by Jun Rentschler, Christoph Klaiber, Mersedeh Tariverdi, Keiko Sakoda, and Miguel Núñez del Prado

Health systems are central to effective disaster risk management. To serve their communities, healthcare providers need — among others — adequate facilities, equipment, staff, medical supplies, information management capabilities, and reliable access to power and clean water. These need to be supported by efficient financing and governance mechanisms to enable reliable routine care and effective emergency responses. Without such systems, healthcare provision is bound to deteriorate during shocks.

Yet of course, health systems themselves are exposed to natural hazards. Shocks can reduce the capacity and capability of healthcare facilities directly — for instance, 25% of healthcare facilities in Colombia are exposed to flooding, thus putting at risk service provision and accessibility of services. This also highlights that health systems are highly dependent on disaster resilient infrastructure systems. Reliable power and water supply in the aftermath of a disaster are crucial for health systems to function, and without resilient transport systems patients and staff cannot access health facilities.

The 2024 Understanding Risk (UR) Global Forum

At UR24, policymakers and practitioners came together to exchange experiences and recent developments — both in terms of the evolving pressures, for instance those due to climate change, but also in terms of emerging new solutions driven by data and technology. At a high-level technical session on the disaster risk management and health nexus, Takahiro Tsuda, Director of the Multilateral Development Banks Division at Japan’s Ministry of Finance, emphasized in his opening remarks how the COVID-19 pandemic highlighted the urgent need for resilient health systems capable of managing emergencies and routine demands alike.

Even prior to the pandemic, many health systems, particularly in developing countries, have struggled to provide universal health coverage and been ill-equipped to handle disasters, as seen in Indonesia’s 2021 earthquakes and Pakistan’s 2022 floods. These events underscored the vulnerability of health systems to various crises, including pandemics, devastating floods, earthquakes, tsunamis, and landslides, with impacts exacerbated by urbanization, demographic shifts, and climate change.

Japan’s Pioneering Initiatives in Health System Resilience 

It is no coincidence that UR24 took place in Japan, which is one of the pioneers in the field of disaster risk management — specifically its efforts to integrate health system planning in its emergency response. Japan’s Disaster Medical Assistance Team (J-DMAT) is a prime example of this. Yoshiki Toyokuni, Chief of the Disaster Medical Coordination Unit at DMAT, highlighted how DMAT was established following the devastating 1995 Hanshin-Awaji Earthquake and has since provided medical disaster assistance in the aftermath of numerous crises, including the 2011 Great Eastern Japan Earthquake and Tsunami, COVID-19 response, as well as numerous overseas deployments including in Türkiye and Syria. DMAT is a success story that several countries around the world are now adopting.

The government of Japan has been a true champion for this critical agenda, both domestically and internationally. Through its generous financial support and deep technical expertise, Japan has played a pivotal role in supporting countries worldwide. Its support to the GFDRR work on climate and disaster resilient health systems is a prime example of this engagement.

Partnerships for Progress

UR24 brought together over 1,700 people, including policymakers, scientists, and private firms. This highlighted the critical role of partnerships in making progress on this complex agenda. The World Health Organization (WHO), which has been pioneering international collaboration in the health sector for over 70 years, is a crucial partner for galvanizing action. During a technical session, Dr. Qudsia Huda, unit head of the WHO health emergency program, emphasized the importance of collaborative efforts to combat scarce resources in low- and middle-income countries through her remarks. Dr. Ryoma Kayano, Technical Officer for Health Emergencies and Disaster Risk Management at the WHO’s Kobe Center, highlighted the importance of evidence-based decision-making for strengthening the resilience of health systems. The WHO Guidance on Research Methods for Health Emergency and Disaster Risk Management provides a common framework to building the evidence base that can guide countries in prioritizing investments in health sector resilience. In the same vein, Prof. Virginia Murray, Head of Global Disaster Risk Reduction at the UK Health Security Agency, emphasized the importance of evidence-driven, cross-sectoral decision processes that aim to prepare health systems for all hazards.

Yet ultimately, progress can be made only if policymakers in countries around the world put plans into action. At the session, Vilma B. Cabrera, Undersecretary for the National Household Targeting System and Pantawid Pamilyang Pilipino Program of the Department of Social Welfare and Development of the Philippines, emphasized that any government action needs to put people at the heart of its crisis response. She played a key role in the Philippines’ response to the devastating Typhoon Haiyan, which affected more than 10 million people in 2013. Integrating health workers in the emergency response was critical for ensuring health care, nutrition, mental health services, and social support.

Call to action

Together, the above experts called for urgent action to better integrate health systems in disaster risk management. They urged a heightened focus on research, collaboration, and community engagement, while highlighting the importance of learning from past crises to build more resilient health systems globally — and to build back better after disasters. GFDRR is supporting this effort through its work on Climate and Disaster Risk Management for Health Systems by working closely with client governments and World Bank Health teams across countries to provide expert knowledge, innovative analytics, and advancing collaboration between international agencies, and public and private actors.

This work is part of GFDRR’s Thematic Area on Climate and Disaster Risk Management for Health Systems, which is funded by the Japan-World Bank Program on Mainstreaming DRM in Developing Countries. The Program collaborates with World Bank teams to assist governments with building more resilient healthcare systems.