From burnout wards to disaster zones, the word resilience promises strength–but in most cases, it provides justifications of low investments. This is why it is time to reconsider this overused idea in the global health policy.

During the 2024 floods in one of the Nairobi hospitals the nurse Amina is handling overcrowded wards and no additional workforce and her resilience workshop certificate is taunting her fatigue. They are also taught not to sink, they are taught to bounce back, but from what? Endless shifts, without help? This scene reflects a trend in the world: resilience as a panacea of systemic ailments.

The Rise of Resilience: From Trauma Labs to Policy Playbooks

Resilience was not necessarily a staple of the public health. It has its roots in psychological studies of invulnerable children in 1970s who succeeded despite their disadvantaged backgrounds. Early researchers such as Norman Garmezy and Emmy Werner observed the Kauai Island children, which revealed protective aspects such as strong relationships to moderate trauma. As early as the 1980s it was extended into a wider meaning of adaptation which has been applied in ecology and disaster studies.

Policymaking jumped after the crisis of 2000s. The 2008 financial crisis and the outbreaks of Ebola highlighted the concept of system resilience, shifting the focus of a person to organizational systems. It was adopted by organizations such as the WHO: In 2014, their response to Ebola was to focus on resilient health systems to absorb shocks without failure. It became doctrine with COVID-19, with WHO positioning paper of 2021 calling to establish resiliency in UHC and security, as a key component of pandemics.

The World Bank was no exception as it incorporated resilience in health financing. In their 2022 report, Change Cannot Wait, resilient systems in the LMICs are recommended to manage the shocks in case of underfunding. Such a change is empowering but critics claim to re-package neoliberal ideals: Adapt or perish and don’t fix root causes.

How Resilience Became a Policy Shortcut

Practically, resilience usually replaces investment. The toolkit provided by WHO encourages training and coping skills to make systems stronger, yet the statistics indicate that LMICs invest only 4% of the GDP in health which is insufficient to meet the requirements of the most basic needs (6%). Policies and not staffing boosts strain individual endurance. The EAP programs of the Bank boast of climate shock resilience, but disregard chronic underfunding which exposes hospitals to vulnerability.

This is the rhetoric, which justifies austerity. When responding to a disaster, FEMA directive defines resilience as the reliance of communities on themselves, thus limiting the amount of federal assistance. In psychiatry, the situation is even worse: WHO recommended resilience building among the workers post-COVID, yet the burnout rate reached 60 per cent all over the world, which is not a mindset issue but a shortage one.

The critics refer to it as scar tissue – strength as the by-product of oppression, which makes one adapt to unfairness. In LMICs, it is acute: UN advice involves resiliency to construct societies, yet in such places as Kenya it substitutes access to treatment with coping training given 50% doctor shortages.

The Data: Burnout, Underfunding, and False Promises

The resistance to resilience is growing. In a 2025 review of mental health interventions, resilience training has been found to reduce burnout effects in the short term but not in the long term unless structural solutions have been implemented. When studying nursing, this revealed that training after initial increases of self-efficacy, 70% of the training is reversed during staffing crises.

As reported by WHO, healthcare worker burnout increased 20 percent after COVID-19 in the world, but policies that emphasize resiliency are associated with zero increase in health funding -LMICs experienced only 2 percent health budget growth 2020-2025. The reports of the Bank acknowledge resilience risks without considering equity, and costs are incurred by the weak. In the high income, it is subtle, in the LMICs, it is pronounced, resilience takes the place of infrastructure, according to a 2021 synthesis.

A Human Cost: Stories from the Frontlines

Meet Dr. Kwame in Ghana: He has been trained through programs by the World Bank to be resilient, where he works 80 hours in a poorly equipped clinic. It is not about recovery, it is not about coming back, it is about surviving that fall, he says. His narrative is like many others: A 2025 profile in Frontiers reveals LMIC physicians experiencing the 40 percent navigating burnout, and resiliency courses provide Band-Aids to systemic trauma.

Conversely, high income examples such as those in U.S. hospitals make use of the resilience apps, yet a Marquette review criticizes them as lacking fullness, since they do not include workload reforms.

Expert Views: When Resilience Works—and When It Fails

Those in support of resilience believe it is essential: the 2024 guideline by WHO views resilience as a partner, not a substitute, of PHC. It thrives in sharp shocks such as Ebola when adaptive capacity would save lives.

But here is a different idea: Resilience may keep individuals in unpleasant positions, a 2024 study cautions. UN critiques consider it a myth in LMICs not to be self-reliant with aid. BMJ captures that inequities are concealed in measurement.

Rethinking Resilience: Pathways Forward

To reclaim it:

• Combine with investment: World Bank guidelines impose funding guidelines, which are mandate resilience plans.
• Pay attention to equity: Emphasis on LMICs that have structural aid and not training only.
• Measure in a holistic manner: Indicators other than the adaptation, such as staffing ratios, should be used.
• Make voices loud: Engage workers in policy, without top-up rhetoric.

It is not resistance to change but its abuse that is the enemy. It is through questioning this shortcut that we are able to create systems that are actually resilient and not merely assuming that individuals will be.