Getting multi-level governance wrong can be a matter of life and death during a pandemic

The COVID-19 pandemic is a global crisis, but it has had a highly varied impact on different regions across Europe. Marta Angelici, Paolo Berta (University of Milano-Bicocca), Joan Costa-Font (LSE) and Gilberto Turati (Università Cattolica del Sacro Cuore) argue that while centralised decision-making can help solve collective action problems like border closures, the management of the response to a health emergency is often more effective when it is implemented at the local level. Decentralised health care governance helps explain why mortality rates were lower in Italy than in Spain during the first wave of the pandemic.