The COVID-19 pandemic highlighted the scale of global unpreparedness to deal with the fast-arising needs of global health threats. This problem was coupled with a crisis of governance and presented in the context of globally hitting climate crisis and disasters. Although such a pandemic was predictable due to the known effects of human intervention on the surrounding environment and its devastating secondary effects, such as climate change and increased zoonoses, most countries were unprepared to deal with the scale and scope of the pandemic. In this context, such as that of the climate crisis, the Global North and Global South faced several common challenges, including, first and foremost, the scarcity of resources required for health, policy, wellbeing and socioeconomic wellness. In this paper, we review the most recent evidence available in the literature related to pandemic preparedness and governance, focusing on principles and practices used during the COVID-19 pandemic, and we place it in the context of a European Parliament Interest Group meeting (this event took place on 21 March 2023 during the “European Health Tech Summit”) to ground it within ongoing discussions and narratives of policy and praxis. The review identified key practices and principles required to better face future health threats and emergencies. Beyond health practices relying on technology and innovation, it is useful to mention the importance of contextualising responses and linking them to clear goals, improving the agreement between science and policymaking, thus building trust and enabling transparent communication with the general public based on clear ethical frameworks.

This paper sets out a structured process for the co-production of knowledge between researchers and societal partners and illustrates its application in an urban health equity project in Accra, Ghana. The main insight of this approach is that research and knowledge co-production is always partial, both in the sense of being incomplete, as well as being circumscribed by the interests of participating researchers and societal partners. A second insight is that project-bound societal engagement takes place in a broader context of public and policy debate. The approach to co-production described here is formed of three recursive processes: co-designing, co-analysing, and co-creating knowledge. These ‘co-production loops’ are themselves iterative, each representing a stage of knowledge production. Each loop is operationalized through a series of research and engagement practices, which we call building blocks. Building blocks are activities and interaction-based methods aimed at bringing together a range of participants involved in joint knowledge production. In practice, recursive iterations within loops may be limited due of constraints on time, resources, or attention. We suggest that co-production loops and building blocks are deployed flexibly.

Managing climate-related risks is clouded in differing levels of uncertainty that are magnified when trying to understand their potential impacts on socio-ecological systems. The ‘cascade of uncertainty’ is particularly apparent in Africa where socio-ecological data are sparse, and the development and validation of impact models are at varying stages. In this context, using heuristics may serve as an effective way for policy makers to incorporate climate change knowledge into decision-making. Previous scholarship has identified the principles of Flexibility, Robustness and Economic low/no regrets in decision-making under uncertainty. In this chapter, we first make the case for adding Equity to these heuristics, where equity involves ensuring that reducing the climate change risk for one cohort of society does not result in its increase for another. Second, we describe how these principles have been applied under two DFID/NERC funded projects: ForPAc and AMMA-2050 through the use of Participatory Impact Pathways Analysis tools.

Systematic assessments of climate change adaptation are critical for monitoring progress and planning effectively, but current approaches are limited in their scope, accuracy, and relevance to local contexts. Here, we present an improved approach using coproduction to quantitively assess adaptation based on local knowledge and priorities. This is applied to locally led adaptation (LLA) to flood risk in Tamale, Ghana, to provide the first quantitative assessments of this increasingly common adaptation practice. Through a multi-year process, including community marble distribution, focus groups, and household surveys, 11 LLA solutions were assessed. Assessments were based on adaptation success criteria that mattered most to local communities and included important considerations that are commonly missing from technical assessments, including multiple risk-reduction mechanisms, equity, sustainability, and co-impacts. Community-based and behavioural LLA solutions, such as collective action and tree planting, were deemed most effective, whilst structural and technical solutions were ranked lower. By integrating these assessments into a flood risk model, we show that LLA approaches significantly reduced flood risk overall but did not address existing inequalities. Our results showcase the potential of coproduction to increase the scope and robustness of adaptation assessments and highlight practical challenges of delivering on the LLA principles in real-world settings.