Policy responses to COVID-19 present a window of opportunity for a paradigm shift in global health policy: An application of the Multiple Streams Framework as a heuristic

Abstract

Drawing on Kingdon's Multiple Streams Framework as a heuristic, this article reviews the three streams - problems, policies, and politics - as applied to the adoption of economic policies in response to the socioeconomic impacts of COVID-19. In doing so, we argue that we are currently presented with a window of opportunity to better address the social determinants of health. First, through assessing the problem stream, an understanding of inequity as a problem gained wider recognition through the disproportionate impacts of COVID-19. Second, in the policy stream, we demonstrate that appropriate and unprecedented policies can be enacted even in the face of changing evidence or evidentiary uncertainty, which are needed to address upstream factors that influence health. Lastly, in the politics stream, we demonstrate that addressing a public health 'problem' can be well-received by the public, making it politically viable. However, it is important to ensure the 'problem' is clearly relayed to the public and that this information is not perceived to change, as this can undermine trust. The social, political, and behavioural lessons presented by the COVID-19 pandemic should be drawn on in this pivotal moment for global public health.

Keywords: COVID-19; Multiple Streams Framework; Public policy; healthy public policy; public health.