Strategic Joint Evaluation of the Collective International Development and Humanitarian Assistance Response to the COVID‑19 Pandemic

4. Working together: Coherence of the international COVID crisis response

Abstract

This chapter examines the coherence of the international development co-operation response to the COVID-19 crisis through four different lenses: overall coherence of assistance globally (including regional co-ordination, co-ordination between providers and co-ordination of vaccination efforts); the consistency of other policies with development and humanitarian efforts; the organisation of the response within provider development agencies; and finally, the set-up and effectiveness of co-ordination in countries receiving support. Special attention is given to the co‑ordination of vaccination efforts, as these were a key focus of the crisis response and illustrate the challenges faced across other intervention areas. This chapter looks at factors that enhanced or hindered coherence and offers insights for future international co-operation.

The overall picture on coherence is mixed. Successes were noted, especially where existing institutions and co-ordination mechanisms were employed at the country and regional levels. There was also an unprecedented multilateral effort to co-ordinate the distribution of vaccines and increase equitable access. The use of electronic communication platforms facilitated virtual meetings between stakeholders, with co-ordination becoming less formal, but more proactive, at least in information sharing, especially where international staff stayed in-country. UN country offices played a key role in supporting joint responses and co-ordinating international funders, national governments and other partners. Within development agencies, drivers of coherence included the designation of a single crisis response body with a whole of government mandate.

Still, significant weaknesses in coherence of international co-operation efforts were reported, with gaps and overlaps of support; parallel efforts instead of streamlined; and a disconnect between political and technical level decision making. The overall global response with incoherent, with the WHO providing insufficient leadership. In the international assistance space, parallel development and humanitarian assessment and planning mechanisms placed an unnecessary burden on host governments, undermined ownership, fragmented the support provided and generated inefficiencies. Most critically, incoherent domestic policy actions undermined the international co-operation efforts, particularly on access to COVID vaccines. Bilateral providers supported the COVAX facility and the equitable distribution of vaccines, but at the same time made bilateral agreements with manufacturers that limited the vaccine supply and directly undermined access for lower income countries.

4.1. Global coherence of the COVID-19 response

Multilateral development organisations and UN agencies were at the heart of the crisis response, and many bilateral providers took a multilateral approach to the crisis, scaling up support through multilateral channels to enable a coherent response. However, the WHO and other global entities did not fulfil their leadership and co-ordination roles sufficiently (Williamson et al., 2022[1]). In addition, especially among larger provider countries, unilateral decision making persisted in parallel and allocations of funding were not co-ordinated between countries.

Fragmentation and a lack of co‑ordination have long been flagged as weaknesses in international assistance as well as a consistent challenge within the global health landscape. Several initiatives to remedy this have been tried with varying degrees of success (e.g. Lusaka Agenda, SDG3 Global Action Plan for Accelerating Health, IPH+, UHC 2030). Efforts to enhance health co‑ordination and collaboration at the global level prior to and during the pandemic did not always account for factors such as political leadership, governance and funding structures, that can either reinforce or hinder country-level co‑ordination (WHO, 2024[2]). Experiences during the COVID crisis brought forth these weaknesses in the global health and crisis response architecture.

The role of the multilateral system

It was recognised early in the pandemic that the scale of the crisis would require concerted and improved co‑ordination and as such was highlighted as a priority in the Development Assistance Committee (DAC) members joint statement (OECD, 2020[3]). Working through experienced and trusted partners and using existing co‑ordination mechanisms was considered to be a key factor in enabling a coherent response, as this helped to co‑ordinate actions efficiently. The prioritisation of the multilateral system is reflected in the higher share of COVID-related funding that was provided to multilaterals, compared to all assistance.

Drawing on findings across more than 100 evaluations, the synthesis found that the multilateral system was key for scaling-up existing co‑ordination mechanisms across development actors, organisational levels and ways of working to launch a coherent response to the health, socio-economic and humanitarian impacts of the crisis (Schwensen and Schiebel Smed, 2023[4]). For example, the Netherlands allocated funding and vaccines primarily through multilateral organisations and initiatives, which supported an externally coherent response (OECD/IOB, 2025[5]).

Likewise, the Spanish case study found that funding multilateral actors supported coherence and enabled multilateral agencies to adapt their support to country needs. The commitment to a multilateral response proved to be successful in the face of the global crisis and allowed Spanish development co‑operation to position itself as an actor that effectively overcame geopolitical divisions to assist other countries during the crisis (Ministerio de Asuntos Exteriores, Unión Europea and Cooperación, 2024[6]). In contrast, the German case study found the share of funding channelled through multilateral organisations did not rise during the crisis, despite the considerable advantages of multilateral organisations in promoting global public goods such as health protection and pandemic control, as well as effectiveness, timeliness and economic efficiency (Römling et al., 2024[7])

The multilateral system was key for scaling-up existing co‑ordination mechanisms across development actors, organisational levels and ways of working, enabling a coherent response to the health, socio-economic and humanitarian impacts of the crisis. However, there was a lack clarity of roles and responsibilities in some cases between partners and agreed ways of working (MOPAN, 2022[8]).

