Global infectious disease threats continue to expose persistent weaknesses in national and international health systems, underscoring the urgent need for resilient preparedness frameworks. This comprehensive review examines major global infectious disease preparedness frameworks and evaluates their contributions to strengthening health system resilience across diverse settings. The review synthesizes evidence from international policy documents, peer-reviewed studies, and institutional reports addressing preparedness governance, surveillance systems, workforce capacity, laboratory infrastructure, emergency coordination, risk communication, financing, and equitable service delivery. Particular attention is given to the International Health Regulations, the Global Health Security Agenda, Joint External Evaluation processes, pandemic preparedness plans, and integrated One Health approaches. Findings indicate that effective preparedness frameworks share several core characteristics: strong governance and accountability mechanisms, interoperable surveillance and data systems, sustained investment in public health infrastructure, multisectoral coordination, community engagement, and adaptive response capacity. However, the review also identifies major implementation gaps, especially in low- and middle-income countries, where limited financing, weak institutions, fragmented data systems, and workforce shortages constrain preparedness outcomes. In addition, the unequal distribution of medical countermeasures, inconsistent political commitment, and insufficient integration of primary health care into emergency planning continue to undermine resilience. Lessons from recent outbreaks demonstrate that preparedness must extend beyond emergency response planning to include long-term system strengthening, local manufacturing capacity, digital health innovation, and context-specific policy adaptation. The review concludes that infectious disease preparedness frameworks are most effective when embedded within broader health system resilience strategies that promote flexibility, inclusiveness, and continuity of essential services during crises. Strengthening preparedness therefore requires coordinated global support, domestic policy commitment, and sustained investments that align health security with universal health coverage goals. By consolidating current knowledge, this review provides practical insights for policymakers, public health leaders, and researchers seeking to build more robust, equitable, and responsive health systems capable of withstanding future infectious disease threats. It further emphasizes the importance of simulation exercises, transparent information sharing, legal readiness, decentralized decision-making, and cross-border collaboration in improving preparedness performance. A resilience-oriented preparedness agenda can reduce morbidity, mortality, social disruption, and economic instability while enhancing trust in health institutions before, during, and after outbreaks. across contexts.
Eweama et al. (Sun,) studied this question.