AN INTRODUCTION

The Context

• Ongoing Covid-19 pandemic bared fault lines across global health systems

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• Health systems assessment frameworks for resilience and pandemic preparedness found lacking in predictive abilities

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• Advanced epidemiological models were way off the mark

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• The concepts of ‘Whole of Systems’ and ‘One Health’ got validated. The concept of ‘One Health’ is being extended to ‘One Earth’ in light of climate change threat.

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• Leadership across nations was found wanting in its response to the crisis

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• It became obvious that the health systems should be designed to meet health & care and health financing needs not only during normal times but also during crisis times

• There have been remarkable examples of the power of human collaboration as reflected in the vaccine roll out within one year of the pandemic

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• This is an opportune time to reflect, research, share, discuss, and debate to learn from the pandemic to prevent future crises and be prepared to respond to them if we could not prevent

The Objective

• To create a global forum where all stakeholders of health systems derive key lessons through a process of knowledge co-creation and reciprocal collaborative learning that can be deployed to prevent future pandemics, to prepare health systems for rapid response when they arise, and to make health and social systems stronger and resilient

What is �Health Systems Resilience?

• Health systems resilience is the ability to prevent, prepare for, effectively respond to, and learn from crises. A crisis is an unforeseen change or shock that stresses a health system beyond what is normal.
• Health systems are resilient if its health actors are able to maintain core functions during crises to protect human life and produce good health outcomes for all.¹

1- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60755-3/fulltext

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Why build�Health Systems Resilience?

• The world has been seeing frequent outbreaks of epidemics and pandemics and other natural disasters over the past few years. SARS-1, MERS, H1N1, Avian Flu, Zika, Ebola, SARS-2 are some of these.
• More recently, COVID-19 has exposed the fragility of health systems across nations and their ill preparedness to withstand shocks.
• Deaths and morbidity, social and economic disruption, and the collapse of even the most basic healthcare services shows the damage a crisis can cause when health systems are not prepared.

•  An independent panel constituted by the World Health Assembly in its report from May 2021 made compelling recommendations for improving the pandemic preparedness of global, regional, and national level health and social systems.

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• There is a growing chorus on the urgency of building resilience in social systems, particularly within health systems.

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The Design

• The Global Learning Collaborative for Health Systems Resilience or the GLC4HSR is a voluntary collaborative of various health systems stakeholders across the globe with a purpose of knowledge co-creation and reciprocal learning towards building strong and resilient health systems to prevent and be prepared for future pandemics and and other health crises.

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• It is a cross country network of technical experts, practitioners, and health policy actors from both public and private sectors.

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• As each country analyses its response to the COVID-19 pandemic, a collaborative approach to learning can yield greater insight for effective policy action.
• The GLC4HSR is set up with a vision to facilitate this synergistic exchange of knowledge.
• Members are equipped to apply this knowledge towards policy reform to ultimately strengthen their health systems to prevent and manage health and social crises and to secure people’s health .  

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Organization

• The participation is voluntary and on invitation
• Participants are drawn from national and sub-national governments from the three regions in Asia to begin with. Participation will be expanded to Africa, South America, Middle East and other regions over time
• Participants are also drawn from governmental and non-governmental academic institutions in health systems
• Participants are drawn from private health systems (healthcare provider and payer, and health tech producer bodies and enterprises) as most health systems are evolving into mixed health systems

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The Learning Process

• The learning approach at the GLC4HSR follows three key steps namely knowledge pooling, knowledge processing, and knowledge presentation and dialogue.
• Researchers generate evidence and create knowledge products that are disseminated among participants through knowledge sharing platforms.

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Dissemination

The Learning Process

• Knowledge pooling includes primary and secondary research and cross-country learning exchanges and focus group discussions.
• Knowledge processing involves co-creating products and tools designed for health systems strengthening through multiple formats such as working groups, virtual collaborations, study groups, research interviews, and flexi pilots around prioritized thematic areas
• Knowledge presentation of products, among participants in a form that is understood by all, including non-technical audiences is the final step.