The World Bank’s COVID-19 recovery efforts emphasised the establishment of “One Health” co‑ordination within countries to support multisector responses and strengthen co‑ordination structures (WHO, 2022[9]). The World Bank also co‑ordinated closely with the International Monetary Fund (IMF), as well as with the Asian Development Bank (ADB) (e.g. on social protection and education support) and in Latin America with the Inter-American Development Bank (World Bank, 2021[10]). UN agencies worked together to co‑ordinate procurement early in the pandemic, when there were critical shortages of lifesaving supplies (MOPAN, 2022[8]).

Fragmentation in the pandemic response

While there was a considerable effort to co‑ordinate pandemic-related support, many of the pre-pandemic challenges related to fragmentation continued or even worsened as providers responded to a context of overwhelming needs. Chronic underinvestment in certain institutions also meant that the multilateral system was less well positioned to play this role .

As described above, existing types of structures and tools (notably a consolidated humanitarian response plan, and a multi-donor trust fund at the UN – see Chapter 2) were used to co-ordinate international co-operation. Many of these were exceptional in scope, and the multilateral system also supported the creation of new mechanisms, including WHO’s One Health initiative and the COVAX initiative, to address the global scale and multi-dimensional aspects of COVID-19 (MOPAN, 2022[8]).

While assessments show that each of these worked well as delivery mechanisms, they did not succeed in global co-ordination as such, given there were many other efforts – notably unilateral actions of provider governments – happening in parallel.

The COVID-19 Global Humanitarian Response Plan (GHRP)1 functioned as a consolidated appeal, rather than acting as a single resource mobilisation mechanism as intended (MOPAN, 2022, p. 32[8]). Consequently, some UN agencies launched their own appeals outside those of the GHRP, which worked against coherence. Furthermore, the WHO Health Emergency Programme and the associated contingency fund for emergencies – established in 2016 following the Ebola outbreak – were underfunded, reducing readiness to respond to COVID-19 (MOPAN, 2022[8]; Gulrajani and Silcock, 2020[11])

The multi-funder UN COVID-19 Response and Recovery Trust Fund (also based on the experiences from Ebola) facilitated coherence between humanitarian and socio-economic support (NORAD, 2020[12]). By pooling funding for joint programming among UN entities, and using existing implementing entities, the fund was a strong driver of strengthened coherence across UN agencies, especially at the country level (UNSDG, 2022[13]) (UNDS, 2023[14]). Entities involved in pooled funding projects noted that the funds effectively incentivised joint work, and worked to reduce reporting and other administrative requirements, though they remained transaction heavy for those involved (UNDS, 2021, p. ix[15]).

Though most providers supported multilateral and pooled funding, most did so in parallel to bilateral assistance, which undermined both efficiency and coherence. For instance, the United States provided health support to Gavi, UNICEF and other COVAX partners, as well as launching a new, whole-of-government response called the Initiative for Global Vaccine Access (Global VAX). Likewise, the People’s Republic of China (hereafter ‘China’) provided funding to the COVAX global effort, while also donating large volumes of vaccine doses directly to priority partner countries (CIKD, 2023[16]). OECD DAC peer reviews illustrate that this was the case for nearly all OECD DAC members, with most providing COVID-related assistance to multilaterals and bilaterally to countries based on their own priorities.

There was no overarching co‑ordination mechanism to drive or even inform, overall allocations across countries. This led to fragmentated approaches to resource mobilisation that reduced coherence and left gaps in funding (UNSDG, 2022[13]). Longstanding competition among UN agencies for resources remained a challenge and was most pronounced in the contexts in which resources were scarce (WHO, 2024[2]).

Regional co‑ordination

While co‑ordination at a global scale was fragmented, there were strong examples of effective regional approaches and regional entities were important co‑ordination platforms for pandemic responses.

The pandemic highlighted the important role of the co‑ordination and planning of regional development actors as part of the response, assessing needs, developing comprehensive plans, and helping avoid a duplication of effort. Platforms supported knowledge and information exchange; the identification of needs; the co‑ordination of supplies; the sharing of resources, information and procurement; and the co‑ordination of policy measures. Regional co‑ordination mechanisms played an important role in responding to transboundary issues; contextualising global policy frameworks, country needs and priorities; building national ownership; and facilitating South-South co‑operation (MOPAN, 2022[8]).

For example, Mexico and China both provided material assistance to Latin America and the Caribbean through the regional mechanism of the Community of Latin American and Caribbean States (CELAC) (see Box ‎4.1). Other countries found that the benefits of such regional approaches were under-valued and more could have been achieved with a regional approach.

The Team Europe approach sought to align the pandemic response of the European Union and its Member States. The success of the Team Europe approach was evident in the Caribbean and Pacific regions, where the European Investment Bank (EIB), the European Commission and other Team Europe members collaborated with local organisations, such as the Caribbean Development Bank, to provide affordable access to vaccines and financial resources, ensuring that the Caribbean could better manage the pandemic's effects. One notable achievement of the initiative was securing EUR 300 million in additional funding from the EIB to boost vaccine deliveries through COVAX, targeting SIDS and other vulnerable regions (European Commission, 2025[17]).

