From Yokohama to WHO Health-EDRM: A Comparative Analysis of Global Disaster Risk Reduction Frameworks and the Evolving Integration of Health Systems

Abstract

Background: Over the past three decades, four international frameworks the Yokohama Strategy (1994), Hyogo Framework for Action (2005–2015), Sendai Framework (2015–2030), and WHO’s Health-EDRM Framework (2019) have shaped the disaster risk reduction (DRR) agenda. Despite advancing norms and principles, a persistent gap remains between policy commitments and implementation, particularly in integrating health systems.Methods: This study conducted a structured qualitative framework analysis of official UN and WHO documents, technical guidance, and monitoring reports. Frameworks were compared across four dimensions: governance, health system integration, monitoring and accountability, and financing/implementation guidance.Findings: Findings show a shift from state-centered governance toward multi-level, all-of-society approaches, although decision-making remains largely centralized. Health integration has progressed from minimal attention in Yokohama to explicit targets in Sendai and operational guidance in Health-EDRM; however, implementation remains fragmented. Monitoring systems have improved, particularly with Sendai’s 38 indicators, yet challenges in data quality and interoperability persist. Financing is consistently the weakest dimension, with limited guidance on sustainable funding.Conclusion: Overall, while DRR frameworks demonstrate normative and institutional progress, gaps in financing, decentralization, and alignment between Sendai monitoring and Health-EDRM implementation limit effectiveness. Future research should focus on translating global frameworks into local practice and their interaction with climate-related agreements.