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Resilient Systems: The Next Big Evolution in Global Health

From the recent earthquake in Nepal to the Ebola outbreak in West Africa, we have witnessed crises that shatter health systems and tear at the economic and social fabric of entire countries and regions.

These crises are symptoms of a new global reality in which shocks—often fueled by globalization, urbanization, and climate change—are the status quo. In our interconnected world, shocks experienced by one country can reverberate across regions and the world.

“Shocks experienced by one country can reverberate across regions and the world.”

Building resilient health systems is now a global imperative. Not only is it the best way to ensure that disruptions, like those caused by the Ebola epidemic, no longer become disasters, but investing in resilient health systems also yields tremendous benefits in times of calm, like better routine health care and economic productivity.

Based on lessons from Dr. Judith Rodin’s recent book, The Resilience Dividend, a new framework published yesterday in The Lancet charts a course for resilient health systems in every corner of the globe, which I was pleased to co-author together with Dr. Margaret Kruk of Harvard and the Honorable Bernice Dahn, Minister of Health and Social Welfare of Liberia.


What is a resilient health system? Lessons from Ebola 

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Building resilient health systems isn’t just a question of how many health professionals, hospital beds, and clinics a place has, or what public health programs it supports. A truly resilient system stitches these elements together into an interactive, dynamic organism in which the whole is more than the sum of its parts. Only then will the system bend but not break under pressure.

Universal health coverage is a key pillar of the framework and an essential measure of resilience, as are important investments in often neglected public health programs. By ensuring that all people can access a broad range of health services without financial hardship, universal health coverage encourages people to seek care and engage with health systems in their daily lives, which fosters trust in the system in times of emergency. In the context of Ebola in West Africa, greater trust in health professionals and service providers could have been the difference between containment and epidemic—life and death.

Photo: West African Yellow Fever Commission at work in lab, 1928. (Photo credit: 100 Years: The Rockefeller Foundation)

Since The Rockefeller Foundation began its work on health more than a century ago, improving the wellbeing of poor and marginalized people has always been at the heart of our work—from our work on disease eradication and vaccine development to catalyzing the field of public health. That same commitment to health continues to guide us today as we constantly adapt our approaches to meet the demands of an ever-changing world.

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Now, it’s clear that resilient health systems must become a priority for global health. By shifting our focus from reacting and responding to planning and preparing, our investments will protect us in times of crisis, strengthen us in times of calm, and ensure gains in the health of all people, regardless of their socioeconomic status or wherever they may be.

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