The inevitability of moving from a Covid-19 elimination strategy to a suppression strategy is starting to become a reality in New Zealand.
Government must now rethink its pandemic management and communication that has largely been informed and shaped by expert knowledge from a narrow group of specialists, and a focus on educating the public to bring about their buy-in to lockdowns and the vaccine rollout.
This type of deficit approach to communication and engagement promotes what Daniel Yankelovich, a public opinion analyst and social scientist calls, ‘The Culture of Technical Control’. This assumes that: policy decisions depend on specialised knowledge and skills; only experts possess this knowledge; citizens or civil society groups are driven by self-interest; and any wayward people who don’t respond to clear messages can be brought in-line by education.
These are naive and fundamentally flawed assumptions that foster a knowledge hierarchy and limit those who are invited to sit around the Covid-19 policy decision-making table.
Covid-19 at its core is a biosecurity issue that manifests as a public health issue. Environmental biosecurity in New Zealand focuses its efforts on the border to protect us from invasive pests and diseases whether it be brown marmorated stink bug or foot and mouth disease. However, this narrow focus on preventing arrivals has led to woefully poor management of invasive organisms once they take a foothold and become established inside the border.
Kauri dieback is an example of this failure to contain and effectively manage biosecurity risk inside the border. For years it was managed by a policy framework that denied local initiatives, marginalised mana whenua, excluded mātauranga and social science knowledges and was riddled with agency territoriality.
It took more than 10 years for a policy change to occur that supported a collaborative approach to kauri dieback management that is guided by mātauranga, social science and science knowledges, and embraces the values and input of mana whenua and community in its programme design and implementation.
While we are now moving into a much better place for kauri dieback management, the pain in getting here will not be forgotten, and we can never recover the loss of kauri that occurred during this toxic journey from centralised to decentralised governance.
Government must learn from this experience as it begins to tackle endemic Covid-19 in New Zealand. The culture of technical control has dominated policy-making since Covid-19 arrived on our shores. Initial efforts to manage the pandemic under an elimination approach from March 2020 did need strong centralised leadership, distinct lines of responsibility and clear messaging. However, under a new disease suppression approach, the massively increasing social complexity that is emerging must be handled through a more devolved and nuanced approach to management.
The Ministry of Health and Ministry of Business Innovation and Employment have constantly displayed reluctance to loosen the reins on their centralised model of technical control.
Why were GPs’ pleas to deliver the Covid vaccine ignored for so long despite them historically being the mainstay of front-line immunisation in New Zealand? How long has it taken for the implementation of the business community’s trial for international travel to enable them to reconnect with the world? Why did it take so long for RSE workers from Covid-19 free nations to be allowed to enter the country to work on New Zealand farms?
Why do Māori and Pacific Island health care providers face constant bureaucratic walls that prevent them meaningfully working with their communities in the vaccine rollout? Why has there been so much resistance by the Ministry of Health to saliva and rapid antigen testing? Why are many overseas New Zealanders effectively stateless as a result of an MIQ booking system created by MBIE that displays anything BUT innovation.
The 12 months of breathing space New Zealand was afforded before Delta arrived, should have been a time when the much vaunted ‘whole of government’ approach to Covid-19 co-developed a long-term vision, strategy and operational plan, with a diverse range of groups for the eventual reality of when New Zealand would have to live with Covid-19.
As Covid-19 case numbers increase, particularly in Auckland, there will be pressure on these ministries to tighten the reins of centralised technical control. Instead, they should support responsible organisations to be innovative, as this will lead to solutions that are more nuanced and relevant, and likely create wider public buy-in to our new normal, particularly in hard-to-reach and marginalised sectors of society.
The team of five million is not a homogenous group of conformists. ‘Vax-a-nation’ slogans, as cute as they are, do not address the drivers for some people’s genuine resistance to vaccines, brought about by long-term systemic racism in the health sector that has created deep-seated distrust. There is a real opportunity now to begin to build trust by facilitating partnerships with those non-governmental and community agencies able to foster this trust.
As we transition from elimination to a disease suppression approach, we need a broader range of voices to be involved in shaping the path forward. This requires bottom-up processes built on enabling partnerships, not a centralised plan created in isolation and on the hoof, and then distributed to groups to implement. The first step in developing meaningful trusting partnerships is to listen.
