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COVID19 has caused an unprecedented global crisis, with social and economic disruptions, vulnerable healthcare systems already struggling to contain costs and meet demand have had their limitations and weaknesses exposed, and millions of

lives lost. With the rapid spread of the virus, businesses were forced to adapt operations at meteoric speed, restructuring and reinventing themselves seemingly overnight. The importance of resiliency and sustainability across different sectors such as healthcare, finance, technology and manufacturing were highlighted during the pandemic and the need for systems to be agile, adaptable, and flexible to respond to rapidly changing circumstances was paramount with organizations scaling innovation at speed. 

In the aftermath of the pandemic, the ability to adapt will be the key to resilient and sustainable business models, including healthcare. While resilience is a core concept in disaster risk reduction, its application in health systems is relatively new. 

Resiliency refers to the ability of the healthcare systems and organizations to adapt and respond effectively to challenges, crises, and unexpected disruptions, while maintaining essential services and functions.31 A resilient healthcare system is one that can quickly and effectively respond to challenges, such as pandemics, natural disasters, or supply chain disruptions, without compromising the quality of care. 

Sustainability, on the other hand, refers to the ability of the healthcare system to maintain and improve essential services and functions over time, while using resources efficiently and responsibly. A sustainable healthcare system is one that can meet the current needs of patients while ensuring that resources are conserved for future generations.32 

The resilience of health systems during the pandemic can provide critical lessons to help strengthen countries’ preparedness, response and approach to future health challenges, including the growing burden of cancer. Application of lessons learned during the pandemic are necessary to enhance resilience, the ability to transform and evolve will be critical in meeting long term structural challenges to health systems.

Health System Sustainability. A health system’s ability to improve population health, by continually delivering the key functions of providing services, generating resources, financing and stewardship, incorporating principles of financial fairness, equity in access, responsiveness and efficiency of care, and to do so in an environmentally sustainable manner.


Health System Resilience. A health system’s ability to prepare for, absorb, adapt to, learn, transform and recover from crises born of short term shocks and accumulated stresses, in order to minimise their negative impact on population health and disruption caused to 

health services. 

source. Sustainability and Resilience in the Canadian Health System. Partnership for 

Health System Sustainability and Resilience November 2022

Building the resilience and sustainability of our health systems has never been more urgent.  The pandemic has required health systems to rapidly adapt and respond* (resilient) to the unprecedented challenges and changing demands of the pandemic. Surge capacity for critical care was raised while non emergent care including diagnostic tests, operations and procedures were deferred. 

Flexibility and agility in the healthcare workforce, including the ability to scale up and down resources, such as hospital beds, medical equipment, and healthcare workers, as needed, were essential in facilitating the development of new care models, enabling HCPs to provide essential services to patients while minimizing the risk of transmission. These models hold enormous promise for expanding access, bringing down costs and improving the quality of care and may shape the future of healthcare beyond the pandemic. 

Little data and evidence available to inform policy choices and decision making at the start of the pandemic led to an increased focus on health data availability, reporting, and timeliness to inform policy choices and resource allocation. The need for timely data to inform decision making accelerated the use of real world data (RWD) to investigate diseases and treatments and inform policy making.

Fee schedules were altered to encourage virtual visits to reduce the risk of transmission, protect patients with chronic disease and conserve personal protective equipment (PPE, rapidly expanding the use of telemedicine and virtual care.33 

Although the COVID19 pandemic led to positive transformations, it also revealed vulnerabilities in our health systems, particularly how our health systems were underprepared, understaffed, and under resourced.34 Overall, these vulnerabilities have highlighted the urgent need for investments in healthcare infrastructure, personnel, and resources to ensure that health systems are prepared to respond to future crises.


A resilient health system is dependent on a resilient healthcare workforce. Healthcare workers, who have been on the frontlines of the pandemic response, providing critical care to patients while facing unprecedented challenges and the risk of infection are the backbone of any healthcare system, and their ability to provide quality care is essential to ensuring that the system can respond effectively to public health crises and other challenges. Workforce shortages pose one of the biggest threats to resilient health systems, with three million extra workers required across the OECD.34  


Many countries increased their investments in workforce, digital infrastructure, and equipment in response to the pandemic. These investments were necessary to ensure that health systems could respond to the surge in demand for healthcare services and to support the delivery of care in new and innovative ways. In order to maintain these investments, governments and healthcare organizations will need to prioritize health system resilience and sustainability as a key policy objective. This will require sustained funding for health systems, as well as ongoing efforts to evaluate and improve the effectiveness of healthcare investments. By maintaining investments in the workforce, digital infrastructure, and equipment, we can build on the gains made during the pandemic and ensure that health systems are well prepared to respond to current and future challenges. Investment in health systems will require resources upfront and over the long term. While resources required are significant, the return on investment can be substantial both in normal times and during crises. Investing in healthcare infrastructure, technology, and workforce development can improve the overall health of the population, increase economic productivity, and reduce the burden of disease on society.


Three months (September 2019) before the outbreak of SARS-COV-2, the Global Preparedness Monitoring Board (GPMB) issued a warning to the international community that a pandemic was only a matter of time, and that the world was not prepared. They were right.

Lack of investment in healthcare and prevention led to our unpreparedness during the pandemic. The adverse effects felt during the pandemic has underscored the importance of making smart investments to reinforce the resilience of health systems. 

This will help safeguard the health of populations, build strong foundations for health systems, and support frontline healthcare workers. Investing in more resilient health systems is essential for creating stronger and more resilient economies. By doing so, we can realize significant economic and societal advantages.34

The pandemic has expedited the pace of innovation and adaptation in healthcare systems, resulting in closer collaborations among stakeholders, prioritizing the needs of patients and their families, and utilizing data to drive decision making while emphasizing health equity. These efforts have led to the development of more resilient and sustainable models of care. The lessons learned from the pandemic are expected to have enduring implications for the future of healthcare delivery.

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