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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.

We must not fail humanity’s greatest test

05/02/2021 - "The lack of international co-operation risks failing the most crucial test: that of vaccinating widely enough to eradicate COVID-19 everywhere. Vaccination is so far confined to a limited number of countries. This failure could lead to an unmitigated economic and social disaster."

Read the SG’s op-edMore on vaccines

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

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...
18/03/2021
> read

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...
11/02/2021
> read

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...
11/02/2021
> read

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...
10/02/2021
> 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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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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English
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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English
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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English
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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10/02/2021
Paper
Science, technology and innovation in the time of COVID-19
Science, technology and innovation (STI) have played a key role in responding to the COVID-19 pandemic and the unprecedented socio-economic crisis it has triggered. This paper explores how the pandemic affected STI in 2020, including how STI was mobilised to provide vaccines, treatments and innovative (often digital) solutions to address “social distancing”. The paper also reviews the quick and agile STI policy responses implemented across countries to stimulate research and innovation activities to find solutions to the pandemic. Moreover, the paper covers STI policies that targeted universities, research centres, innovative businesses and entrepreneurs most affected by the crisis. It also raises key debates on the effectiveness of such policies. Follow-up work will leverage more and better data to improve this early assessment of the impacts of the crisis and STI policy responses.
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04/02/2021
Policy response
Coronavirus (COVID-19) vaccines for developing countries: An equal shot at recovery
As the roll out of coronavirus (COVID-19) vaccines begins, this policy brief asks how to ensure vaccines for all. In doing so, it examines the case for multilateral approaches to access and delivery, maps key challenges, and identifies priority actions for policy makers. The absence of a comprehensive approach to ensure vaccine access in developing countries threatens to prolong the pandemic, escalating inequalities and delaying the global economic recovery. While new collaborative efforts such as ACT Accelerator and its COVAX initiative are helping to bridge current gaps, these are not enough in circumstances where demand far outstrips supply. Based on the current trajectory, mass immunisation efforts for poorer countries could be delayed until 2024 or beyond, prolonging human and economic suffering for all countries. Policy actions to support equitable vaccine access in developing countries include: (i) supporting multilateral frameworks for equitable allocation of vaccines and for crisis response, resilience and prevention; (ii) highlighting the role of development finance; and, (iii) promoting context-driven solutions.
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01/02/2021
Paper
Federalism and public health decentralisation in the time of COVID-19
The Coronavirus pandemic has put extreme pressure on public health services, often delivered at the local and regional levels of government. The paper focuses on how countries made changes to the configuration of federalism during the first wave of the pandemic. These changes typically have involved the centralisation and decentralisation of certain health-related activities, as well as the creation of new coordination and funding mechanisms. Specific tools that have been used include an enhanced role of the executive branch (“executive federalism”), the use of centres of government for vertical coordination, as well as the introduction of unique state-of-emergency laws. New horizontal coordination arrangements have also emerged with the more decentralised approaches. The strengths, weaknesses and implementation risks of various approaches are analysed using country examples.
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08/01/2021
Policy response
The role of online platforms in weathering the COVID-19 shock
This policy brief reports on the activity of online platforms during the COVID-19 crisis. Google Trends data for OECD and other G20 countries indicate that in some areas (such as retail sales, restaurant delivery, and mobile payments) online-platform use increased markedly during the first half of 2020, when most countries imposed lockdown and physical distancing measures. Thus, in this period, some economic transactions may have shifted to online marketplaces as people and businesses increasingly turned to online platforms to pursue economic and social activities. The rise in platform use was however highly heterogeneous across areas of activity and countries. Countries with higher levels of economic and technological development, easier access to infrastructure and connectivity, better digital skills, and wider Internet use tended to experience a larger increase in the use of online marketplaces, possibly mitigating the negative effects on output and jobs of the COVID-19 shock. This highlights the role of policies in strengthening countries’ digital preparedness and their resilience to future shocks.
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09/12/2020
Blog article
Co-operating on Vaccines: 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 it is only the first step and there are many challenges ahead. We can succeed — but only if we continue to work closely together.
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English
04/12/2020
Policy response
Testing for COVID-19: How to best use the various tests?