The case study on the Small Island Developing States (SIDS) found good evidence suggesting that regional co‑ordination, particularly in the Pacific and Caribbean regions, was effective and included information sharing among providers, including national governments, partner countries and regional organisations. For example, the Pacific Islands Forum brought together leaders, ministers, regional organisations (e.g. the Pacific Community) and UN agencies to co‑ordinate a regional response (European Commission, 2025[17]). Co‑ordination with SIDS governments was reduced due to providers dealing directly (bilaterally) with them. Key informants and several evaluations highlighted the need for providers to align with regional bodies and use them more intentionally to better align their support and enable greater coherence (European Commission, 2025[17]; AFD, 2024[18]).

The Pacific Humanitarian Protection Cluster (PHPC) supported governments in the Pacific region to address the challenges of geographic isolation and border closures. The PHPC supported shared decision making on critical issues, such as the movement of goods and people, ensuring that support reached isolated and vulnerable populations. Information sharing within the PHPC framework helped align national responses with regional priorities, further demonstrating the responsiveness of bilateral programming to the needs of SIDS. Strong sectoral co‑ordination was important in crisis responses and clusters/sectors broadly performed well in providing strategic technical direction and offering relevant guidance and support.

Box ‎4.1. Responding to the COVID-19 crisis in the Latin America and Caribbean region

In 2019, under the leadership of Mexico, the Community of Latin American and Caribbean States (CELAC) identified the need for a project to monitor and analyse viruses in the Latin America and the Caribbean (LAC) region. Mexico had gained experience in its fight against AH1N1 (swine flu) in 2009. The first meeting of CELAC took place on 30 January 2020, the same day the WHO Director General declared that the outbreak of COVID-19 constituted a public health emergency of international concern. The region went on to establish the CELAC Network of Experts on Infectious Agents and Emerging and Re-emerging Diseases. Strong regional leadership played a pivotal role in co‑ordinating responses, mobilising resources and fostering collaboration among countries. CELAC continued to arrange meetings, support specific studies and initiate joint declarations between CELAC–FAO, CELAC–CARICOM and CELAC–the Organisation of Eastern Caribbean States (OECS). The objective was to contribute to greater knowledge and transparency regarding information on specific issues related to the pandemic.

These regional entities proved critical in matching assistance to needs, including facilitating triangular co‑operation, ensuring that expertise, funding and resources were effectively channelled to where they were most needed.

Co‑ordination between providers

Both in international fora, and especially at the country level, providers co-ordinated both between themselves and with national governments and other partners, which illustrate good practices that can be replicated in the future. However, the lack of any overarching mechanism to enable co-ordination and the slow and limited role of the WHO in driving and co-ordinating action globally – together with the pressure created by competing interests – meant that assistance was not as well co-ordinated as it could have been.

In addition to the DAC statement in 2020, which emphasised the need for quick and co-ordinated action not only among DAC members, but also with other providers and private sector actors, there were many positive initiatives to co-ordinate responses between providers of international assistance:

• Ministers of Development Co‑operation in Nordic countries began meeting together in mid-2020 and co‑ordinated closely in the early days of understanding the pandemic impacts, implications and taking decisions on response strategies (Ministry for Foreign Affairs of Finland, 2022[19]).

• New Zealand – in co‑ordination with Australia, the ADB and the World Bank – provided grant funding in the form of emergency budget support across the Pacific. From a Pacific regional perspective, New Zealand’s response supported the Polynesian countries in reducing the impact of the virus. It also strengthened relationships and trust between the New Zealand and Polynesian health systems (Ministry of Foreign Affairs and Trade of New Zealand, 2025[20]).

• At the 2021 UN General Assembly Meeting, China announced the Global Development Initiative (GDI) to “speed up the implementation of the 2030 agenda” and to address the needs of countries impacted by the pandemic and adapting to climate change. In January 2022, the Group of Friends of the Global Development Initiative was launched with the support of the United Nations (Schwarz and Rudyak, 2023[21]).

• Team Europe was set up by the European Commission to facilitate greater co‑ordination and scale-up of resources across the Commission, as well as foster coherence with EU Member States and European Development Finance Institutions, building on the spirit of “Working Better Together”. A fast-track assessment of the EU’s response to the pandemic concluded that “co‑ordination, co‑operation and partnerships with EU Member States, UN organisations, non-EU donors and other partners” helped the European Union to offer expertise that had not been part of the pandemic “co‑operation envelope” for certain countries (e.g. health in Fiji) (European Commission, 2022[22]).

• As illustrated in Box ‎4.1, Mexico played a key role in helping to co-ordinate among providers in the Latin America and Caribbean region.

• The German case study rated the co‑operation of multiple bilateral and multilateral donors – such as through basket funds – as effective, particularly where it enabled bundling the knowledge of various partners along with large funding volumes (Römling et al., 2024[7]).

Many UN agencies reported increased collaboration through strategic and technical inter-agency co‑ordination mechanisms and joint programming. However, the UN COVID-19 Socio-Economic Response and Recovery Plans (SERPs) or Socio-Economic Development Plans (SEDPs) which were intended to help this co‑ordination, often served more for UN funding calls rather than true drivers of partnership between international agencies and governments. The 2022 interim system-wide evaluation of UNDS’s response found that partnerships and collaborations were formed among UN entities at country level (UNSDG, 2022[13]). The UN Framework was an effective instrument in guiding coherence at country level, through adapting socio-economic response plans (SERPs) to local contexts. However, the three-pillar structure of the UN COVID response presented challenges for the UN country teams (UNCTs) in integrating planning across all three pillars (UNSDG, 2022[13]). While there was recognition of the need for a holistic response, existing levels of collaboration and co‑ordination between humanitarian, development and peace actors were not generally strengthened during the pandemic (IAHE, 2022[23]). Furthermore, the IMF, multilateral development banks and other global financing instruments were not consistently or effectively engaged with UNCTs across countries to ensure coherence in policy engagement, advocacy and programming (UNSDG, 2022[13]).

