Change cannot wait : building resilient health systems in the shadow of COVID-19

The only way to prevent, prepare for, and manage these threats is by building resilient health systems to withstand shocks and improve health outcomes between crises. This report, which is filled with country examples of resilience, shows how strengthening resilience is within every country’s reach, even those with low incomes. It describes the key features of resilient systems as integrated systems that are aware of threats; agile in response to evolving needs; absorptive of shocks; adaptive to minimize disruptions; and able to transform after crises, based on lessons learned. The report makes recommendations for countries to operationalize resilience based on a framework that prioritizes investments according to their impact. The most important investments centre on risk reduction, including prevention and community preparedness. The second most important investments focus on disease detection, containment, and mitigation to contain outbreaks before they spread widely. The final set focuses on advanced case management and surge response during an epidemic or pandemic, making this the most expensive and least cost-effective tier. The final message of the report is urgency. Investments are needed to save lives and economies before it is too late.