Preparing health systems for emergencies through a systems approach

Supporting research on governance of public health agencies and service delivery in conflict settings to build resilient systems in fragile and protracted crisis environments.

Overview

Health emergencies – whether pandemics, conflicts or natural disasters – are not isolated events. They are systemic shocks that test the resilience of entire societies. The Alliance supports research and learning to apply a health systems approach to preparedness and response, ensuring that health systems can maintain essential services during crises.

This work helps countries move beyond reactive, short-term measures to strengthen institutions and governance arrangements that embed resilience into health systems by design.

Systems framing

The Alliance approaches emergency preparedness not as a separate, vertical function, but as a core attribute of a strong and resilient health system. Work in this area reframes emergency response by shifting the focus from episodic crisis management to long-term institutional capacity and governance.

This systems-level approach focuses on:

• Reframing conflict response – challenging the assumption that service delivery in conflict-affected settings is solely the domain of humanitarian actors. The Alliance treats continuity of care in fragile contexts as a core responsibility of routine health systems, examining how essential services can be sustained even where governance is fragmented;
• Governance over positionality – moving beyond questions of where national public health agencies sit within government structures to examine legal mandates, institutional autonomy and accountability arrangements that enable these agencies to function effectively; and
• Systemic interactions – understanding preparedness as the product of interactions between health systems, socioeconomic conditions and political contexts, including how governance, financing and policy choices shape a country’s capacity to anticipate, absorb and respond to shocks.

How the Alliance approaches this area

The Alliance’s strategy for 2024–2028 applies a health systems approach to emergency preparedness and response across three interrelated dimensions: