Are we repeating the mistakes of the human immunodeficiency virus (HIV) epidemic in our approach to combating coronavirus disease 2019 (COVID-19)? Is the world’s emphasis on developing vaccines overshadowing investment in the health systems that can deliver them? The authors analyse a report on the politics of investing in health policy and systems research (HPSR) and conclude by outlining three critical actions, using the Stuckler–McKee model of social change in health. These are: exploiting a political window of opportunity; changing the conversation; and mobilising a campaign to drive the agenda. When implemented together, these actions could help accelerate investment in health systems to combat the immediate COVID-19 pandemic and prepare health systems for the next crisis.

Key points:

• Similar to the HIV epidemic, the fight against coronavirus disease 2019 (COVID-19) has placed heavy emphasis on drugs and medicines, but less on strengthening health systems
• The health systems and policy research (HPSR) field developed in the mid-1990s to help overcome the weaknesses in the fight against human immunodeficiency virus (HIV)
• Current investment in HPSR is very low: $0.02 of every $1 in global health is for health systems strengthening
• The authors argue that greater investment in HPSR is needed to address the shortcomings of the global COVID-19 response