The Politics of Pandemics: Why Some Countries Respond Better Than Others

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The capacity of a state and the degree of economic inequality among its residents will determine how successful it is in coping effectively with a pandemic like COVID-19. Whether it is a democracy or a dictatorship matters relatively less, according to recent research by Wharton management professor Mauro Guillen.

Titled, “The Politics of Pandemics: Democracy, State Capacity, and Economic Inequality,” Guillen’s working paper tracks epidemic outbreaks in 146 countries since 1995. It is the first study to explore the effects of democracy, state capacity, and income inequality on epidemic dynamics.

“In democracies, greater transparency, accountability, and public trust reduce the frequency and lethality of epidemics, shorten response time, and enhance people’s compliance with public health measures,” Guillen wrote in his paper. However, “democracy has no effects on the likelihood and lethality of epidemics.”

According to the paper, inequality increases the frequency and scale of an epidemic, and it undermines people’s compliance with epidemic containment policies such as social distancing and sheltering in place because people at the low end of the socioeconomic scale cannot afford to stay at home—they must go to work. But strong state and government structures could help offset most of the shortcomings. “State capacity is a bulwark against the occurrence and ill effects of crises and emergencies, while economic inequality exacerbates them,” Guillen wrote.

Takeaways for Governments

“The most important result in my analysis is that you have to have the resources, the capacity and the [requisite] state structures in place to deal with these national emergencies,” said Guillen. “Countries that score higher in state capacity, because they have more resourceful governments, regardless which party is running it, have fewer of these epidemics. And if they have one, they tend to have fewer deaths and cases.”

The second takeaway from the study is that “for the most part, it doesn’t really matter whether you’re a democracy or a dictatorship,” he added. “But inequality can make the consequences of all of this much, much worse, especially in terms of the number of people affected.”

He explained that a high degree of economic inequality means that people don’t have good nutrition or access to health care, and they don’t have savings or other resources. “Even during a pandemic, they have to continue working and use public transportation. So they don’t observe social distancing or sheltering-in-place and therefore they become more exposed to the potential consequences of the virus.”

“Countries that score higher in state capacity, because they have more resourceful governments, regardless which party is running it, have fewer of these epidemics.”–Mauro Guillen

‘Mosaic of Experiences’

What interested Guillen about the pandemic is “the mosaic of experiences around the world” — both in the way in which countries are affected by it and how their governments respond. He noted that while the pandemic is global, it is felt in very different ways around the world, and also that it didn’t start in every country at the same time. There is also a wide variation in the responses by governments and by people in different countries.

He said he was “specifically interested in seeing whether politics has anything to do with how effectively countries deal with these kinds of situations or crises.” He also noticed in the debates on the pandemic that “there were some misconceptions about the relative ability of different types of political regimes to intervene.”

Guillen identified “three big debates” around the pandemic. One is about whether democracies do a better job or a worse job than dictatorships in managing health crises. (He clarified that he used the term dictatorships to refer to non-democracies of various types, including those that are totalitarian or authoritarian.) The second is over whether the governments are prepared with the requisite capacity to deal with health emergencies. The third debate is on how economic inequality makes a country vulnerable to relatively harsher consequences than others that are better off on that score. Guillen decided to delve into the data to bring more clarity to those three debates.

He conducted three studies to ascertain the impact of political regime, state capacity and economic inequality on “epidemic dynamics.” The first reviewed the occurrence and lethality of epidemic outbreaks worldwide between 1990 and 2019. The second analyzed the speed with which a government-mandated lockdown came into being during COVID-19 “as the most dramatic policy to curb the spread of a contagious disease.” The third study examined people’s compliance with social distancing and sheltering-in-place measures across countries during 60 days of the pandemic.

Guillen also looked at how the form of government interacts with state capacity to cope with a health emergency or with economic inequality. Being a democracy and having state capacity are not always correlated, said Guillen. Some democracies are newly independent countries and relatively poor, and they don’t have strong government programs. “Over the last 20 years, we’ve seen a lot of these countries — for example, in Africa — becoming democracies. But they lack resources and they lack strong government programs. Those are the most vulnerable, and this is why we see that so many epidemics ravage the developing world.”

It gets worse for poor countries that remain dictatorships. “They face a double whammy because they don’t have resources, and they don’t have strong government programs,” said Guillen. Further, in dictatorships, the population typically does not have much trust in the government and its responses to an epidemic, he added. “That’s the worst of all situations.”

The study found that countries with high population densities are generally more vulnerable to epidemics and have a lower ability to bring them under control. They need to put more systems in place to prevent epidemic outbreaks, said Guillen.

However, some countries that have very high population densities are also very rich — like Japan, Singapore or Holland, Guillen pointed out. “They don’t have epidemics because they compensate with very strong government programs,” he said, adding that they can afford those programs because they are wealthy.

As the COVID-19 pandemic continues its spread, it is far too early to take stock and identify winners and losers among countries. However, South Korea, Taiwan and Singapore are among a few countries stand out for having state capacity and strong government programs in place to deal with such emergencies, said Guillen.

Those countries had strong government programs in public health in particular because they are rich countries, and also because they became wiser after having encountered health emergencies like SARS in the past, he noted. The strength of their state capacity and public health programs mattered more than the form of government, he added.

