Building Resilient Health Systems: An Analysis of Epidemic Preparedness and Response in Togo

Epidemics pose a continuous threat to health systems in West Africa, exposing vulnerabilities and testing resilience. Togo’s health system, like others in the region, has faced multiple epidemic shocks, necessitating an analysis of its preparedness and response capacities. This working paper analyses the resilience of Togo’s health system in the face of epidemics. Its objectives are to identify key strengths and vulnerabilities in epidemic preparedness and response, and to derive lessons for building more robust health systems in similar contexts. The analysis employs a qualitative case study design, drawing on document analysis of policy frameworks and operational reports, alongside key informant interviews with health system stakeholders at national and sub-national levels. A central theme is the critical role of community health workers in early detection and response, identified as a major strength. Systemic vulnerabilities include fragmented supply chains for essential medical commodities and insufficient surge capacity for human resources during peak epidemic periods. Togo’s health system demonstrates pockets of resilience, particularly in community-based surveillance, but is hindered by persistent systemic weaknesses. Building true resilience requires moving beyond reactive measures to address foundational health system constraints. Recommendations include investing in integrated supply chain management, formalising and supporting the role of community health workers in epidemic response, and developing flexible human resource strategies that can scale during public health emergencies. Health systems resilience, epidemic preparedness, Togo, West Africa, community health workers, health policy This paper contributes to African Studies and health policy discourse by providing a contextualised analysis of health system resilience in a Francophone West African setting, offering practical insights for policymakers and practitioners in the region.