The Learning Process

• Experts drawn from core subsystems of public health, health finance, health policy, health regulation, healthcare provision, and health information system along with experts from related areas of human resources for health, surveillance, epidemiology, digital and molecular technologies, social sciences, pharma industry, policy research on drug procurement and delivery, support the collaborative learning process of the participants

Reciprocal Learning

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The GLC4HSR facilitates reciprocal learning among diverse stakeholders

The Knowledge Portal

• A dedicated website will provide access to various knowledge products, discussions, and learning briefs, supported through a Knowledge and Learning Management System

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• The knowledge portal act as a repository of knowledge products such as research studies, case studies, manuals, frameworks, and tools for learning and practical application.

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Core Learning Themes

• Pandemics threat assessment and mitigation: Pandemic threat assessment is data intensive. It uses tools to understand systems’ preparedness and response to a public health threat. It helps to classify population and individuals based on their vulnerability. Learning from these processes could enable early containment and pandemic mitigation.

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• Health systems assessment for pandemic preparedness –Resilient health systems ensure quality health services that are delivered prior to, maintained during, and improved upon following an emergency. To become resilient, a health system should prepare for appropriate distribution of human and physical resources and increase capacity to cope with a sudden surge in demand.

Core Learning Themes

• Rapid response systems including surveillance systems –Surveillance is a core public health function that ensures the availability of the right information at the right time and in the right place to inform public health decisions and actions. It is important that digital response systems are evaluated, and change mechanism are in place during a pandemic.

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• Financial and social protection – Resilient systems ensure that sufficient monetary resources are held in reserve with a flexibility to reallocate and inject additional funds as per need. Countercyclical health financing mechanisms and reserves play an important role in stabilizing the health system, as do purchasing flexibility and the reallocation of funding to meet changing needs during pandemics.

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Core Learning Themes

• The role of leadership – Decisions made by the leadership govern the adequacy of the abovementioned systems, including healthcare infrastructure, guidelines, rapid response, and financing. Pandemics have often highlighted the need for evidence-based policies and inter sectoral or organizational coordination. The role of the leadership at the local and community levels is crucial during public health emergencies.

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• The role of private sector – Majority of global health systems are mixed with equal or dominant role of private sector. Private sector played a pivotal role during ongoing pandemic. However, the response was chaotic and uncoordinated with weak stewardship from the governments. Engaging private sector for future crises is vital.

Evolution of the GLC4HSR

• The collaborative is designed to evolve organically
• The evolution will be supported by contributions from donors. Initial seed-funding has come from The Rockefeller Foundation
• A self-sustainable model will evolve over time

The Secretariat

• ACCESS Health International, a global thinktank in health systems, provides the secretarial and technical support function through its regional offices located in India, Singapore, and China and through its strategic health systems partners in other regions of the world.

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• ACCESS Health has prior experience in founding and nurturing similar organizations from their inception. These include Joint Learning Network (JLN) and India Health Systems Collaborative (IHSC)

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• It supports in compiling knowledge through secondary and primary research done by its own teams and its academic partners

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• It curates the information into reports and learning briefs

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• It facilitates debate and dialogue amongst health systems actors on various themes of practical importance

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• It provides access to learning resources (research publications, learning briefs, case studies, recorded discussions etc.,) through the knowledge portal

Impact assessment

• The impact of the collaborative will be monitored using a structured framework

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• Independent review will be carried out to validate the impact

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• Insights from concurrent monitoring and evaluation will inform continuous improvements in the learning processes

Get Involved

• The GLC4HSR welcomes association with multiple stakeholders working towards strengthening health and other social systems.
• Involvement with the GLC4HSR ranges from full and associate membership(s) to purpose-driven partnerships.
• Any person or an institution working in healthcare, public health, pharmaceuticals, genetics, bioinformatics, biotechnology, surveillance, finance, policymaking, academics, research and development institutions, technical agencies, capacity building, information technology, health system groups and agencies, industry bodies, and associations can partner with the collaborative.
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Get in touch

• Contact the GLC4HSR Secretariat to learn more.
• For further information on the GLC4HSR, write to us as at info@glc4hsr.org / glcpmo@accessh.org
• For membership related queries, write to us at members@glc4hsr.og / glcpmo@accessh.org
• For more information visit www.glc4hsr.org (Website coming soon)