This is no satire. ‘Wicked Problem’ is a technical term used in policy and planning to refer to issues that are difficult to solve. Like most terms in social sciences, it is often difficult to get everyone to agree on precisely what it means. Issues considered ‘wicked’ by some are seen as not so ‘wicked’ by others. However, if there were ever a situation that should bring everyone to an agreement, it would be the Covid-19 Pandemic. Wicked problems are tricky and challenging, uniquely so because just about every proposed solution comes at a high collateral cost with no exact best approach. If not correctly addressed, wicked problems could be made worse, leaving communities and countries in ruins. I guess the next question should be, “what makes the Covid-19 pandemic wicked”. The simple answer is ‘wickedness’ lies in every solution available to us thus far. Let us start by examining the solution and the inherent danger in the approaches before considering the caution that should be heeded.
The lockdown – the debate as to the effectiveness of this approach is not within the scope of this article. However, the article wishes to count the cost of the lockdown approach. The massive economic loss is one that has been discussed far too many times. But what is its health implication? The Sustainable Development Goal 2 says ‘Zero hunger’. However, the United Nation has estimated that 256 million people are now at risk of suffering from acute hunger by the end of the year 2020 – doubling the estimate from 2019. The NEPAD draft strategy estimates that 5-million people die annually from starvation in Africa. We are now left to wonder what the forecast will be after the economic strain from the lockdown. It already looks far more than the expected direct deaths from Covid-19. Can you see the ‘wickedness’ in the wicked problem?
What is the alternative? Stay and do nothing? What government will hesitate to act? Especially in the face of the newness of this pandemic. Every government should be eager to help. But it is important to note that however good the intentions are, failure to consider the ‘wicked’ nature of this pandemic could get more people killed. Any decision that as much as worsens the existing poor health indices may become a greater evil than the Covid-19. Take a look at the current numbers of death from various infectious diseases in Nigeria. Diarrhoea kills 150,000 annually; Tuberculosis 245,000 and Pneumonia 162,000 (this is just in children under the age of five). What about pregnancy-related deaths and the health centres in rural areas barely surviving? Any decision that has the potential of doubling any of these numbers becomes ‘a cure worse than the disease’.
So now, how are wicked problems to be addressed? Is there a simple solution that is eluding everyone? Rittel and Webber gave a great answer in their 1973 essay titled Dilemmas in a General Theory of Planning: “There are no meaningfully correct or false responses. It makes no sense to talk about optimal solutions unless severe qualifications are first imposed. Even worse, there is no solution in the sense of definitive and objective answers.” This is the challenge with wicked problems; without a definitive answer, each country is saddled with the responsibility of qualifying what success looks like before choosing its approach. The question must then be answered; what consequence can we live with or which solution will lead to the least collateral damage? The answer is almost always different between and within countries, hence the different approaches we see. At the time of this writing, four months since the start of Covid-19 in China just about 1/3rd of the world’s population is on partial or total lockdown involving over forty countries. The other 2/3rd and 140+ countries have chosen their approach to their Covid-19 challenge.
The developed world may be able to accommodate the challenge of an economic downturn as they have enough financial backup to attempt to stimulate the economy. Already, the United States plans a 2.2 trillion dollar relief fund (compare that to Africa’s combined 2020 nominal GDP of 2.58 trillion dollars); Japan 990 billion dollars; Germany 800 billion dollars. The economic effect on health is expected to be less severe in these countries. The aim is not to compare lives to dollars, but a collapsed economy leads to hunger, crime, conflict, disease, poor healthcare and deaths. Keep in mind the initial problem is to prevent death from Covid-19; success should be avoiding as many casualties from Covid-19 without killing more people in the process. Therein lies the wickedness in the problem.
The goal of this article is to bring the reader to the realisation of the ‘wicked’ nature of the Covid-19 pandemic and the grave consequence of chasing the ‘ideal’ solution without adequately considering the fallouts. It is dangerous thinking ‘what do we have to lose’ as jumping on any, and every solution could indeed be worse than not inaction – setting Africa years behind the rest of the developed world. So, maybe, just maybe, the leaders who are careful and appear slow to act may have saved millions of lives. It is easy to count the short-term gains (or loses). Still, we must look critically into long-term impacts, particularly unintended consequences. I hope we also ask, “What other wicked problems have we inadvertently worsened with our interventions”. I will leave you with the words of Charles C. Soludo professor of economics and former Nigerian CBN governor. In his article titled Can Africa Afford Lockdowns, he appeals “LET US THINK THIS THROUGH!”
Dr Ohize, health promotion professional, Mandela Washington fellow and Commonwealth scholar, writes via [email protected]om