Health systems with stronger investments in UHC

Countries with strong UHC systems have also struggled with the pandemic if they did not cohesively implement robust GHS measures. Although Italy offers universal access to care, its Lombardy province (ie, one of Europe’s wealthiest areas) was disproportionately affected Health Policy. Inadequate coordination prevented proactive testing and left health workers unprotected.Despite strong UHC providing services to individuals, Lombardy sidelined core GHS capacities based in the community, which could have mitigated the effects of the outbreak. Meanwhile, the UK, despite appearing to rank highly in the Global Health Security Index and offering widespread UHC, did not act quickly and struggled to ensure that its National Health Service could meet demand. This struggle was largely due to poor integration of key GHS capacities, including leadership coordination and surveillance via tracing and testing, as well as neglect to factor in the governance and political economy of its health systems as important indicators for pandemic preparedness. Furthermore, a 50% decrease in admissions to hospital accident and emergency departments for heart attacks suggests an increase in unreported illnesses, resulting from poor risk communication and community engagement. Finally, both the UK and Spain delayed early investments in building the necessary testing capacity and stockpiling personal protective equipment, despite reassuring their populations that they were prepared. Where UHC systems are not effectively aligned with GHS strategies and properly documented in global assessments, world leaders can be in danger of having overconfidence in existing health systems, leading to collective complacency and politicisation of necessary public health responses during crises.