PERSPECTIVE article
Front. Public Health
Sec. Planetary Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1653839
This article is part of the Research TopicSafeguarding Planetary and Human Health: Reflections on the Virchow Prize 2024View all 3 articles
Health Systems as Human Systems: Reflexivity, Relationships, and Resilience in the Pursuit of the SDGs
Provisionally accepted
- 1Health Policy and Systems Division, School of Public Health, University of Cape Town, Observatory, South Africa
- 2Virchow Foundation, Berlin, Germany
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Health Policy and Systems Research (HPSR) plays a critical role in efforts to strengthen health systems in pursuit of the Sustainable Development Goals (SDGs). This manuscript, adapted from the 2024 Virchow Lecture, explores the nature of HPSR, presents a systemsthinking perspective on health systems, and outlines key principles and strategies towards health system strengthening. It emphasizes the human dimensions of health systemsrelationships, trust, leadership, values and meaning-making -as foundational to their resilience and outcomes. This narrative is informed by decades of experience and research at the intersection of policy, practice, and academia, particularly in low-and middle-income countries. The paper concludes with a call to reimagine health systems as open, dynamic, and human-centred institutions that generate public value and promote equity.
Keywords: Health Policy and Systems Research (HPSR), Health system strengthening, complex adaptive systems, health equity, Leadership, reflexivity, resilience, Sustainable Development Goals (SDGs)
Received: 25 Jun 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Gilson and Grandsoult. 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: Victoria Grandsoult, Virchow Foundation, Berlin, Germany
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