April 16, 2020
Local coordination key in management of pandemic
The pandemic is still going on, but Germany seem to have fared far better through the crisis than others. Why?
One of Germany's advantages in managing this pandemic is that it has a well-established country-wide coordination on health, despite this being a prerogative of the Länder. The German federal republic has not one public health authority but 400 different authorities throughout the country. Public health is run at the local level, with health authorities and departments run by municipality and rural district administrations. France and Italy, by contrast, found that it is hard to organise a crisis response without the logistical help of the mayors and the economic assistance of the regions.
The Covid-19 pandemic requires coordination of logistics, material and policy responses to manage local hotspots or the distribution of protective gear and tests. Germany was well ahead of the curve and prepared, needing nothing so dramatic as the policy shifts we have seen in the UK. The lockdown was gradual and health care had enough time to prepare for the peak. Germany had the institutional infrastructure and culture to coordinate its response at the local level throughout the country.
Early testing in Germany was a result of cooperation, too, though a different kind. The Robert Koch Institute played a crucial role in this. It coordinating a network of public, private, and university laboratories and research facilities to identify solutions to diseases which threaten public health. It was the collaboration between a private biotech company and the Charité hospital in Berlin that developed comparatively reliable tests already in early January, and had 4m testing kits ready by mid-March which they then distributed throughout the Länder and abroad.
The next challenge will be the end of the lockdown and how to manage an uptick in infections should they recur. Here, too, coordination is key. In France the German example seems to inspire the president. Emmanuel Macron is counting on the delegates of municipal councils, the so-called grands élus, not the MPs nor the government, to write up the exit strategy. Could this new collaboration between the state and the municipalities, so essential in Germany, acquire a permanent place in France after the crisis? Cécile Cornudet thinks this is likely, and suggests an informal council of grands élus, a bit like the council of ministers, to steer the country through the times ahead. A rebalancing of power between central and local authorities in France could be an unexpected side effect of the health crisis.