Background Inadequate leadership capacity compounds the world's workforce lack of
preparedness for outbreaks of all sizes, as illustrated by the COVID-19 pandemic.
Traditional human resources for health (HRH) leadership has focused on determining
the health workforce requirements, often failing to fully consider the unpredictability
associated with issues such as public health emergencies (PHE). Main arguments The
current COVID-19 pandemic demonstrates that policy-making and relevant leadership
have to be effective under conditions of ethical uncertainty and with inconclusive
evidence. The forces at work in health labor markets (HLM) entail leadership that
bridges across sectors and all levels of the health systems. Developing and applying
leadership competencies must then be understood from a systemic as well as an individual
perspective. To address the challenges described and to achieve universal health coverage
(UHC) by 2030, countries need to develop effective HRH leaderships relevant to the
complexity of HLM in the most diverse contexts, including acute surge events during
PHE. In complex and rapidly changing contexts, such as PHE, leadership needs to be
attentive, nimble, adaptive, action oriented, transformative, accountable and provided
throughout the system, i.e., authentic, distributed and participatory. This type of
leadership is particularly important, as it can contribute to complex organizational
changes as required in surge events associated with PHE, even in in the absence of
formal management plans, roles, and structures. To deal with the uncertainty it needs
agile tools that may allow prompt human resources impact assessments. Conclusions
The complexity of PHE requires transformative, authentic, distributed and participatory
leadership of HRH. The unpredictable aspects of the dynamics of the HLM during PHE
require the need to rethink, adapt and operationalize appropriate tools, such as HRH
impact assessment tools, to redirect workforce operations rapidly and with precision.
