On March 29th, the Alliance for Health Policy and Systems Research (HPSR) marked its 25th anniversary with the first in a series of events. Held at the London School of Hygiene and Tropical Medicine, the gathering brought together an illustrious array of speakers and panelists to reflect on HPSR's historical milestones and discuss paths forward in a rapidly changing world.
After the battering of the COVID-19 pandemic – with its unparalleled global devastation and significant movement of international solidarity and action – this was a moment for careful consideration of our movement to create health systems resilience.
As the Rt Hon. Helen Clark, Chair of the Alliance’s Board put it, “Health systems have always faced new challenges. We're in a different era, and health systems are having to grapple with this syndemic of crises which all end up linking one way or another and increasing risks.”
Celebrating legacy
For all the challenges faced, there is a great deal of innovation and positive change in the history of HPSR. Speakers such as Prof. Anne Mills and Prof. Kara Hanson provided a broad sweep of the evolution of the Alliance, the field of HPSR and some of the important thinkers who have shaped the field.
The audience heard about the evolution of the discipline, from one dominated by economists to a truly multidisciplinary endeavour, with strong representation from the social sciences, particularly anthropology. How systems thinking has revolutionized HPSR approaches – with its focus on relationships, social networks, agent modelling, unintended consequences, emergent change, causality and feedback loops. Embedded approaches to research that heighten the appropriateness and applicability of questions and findings were explored as mechanisms for ensuring research uptake.
Looking to the future
While strides have been made in HPSR, much of the meeting was spent identifying future challenges that the field must respond and adapt to.
Dr. Kumanan Rasanathan, Executive Director of the Alliance, started with a challenge: while there has been exponential growth in global health publications, this has not led to desired changes in policy and practice.
A lively panel discussion featuring Dr. Robert Marten, Dr. Sharif Ismail, Dr. Aku Kwamie and Dr. Jeanette Vega highlighted key issues, such as:
- Transitioning short-term health responses in times of crisis to long-term, system-wide interventions;
- Recognizing that building resilient health systems amid shocks and threats takes time and requires long-term commitments;
- Addressing the intertwined menace of climate change and ill-health and the seismic shifts required to respond to issues such as extreme heat, wildfires, floods and associated alterations in viruses, parasites and vector-borne diseases;
- Communicating systems thinking methods to policy-makers;
- Fostering citizen ownership and cross-sectoral, participatory approaches to challenge entrenched power structures for community-owned action;
- Navigating the potentials and pitfalls of new technology;
- Tackling refugee and migrant health challenges;
- Dealing with the dual and interrelated health and care crises;
- Combating corruption and unjust global systems that limit access to medicines and health technologies; and
- Coordinating cross-sectoral action on health, energy, food and water systems.
This event marked an important beginning of a conversation on HPSR's future direction – a conversation that the Alliance will be continuing as it marks its anniversary and consults on its refreshed strategy. Further meetings are scheduled for 20 April in Oslo, Norway, and on 27 April in Beirut, Lebanon, which will also be livestreamed. As the field continues
to evolve, the Alliance remains committed to fostering innovation and resilience in health systems worldwide.