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Distributing systems level leadership to address the COVID-19 pandemic
  1. Graeme Currie1,
  2. Kamal Gulati2,
  3. Amrik Sohal3,
  4. Dimitrios Spyridonidis1,
  5. Jamiu O Busari4,5
  1. 1 Warwick Business School, University of Warwick, Coventry, UK
  2. 2 Clinical Epidemiology Unit, All India Institute of Medical Sciences New Delhi, New Delhi, India
  3. 3 Department of Management, Monash University, Melbourne, Victoria, Australia
  4. 4 Faculty of health, medicine and life sci, Maastricht University, Maastricht, The Netherlands
  5. 5 Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Caya Punta Brabo, Aruba
  1. Correspondence to Dr Graeme Currie, Warwick Business School, University of Warwick, Coventry CV4 7AL, UK; graeme.currie{at}

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COVID-19 pandemic has disrupted the political, economic and healthcare systems of most, if not all countries across the globe. As such, the COVID-19 pandemic represents another global health catastrophe similar to the Spanish influenza (1918–1920), H1N1 swine influenza (2009–2010) and West African Ebola (2014–2016) with high mortalities. Current public health measures aimed at subduing the spread of COVID-19 virus seem to be working but are not extensive enough to prevent ongoing infections and death.1 There is a need for leadership at the systems level, necessary because COVID-19 represents a complex problem, of a type commonly characterised as (volatile, uncertain, complex ambiguous (VUCA) unlikely to be effectively addressed by a single agency or person.2 In the context of COVID-19, leadership of the system encompasses politicians, scientific experts, civil servants and front-line practitioners, where leadership is shaped by the system in which it is enacted, and its historical, political and national characteristics.3 4 We discuss systems level leadership to address the COVID-19 outbreak,5–7 with concern for recovering from COVID-19.

As our first aim, we outline three themes related to how systems level leadership might influence recovery from the COVID-19 pandemic. Second, we provide comparative international descriptors that we critically evaluate against these three systems level leadership themes. We draw on observations of the way systems level leadership is enacted across England, Australia, India and in the Caribbean (Aruba), thus drawing on lessons from both OECD nations and low-income and middle-income countries (LMICs), and small as well as large countries, in our analysis. Following which, in our conclusion, we set out prescriptions for systems level leadership in the context of considerable VUCA.2

Theoretical insight

As our first theme, to understand prospects for recovery, we need to examine preparation precrisis. In the preparation phase, while organisations and their leaders are faced …

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  • Correction notice The affiliation “Department of Pediatrics, Dr. Horacio E. Oduber Hospital, Caya Punta Brabo, Aruba” has been added for author Jamiu Busari.

  • Contributors All five authors (GC, KG, AS, DS and JOB) have contributed to the Commentary. All provided empirical description of leadership in their health systems, GC took the lead in developing the analytical framework and writing.

  • Funding National Institute for Health Research Applied Research Centre West Midlands.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.