Health Security in Germany: Assessing and Enhancing Crisis and Disaster Resilience in the Healthcare System

Health security is a vital pillar of German national security. While the COVID-19 pandemic was a stress test, high expenditure failing to yield superior health outcomes reveals structural inefficiency in the German healthcare system. The current "fair-weather system" is hampered by fragmented responsibilities, a lack of digitalisation and under a multi-threat landscape including chemical, biological, radiological, and nuclear (CBRN) incidents and hybrid warfare. Recent hospital reforms cutting crisis-relevant specialties like infectious diseases. Five core demands are proposed including enacting a Federal National Health Security Act, establishing a National Centre for Health Security, formalizing civil-military medical cooperation, investing in infrastructure resilience and reversing cuts to emergency expertise. Ultimately, a paradigm shift is required to move from reactive mechanisms to a proactive, integrated and data-driven resilient infrastructure.