Faith as a complex system: engaging with the faith sector for strengthened health emergency preparedness and response
Authors: Sarah Hess, Sally Smith, Shanmugapriya Umachandran
Journal: The Lancet Global Health (2024)

The world continues to face an increasing number of concurrent and interlinked crises, driven by climate change, deepening inequality, conflict, and the impact of the COVID-19 pandemic. Responding to this polycrisis and strengthening health emergency preparedness, response, and resilience1WHOStrengthening health emergency prevention, preparedness, response and resilience. 2023.https://cdn.who.int/media/docs/default-source/emergency-preparedness/who_hepr_wha2023-21051248b.pdf?sfvrsn=a82abdf4_3&download=trueDate accessed: April 29, 2024Google Scholar will require developing and maintaining multisectoral partnerships and adopting approaches that are efficient, effective, and sustainable. Historically, secular public health approaches, structures, and systems and those of the faith sector have been divided, both globally and within many countries. A secularist discourse supporting this division has influenced and limited multisectoral partnerships since the late 1970s (post Alma-Ata).2Winiger F Peng-Keller S Religion and the World Health Organization: an evolving relationship.BMJ Glob Health. 2021; 6: e004073Crossref PubMed Scopus (22) Google Scholar, 3Casanova J Global religious and secular dynamics: the modern system of classification.Brill Research Perspectives in Religion and Politics. 2019; 1: 1-74Crossref Google Scholar To challenge this discourse within public health, this Comment suggests understanding the faith sector as a complex system: a network of multifaith, religious, political, social, health, and educational systems, including religious leaders, faith-based organisations, and faith communities as well as their social, physical, and health infrastructures, which, throughout history, have played a key role in health emergency preparedness, response, and resilience. Multifaith systems contribute substantially to national health and community systems, strengthening them both before and during health emergencies. Religious leaders and faith-based and religious organisations commonly manage a broad portfolio that includes religious sites and gatherings; schools and universities; literacy and income-generating programmes; hospitals, clinics, and community health programmes; refugee and migrant support; agricultural programmes; and other social services. These services are delivered through faith infrastructures that are often embedded within communities and leveraged early in emergency responses.4Berkley Center for Religion, Peace & World AffairsReligious responses to COVID-19. 2024.https://berkleycenter.georgetown.edu/subprojects/religious-responses-to-COVID-19Date accessed: April 29, 2024Google Scholar Religious leaders operate at many levels, including politics and policy making, from a head of state such as the Pope, to the equivalent of mayors and community leaders. They also provide spiritual care and mental health and psychosocial support during crises. They are often trusted in communities and use their reach and influence to share information and advocate for change.5Idler E Bernau JA Zaras D Narratives and counter-narratives in religious responses to COVID-19: a computational text analysis.PLoS One. 2022; 17: e0262905Crossref PubMed Scopus (9) Google Scholar With a growing understanding of the importance of faith systems, WHO established a Faith Network for the COVID-19 pandemic and beyond.6WHOWHO Faith Network.https://www.who.int/groups/who-faith-networkDate accessed: July 26, 2024Google Scholar Like many other complex systems, faith systems include both positive and negative dimensions and cannot be fully understood or controlled. For example, some systems do not align with ethical, human-rights-based approaches to health emergency preparedness, response, and resilience that promote the health and wellbeing of all.7Tomkins A Duff J Fitzgibbon A et al.Controversies in faith and health care.Lancet. 2015; 386: 1776-1785Summary Full Text Full Text PDF PubMed Google Scholar Through dialogue, research, and engagement, however, positive outcomes can be achieved; disregarding entire systems due to negative components is neither appropriate, wise, nor the norm.8McGill E Er V Penney T et al.Evaluation of public health interventions from a complex systems perspective: a research methods review.Soc Sci Med. 2021; 272: 113697Crossref PubMed Scopus (102) Google Scholar Rather, engagement with these systems must recognise the diversity that comes with complexity and establish mechanisms to centre engagement around agreed values and principles shared by faith and public health systems. This includes committing to the principles of sound evidence; upholding human rights; caring for those in need; protecting health; and promoting equity.9WHOWorld Health Organization strategy for engaging religious leaders, faith-based organizations and faith communities in health emergencies. 2021.https://iris.who.int/handle/10665/347871Date accessed: May 19, 2024Google Scholar These commonalities form the basis on which effective partnerships can be built and negative influences tempered. Engaging with faith systems should be approached as one would consider and engage with other complex systems, such as political systems or the private sector, in which appropriate collaborative agreements, due diligence, and safeguards guide partnerships. Given the global context, re-evaluating and normalising engagement with complex faith systems is both necessary and important for countries and public health institutions. These partnerships, if approached through a complex system lens, will be substantially different to partnerships with other civil society or non-governmental organisations. The secularist discourse that has historically limited engagement with the faith system must make space for a more multifaceted discourse reflective of systems theory.10Cho F Squier RK Religion as a complex and dynamic system.J Am Acad Relig. 2013; 81: 357-398Crossref Scopus (19) Google Scholar As these partnerships are built and nurtured, there will be opportunities to identify the strengths and weaknesses of different approaches and adaptive, effective ways of working and engaging in different settings. Effective engagement with complex faith systems offers opportunities to strengthen health emergency preparedness, response, and resilience, particularly in the current context of multiple crises at the global, regional, and national level, all of which include a health dimension. If managed well, strategic engagement of multifaith partners can also promote collaboration towards joint goals of peace, security, health, and wellbeing. We declare no competing interests.