特集 レジリエンス, Research Article, インフラ整備による衣食住環境の改善や抗生物質の普及によって、とりわけ先進国における人間の主要な死因は感染症疾患から非感染症疾患にシフトし、公衆衛生対策も肥満、糖尿病、高血圧などの慢性疾患予防により重点があてられてきた。そうした中、2019 年末に中国武漢市から発生したとされる新型コロナウイルス感染症(COVID-19)が猛威をふるった。先進国を中心に世界の死者数は300 万人を超え(2021年5月現在)、PCR 検査の普及からワクチン開発およびその配分の透明性まで、現代医療体制への信頼が世界中で脅かされている。人獣共通感染症であるCOVID-19 は、ウイルス(一次)感染と病院での細菌(二次)感染との関係性を露わにし、人間を中心に行われてきた医療の非弾力性が問われるきっかけにもなっている。本稿では、国際保健学者の山本太郎のレジリエンス論を借りながら、微生物とヒトとの共生の視点から、レジリエンスを維持する社会-生態系システムとしての医療について論じる。COVID-19 にまつわる2つの事例をふまえ、(1)可塑性、(2)多様性、(3)持続可能性の3つの側面から医療のレジリエンスについて試論を提示する。そして最後の節では、「プラネタリーヘルス」の視点を紹介し、地球と人類の健康を互いに創りあげる方法と可能性を探る。, City planning, improvements in personal hygiene and medical innovations over the past two centuries led to the decline in infectious disease mortality in most parts of the world. As a consequence of this so-called epidemiological transition, modern public health concerns and policies have become increasingly structured around non-communicable diseases (NCDs), such as diabetes, obesity or hypertension. It is in this context that the new type of coronavirus (COVID-19) emerged from Wuhan, China, in late 2019. More than 3 million deaths worldwide as of May, 2021 combined with often low levels of transparency regarding the availability of PCR tests or the development and distribution of vaccines have considerably damaged the trust in modern healthcare systems around the world. COVID-19, a zoonotic disease, illustrates the systemic vulnerability and inflexibility of modern, anthropocentric infrastructures such as public healthcare systems. The causal relation between primary (viral) and multiple secondary (bacterial) infections in overloaded hospital settings is an obvious example. In this essay, we start from the medical notion of resilience to discuss the importance of coexistence with microorganisms for a more resilient healthcare system, by which we mean a ‘social-ecological system.’ The two different cases, 2009H1N1 influenza and antimicrobial resistance, introduced and discussed here are related to the COVID-19 pandemic in important systemic ways and will allow us to highlight three aspects of resilience in healthcare: (1) plasticity, (2) diversity and (3) sustainability. In the last section, we discuss the concept of planetary health that we hope can help us imagine better ways of protecting the health of both humans and the planet in pandemic and post-pandemic times.