Rebuilding resilient health systems for Europe

Abstract

The COVID-19 pandemic has created a unique opportunity to reevaluate and reimagine health system governance and structures, to be better prepared for future catastrophic events, such as a pandemic, extreme weather events, or economic crises. Against this backdrop, The Lancet Regional Health Europe presents a Series of 11 papers on rebuilding resilient health systems for Europe, addressing the lessons that have been learnt during the pandemic, changes that have been adopted, and the transformations that will be needed to achieve health system resilience—the ability to prepare for, manage (absorb, adapt, and transform), and learn from shocks. During global health emergencies, coordination between countries is of prime importance to achieve better mitigation outcomes domestically and internationally. Mark Jit and colleagues explore how multilateral collaboration between countries, in particular collaboration around issues with economic consequences, is crucial for successful responses to public health emergencies linked to infectious disease outbreaks. The importance of multilateralism is underscored by the estimates of the International Chamber of Commerce Research Foundation—should countries continue to pursue an uncoordinated approach to vaccine distribution, the world risks global gross domestic product losses of as much as US$ 9¢2 trillion. Collaboration should also be extended beyond the usual infrastructures and disciplines towards global early-warning surveillance at the human, animal, and environmental interface, as a key pillar of preparedness. Marion Koopmans and colleagues outline their perspectives on future development of global genomic surveillance strategies and highlight the importance of metagenomic approaches within the framework of the One Health approach to provide a true early warning system. It is clear that novel data streams have the potential to reshape epidemic preparedness and response, but there remains a pressing need to address issues around data sharing, sustainability, and scalability that could hinder future epidemic preparedness, as discussed by Adam J Kucharski and colleagues. Regionally, the resilience of European medicine regulators has never been tested to the extent as in the pandemic, due to the unprecedented need to evaluate and approve new therapeutic and preventive medicines, while maintaining their supervisory roles for all other medicines in the EU. Marco Cavaleri and colleagues provide a concise perspective on what has been happening at the European