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Interrogating resilience in health systems development.
Remco van de Pas1, Majdi Ashour2, Anuj Kapilashrami2
1Health Policy Unit, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
Resilience in health systems, while promoted after crises like Ebola, may hinder democratic priority-setting and equitable system development. True progress requires global solidarity and justice, not just resilience.
Area of Science:
- Health Systems Research
- Global Health Policy
- Public Health
Background:
- The concept of resilient health systems gained traction following the 2014-15 Ebola outbreak.
- Development actors and foundations, like the Rockefeller Foundation, have promoted resilience in global health.
- The Fourth Global Symposium on Health Systems Research focused on resilient and responsive systems.
Purpose of the Study:
- To critically examine the discourse and application of resilience in health systems development.
- To explore concerns regarding the narrative and practical implementation of resilience in public health.
- To question whether resilience is an effective strategy for building sustainable and equitable health systems.
Main Methods:
- Analysis of a panel discussion from the Fourth Global Symposium on Health Systems Research.
- Critical interrogation of the resilience discourse in health systems.
- Examination of an empirical case study from Gaza.
Main Results:
- The resilience narrative may override democratic procedures and public health agenda setting.
- Resilience can perpetuate the status quo, excluding visions of just and equitable health systems.
- In Gaza, resilience and vulnerability were found to be symbiotic, not a solution for system strength.
Conclusions:
- Resilience is not the answer for achieving sustainable, universally accessible health systems.
- Current global health challenges necessitate a move beyond resilience towards global solidarity and justice.
- Alternative frameworks are needed to imagine and build equitable health systems.
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