The Global Health Architecture of Pandemic Preparedness and Response: Comparing and Contrasting Experiences of Zika and COVID-19 in Brazil

The current COVID-19 pandemic shows the frailty of global public health systems and the urgent need to strengthen responses to Public Health Emergencies of International Concern (PHEIC). This chapter is based on an original research conducted between November 2019 and July 2020 that reflected on the PHEIC of Zika virus (ZIKV) in Brazil in 2015 and compared and contrasted to the COVID-19 PHEIC. The research aimed to highlight lessons learned in both PHEICs to further improve the responses to future PHEICs and the global architecture of pandemic preparedness and response as a whole. Online in-depth expert interviews and a qualitative survey were applied to gather knowledge of international and Brazilian experts in the field. In this chapter, we outline our findings and in retrospective connect them with the key concepts of this book. The findings stress that emergency responses should incorporate solutions to underlying structural problems, especially inequalities, and include a gendered approach to be sustainable and effective on the long term. It became clear that responses to PHEICs are to a great extent shaped by politics. However, effective responses should be evidence-based and managed in a technical manner rather than used as a political tool. Strong outbreak preparedness is more sustainable than rushed emergency responses. On both national and global scales, this requires transparency and consistency in outbreak preparedness and compliance to the international health regulations (IHR); guidelines and protocols being uniformly applied; and decisions made based on science, without too much political interference.