Case #2269.0

Nothing Can Prepare You for This Job: Germany’s Health Minister Faces Tough Decisions during COVID-19

Publication Date: September 24, 2023
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This case and video supplement recount three high-profile public health decisions that German Minister of Health, Jens Spahn, made during the first year of the COVID-19 pandemic: how to procure masks, which vaccines to procure (and how many doses), and whether to pause AstraZeneca vaccine distribution after preliminary evidence linked it to a rare, lethal side effect. These inflection points called on Spahn to evaluate tough tradeoffs and rapidly execute a series of high-stakes decisions with limited information, and under intense public scrutiny. In April of 2020, amid a global scramble for coveted N95 face masks and a wildly fluctuating market, Spahn procured millions of masks for German health care workers at the high cost of 4.50 euros each. The decision garnered bad press just a few weeks later as supply chains relaxed and mask prices plummeted. The following month, Spahn led Germany to secure contracts with as many vaccine manufacturers as possible and spearheaded a push for the European Union to negotiate vaccine procurement as a unified bloc. To achieve this, Germany had to assume a greater share of the purchasing risk than other EU countries and purchased significantly more vaccine doses than they would have otherwise. Then in March 2021, having received preliminary evidence that the AstraZeneca vaccine was linked to a rare but potentially fatal side effect, Spahn paused distribution of AstraZeneca in Germany. This case includes a 14:38 video supplement in which Jens Spahn revisits his approach to these key decisions, the factors that influenced his thinking, and some of the lessons learned.

Learning Objective:
Students will understand the challenges of effective decision-making under conditions of high uncertainty including: recognizing that good decisions may sometimes result in bad outcomes; distinguishing between errors of omission and errors of commission (and how people often treat them differently, disregarding a comparison of their consequences); analyzing the tradeoff between time and accuracy in decision-making; and, examining the challenge of balancing technical, political, and administrative dimensions of high-stakes decisions.







Other Details

Teaching Plan:
Available with Educator Access
Case Author:
Paige Taylor
Video Producer:
Patricia Garcia-Rios
Faculty Lead:
Dan Levy
Pages (incl. exhibits):
Funding Source:
The Joseph B. Tompkins, Jr. Fund for Case Study and Research