Co‑ordination between international financial institutions (IFIs) was mixed. The IMF and the World Bank, worked together during the pandemic in pressing for official debt relief and multilateral vaccination support initiatives. They also worked in close co‑operation with country teams in assessing the impact of the pandemic at country level. However, their coherence was sometimes compromised due to differences in approach. For example, the IMF generally prioritised rapid disbursement through its emergency facilities to meet urgent needs, whereas the World Bank placed greater emphasis on debt sustainability issues and lending through its policy-related instruments. Secondly, the institutions were not always aligned on assessments of countries’ debt sustainability (IEO, 2023[24]).

Co‑ordination of vaccination efforts

The co‑ordination of vaccination efforts at a global scale was fragmented, despite the deployment of an innovative multilateral initiative with the ACT-A and COVAX vaccine pillar. COVAX, which prioritised joint procurement and collaboration, was hindered by parallel, unilateral efforts, as well as by provider countries procurement of vaccine for domestic use – in some cases at volumes far exceeding their needs – which drove up prices and increased inequity (as discussed further below).

The aim of COVAX was to drive a coherent and equitable global response, and this effort largely succeeded in accelerating the speed at which countries received vaccines. There was a good coherence of efforts within the scope of the facility itself. However, significant challenges arose due to the lack of co‑ordination between the procurement efforts of COVAX and those of individual donor countries, as well as their domestic actions which undermined the co‑ordinated global effort. Individual countries with strong purchasing power, such as the United States and the United Kingdom, were able to order huge quantities of vaccine doses from suppliers for their domestic population, leaving little for COVAX to procure. To illustrate, by June 2021, high-income countries (HICs) had placed orders for six billion vaccine doses, while COVAX had only secured 2.3 billion (Launch and Scale Speedometer, 2023[25]).

Co‑ordinating donations of vaccines across multilateral and bilateral channels was also a challenge. Some providers chose to donate vaccines directly to partner countries, often to strengthen bilateral relationships and increase the visibility of the provider country. These rather ad hoc bilateral donations were out of sync with and often worked against the evidence-driven strategic allocation strategy of COVAX.

For example, island nations closely linked to certain donor governments – such as Samoa and the Marshal Islands with the United States – swiftly received direct donations (European Commission, 2025[17]). Another example pertains to the Netherlands and their decision to donate vaccines to Suriname, which was partly due to their desire to strengthen bilateral ties and societal connectedness (OECD/IOB, 2025[5]). Likewise, in addition to support from COVAX, several international partners – including China and Australia – prioritised donating doses bilaterally to Cambodia, due to strong historic relationships and Cambodia’s relatively strong roll-out capacity. While from the perspective of effectiveness Cambodia was a success story, globally such practices deepened inequalities (OECD, forthcoming[26]).

Partnerships between providers and multilateral health organisations, including via COVAX were crucial in co‑ordinating global vaccine distribution (MOPAN, 2022[8]). Such collaborative efforts were essential in pooling resources to facilitate equitable distribution and uptake. This was especially pertinent in regions with minimal healthcare infrastructure, where multilateral actors could co‑ordinate through joint platforms to provide technical assistance and other support to facilitate vaccination campaigns, alongside the donation of the vaccines themselves. Unfortunately, this accompanying health systems’ support for administering vaccines was insufficient or not reliably available (Gooding, Webster and Wiafe, 2021[27]). Furthermore, the way some vaccine donations were managed – notably stocks that arrived with short expiry windows – made it difficult for health systems to rollout available doses (Gooding, Webster and Wiafe, 2021[27]) (IAHE, 2022[23]). For example, in April 2021, the Democratic Republic of the Congo had to return 1.3 million doses to COVAX because they could not be administered before the expiration date (IAHE, 2022[23]).

At country level there were mixed experiences: some countries – including Bangladesh, Cabo Verde, Cambodia and Georgia – reported well-co‑ordinated national vaccination campaigns strongly supported by international partners, while others highlighted challenges in both delivery and co‑ordination. An after-action review in Mozambique (WHO, 2021[28]), highlights several of the most frequently identified shortcomings and lessons: Despite the good practice of establishing a COVID-19 Vaccination Coordination Committee at all levels (central, provincial and district) to ensure a harmonised approach across various sectors and stakeholders, including religious leaders and Ministry of Health partners, and enhance community participation, the vaccination campaign made very slow progress and was undermined by uncoordinated efforts. Challenges included low levels of collaboration among COVID-19 vaccination partners leading to duplication of efforts, and insufficient communication on vaccine delivery dates leading to disruptions and delays. Weak community engagement led to vaccination hesitancy in some areas and combatting misinformation was a major challenge.

