COVID-19: time for paradigm shift in the nexus between local, national and global health

The COVID-19 pandemic has triggered unprecedented measures worldwide, which have often been adopted in an ‘emergency’ mode and are largely reactionary. Alternatively, COVID-19 needs to be appraised as part of a much bigger health picture, adopting a “systems approach” that enables interactions with other acknowledged and preventable health conditions, which often receive disproportionately low attention. To do so requires a paradigm shift in global health governance, from a specific reactional paradigm to a systemic, coordinated and preventive paradigm. It is necessary to adopt a holistic approach to health reflecting both a security approach and a health development approach, tackling upstream causes and determinants, aimed at helping populations reduce their individual risk factors and augment their natural immunity ► Such preventive health policies must be tailored to local specificities and local environments, and health systems must be strengthened at the local level so as to be able to respond to population needs and expectations. The current crisis calls for a paradigm shift in public and global health policies; and in the in the nexus between local, national and global health policies and systems.