PERSPECTIVE article

Front. Public Health

Sec. Disaster and Emergency Medicine

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1630933

When the Lights Went Out: impacts of the April 2025 Iberian Blackout on the Portuguese National Health Service sovereignty A Reflection on National Defence, Health Sovereignty, Risk, and Infrastructural Dependency

Provisionally accepted
Francisco Goiana-da-SilvaFrancisco Goiana-da-Silva1,2,3*Daniel Madureira-FonsecaDaniel Madureira-Fonseca4Duarte Tude GraçaDuarte Tude Graça2Maria Moitinho de AlmeidaMaria Moitinho de Almeida5Miguel Cabral PinhoMiguel Cabral Pinho6Juliana SáJuliana Sá7,8,9Rui MoreiraRui Moreira10Luís CabralLuís Cabral11Nelson PereiraNelson Pereira6Alexandre Morais NunesAlexandre Morais Nunes12Alexandre LourençoAlexandre Lourenço13,2Jaime Da Cunha BrancoJaime Da Cunha Branco2Hutan AshrafianHutan Ashrafian1Ara DarziAra Darzi14,15
  • 1Imperial College London, London, United Kingdom
  • 2Universidade NOVA de Lisboa, Lisbon, Portugal
  • 3Universidade da Beira Interior, Covilhã, Portugal
  • 4Supreme Headquarters Allied Powers Europe, NATO, Mons, Belgium
  • 5UCLouvain, Leuven, Belgium
  • 6ULS São João, Porto, Portugal
  • 7ULS Santo António, Porto, Portugal
  • 8Universidade da Beira Interior,, Covilhã, Portugal
  • 9University of Aveiro, Aveiro, Portugal
  • 10Universidade Portucalense, Porto, Portugal
  • 11Servico Regional de Protecao Civil e Bombeiros dos Acores, Ilha Terceira, Portugal
  • 12University of Lisbon, Lisbon, Portugal
  • 13ULS Coimbra, Coimbra, Portugal
  • 14Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
  • 15Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom

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The April 2025 blackout in the Iberian Peninsula severely disrupted The Portuguese National Health Service (NHS). It led to failures for over eight hours in power supply, digital systems, telecommunications, and inter-institutional coordination. Hospitals operated on limited generator capacity, essential medical equipment was triaged, and digital health records became inaccessible. Cold storage failures endangered temperature-sensitive medicines, while emergency communications and transport systems were severely compromised. This perspective article based on first-hand experience and grey literature proposes a first rapid analyses on the blackout as through the World Health Organization's Health Emergency and Disaster Risk Management Framework. Advocating that health care resilience must then be acknowledged as a fundamental area of national security the article calls for regulatory improvement, decentralised energy solutions, digital redundancy, and integrated command structures linking health, civil protection, and defence sectors. It offers further insights into building anticipatory health systems capable of withstanding future complex disruptions.

Keywords: Health system resilience, emergency preparedness, Critical infrastructure, Energy Blackout, cross-sectoral coordination

Received: 23 May 2025; Accepted: 24 Jun 2025.

Copyright: © 2025 Goiana-da-Silva, Madureira-Fonseca, Tude Graça, Moitinho de Almeida, Cabral Pinho, Sá, Moreira, Cabral, Pereira, Nunes, Lourenço, Branco, Ashrafian and Darzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Francisco Goiana-da-Silva, Imperial College London, London, United Kingdom

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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