The Covid-19 pandemic is constantly evolving, with leaders facing unpredictability, imperfect information, multiple unknowns, and the need to identify responses quickly — all while recognizing the multi-dimensional (health-related, economic, social, political, cultural) nature of the crisis.

Responding to the crisis requires adaptive leadership, which involves what we refer to as the 4 A’s:

• Anticipation of likely future needs, trends and options.
• Articulation of these needs to build collective understanding and support for action.
• Adaptation so that there is continuous learning and the adjustment of responses as necessary.
• Accountability, including maximum transparency in decision making processes and openness to challenges and feedback.

All of the 4 A’s are plain to see in the most successful responses to the pandemic. Take the pharmaceutical firm AstraZeneca. Thanks to their large Chinese operations, they learned about the virus early, and started working to anticipate future needs and issues, while also navigating the considerable uncertainties and unknowns. They articulated these needs to a wide range of internal and external stakeholders to garner commitment and support, and adapted a range of new business models and partnerships to effectively meet the most urgent Covid-19 needs — most notably vaccine development, but also testing and screening methods, health facility development, and the use of AI to support diagnostics and case management. Perhaps most notably, the firm has established an inclusive approach to accountability, with a commitment to support the global Covid-19 response “as economically and as equitably” as possible — including numerous agreements for the large-scale production and distribution of any successful vaccine at zero profit during the period of pandemic.

From our collective experience at the heart of WHO’s Covid-19 response (David), advising those at the top of national governments (Arkebe), leading and advising on large complex health and care systems (Ruth), and supporting crisis responses in developed and developing countries as well as humanitarian settings (Ben and Leni), we have identified five common principles to guide this kind of adaptive leadership across the Covid-19 response.