TY - JOUR T1 - Strategies to Promote Health System Strengthening and Global Health Security at the Subnational Level in a World Changed by COVID-19 JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-21-00478 VL - 10 IS - 2 SP - e2100478 AU - Martin Alilio AU - Neetu Hariharan AU - Elizabeth Lugten AU - Kama Garrison AU - Rhea Bright AU - Wilberforce Owembabazi AU - Uwem Inyang AU - Saad El-Din Hassan AU - Kelly Saldana Y1 - 2022/04/28 UR - http://www.ghspjournal.org/content/10/2/e2100478.abstract N2 - Key MessagesAchieving strong, resilient health systems that reach both global health security and universal health coverage goals requires a unified approach to how we work across the system.We propose the following 3 key overarching approaches:Strengthen comprehensive district planning (i.e., to be successful, district planners must understand how various public health programs come together within their communities, the range of stakeholders who have a role to play in health efforts, and how public and private funding and information systems can be leveraged at the local level to achieve their objectives).Support flexibility of district health systems to break the silos of vertical programs and take on new roles as circumstances warrant.Use the ongoing roll-out of COVID-19 interventions as an opportunity to address management, coordination, and integration challenges at the district level.The scale and severity of the global health and economic impacts caused by the coronavirus disease (COVID-19) pandemic remain difficult to estimate.1 However, it is clear from the subsequent COVID-19 waves experienced in India, South Africa, and other countries that the pandemic has placed tremendous pressure on health systems and created a catastrophic situation for millions of people in low- and middle-income countries (LMICs) worldwide. The response to the COVID-19 pandemic has shifted resources and attention toward tertiary care at the expense of other essential services.2 As such, many people living in LMICs no longer have access to routine preventive health and treatment services.According to the World Health Organization (WHO), since the outbreak of COVID- 19 in March 2020, approximately 68 of 129 countries reported moderate to severe disruptions in vaccination campaigns, leaving more than 80 million children at risk.3 Infectious disease outbreaks often lead to a short-term breakdown of health systems, which then result in long-lasting reversals of public health gains.4 At … ER -