In a crisis, every decision counts – especially relating to public health and social measures (PHSM)
The World Health Organization (WHO) has published the PHSM Decision Navigator, a first‑of‑its‑kind framework designed to support governments in navigating complex decisions on PHSM during health emergencies.
Why PHSM decision-making is challenging
PHSM are vital in reducing the risk and scale of infectious disease transmission and lowering hospitalization and deaths. Examples include contact tracing, quarantine and isolation, mask use, ventilation, school or workplace measures, mobility restrictions and travel requirements.
While these measures are essential, decision-making on PHSM becomes particularly complex during rapidly evolving health emergencies, with incomplete information and under significant public and political pressure, especially when the pathogen is novel or poorly understood. In such contexts, guidance needs to be agile and responsive, developed and adapted based on emerging evidence and shifting epidemiological patterns. Decision-makers are frequently confronted with difficult trade-offs, having to balance measures that are:
─ effective but socially disruptive;
─ cost-effective but logistically burdensome;
─ beneficial for public health but economically disruptive; or
─ practical but inequitable or unethical.
Therefore, selecting and adjusting PHSM requires careful consideration of a complex array of factors, including the epidemiological situation, health system capacity, availability of medical countermeasures, along with resource availability, political and legal feasibility and public acceptance of the PHSM being considered.
WHO has developed the PHSM Decision Navigator, in response to the request of Member States, to provide a clear, systematic, and equitable framework in guiding governments in making these critical decisions. This work has been prioritized according to the World Health Assembly Resolution 74.7 which requested the WHO Director-General to develop a global framework to translate evidence into effective health emergency and preparedness policies.
What the PHSM Decision Navigator offers
The Navigator is threat-agnostic and designed for use in a wide range of health emergencies. It provides a structured, risk-based, evidence-informed approach to support governments design, balance, prioritize and adapt PHSM within the context of overall response strategies.
Specifically, the Navigator supports decision-makers to:
─ bridge evidence and action by applying the best available evidence;
─ balance public health benefits with unintended negative consequences of PHSM implementation;
─ strengthen equitable and ethical considerations; and
─ improve adaptability and responsiveness in dynamic and uncertain contexts.
By offering this practical, step-by-step framework, the Navigator supports governments in protecting lives and safeguarding livelihoods.
WHO encourages policy-makers, health authorities and partners across sectors to explore the Navigator and integrate it into emergency preparedness and response planning.
The Navigator complements WHO’s broader efforts to strengthen the evidence base on the effectiveness of PHSM, their unintended negative consequences and determinants of adherence to PHSM.
Read more about the WHO global PHSM initiative here: https://www.who.int/initiatives/who-public-health-and-social-measures-initiative.
Related links
The PHSM Decision Navigator: https://www.who.int/publications/i/item/9789240114623.
WHO global initiative on PHSM during health emergencies: https://www.who.int/initiatives/who-public-health-and-social-measures-initiative.