After outlining a new five-year strategic plan in 2021, the Alliance for Health Policy and Systems Research has been working this year to broaden its horizons beyond tradition health systems to consider the wider determinants of health. The Alliance supported 15 ongoing projects, representing 145 grants across 80 countries. Find out more about these projects and how they are contributing to the achievement of the Alliance's objectives: advancing knowledge, catalysing change and empowering leaders. We also look at the impact of some of the Alliance’s projects.

The COVID-19 pandemic has caused unprecedented disruption worldwide highlighting once again the interdependency of health and socioeconomic development, and the global lack of health systems resilience. Two years into the pandemic, most countries report sustained disruptions across service delivery platforms and health areas with a profound impact on health outcomes. The impact of these disruptions is magnified within marginalized communities and in countries experiencing protracted conflict. There is an urgent need to focus on recovery through investment in the essential public health functions (EPHFs) and the foundations of health systems with a focus on primary health care, and whole-of-government and -society engagement. The aim of this Research Topic is to gather, transfer and promote operationalization of key experiences from COVID-19 to inform global and country level recovery that better promote health; guide policy direction towards building health systems resilience; and thereby ensure economic and social prosperity. Experience with COVID-19 has demonstrated that traditional approaches to health system strengthening have failed to achieve the complementary goals of Universal Health Coverage (UHC) and health security with the divide between the most vulnerable and well-off only widening. Much of what had been learned from previous experiences such as Ebola in West Africa has not been widely applied. This has left health and economic systems vulnerable to 21 st century public health challenges, ranging from conflict and natural disasters to aging demographics and rising rates of non-communicable and communicable diseases and antimicrobial resistance. These challenges require intentional focus and investment as well as whole-of-government and -society engagement with health to build health system resilience. Greater action is needed to prevent the devastating effects of war and conflict on the health of the most vulnerable. This Research Topic will convene the knowledge and practices of leaders in public health, health systems, and humanitarian and development sectors. This is to ensure lessons from COVID-19 inform the recovery agenda and promote sustainable health and socioeconomic recovery for all. Lest we forget and find ourselves again unprepared and vulnerable in the face of an even greater threat.

Experience with public health emergencies such as the COVID-19 pandemic clearly demonstrates that weak public health capacities leave populations and health, economic, and social systems vulnerable. Health system challenges are increasing in number and complexity, while health system resourcing, often seen as a cost rather than an investment, remains inadequate. The limited resources available are skewed towards clinical services and emergency response, leaving persistent weaknesses in preventive, promotive and protective capacities. World Health Assembly resolution WHA69.1 of 2016 provided the World Health Organization (WHO) with a mandate to support Member States to strengthen the essential public health functions (EPHFs) while recognizing their critical role in achieving universal health coverage. This has been reaffirmed in the Declaration of Astana on Primary Health Care, 2018, and by global partners since, creating an impetus towards and need for guidance in strengthening public health stewardship and capacities informed by the EPHFs. This technical package provides a range of technical resources and flexible tools in relation to EPHFs, to support comprehensive operationalization of public health in countries. The unified list of essential public health functions (EPHFs) consists of 12 activities that can be used to operationalize public health in a country. This comprehensive approach to public health orients health systems to population need and health system risks, and governments and societies towards health and well-being. This maximizes health gains within available resources and builds resilience, while reducing population vulnerability and the overall burden on the health system. The EPHFs can be used to plan public health systems, strengthen stewardship and coordination for public health delivery at national and subnational levels, and integrate public health capacities within health and allied sectors. The EPHFs anchor protective, promotive and preventive capacities within health systems while leveraging multisectoral efforts for health. In this way, strengthening health systems with the EPHFs is central to the primary health care approach and supports the achievement of universal health coverage, health security and healthier populations in tandem.

Makes the case for systems thinking in an easily accessible form for a broad interdisciplinary audience, including health system stewards, programme implementers, researchers, evaluators, and funding partners.