South Korea, Taiwan and Iceland also showed low economic inequality in Guillen’s research. That buttressed his finding that the greater the economic inequality, the more the likelihood of an epidemic outbreak, and with more consequences than countries with better scores on that measure.

At the other end of the spectrum, inadequate or fragmented state capacity was the reason why countries in Southern Europe like Spain and Italy have suffered heavily in the pandemic. It didn’t seem to matter that they are democracies – their governments have been “completely disorganized” in their response to the pandemic, Guillen said. “The problem there has been that they don’t have the resources that some of those other countries in Europe had in place.” To boot, the degree of economic inequality in Southern Europe is also higher than in Northern and Central Europe, he noted.

“Being a democracy helps in general, because it’s easier for you as a government to generate trust among the population in order to cope with a pandemic,” said Guillen. “But if you don’t have strong government resources or capabilities, then you’re going to be at a disadvantage.”

“Being a democracy helps in general, because it’s easier for you as a government to generate trust among the population in order to cope with a pandemic.”–Mauro Guillen

Pointers from the Past

Drawing upon previous research by Guillen and other experts, the paper traced the quality of government responses in earlier crises such as the East Asian financial crisis in 1997, the Arab Spring in 2010 and the 2008-2010 global financial crisis.

The outcomes of those crises were mixed. In the East Asian crisis, for instance, South Korea had preexisting ties with its business and financial sectors, which enabled it able to respond more effectively than Thailand did. Semi-authoritarian regimes like Malaysia or dictatorial regimes like Indonesia took action more swiftly, but with less consistency, and with uncertain outcomes due to favoritism and corruption, Guillen’s research showed.

The 2008-2010 global financial crisis primarily affected high-income democracies. Although “several governments on both sides of the Atlantic were defeated at the polls, democracy itself survived and economic growth resumed relatively quickly in most countries,” according to research by Guillen and another study by Stanford University political science professor Larry Diamond.

By contrast, the Arab Spring led to “the downfall of several governments, the overthrow of political regimes, a continued economic slide, and, in some cases, civil war,” Guillen’s paper noted, citing a United Nations survey of 2015-2016.

Who Fares Better: Dictatorships or Democracies?

While democracies fared relatively better than dictatorships in previous crises, they may face different challenges with the COVID-19 pandemic “in terms of the sacrifices that it demands from the population in order to contain it,” Guillen noted in his paper. Dictatorships can respond “more swiftly and resolutely” in imposing quarantines and enforcing other steps that infringe on individual liberties.

On the other hand, greater transparency in democracies may allow them to respond promptly to a public-health emergency, and secure public trust and collaboration. The paper notes that research by The Economist on epidemics since 1960 found lower mortality rates in democracies than in dictatorships. All considered, Guillen’s research suggests that democracies structurally lend themselves to more effective responses to epidemics than dictatorships.

The upshot from those previous episodes: With democracy, economies have the opportunity to recover after a crisis. Without democracy, economies may continue to slide, favoritism and corruption may rule the day, and governments may fall.

“The pandemic came the moment when global cooperation on key issues, such as climate change, was at an all-time low.”–Mauro Guillen

Guillen agreed that governments in democracies face constraints such as the need for building a consensus, or have to make trade-offs in multiparty politics that result in less than optimal policy responses. “That’s one of the potential dysfunctions of democracy,” he said.

“But on the other hand, in a democracy, the government can be voted out,” Guillen continued. “The government wants to have at least majority support among the population, and so it has an interest in delivering a certain standard of well-being to a majority of the population.”

Most dictatorships, however, tend to ensure that they will continue to run the country by allocating subsidies and rents to a few important groups that support it, he added.

Guillen’s research produced some surprises, too. He did expect countries with income inequality to have reduced compliance in social distancing because they would have more people who live “from paycheck to paycheck, who need to go to work.” But he was surprised that democracy didn’t have an effect on social distancing. He had thought that those measures are easier to implement in democracies where people have more trust in their governments than in dictatorships. “But I didn’t find that effect at all,” he said. “I found no difference between democracies and dictatorships when it came to compliance with social distancing and sheltering-in-place [guidelines].”

International Cooperation

For sure, countries suddenly facing a pandemic cannot overnight fill gaps in government capacity or economic resilience, or economic inequalities among their populations. Here, international cooperation could help overcome shortcomings.

“Every infectious disease outbreak is a problem for the entire world, not just for one country, especially when it becomes a pandemic,” said Guillen. “So, it’s extremely unfortunate that right now very few countries are talking to each other. Part of this is because we came from a period of turmoil in the world, not knowing what the role of the U.S. was, for example, and having trade wars and other kinds of frictions in the world. It’s unfortunate that the pandemic came the moment when global cooperation on key issues, such as climate change, was at an all-time low.”

That is unfortunate because in a pandemic, it is essential that governments exchange information about the spread of the disease and about what works and doesn’t work in containing the spread of the virus, he noted. The World Health Organization has been trying to forge international collaborations to try and develop effective therapeutic treatments and a vaccine for COVID-19. “It is unfortunate that the one organization that we have that can help coordinate global actions in the midst of a pandemic is under attack.”