Private sector involvement in the COVID-19 response

The COVID crisis highlighted both the contributions and challenges of private sector engagement in international co-operation (Kabwama et al., 2022[29]; Wallace et al., 2022[30]).The private sector played a significant role in the COVID-19 response across developing countries, complementing public and development co‑operation efforts in health service delivery, logistics and social protection. However, official development finance for private sector entities dropped, particularly in the first year of the pandemic.

A study across four countries in Africa (Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda) found that the private sector supported expansion of access to COVID-19 testing services through establishing partnerships with the public health sector (Kabwama et al., 2022[29]). In the DRC and Nigeria, private entities supported contact tracing and surveillance activities, while in Senegal and Uganda, governments established partnerships with the private sector to manufacture COVID-19 rapid diagnostic tests. The private sector also contributed to provision of personal protective equipment, risk communication and health service continuity. Another study of Bangladesh, Ghana, Nepal and Nigeria also highlighted that the private sector supported the response by providing facilities for quarantine, isolation and treatment through the conversion of unused space.

Nonetheless, the two studies highlight challenges, notably around co‑ordination issues, as in some cases the lack of formal frameworks for public–private partnerships resulted in fragmented efforts and duplication of resources, as well as concerns related to reporting, quality and cost of services, calling for quality and price regulation in the provision of services.

There is limited available evidence on the effectiveness of different approaches to involving the private sector in bilateral development agencies’ response, or how these were co-ordinated with multilateral efforts – though many providers gave examples of how they involved companies in their crisis response. The UK FCDO worked with social enterprises to set up COVID booths to facilitate testing early in the pandemic in Bangladesh, and there were some indications that these were successful (Global Partnership for Effective Development Co-operation, 2021[31]). Czechia created a new instrument to supply health products to their priority countries. Japan also reported that Japanese technology and products provided to developing countries played a lifesaving role during the pandemic (JICA, 2024[32]). For example, through grant assistance, Twinbird Corporation’s portable ultra-low temperature, vibration-resistant refrigerators for carrying vaccines were distributed in East Timor and Mozambique, enabling delivery of the COVID vaccines to the “Last One Mile” such as remote areas with rough roads.

4.2. Policy coherence for sustainable development

Well before the COVID crisis, it was clear that even the most effective and well-coordinated international assistance will only lead to good outcomes if it is supported by other policy actions of both provider and recipient countries. International development and humanitarian assistance cannot be understood in isolation, as other policy actions greatly influenced – both positively and negatively – the overall outcomes of the crisis response.

While few evaluation functions are mandated to look at policy areas beyond international assistance, several studies have identified major challenges with policy incoherence (Schwensen and Schiebel Smed, 2023[4]) (Williamson et al., 2022[1]) i.e. where other policy decisions by provider countries compromised their development co-operation efforts. Some of the key areas included:

• Export bans, vaccine hoarding and purchase agreements that raised prices and reduced supply: Vaccine policies of many countries – including purchases by several rich nations in quantities far exceeding their population’s needs – undermined otherwise effective international assistance and multilateral co-operation for equitable access to COVID vaccines.

• Public spending and debt: The knock-on effects of increased public expenditures and public debt drove up the costs of borrowing for developing countries (IMF, 2025[33]).

• Travel bans and closures: The closure of country borders likely had no effect on the trajectory of the outbreak, but had a substantial impact on the rights of refugees and on the economies of low- and middle-income countries (LMICs) by disrupting trade and supply chains, causing a collapse in tourism and hospitality, and reducing remittances and foreign direct investment (Williamson et al., 2022[1]).

• Refoulement of refugees and asylum seekers: Border closures and other movement restrictions related to the pandemic had significant repercussions for refugee rights and for protection actors. In 2020, across all regions of the world, there were approximately 1.5 million fewer arrivals of refugees and asylum seekers than expected. There is clear evidence that some states used the pandemic as a purported justification to introduce restrictive measures detrimental to the rights of refugees (UNHCR, 2022[34]). A Joint Evaluation of the Protection of Rights of Refugees during the COVID-19 pandemic carried out under the auspices of the COVID-19 Global Evaluation Coalition by the United Nations High Commissioner for Refugees (UNHCR), Finland, Colombia, Uganda and the Active Learning Network for Accountability and Performance (ALNAP) looked at how the COVID-19 pandemic challenged the protection of the fundamental rights of refugees, and how the combined response of key actors worked to avoid exclusion.

• Disinformation and misinformation: Widespread misinformation and even intentional disinformation was not sufficiently addressed, undermining public confidence with long term consequences.

Incoherence was at times driven by short-term political interests including a desire for high visibility, which led to a supply-driven, hardware-heavy approach often with insufficient attention to efficiency and relevance.

Incoherent policy actions were often framed as serving national interests. However, several studies have shown that during the COVID crisis, incoherence undermined the global response, which ultimately lead to worse outcomes for all (Williamson et al., 2022[1]). Furthermore, there is evidence from many countries of high-levels of public support for international assistance and in some countries support increased during the COVID crisis (Box ‎4.2). While there may be public communication goals for demonstrating the contribution of specific provider countries, there is little evidence that such approaches are necessary nor effective at increasing public support for international assistance. In any case, the risks in terms of cost, efficiency and effectiveness should be duly considered as waste and low impact can in the longer term undermine public support.

Experiences from several providers showed that a more global framing of national interest and global public health, resulted in more support for international assistance during the crisis, and in more coherent and effective international assistance. A good example was New Zealand’s public health security strategy of involving neighbouring countries in its national vaccine procurement strategy, which helped all countries in the region reach their vaccination targets – benefiting New Zealand as well as its developing country partners (Ministry of Foreign Affairs and Trade of New Zealand, 2025[20]).

Box ‎4.2. International solidarity during the crisis: Public opinion in Germany

Opinion-based data from the German public in mid-2020, found that:

• The public favoured greater global solidarity to cope with the coronavirus pandemic.

• The indicators for “own health concerns” correlated slightly positively with support for development co-operation — i.e. the greater the concern for the health of family and friends or one’s own health, the greater the approval of increased development and humanitarian spending.

• Trust in Germany’s own government correlates positively with support for increased global solidarity, creating potential risks if trust declines. This finding is consistent with previous studies that found trust in one’s own government positively affects the support for co-operation.

The results of a representative survey among 1 000 individuals in Germany conducted in November 2021 found that despite the acute, ongoing pandemic crisis in Germany, there was still a high level of public support for measures to tackle the pandemic in the Global South:

• The level of support among the German population for development policy measures to tackle the coronavirus pandemic in the Global South remained high, especially for support to health care and food security measures. In contrast, those surveyed were more sceptical towards granting debt relief or providing economic aid.

• The population supported donating an increased number of vaccine doses to countries of the Global South, and perceived vaccine distribution as unequal and unfair.

• With regard to patent protection for COVID-19 vaccines, public opinion was divided.

Sources: Bruder et al. (2020[35]), “Public Opinion on International Solidarity in the Coronavirus Pandemic”, DEval Policy Brief 2020, German Institute for Development Evaluation (DEval), Bonn; Eger et al. (Eger et al., 2022[36]), “COVID-19: The general public's attitudes towards development policy measures and vaccine distribution: Results of a survey on international solidarity during the coronavirus pandemic”, DEval Policy Brief 2/2022, German Institute for Development Evaluation (DEval), Bonn, https://nbn-resolving.org/urn:nbn:de:0168-ssoar-79708-5.

4.3. Co-ordinating international assistance within provider governments

Bilateral providers had many good examples of aiming for whole-of-government crisis response efforts, including formal mechanisms, such as taskforces and platforms, for co-ordinating foreign ministries, development agencies, ministries of health, the private sector including pharmaceutical companies (e.g. China, Italy, Mexico, and Japan) and civil society organisations (e.g. Italy, Spain) (OECD, 2020[37]). Several DAC members have described efforts to restore supply chains and international trade. The clear message that emerges is the usefulness of having a single, dedicated body (either pre-established or ad-hoc), and to establish channels for collaboration both within government and with relevant partners.

Consistent with other studies of whole-of-government approaches, the combination of technical know-how (of line ministries or specialised agencies) with a high-level political vision (from the Head of Government) seems to have been a driver of effective action, especially in creating a sense of urgency that helped overcome barriers. Likewise, formal mechanisms that used or built on existing structures, and had a clear mandate with decision-making power, seem to have worked best.

Providers established a range of approaches for internal, whole-of-government co-ordination of international assistance. These varied in terms of institutional lead (centre of government or the foreign ministry); whether they were created during the crisis or built on existing co-ordination mechanisms; and the degree of formality.

• Germany’s Emergency COVID-19 Support Programme (Corona-Sofortprogramm) used a crisis committee mechanism to co‑ordinate across the German Federal Ministry for Economic Cooperation and Development (BMZ) and implementing organisations. This was found to have helped with internal coherence with regard to the distribution of funding, though it did not actively steer the programme, monitor the success, or take up lessons afterwards. (Römling et al., 2024[7]). For a future global crisis of a similar extent, the German Institute for Development Evaluation (DEval) recommends that the BMZ should appoint a specific office to be responsible for institutionally anchoring a crisis response programme, and for incorporating and making available the insights gained from internal and external learning and assessment processes. The appointed office should be responsible for implementing preparatory measures to be applied in the event of a future crisis. In particular, when setting up any future crisis response programme, it should be defined who is responsible for its planning, steering and subsequent evaluation (DEval, 2024[38]; AFD, 2024[39]).

• The Netherlands Ministry of Foreign Affairs (MFA) instituted two co‑ordination task forces – the Corona Task Force to co‑ordinate the Dutch development co-operation and humanitarian assistance response within the ministry and the International COVID-19 Support Task Force with the Ministry of Health to co‑ordinate in-kind donations (OECD/IOB, 2025[5]). These task forces were important drivers of coherence (OECD/IOB, 2025[5]). However, the Netherlands found that despite these mechanisms, the different collaborating Dutch ministries were guided by different priorities and this, combined with, at times, ad hoc political decision making, resulted in strategic uncertainty and incoherence in the Dutch response.

• In the United States, USAID and the U.S. Department of State jointly supported efforts to develop sustainable financing options for global heath security, including using bilateral and multilateral channels to assist developing countries to address the pandemic and to prevent future threats. USAID co-ordinated efforts to address key pharmaceutical system bottlenecks to the manufacture of vaccines, as well as the knowledge and products required to develop vaccines (USAID, 2022[40]), building on existing cross-government partnerships such as the President’s Emergency Fund for AIDS Relief (PEPFAR), and the President’s Malaria Initiative. In addition, USAID and the US Center for Disease Control (CDC) collaborated with the COVAX initiative and other global and regional organisations, as well as with the broader donor community, to ensure co‑ordination of activities.

