Public Services

From Standby to Always On: How to Build Global Health Resilience

Commentary20th June 2022

Future pandemic preparedness will be a priority for G20 health and finance ministers as they meet in Indonesia this week. To ensure resilient health systems, the smartest investment countries can make is to invest in building a global health system that is “always on”.

Always on means harnessing advancements in data science, digitalisation and medicine to save lives and mitigate the effects of ongoing health crises, while also ensuring our health systems have the tools and technology to spot and rapidly contain the next global pandemic threat.

Resilience for future pandemics will not arise from funds set aside for a crisis. While valuable, this act alone would merely put our crisis systems on standby, waiting for the funding to "turn on" only after a threat is identified. To truly divert future storms, we need active systems that are evolving with science and technology between pandemics, thereby building global capacity to sound early alarms. The great news is, this investment builds resilience but also gets us closer to a world where preventable disease is history.  

Future Resilience

From 2014 to 2020, I supported the presidency of Sierra Leone on national priorities and response systems, including the Ebola outbreak, the Ebola recovery, and the Covid-19 pandemic. Following Ebola, the country made substantial efforts to translate the massive investments in the Ebola response into long-standing health-system benefits, but funding flows quicker to crisis and response than it does to prevention. While some legacy systems from Ebola were effectively utilised for Covid-19 such as the national public health emergency hotline, others needed major investments to be effectively stood up again.

This is a mistake and it’s time for global leaders to act.

To drive such changes, we need to strengthen our health systems and response, not only for future pandemics but also for ongoing health crises that affected the globe before the Covid-19 pandemic and which continue to cost us lives and money today. This includes tuberculosis (TB), malaria and non-communicable diseases such as cardiovascular diseases. Approximately 10 million people die every year from preventable diseases; it doesn’t have to be this way.

A New Era in Medicine

Take the technological advancements being made in medicine. We have forthcoming vaccines for pathogens such as TB, malaria and dengue while therapeutics for non-communicable diseases, including heart disease and cancer, are on the brink of reality.

The Covid-19 pandemic accelerated the development of global health infrastructure and vaccine-manufacturing capabilities, showing what is possible with investment and global efforts. Yet it also showed how the benefits of these advancements are grossly unequal. For instance, as of March 2022, only 15 per cent of the adult population in Africa had been fully vaccinated against Covid-19, compared to more than 60 per cent globally.

Collaboration and Coordination

Future resilience must lean into scientific and medical advancements while also addressing the global inequalities that the pandemic highlighted. For example, establishing vaccine-manufacturing hubs and research and development (R&D) centres in low- and middle-income countries by harnessing scientific innovations in vaccines and therapeutics, and by strengthening health systems. New monitoring systems in genomic sequencing can also improve the global ability to identify and track pathogens that cause disease outbreaks. This can build local capacity and set standards for information sharing on infectious diseases.

By changing how disease is prevented and treated worldwide, it will be possible to build a more resilient future where good health is within reach.

As host country of the first G20 Health Ministerial Meeting, Indonesia's Health Minister Budi Gunadi Sadikin has shown leadership by securing support among G20 member states for a financial intermediary fund for pandemic prevention, preparedness and response. The Indonesian presidency of the G20 has also led conversations around the need to establish a permanent coordinating platform to ensure equitable and timely access to emergency medical countermeasures, as well as pushing for the establishment of a network of global research and manufacturing hubs for vaccines, therapeutics and diagnostics across the Global South. These are encouraging first steps to establish an “always on” global health system, but the onus is on the international community to continue to push the global health architecture while keeping up with the fast pace of medical advancements and ensuring that no country is left behind.

"From Earthquakes, Mountains Rise"

Earlier this month during the G20 Health Working Group technical discussions, Minister Budi reminded attendees that "from earthquakes, mountains rise". The world is already better prepared for the next pandemic because of the technologies developed and the global solidarity built in response to Covid-19. We must not lose this momentum. As G20 ministers meet this week, they have an opportunity to use this recent progress to build a permanent programme that improves people's health and alleviates inequities. Global collaboration has the potential to save millions of lives and the world economy billions of dollars in health-care costs. Standby is not good enough; health systems must be always on.


The Global Health Security Consortium (GHSC), provides insight, analysis and support for leaders around the world to help them deal with Covid-19 today and prepare for the health security challenges of tomorrow. It is a joint initiative of the Tony Blair Institute for Global Change, the Ellison Institute for Transformative Medicine and a team of scientists at the University of Oxford. As Director of the GHSC, Emily recently joined the technical discussions of the G20’s Health Working Group in Lombok, Indonesia on 6-7 June.

Article Tags


Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas

Practical SolutionsRadical Ideas