We are navigating a world where crises no longer occur in isolation. Climate change-induced events, armed conflicts, mass displacement, trade tensions, pandemics, and political fragmentation are increasingly colliding, forming a tangled web of disruptions. This phenomenon, described as a “polycrisis,” marks a new global condition—one in which systemic shocks interact and amplify one another. It is a lens we must urgently apply to health systems, particularly to the supply chains that sustain them.
Health systems do not operate in a vacuum. They are deeply embedded within global political and economic structures. The current political economy of health is shaped by dependencies on global trade, governance, and access to essential medical resources. When shocks reverberate through the broader global system, their impact on health is not incidental—it is direct and often devastating.
The COVID-19 pandemic starkly revealed the fragility of medical supply chains. For a brief moment, the world collectively recognized the strategic importance of secure access to essential health products. But only a few years later, that urgency is waning. Cost containment has once again overshadowed resilience, leaving health supply chains vulnerable to precisely the kind of multi-system shocks we continue to experience.
Geopolitical conflicts have disrupted pharmaceutical exports and vaccine manufacturing. Climate-related disasters have cut off access to medical supplies in entire regions. Technology failures or digital infrastructure disruptions have brought down health IT systems.
Recent reductions or redirections in global health funding from major donors have led to widespread disruptions in the procurement and distribution of essential medical supplies in low- and middle-income countries. These disruptions have resulted in shortages of life-saving medications, including those for HIV and malaria, halted immunization campaigns, and forced the closure of health clinics. Supply chains for therapeutic food for malnourished children have also been affected, with production delays and factory shutdowns. These funding shifts have not only interrupted service delivery but have also deepened existing health inequities, disproportionately impacting the most vulnerable populations.
This complex, entangled crisis environment demands a rethinking of how we build resilient supply chains for health systems. First, resilience must be treated as a strategic priority, not a cost center. Regional diversification of manufacturing, investment in local production capacities, and robust warehousing can reduce dependence on vulnerable international routes. This also requires nurturing a strong research and development ecosystem through public investment and public-private partnerships, and supporting the localisation—whether national or regional—of manufacturing to increase supply autonomy.
Second, global cooperation must move beyond emergency response. We need structured, long-term agreements for pooled procurement, regional stockpiling, and equitable distribution of essential supplies, especially in times of crisis. While a pandemic treaty currently in its final stages of negotiation is a critical step forward, such cooperation must not be limited to moments of global emergency. Building resilient supply systems requires sustained collaboration during periods of normalcy as well—when institutions have the bandwidth to plan, invest, and reinforce trust. Without these mechanisms in place consistently, health security risks become a privilege of the few, rather than a shared global good. This must also include harmonisation of regulatory systems and standards across regions to streamline cross-border collaboration and ensure the quality and safety of essential medical products.
Third, we must embed climate foresight and risk mitigation strategies into supply chain design. The frequency and severity of climate-linked disruptions will only increase. Anticipating their impact is no longer optional but a requirement for survival.
We must also harness innovation and digital tools to strengthen system-wide efficiency. This includes IT-enabled distribution networks that provide real-time visibility across the supply chain and improve forecasting accuracy. Further, mechanisms like patent pooling can help reduce licensing costs and expand access to critical technologies.
Resilience also means responsible consumption. Optimising the use of medical products through evidence-based guidelines and eliminating unnecessary tests and treatments not only reduces waste but also strengthens system sustainability.
Lastly, we must confront the reality that unequal power dynamics—within and between countries—shape access to health. A resilient supply chain cannot be built on unequal relationships. We need to shift toward cooperative, capacity-building models that strengthen regional autonomy and institutional resilience. This includes empowering countries and regions to participate equitably in global procurement and regulatory processes, thereby enhancing both sovereignty and solidarity.
If the polycrisis teaches us anything, it is that no shock is truly isolated. The health of a population in one corner of the world is increasingly influenced by events across the globe. In this deeply interconnected reality, resilience is not just about logistics or procurement—it is about foresight, justice and solidarity. Our collective future depends on it.
Dr. N. Krishna Reddy, CEO, ACCESS Health International