be attributed to disruptions to access to mental health services, the wide‑ranging impacts of school closures, and a labour market crisis that is disproportionately affecting young people. With adequate support and timely intervention, young people experiencing mental distress may be able to bounce back as we recover from the COVID‑19 crisis. This will require a scaling up of existing mental health support in education systems, workplaces and health systems, and comprehensive policies to support young people to remain in education, or to find and keep a job.
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10/05/2021
Policy response
Enhancing public trust in COVID-19 vaccination: The role of governments
While the rapid development of vaccines against COVID‑19 is an extraordinary achievement, successfully vaccinating the global population presents many challenges, from production to distribution, deployment, and importantly, acceptance. Trust in the vaccines is vital, and is critically dependant on the ability of governments to communicate the benefits of vaccination, and to deliver the vaccines safely and effectively. This brief addresses the role of governments in promoting confidence in the effectiveness and safety through effective communication, as well as trust in their ability to procure and distribute them efficiently and equitably. While only a small minority of the population holds strong anti-vaccination views, hesitancy about COVID‑19 vaccination is evident in many countries. Recognising that vaccination campaigns of the magnitude needed are unprecedented, government actions to garner trust will be essential to their success, and to the emergence of more resilient societies after the crisis.
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24/03/2021
Report
Water Governance in African Cities
The COVID-19 pandemic has acted as a magnifying glass on pressing water and sanitation challenges in African cities, stressing and widening inequalities, especially for the 56% of the urban population living in informal settlements, lacking basic handwashing facilities, and relying on public water points and shared toilets. Before the pandemic, African countries and cities were already facing mounting water challenges with, in Sub-Saharan Africa only, 418 million people lacking basic access to water supply and 717 million to sanitation, in addition to concomitant floods, droughts and pollution issues. Megatrends related to climate change, urbanisation and population growth add more pressure on water resources and require urgent attention for African cities to cope with future water challenges. Building on a Survey on Water Governance across 36 cities of all size in Africa, this report provides a regional overview of the allocation of roles and responsibilities for water management, the existence and implementation of institutional, policy and regulatory frameworks, as well as the critical governance gaps that need to be bridged in order to boost city government capacity to drive water security in the continent.
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18/03/2021
Policy response
Access to COVID-19 vaccines: Global approaches in a global crisis
Following the extraordinarily rapid development of COVID‑19 vaccines, immunisation is underway in many OECD countries. However, demand will continue to outstrip supply for some time and currently, distribution is strongly skewed in favour of high-income countries. This both inequitable and inefficient. Directing vaccine to where need is greatest would maximise the number of lives saved and speed bringing the pandemic under control, by slowing transmission and reducing the likelihood of the emergence of viral variants of concern. Governments should therefore act now to accelerate vaccination globally, regardless of international borders, by reallocating supplies to areas of greatest need; continuing the scaling-up of production; ensuring that necessary logistics and health care infrastructure are in place; providing further financial and in-kind support to COVAX; and developing long-term strategies that include commitments to making vaccines available where they are needed most, including through sharing intellectual property and facilitating technology transfer.
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05/03/2021
Report
Delivering Quality Education and Health Care to All
COVID-19 has put renewed focus on the importance of addressing longstanding challenges that OECD governments face in delivering public services, especially in regions with people spread over a wider area where economies of scale are more difficult to achieve. The physical infrastructure needed to provide good quality education and health services can be more complex and expensive in rural and remote regions that also struggle to attract and retain education and health care professionals. Acute ageing trends in many rural regions and, in some cases, a shrinking population will require sustainable policy responses that will need to be coherent with pressure to drive efficiencies in public spending. This report examines the nuances specific to the delivery of education and health care to people everywhere, offering recommendations on how to better adapt provision to the realities of today and the emerging realities of tomorrow to face the challenges of distance, demographic change and fiscal belt-tightening. The report also examines digital connectivity issues in rural and remote regions, recognising the significant scope for digital delivery of services to mitigate challenges related to distance. Finally, the report looks at governance issues, including fiscal issues, through which the delivery of these critical services is administered and paid for.
