Issue Brief - Health systems resilience and strengthening
December 12, 2022
Health systems resilience is a requisite for crisis management and recovery –from disease to civil conflict to environmental disasters and decay. Resilience in this context is defined as the ability to prepare for, manage (absorb, adapt and transform) and learn from shocks. This definition incorporates adaptive and transformative capabilities that allow a system to adjust or change from its original state, denying the assumption that a system will return to homeostasis.
Catastrophic events over the past decade have demonstrated that, despite advancements in medical science and tools, the power of these resources cannot be leveraged without an equally powered health system to deliver and sustain them in the face of unforeseen shock.
In addition to acute shocks, a more dynamic interpretation of resilience is broadened to include chronic stresses that continuously challenge health systems and hinder adaptive and transformative capabilities. Progressive challenges, such as antibiotic resistance, the growing burden of non-communicable disease and climate change, emerge slowly, adding compounding stress onto systems. In this scenario, a system can only absorb shocks and cannot adapt or transform. There is an urgent and compelling need to address underlying weaknesses and progressive stressors that leave health systems overwhelmed and unable to deliver essential functions during times of instability.
There remains a lack of consensus around a global definition for health systems resilience. The World Health Organization states that “there is no single set of best practices,” as health systems are “highly context-specific.” However, the toll of a fragile health system is clearly evidenced by the devastating human, political and economic impact of COVID-19. While there may be no single formula for health system resilience and strengthening that can be applied to all countries, there remains an urgent need to better understand ways to build and support systems capable of managing both long-and immediate-term global health challenges.