What COVID-19 tells us about strengthening global public health systems
Covid-19 is not the first time the international health systems have been tested for their resilience, and neither it would be the last time. Let us see what sort of pandemic or global health emergencies, we have faced in recent times and their impact:- 2003 SARS: Cases = 8098, Deaths = 774
- 2009 Swine flu: Cases = 1.6 million, Deaths = 18,449
- 2015 Ebola: Cases = 28,600 cases, Deaths = 11325
- Mortality and morbidity Cases: = 2.68 million, Deaths = 187000 (as of 23 April 20)
- Clinical care and collateral damage: All the healthcare capacity being used for COVID-19 and millions of operations/appointments have been cancelled
- Social determinants: 0.5 billion people across the globe will end up below the poverty line, Employment figures are on a free fall, Domestic violence on the rise
- Financial consequences so far: Global economy is projected to contract sharply by -3% in 2020, UK: £330 billion bailout package (almost 2.5 times of the total NHS budget), USA: $2.2 trillion financial relief package, European Central Bank (EB): €870 billion Pandemic Emergency Purchase Programme (amounts to 7.3% of Euro’s GDP), World Bank: $160 billion relief package for developing countries, IMF: £50 billion emergency relief for developing countries, every country also diverted its budgets to deal with immediate clinical impact.
- health protection
- health promotion
- healthcare quality and efficiency – and data and intelligence underpin all three.


- Make it binding that their funds will be prioritised to strengthen some or all elements of PH systems in respective countries
- Mandatory ‘Public Health System Impact Assessment’ of all of their investment projects
- Promote the art and science of improving ‘public health system (PHS)’. They should encompass all the elements of effective public health system with appropriate assessment indicators in their healthcare projects.
- Export and cross-fertilise best PHS practices across the globe through their countries-wide networks.
- An ‘International Knowledge Management Repository’ using technologies like ‘Blockchain’ to keep it current and securely accessible
- Regional ‘Public Health System Collaborative Centres’ to help in shifting the balance of power from healthcare to health.