Finance

Physics

Psychological resilience

Public health

Philosophy

Pathology

Business

Psychology

Nursing

Economics

Marketing

Political science

Government (linguistics)

Workforce

Disease

Resilience (materials science)

Service (business)

Coronavirus disease 2019 (COVID-19)

Corporate governance

Public relations

Linguistics

Economic growth

Infectious disease (medical specialty)

Psychotherapist

Service delivery framework

Medicine

Pandemic

Thermodynamics

Nature Medicine

Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, we review COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, we conducted a comparative analysis of national responses. We report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. We then synthesize four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally.

Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries