OECD Health Ministerial and High-Level Policy Forum

Strengthening health system resilience for social and economic prosperity

Jointly authored by: 
The Hon Ged Kearney MP, Assistant Minister for Health and Aged Care, Australia,
Prof. Frank Vandenbroucke, Deputy Prime Minister and Minister of Social Affairs and Public Health, Belgium,
Dr. Ximena Aguilera Sanhueza, Minister of Health, Chile,
Prof. Dr. Karl Lauterbach, Federal Minister of Health, Germany,
Ms. Ingvild Kjerkol, Minister of Health and Care Services, Norway, and
Prof. Dr. Valentina Prevolnik Rupel, Minister of Health, Slovenia

In the coming years, social, environmental and technological change will challenge health systems already pushed to their limits by the biggest public health emergency in more than a century. 

The impact of the pandemic has been dramatic and wide-reaching, notwithstanding the courage and resilience demonstrated by our health care professionals. Worldwide, between 2020 and 2022 there were around 6.8 million confirmed deaths from COVID-19. Even OECD countries, with the most advanced health systems in the world, were not ready for the scale of this shock. 

The world will face new pandemics, and other health system shocks, and there is an urgent need to improve health system resilience to ensure that next time we are better prepared. We can already see where some of these challenges may come from. Climate-related risks to health and well-being are projected to increase with global warming; already, heat-related deaths among people aged 65 and over are estimated to have increased by nearly 70% over the past two decades. Fast-paced digitalisation brings opportunities for more effective and innovative, delivery of health care, but also new risks for health data security. Infections caused by resistant pathogens already pose an enormous burden on health systems and economies. Without effective antibiotics many of the hallmark successes of modern medicine, such as chemotherapy, knee replacement surgery and even preterm birth treatments, would be extremely risky. But these are just the threats we can already anticipate.

The pandemic was a forceful demonstration that, first, the speed and scale of health shocks can be hard to see coming. And second, that the causes and consequences of shocks and stresses will not be isolated to single systems or societies. Nor are the levers for addressing them: we must look to global solutions to these global challenges. Today, January 23rd 2024, OECD health Ministers met in Paris to work together to find some of these global solutions. Ministers and high-level representatives from 38 OECD countries, the European Union, partner and accession countries demonstrated our commitment to global health co-operation to address some of the biggest health policy challenges that we face, and discussed the urgent actions that are needed to strengthen the resilience of our health systems and increase their responsiveness to the needs of citizens.

Our discussions highlighted, in particular, the necessity of well-considered reforms and targeted investments to ensure that health systems are sufficiently prepared for future shocks and stresses. These reforms must bolster public health and disease prevention and strengthen mental health resilience. They must also focus on health system transformation: strengthening the health and social care workforce and ensuring that health data infrastructures are fit-for-purpose and support stronger health system governance, and health outcomes. Our efforts to strengthen health system resilience cannot be taken alone: global cooperation will be critical. We must, notably, increase pharmaceutical supply chain resilience, and foster international cooperation to accelerate work to decarbonise health systems.

Alongside fellow Ministers and high-level representatives, we adopted a Declaration aimed at strengthening health system resilience, in which we made a series of commitments, and called on the OECD’s continued to support to enable us to achieve them:

• We committed to further strengthen health system resilience to prevent and address the impact of shocks on our populations, including by strengthening and supporting the workforce through concerted action to train, retain, and improve the working conditions of health and care workers. We endorsed the OECD’s renewed Health System Performance Assessment Framework, reflecting our shared recognition of resilience as a critical objective of health systems, and asked the OECD to use it as a tool to support us in assessing and improving the resilience, performance and people-centeredness of our health systems, including by assessing and addressing health inequalities;
• We renewed our shared commitment to improve the people-centredness of health systems, including by assessing patients’ experiences and outcomes of care. We welcomed preliminary results of the OECD’s Patient-Reported Indicator Surveys (PaRIS) initiative, a first-of-its kind internationally comparable survey on patients’ experiences and outcomes of care, to help us to identify where quality improvements are needed to ensure that health systems deliver for the people using them; and
• We reiterated our commitments to work toward climate-resilient health systems, and climate-neutral health systems by 2050, and called on the OECD to develop a dashboard of climate measures to help us track progress toward achieving those ambitions. 

These measures represent a significant step in our efforts to improve health and healthcare globally. Delivering on these commitments will require consistent efforts at both the national and international level - and some difficult decisions given the pressure to limit expenditure increases - but we have learned the lessons of the COVID-19 crisis, and recognise that strengthening health system resilience is fundamental for social and economic prosperity.