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04/03/2021
Paper
Financing transition in the health sector
This paper explores the health financing challenges that countries face when they transition from low-income towards middle-income level and beyond. While domestic actors bear an increasing share of the national health expenditure in this process, the transition is not automatic nor necessarily smooth. The challenges that emerge in the process are recently exacerbated by the COVID-19 crisis, which risks diverting resources away from basic health services. The role of development actors during this stage can be critical in setting up sustainable systems of health financing in those countries. The paper starts with a review of the progress on the global health agenda by taking stock of past achievements and remaining challenges. Then, it explores how the health financing landscape transitions with the income level of a country, tracing how this can give rise to transition setbacks. Finally, the paper zooms in on the role of development finance and how it can be reshaped to better facilitate the transition process of countries.
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01/03/2021
Paper
Building and sustaining collaborative platforms in genomics and biobanks for health innovation
Genomic and biobank collaborative platforms hold significant promise for the development of new discoveries and therapies. This paper explores the complex technical, legal and business challenges arising from genomics and biobanks, and brings together ideas and best practices from major national and international platforms, and from a diverse range of experts. The global sharing of biological samples and genomic data has been critical for accelerating our understanding of the biology and spread of COVID-19, and for the development of vaccines and diagnostics. Although some of the policy challenges in the field are well known, they have been reconfigured by the digitalisation of health innovation combined with the increasing complexity and volume of data, the push for global collaboration, and the growing awareness of ethical, legal, and social implications.
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15/02/2021
Blog article
Vaccines, hesitancy and public health communications: The hurdles ahead
This blog drafted by Anthony Gooch argues that heading into 2021, light has begun to appear at the end of the COVID-19 tunnel as the first vaccines are approved and deployed. But the biggest public policy challenge of all is perhaps to come.
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11/02/2021
Policy response
Using trade to fight COVID-19: Manufacturing and distributing vaccines
All countries need vaccines but not all can produce them. Vaccine production is highly specialised, subject to comparative advantages, and concentrated in few countries, making trade a vital means to deploying vaccines broadly. Keeping markets open by reducing tariffs, streamlining trade-related processes at and behind the border while ensuring better co-ordination of logistical processes will be key to ensuring timely access to vaccines for all. This note discusses trade and trade policy considerations underpinning access to the final and intermediate goods needed to effectively produce, deliver and administer COVID-19 vaccines. It focuses on the international aspects of the vaccine supply chain, discussing the sourcing, production, distribution and need to expedite international border crossing and transportation (including in the context of the cold supply chain).
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11/02/2021
Policy response
Global value chains: Efficiency and risks in the context of COVID-19
The policy debate on whether the gains from international specialisation in global value chains (GVCs) outweigh the associated risks of transmission of shocks has intensified in the aftermath of the COVID-19 outbreak and the resulting disruptions in supply chains of some manufacturing and medical products. Questions are even being asked whether governments should use policy tools to “re-localis” GVCs. This policy brief first identifies key potential sources of exposure to shocks in GVCs. Second, it uses the OECD’s global trade model to shed light on the consequences of a stylised re-localisation policy scenario, in terms of both economic efficiency and stability. In this scenario, countries are less exposed to foreign shocks, but they are also less efficient and less able to cushion shocks through trade. Quantitatively, the latter effect tends to dominate. The economic case for policy-induced reshoring of GVCs is therefore weak. There is nevertheless scope for international co-operation and governments to join efforts with businesses to improve risk preparedness.
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10/02/2021
Policy response
Strengthening the frontline: How primary health care helps health systems adapt during the COVID 19 pandemic
Health systems continue to adapt to cope with the COVID‑19 pandemic. Much focus has been placed on the scaling-up of hospital capacities. However, the pandemic is also deeply affecting the health of many people who are not infected by the virus. People living with chronic conditions are not only highly vulnerable to complications and death from COVID‑19, but they are also suffering from disruptions to their regular care routines. The COVID‑19 crisis demonstrates the importance of placing primary health care at the core of health systems, both to manage an unexpected surge of demand and to maintain continuity of care for all. Strong primary health care – organised in multi-disciplinary teams and with innovative roles for health professionals, integrated with community health services, equipped with digital technology, and working with well-designed incentives – helps deliver a successful health system response. The innovations introduced in response to the pandemic need to be maintained to make health systems more resilient against future public health emergencies, and able to meet the challenges of ageing societies and the growing burden of chronic conditions.
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