Health systems for all in the SDG era: Key reflections based on the Liverpool statement for the fifth global symposium on health systems research

Abstract

The year 2018 marked anniversaries of several significant milestones in public health: the birth of the UK National Health Service, the Alma Ata declaration and the Commission on Social Determinants of Health. The Fifth Global Symposium on Health Systems Research in Liverpool reflected on these foundational events and their significance for the maturing field of health policy and systems research (HPSR) and for our growing professional association, Health Systems Global (HSG; Text Box 1). The Symposium’s theme, Health Systems for All in the Sustainable Development Goal Era, encapsulated the spirit of those historical commitments and brought them forward into current con- texts, framing universal health coverage and beyond (5th Global Symposium on Health Systems Research, 2018). Our democracies are under threat, our societies more polarized and our ecosystems undermined. Conflict and epidemics are not given adequate political attention, and across countries gender and intersectional inequalities remain glaring. It is amidst these contexts that our histories remind us of the progressive values that underpin ideal health systems. A key aim of HSG is to strengthen health systems by combining socially relevant science with effective, accountable and inclusive institutions to guide diverse social actors on the path to health and equity. In doing so, it is critical for health policy and systems researchers and practitioners to, above all, remain undaunted in striving for the realization of our aspirational goals despite these contemporary challenges.