The COVID-19 pandemic waves before the vaccines were made available to the broader population required the set up of an emergency response of unprecented scale, and unveiled the need for our health care system to strengthen their capacity in terms of resilience. This translates into a joint effort between hospitals and territory to harmonise and integrate their service offer, in a way that can react timely to health threats. The challenges of providing health care in the midst of emergencies have been known for a long time: besides pandemics there are floods, earthquakes, armed conflicts.

Global-scale disasters, such as the earthquakes, and long-lasting and protracted conflicts generate huge numbers of casualties and simultaneously damage local infrastructure, including medical facilities. They have consequences not only for the earthquake or warwounded but also for the health of entire communities (1). A number of experiences are available to support disaster preparedness (2), and the UN highlighted how some policies and frameworks need to be rethought or redesigned, while others need to be better implemented during the course of emergencies (3). Stronger coordination and engagement of local key actors is at the core of an improved approach. Innovative service integration may contribute to the effectiveness of the response in the course of an emergency threatening health in a multi-hazard scenarios.