The collective insecurity generated by the pandemic requires a decisive public health response. This response has, however, tended to apply centralised, top-down and undemocratic decision-making, often using “war” narratives that prompt or reinforce fear, and that promote individual self-protection. Reactive interventions have not adequately taken local conditions and rights into account, prevented longer-term harms to health — including from gender violence — nor protected income, food security or social trust. However, the pandemic also offers an important opportunity to demonstrate that alternative, people-centred, democratic and collective responses are possible. Indeed they are essential, not just to prevent and contain infection and mitigate the impact of the pandemic, but also to “build back” using a stronger, more compassionate and equity-driven form of public health.