As the world approaches the third anniversary of the SARS-CoV-2 outbreak, the devastating health, economic, and societal impacts of the COVID-19 pandemic remain on every continent. COVID-19 underscored how unprepared we are for a public-health emergency of staggering proportions. And yet potentially graver health threats loom. The increasing number of acute infectious diseases combines with trends such as population aging, chronic-disease burdens, and climate change to raise the risk of syndemics-events in which two or more diseases adversely interact with each other and with political and economic conditions of inequality and poverty. The only way to prevent, prepare for, and manage these threats is by building resilient health systems to withstand shocks and improve health outcomes between crises. This report, which is filled with country examples of resilience, shows how strengthening resilience is within every country's reach, even those with low incomes. It describes the key features of resilient systems as integrated systems that are aware of threats
agile in response to evolving needs
absorptive of shocks
adaptive to minimize disruptions
and able to transform after crises, based on lessons learned. The report makes recommendations for countries to operationalize resilience based on a framework that prioritizes investments according to their impact. The most important investments center on risk reduction, including prevention and community preparedness. The second most important investments focus on disease detection, containment, and mitigation to contain outbreaks before they spread widely. The final set focuses on advanced case management and surge response during an epidemic or pandemic, making this the most expensive and least cost-effective tier. The final message of the report is urgency. Investments are needed to save lives and economies - before it is too late.