Topp SM, Power and politics: the case for linking resilience to health system governance, BMJ Global Health 2020;5:e002891
Since the watershed moment of the 2014 Ebola epidemic in West Africa and again in the midst of the current COVID-19 crisis, the concept of health system resilience has been a recurring theme in global health discussions. Although most frequently used in the context of epidemic response, resilience has also been framed as a ‘key pillar’ of health, and invoked in high-level calls for countries to ‘lead the work on building health system resilience’. Yet, as the authors of one of several recent reviews observed, the concept of health systems resilience remains ‘highly confusing’ and ‘still polysemic’. What it means ‘depends on one’s perception, one’s discipline, one’s function and what one wants to achieve’. In this editorial, I will, from the perspective of a health policy and systems researcher, draw out and reflect on some of these tensions, and make some suggestions about how we might achieve greater clarity.