• In South Africa an intergovernmental mechanism, anchored in the foreign ministry and mandated as a single point of leadership, was identified as an important mechanism for coherence and consistency of policymaking and implementation (Presidency of South Africa, 2021, p. 599[41]).

• Likewise, the Mexico example showed that a single co-ordinating entity – the Mexican Agency for International Development Cooperation (AMEXCID) within the Ministry of Foreign Affairs – with a mandate to co-ordinate actions across health, military and other parts of government, was operationally effective in delivering assistance, and supported Mexico’s regional leadership (OECD, 2025[42]).

• The New Zealand case study concludes that strong domestic collaboration is required for the successful delivery of vaccines and other assistance. To enable co‑ordination, New Zealand’s Ministry of Foreign Affairs and Trade (MFAT) established a new temporary division during the COVID-19 pandemic, which convened multi-agency meetings. The programme oversaw New Zealand’s contribution to the vaccine rollout in six Polynesian countries and Fiji, and was built on a foundation of robust collaboration and communication between the Global Health team at the Ministry of Health, and the health team within the Pacific and Development Group (PDG) in MFAT which was established before the crisis. Because the crisis response (the “Pacific Resilience Approach”) was delivered via a cabinet mandate, it meant that all New Zealand government agencies operated under a shared strategy and guiding principles when engaging with the Pacific (Ministry of Foreign Affairs and Trade of New Zealand, 2025[20]).

• In Spain, inter-ministerial co‑ordination through a tripartite committee led by the Prime Minister's Office together with relevant ministries proved to be a success. During the crisis it was a useful tool to articulate the capacities and interests of the different ministries, as well as to provide a rapid and flexible response in a changing situation. The design included ad hoc spaces for participation in addition to the usual channels (inter-ministerial and inter-territorial commissions), notably the “Day After” platform, which had a broad participation of actors and experts in Spanish development co‑operation and sector-wide approaches. This approach reinforced coherence across Spanish co‑operation sectoral instruments and strategies (Ministerio de Asuntos Exteriores, Unión Europea and Cooperación, 2024[6]).

In terms of pre-pandemic preparedness, there was a mix of experiences. Some reported that their crisis contingency plans were inadequate in the face of the scale, duration and global scope of the COVID crisis, while others described effectively building on crisis response plans. An evaluation of Finland’s Ministry of Foreign Affairs found that “the MFA managed rather well without pre-existing crisis response plans and pandemic-specific risk analysis. It would have benefited from a headquarters preparedness plan to support moving human resources at crises and better preparedness to monitor the effectiveness of the COVID-19-time development cooperation” (Ministry for Foreign Affairs of Finland, 2022[19]).

4.4. Co-ordination at country-level

A key success factor in a well-coordinated crisis response was government capacity and leadership – around which international partners could align and co-ordinate actions.

National governments and development partners employed several approaches to co‑ordinate pandemic responses in partner countries, including government convened donor co‑ordination mechanisms (such as the Troika in Burkina Faso), UN Country Team-led co‑ordination and technical working groups. In settings where humanitarian responses were underway, UN-defined clusters, including the health cluster were used to co‑ordinate action across agencies.

Effective COVID-19 co‑ordination was linked strongly to government capacity (e.g. South Sudan, Ethiopia and Rwanda) (Gooding, Webster and Wiafe, 2021[27]). In Cambodia, for example, a strong national development co‑ordination council has worked for many years to lead development policy and planning and co‑ordinate the support of international partners. High-level government leadership and political will was vital in supporting and guiding response co‑ordination at country level but was mainly effective when it was accompanied by partner country decision making power, and balanced with technical input and collaboration with development partners (Schwensen and Schiebel Smed, 2023[4]). Despite the importance of the government-led co‑ordination, partner country co‑ordination remained uneven, impacting agility (MOPAN, 2022[8]). In some countries, both prior to and during the pandemic, there were functioning co‑ordination mechanisms to bring partners together, whereas in others, these were absent or operated only for information sharing, rather than driving enhanced coherence (MOPAN, 2022[8]).

Multisectoral co‑ordination mechanisms were of critical importance during the pandemic response to ensure a coherent response, particularly when integrating public health programming with livelihoods and cash assistance to address food security and cost barriers to health services. Strong political leadership was key to successful responses, as seen for example in Kenya's COVID-19 response which was spearheaded by the Executive Office of the President and employed a comprehensive, whole-of-government strategy. This approach co‑ordinated various governmental levels and agencies and actively partnered with the private sector. A national COVID-19 taskforce was established, bringing together stakeholders such as the Ministry of Health, other government ministries and agencies, UN agencies, development partners, non-governmental organisations (NGOs) and civil society organisations (CSOs). The taskforce participated in various high-level committees, which supported the implementation of Kenya’s response to the COVID-19 pandemic (OECD/AfDB, 2025[43]).

Countries that had prior experience or ongoing humanitarian operations tended to be more successful at employing integrated humanitarian-development approaches during the COVID-19 crisis response (IAHE, 2022[23]). According to IAHE’s analysis, in Colombia, the health and humanitarian aspects of the response were well-integrated, including during COVID-19, while in many other countries – including the Democratic Republic of Congo (DRC) – the COVID-19 response was siloed and fragmented. In Lebanon and Yemen, COVID-19 response efforts were folded into ongoing humanitarian efforts, focusing on health, food security and livelihoods to address both immediate pandemic health needs and long-term development goals (Humanitarian Action, 2020[44]; Lilly, 2020[45]; OECD, 2025[46]). There are some indications however, of continued fragmentation between development and humanitarian operations, with the pandemic crisis response being added as a third line of support, rather than integrating with more coherence approaches (Schwensen and Schiebel Smed, 2023[4]).

Several evaluations and case studies showed that country-level health support – both before and during the pandemic – was delivered through parallel systems, creating duplication and inefficiencies, as well as failing to deliver stronger national capacities to support sustainable health systems.

Multilateral actors acted as catalysts and hubs for co-ordination, particularly in countries like Nicaragua where there were tensions between the government and other countries which limited bilateral engagement. From January to March 2020, UN country teams began taking rapid collective action under the co-ordination and leadership of Residence Coordinators (RC) supported by Resident Coordinator Office (RCO) staff. This facilitated a rapid transition to collective analysis and planning. Leadership and co-ordination by these offices helped UN agencies to maintain a safe operational presence and meet UN obligations of duty of care to staff during this critical period (UNSDG, 2022[13]).

In Bangladesh, the presence of UN organisations with dual mandates across multiple co‑ordination platforms, such as UNICEF, was noted as an enabler of co‑ordination across the development of a humanitarian response (OECD, 2025[47]). Bangladesh created a new mechanism for its socio-economic response, with a particular emphasis on coherence and complementarity among development partners. It particularly stressed co‑operation with UN agencies and benefiting from their existing expertise. This enabled it to be more strategic in its response (OECD, 2025[47]). In Cambodia, WHO played a key role as the designated intermediary between the government and development partners. This helped to streamline co‑ordination among partners and the government, without overwhelming the government with requests. It also made WHO responsible for navigating around sensitive political and scientific issues. Reflecting the same pattern as development partner co‑ordination, new and established mechanisms were used for cross government co-ordination, and, in the case of partner countries, provider co‑ordination.

The health cluster system2 played an important part in co‑ordinating the humanitarian health response. The system was designed to facilitate collaboration among various humanitarian actors to address health needs at country level. In response to the unprecedented threat to global public health and socio-economic stability, particularly in countries affected by humanitarian crises, the Global Health Cluster (GHC) scaled up its country co‑ordination support to provide context-appropriate technical and operational guidance to effectively implement the 2020 Strategic Preparedness and Response Plan (SPRP) and the 2020 GHRP. As a result, the SPRPs for 2021 and 2022, as integral components of the subsequent humanitarian response plans, were also scaled up. These served both to mitigate the direct impact of COVID-19 and to maintain the provision of existing humanitarian health action, including essential health services.

Other factors supporting co‑ordination included preexisting relationships with governments, implementing partners and the private sector, as highlighted in the evaluation of UNICEF’s pandemic response (UNICEF, 2023[48]). Where partners already knew each other and international staff remained in-country, co‑ordination worked better. Preexisting relationships facilitated the shift to less formal, more intimate person to person co‑ordination through platforms like WhatsApp and Telegram, especially during intense periods such as lockdowns or restrictions on movement.

Examples from both provider and partner country cases also highlighted a disconnect between high-level political decisions (and announcements) and technical level co‑ordination and management. In several provider countries prime ministers or presidents made public pledges of support – sometimes specifying recipient countries or types of support. There were also reports of high-level meetings between heads of state (or ministers) resulting in agreement to provide certain pandemic supplies. However, these political level decisions were sometimes out of sync with technical level co‑ordination and planning mechanisms.

For instance, in one provider case, the president announced a volume of vaccine donations to be donated to neighbouring countries that far exceeded the population needs. In another country, local efforts to carefully map oxygen needs in each medical facility, were ignored when one donor provided oxygen production equipment to a particular hospital during a high-level visit, undermining the technical-level’s strategic plan for allocating oxygen supplies based on identified needs. There were also examples of high-level commitments that do not seem to have materialised (perhaps due to this disconnect).

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Notes

← 1.  The COVID-19 Global Humanitarian Response Plan was set up to combine humanitarian funding appeals. It targeted preparedness, prevention, mitigation and response in countries most vulnerable to the pandemic and least able to respond. While unprecedented in its global scale, the approach built on existing structures to co-ordinate humanitarian responses by consolidating funding appeals and action planning for a specific humanitarian crisis.

← 2.  The UN Cluster System is a co‑ordination mechanism established by the United Nations to enhance the effectiveness of humanitarian responses during emergencies. It brings together humanitarian organisations into sector-specific groups, or “clusters” (e.g. Health, Shelter, Nutrition), each led by a designated UN agency. The system aims to ensure more predictable, accountable and co‑ordinated support by clarifying roles and responsibilities, promoting joint planning, and avoiding duplication of efforts among humanitarian actors.