Health system resilience and pandemic response: a comparative analysis of China, Singapore, the U.S., and the U.K.

Health system resilience and pandemic response: a comparative analysis of China, Singapore, the U.S., and the U.K.

Publication date: Jul 15, 2025

Infectious disease outbreaks have imprinted unprecedentedly on global economies, societies, politics, and healthcare systems. The COVID-19 pandemic underscored critical challenges in global healthcare delivery, necessitating the translation of lessons into actionable strategies for strengthening health system resilience against future outbreaks. This paper divides resilience into two dimensions: resilience from scale and resilience from structure. The former pertains to the overall resilience of the “state-society” system, while the latter refers to resilience rooted in the system’s internal structure. Expert consultation method is used to assess the potential and actual levels of two types of resilience. The case study and time slicing approach are used to analyze the anti-epidemic policies in four countries. There are significant differences in the potential and actual levels of resilience from scale and resilience from structure in the event of infectious disease outbreaks in China, Singapore, the U. S., and the U. K., as a result of a combination of political and non-political factors. Based on the original perspective of two types of resilience, this study reveals that differences in anti-epidemic policies among these countries stem from variations in the resilience from scale and resilience from structure. This paper elucidates the divergent global responses to the same virus from the original perspective of two types of resilience. Furthermore, the study presents a practice-oriented framework that links health system scale and structure to anti-epidemic policies, thereby moving beyond existing indices like the Global Health Security Index. The findings deliver concrete lessons for improving managerial practices, enhancing preparedness, and informing future healthcare delivery innovations, directly contributing to translating pandemic experience into implementable best practices for strengthening health systems against infectious disease threats.

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Concepts Keywords
China China
Global COVID-19
Healthcare COVID-19
Pandemic Health Policy
Politics health policy
Humans
Pandemics
resilience
resilience from scale
resilience from structure
Singapore
United States

Semantics

Type Source Name
disease MESH Infectious disease
pathway REACTOME Infectious disease
disease MESH COVID-19 pandemic
pathway REACTOME Translation
pathway REACTOME Reproduction
disease IDO country
disease MESH infection
disease IDO virulence
disease MESH emergency
disease IDO process
drug DRUGBANK Water
drug DRUGBANK Aspartame
disease IDO role
disease IDO intervention
disease IDO production
drug DRUGBANK Medical air
disease IDO nucleic acid
disease MESH uncertainty
disease MESH influenza
disease IDO infectivity
disease IDO contact tracing
disease IDO facility
drug DRUGBANK Etoperidone
disease MESH pneumonia
drug DRUGBANK L-Phenylalanine
disease MESH shock
disease MESH death
disease IDO quality
drug DRUGBANK (S)-Des-Me-Ampa
drug DRUGBANK Coenzyme M

Original Article

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