Politics and implications on the health systems preparedness to COVID-19 pandemic response: The Malawian experience.

The spread of the COVID-19 disease to Africa has raised concerns around the resultant effects on the fragile and non-resilient health systems. Malawi reported its first COVID-19 cases in early April 2020 at the time of the country's political turmoil, as the courts ruled for a re-run of presidential elections in July 2020 due to irregularities observed in the May 2019 elections. Therefore, assessing the implications of politics on the COVID-19 health systems preparedness is critical to design health systems strengthening efforts during the pandemic. We applied the WHO health systems framework to assess the implications of politics on the COVID-19 on the Malawi health systems preparedness. There was the population's lack of trust in government hampering government efforts, which posed as a huge concern for Malawi to navigate through the pandemic including the health systems preparedness for the pandemic. This, coupled with mass demonstrations by the public disagreeing with the Lockdown and health service providers put across their COVID-19 related demands. The political environment and the trust people have in the government determines a country's response to a pandemic. In a pandemic situation like COVID-19, the government's ability to coordinate the various key stakeholders while instilling trust in people remain critical in strengthening health systems to contain and mitigate the pandemic. However, the Malawi political turmoil highlighted in this paper derailed the process and efforts to contain the and timely prepare the health systems to manage the pandemic whilst maintaining its core functions of delivering essential health services. Therefore, governments should consider the effects of political challenges in supporting a country's health system to prepare for pandemics.