Health Systems Resilience


The COVID-19 pandemic has led to massive societal and economic consequences across OECD countries and beyond, including millions of deaths, reduced life expectancy and long-lasting health impacts. The pandemic has put health systems under extreme stress; they have had to adapt to changing circumstances while continuing to provide high quality healthcare. Ongoing and future challenges, such as antimicrobial resistance and climate change, also require resilient health systems.

The OECD is providing policy insights and guidance to improve health system resilience.



Investing in Health System Resilience

Released 23 February 2023

The COVID-19 pandemic had massive consequences for societies and health systems across the OECD and beyond. Health systems were not resilient enough. Resilient health systems plan and are ready for shocks, such as pandemics, economic crises or the effects of climate change. They are able to minimise the negative consequences of crises, recover as quickly as possible, and adapt to become better performing and more prepared. Smart, targeted investments in health system resilience are needed to improve health and ensure the next shock is less disruptive and costly.
This report reviews the lessons of the COVID-19 pandemic and applies them to build policy recommendations to ensure the global community is ready for the next crisis. The reviews and recommendations cover health system issues – including workforce, digitalisation, continuity of care and mental health – and other topics, including long-term care, supply chains and international co-operation.

WHAT is resilience and why is it important?

Health system resilience is the ability of health systems not only to prepare for shocks, but also to minimise the negative consequences of such disruptions, recover as quickly as possible, and adapt by learning lessons from the experience to become better performing and more prepared. Resilience calls for a multidisciplinary approach, which the OECD has adopted.

The disruption cycle: the four stages of a response over time

Stages of disruption

Sources: Adapted from OECD (2019), “Resilience-based Strategies and Policies to Address Systemic Risks”, and National Research Council (2012), Disaster resilience: A national imperative.

Discussions between countries, experts and other stakeholders

Resilience Webinar_May2022_Speakers


Following the COVID-19 pandemic, countries are looking to build more secure and resilient health systems, to be better prepared for future crises, and mitigate future pandemic related economic costs. However making the best investment decisions, and ensuring finance ministries support, at a time of constrained public expenditure will be very challenging. Closer collaboration between Finance and Health Ministries is needed, including the development of multi-year commitments, to enhance both efficiency and resilience while reducing waste in health systems.

Smart investments in health resilience can protect economies from destabilising shocks, and protect people from premature death. The challenge, which will be a point of discussion during this year’s OECD Ministerial Council Meeting, is to make these necessary investments whilst maintaining the financial sustainability of health systems. This webinar, supported by the NAEC Initiative, discussed how to incorporate such resilience thinking within a comprehensive strategy for high-performing, sustainable health systems.


Resilience testing

  • The European Commission’s Expert Panel on effective ways of investing in health recommended resilience testing of the health systems of European Union Members. The EU4Health Programme is funding joint work between the OECD and the European Observatory on Health Systems and Policies to test resilience scenarios and produce a handbook


As countries seek to learn from the COVID-19 crisis and increase their resilience for the future, evaluations are important tools to understand what worked or not, why and for whom.


Note: Based on annual reported totals of deaths from all-causes. Age standardised mortality rate uses the 2015 OECD Standard Population.
Information on data for Israel.



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