Even with promising recent news on vaccine development, testing, tracking, tracing and isolating (TTTI) quickly and on a large scale continue to be essential to public health policy responses to the COVID‑19 pandemic. This note provides an update to an earlier OECD brief on such strategies in the light of recent developments in testing technologies. Molecular tests, and in particular RT-PCR, remain the reference for identifying infections because these tests are very reliable. But capacity constraints and the relatively high cost of RT-PCR limit its use on a massive scale. More recently-developed rapid antigen tests offer the advantage of producing results much more quickly. They are also cheaper, simple to use, and can be performed at point-of-care, thus allowing their use on a very large scale. However, they are less reliable than molecular tests. To achieve their objectives, testing strategies can combine different technologies and use them in complementary ways, taking into account their respective strengths and limitations.
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30/11/2020
Report
OECD Regions and Cities at a Glance 2020
Regions and Cities at a Glance 2020 provides a comprehensive assessment of how regions and cities across the OECD are progressing towards stronger, more sustainable and more resilient economies and societies. The publication provides a unique comparative picture in a number of aspects connected to economic development, health, well-being and net zero-carbon transition across regions and cities in OECD and selected non-OECD countries. In the light of the health crisis caused by the COVID-19 pandemic, the report analyses outcomes and drivers of social, economic and environmental resilience.This edition provides several new features. First, an extended set of health-related indicators, including excess mortality, morbidity rates, and air quality. Second, novel indicators on the potential of regions and cities to remote working, as well as on trade openness and access to digital infrastructure enrich the economic chapter. Third, the report offers a number of new climate-and environment-related indicators, including on sustainable electricity production and related carbon emissions. The report shows population trends in over nine thousands cities and metropolitan areas across the entire world. Finally, the last chapter presents new indicators on spending and revenues capacity of regional governments in OECD countries.
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30/11/2020
Policy response
Walking the tightrope: Avoiding a lockdown while containing the virus
Empirical work described in this policy brief explains the daily evolution of the reproduction rate, R, and mobility for a large sample of countries, in terms of containment and public health policies. This is with a view to providing insight into the appropriate policy stance as countries prepare for a potentially protracted period characterised by new infection waves. While a comprehensive package of containment measures may be necessary when the virus is widespread and can have a large effect on reducing R, they also have effect on mobility and, by extension, economic activity. A wide-ranging package of public health policies – with an emphasis on comprehensive testing, tracing and isolation, but also including mask-wearing and policies directed at vulnerable groups, especially those in care homes – offer the best approach to avoiding a full lockdown while containing the spread of the virus. Such policies may, however, need to be complemented by selective containment measures (such as restricting large public events and international travel or localised lockdowns) both to contain local outbreaks and because implementing some of the recommended public health policies may be difficult to achieve or have unacceptable social costs.
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27/11/2020
Report
Health at a Glance: Asia/Pacific 2020
This sixth edition of Health at a Glance Asia/Pacific presents a set of key indicators of health status, the determinants of health, health care resources and utilisation, health care expenditure and financing and quality of care across 27 Asia-Pacific countries and territories. It also provides a series of dashboards to compare performance across countries and territories, and a thematic analysis on the impact of the COVID-19 outbreak on Asia/Pacific health systems. Drawing on a wide range of data sources, it builds on the format used in previous editions of Health at a Glance, and gives readers a better understanding of the factors that affect the health of populations and the performance of health systems in these countries and territories. Each of the indicators is presented in a user-friendly format, consisting of charts illustrating variations across countries and territories and over time, brief descriptive analyses highlighting the major findings conveyed by the data, and a methodological box on the definition of the indicators and any limitations in data comparability. An annex provides additional information on the demographic and economic context in which health systems operate.
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19/11/2020
Report
Health at a Glance: Europe 2020
The 2020 edition of Health at a Glance: Europe focuses on the impact of the COVID‑19 crisis. Chapter 1 provides an initial assessment of the resilience of European health systems to the COVID-19 pandemic and their ability to contain and respond to the worst pandemic in the past century. Chapter 2 reviews the huge health and welfare burden of air pollution as another major public health issue in European countries, and highlights the need for sustained efforts to reduce air pollution to mitigate its impact on health and mortality. The five other chapters provide an overview of key indicators of health and health systems across the 27 EU member states, 5 EU candidate countries, 3 European Free Trade Association countries and the United Kingdom. Health at a Glance: Europe is the first step in the State of Health in the EU cycle.
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19/11/2020
Blog article
Resilience of health systems to the COVID-19 Pandemic in Europe: Learning from the first wave
COVID-19 is testing the resilience of health systems and placing immense pressure on health workers. The first wave of the pandemic showed how European countries need to prepare better and emerge better prepared from current restrictions to avoid future costly containment and mitigation measures. Effective testing, tracking, tracing and isolation are essential to contain the spread of the virus. Yet many European countries struggled to scale up their response, leaving them with fewer measures at their disposal.
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