We should have been better prepared for the pandemic, say Alistair McGuire, George Wharton and Lucy Thompson (LSE). A new partnership between LSE, the World Economic Forum and AstraZeneca is conducting research in eight countries and will share insights into how to deal with crises.
Five years ago, the Ebola outbreak ravaged health systems in Africa, primarily those of Guinea, Liberia, and Sierra Leone. The limited public health services available were fully diverted to Ebola. Overstretched and exhausted health workers became ill and died from the virus. As a result, the general population faced substantial barriers in trying to get care – whether for Ebola or for more common health conditions.
Now the same thing has happened all over again. The disease has tested many countries’ health systems beyond their limits, even those once considered trailblazers in global health. It has painfully exposed persisting health inequalities that transcend global societies. The economic recession brought about by the pandemic will only make these inequalities worse.
Worldwide, there have been more than 50 million confirmed cases and close to 1.3 million deaths to date. These numbers will continue to rise until the virus is eradicated through global immunisation, or unless it is rendered innocuous through effective prevention and treatment programmes.
Yet, while this pandemic has been catastrophic, it also presents a brief window of opportunity to act. COVID-19 has generated unprecedented public awareness, and, we hope, the political will to address global health issues. It has exposed once again the need for resilient and sustainable health systems and economies. We could – and should – have been better prepared for this crisis. For example, are healthcare workers stuck in rigid, outmoded job roles that are no longer productive? How can we avoid hospitals ‘running hot’ so that a surge in demand forces them to shut down some services? Why do we under-value both health and the full cost of disease?
This is what the newly launched Partnership for Health System Sustainability and Resilience (PHSSR) seeks to do. PHSSR is a collaboration between the London School of Economics (LSE), the World Economic Forum (WEF) and AstraZeneca. It aims to make a significant, lasting contribution to global health, particularly in:
• Health system resilience – the ability of health systems to prevent, mitigate, overcome and rebound stronger from crises, both chronic and acute. This includes the COVID-19 pandemic, natural disasters and the climate emergency.
• Health system sustainability – the ability of these systems to maintain, generate resources and provide services, and learn and improve in their ability to do so.
In its pilot phase, running from August 2020 to January 2021 (when our report will be published), PHSSR is working with teams of researchers in eight countries to conduct rapid reviews of health system sustainability and resilience.
A common framework for analysis is applied flexibly to suit the local context. Country teams in France, Germany, Italy, Poland, Russia, Spain, the UK and Vietnam are able to identify specific actions that can be taken to strengthen their health systems, and generate insights that can be transferred to other countries. The pilot country reviews will home in on key factors that determine health system resilience and sustainability, such as:
• How health systems are led and governed
• How health systems are funded and financed
• The health and care workforce
• How health systems harness medicines and technology
• How health services are organised and delivered
This exchange of knowledge will help to identify solutions with the greatest potential and support their adoption.
Difficult though it might be to imagine now, the day will arrive when COVID-19 will no longer be the world’s principal health concern. Instead of focusing exclusively on bringing the pandemic under control, we need to build systems that are grounded in primary health-care principles and can respond to routine as well as unexpected challenges. We want to do this by breaking down the traditional barriers between academia, business and the public sector and creating a platform to disseminate breakthrough insights, and enable health systems to act upon them.
This post represents the views of the author and not those of the COVID-19 blog, nor LSE.