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Title page
Contents
Acknowledgements 4
1. Introduction 7
2. Defining the key investments needed to strengthen health system resilience 10
Pillar 1: Protect people's underlying health 10
Pillar 2: Fortify the foundations of health systems 13
Pillar 3: Bolster health professionals working on the frontline 14
3. How much will these investments to strengthen health system resilience cost? 16
3.1. Overall magnitude of costs 16
3.2. Cost estimates by investment component 18
4. Conclusions 29
References 30
Annex A. Sources and methods for cost estimates 33
Figure 1. Relationship between spending on resilience and pandemic preparedness, at the national and international levels 9
Figure 2. A trajectory: medium-term spending implications of investing in more resilient health systems 17
Figure 3. Investment range by pillar, as a share of GDP (relative to 2019 baseline) 18
Figure 4. Investing in prevention and public health systems, as a share of GDP 19
Figure 5. Estimated additional annual cost of mass testing and/or vaccination programmes, as a share of GDP 21
Figure 6. Surge control: investing in adequate PPE needs and a medical reserve force, as a share of GDP 22
Figure 7. Average investment in equipment and software, as a share of GDP, 2016-2019 23
Figure 8. Expenditure on software, databases, and ICT services by the health sector 24
Figure 9. Additional spending to harness health information in OECD countries, as a share of GDP 24
Figure 10. Practising physicians (headcount) per 1000 population, 2019 (or latest year) 26
Figure 11. Practising nurses/midwives (headcount) per 1000 population, 2019 (or latest year) 26
Figure 12. Improving the salary levels of nurses and personal carers, as a share of GDP 28
Boxes
Box 2.1. Research and Development into New Vaccines and Treatments for COVID-19 and Other Emerging Pathogens 12
Annex Tables
Table A.A.1. Order-of-magnitude cost estimates, by pillar/investment area as % of GDP 33
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