TY - JOUR T1 - Health systems resilience and preparedness: critical displacements and disruption JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-007237 VL - 6 IS - 9 SP - e007237 AU - Mickey Chopra AU - Toby Kasper Y1 - 2021/09/01 UR - http://gh.bmj.com/content/6/9/e007237.abstract N2 - SummaryThe COVID-19 pandemic has presented an opportunity to reconsider health systems from the perspective of resilience and pandemic prevention and preparedness.Lessons from previous epidemics along with insights from other fields have not only already given rise to a burgeoning literature on elements of such systems but have also systematically underplayed key elements such as power.We argue that the current framing of the issues is displacing several more fundamental drivers of poor systems performance and population outcomes such as political economy, politics and history.The incorporation of a broader framing of the issues leads to a very different approach towards analysing the causes and formulating the response to build more resilient and just health systems.COVID-19 has highlighted the importance of resilient health systems. The concept of resilience has been evolving, with attributes such as feedback loops, learning capacity, adaptable management, flexibility and openness to systemic change take on greater importance from the earlier emphasis upon more fixed attributes such as numbers of laboratories, surveillance systems, etc1–3However, a recent review notes the missing role of power relations and actors in such studies.4 That this is so prevalent suggests a systematic oversight. Here, we identify three ‘displacements’ in many approaches to resilience and how this can radically change the approach.In the face of perpetual and multiple threats, the emphasis is on the resourcefulness and ingenuities of individuals and communities that refuse to surrender to all forms of endangerment. This emphasis on resourcefulness and ingenuity is part of the wider assemblage of ‘disaster management’ that focuses on the importance of being prepared and resilient against shocks such as climate change and, now, pandemics.5Earlier these shocks were understood to be an act of nature or divinity, whereas they are now … ER -