4.I. Workshop: Health systems resilience during COVID-19: Lessons for building back better
Authors:   Organised by: European Observatory, WHO/Europe,   Chair persons: Josep Figueras (European Observatory), Natasha Azzopardi Muscat (WHO/Europe)
Published: October 2021

In December 2019, a novel coronavirus (SARS-CoV-2) appeared in the city of Wuhan, China. Since little was known about the new virus at the time, the initial reaction in many countries, including most countries in Europe, was to follow their existing pandemic influenza response plans. Countries that adopted this approach presumed that case- and contact-based management would be unable to cope with the scale of the outbreak and widespread community transmission would be inevitable. Yet it became increasingly apparent that COVID-19 was not like pandemic influenza, not least because it was caused by a coronavirus similar to SARS that had emerged in 2003 and whose successful management, maximum suppression leading to elimination, had been very different to that normally adopted with influenza. This was soon confirmed by knowledge of its transmission dynamics and epidemiology, as well as evidence from Wuhan, where the virus has been effectively eliminated even after widespread community transmission had commenced. There was also strong evidence to support the elimination approach from the early success of Taiwan, Hong Kong and South Korea and several countries outside Asia, such as New Zealand and Australia, which adopted a similar approach. As the pandemic continues into its second year, national responses to COVID-19 so far offer useful learning for the months ahead, as well as broader lessons for health system strengthening for the post-pandemic recovery. Countries that have been the most effective in containing the virus and preventing its resurgence offer valuable lessons to those that are still struggling with large numbers of cases and deaths. Mistakes or mis-steps are also important for future learning and decision-making. This workshop draws on the conceptual framework for analysing health system resilience developed by the European Observatory on Health Systems and Policies (Policy Brief 36 ‘Strengthening health systems resilience: key concepts and strategies') and on the methodology and content compiled in the COVID-19 Health System Response Monitor (HSRM), which tracks policy responses to the pandemic in the WHO European Region. The purpose of the workshop is to distil learning from national and international responses into a set of resilience enhancing strategies, thereby offering crucial learning for reacting to similar shocks in the future and enabling the commitment to ‘build back better'.

The workshop is organised as five presentations, each covering the key resilience enhancing strategies as well as examples of metrics to assess them:

Governing the COVID-19 response Financing the COVID-19 response Mobilizing human resources Delivering public health interventions Delivering health and social services

Key messages

Analysis of national responses to the pandemic so far enables distilling a set of resilience enhancing strategies that offer crucial learning for responding to similar shocks in the future. Governance plays a crucial role in ensuring that financing, human and physical resources are optimally deployed, in their given national contexts, to ensure effective delivery of services.