No country is prepared for a pandemic

World in a petri dish

According to the Johns Hopkins Center for Health Security and the Nuclear Threat Initiative (NTI), even high-income countries are sorely lacking when it comes to preparedness

The inaugural Global Health Security Index from Johns Hopkins and the NTI is the first comprehensive assessment of health security and preparedness capability across 195 countries, and its findings are damning – that not a single country in the world is adequately prepared for epidemics or pandemics.

The report scores countries on various metrics, and the average across the whole Index is just above 40 out of a possible 100, indicating severe weaknesses in prevention, detection and response capabilities. Of the 60 highest-income countries included in the report, the average score was only 51.9.

The researchers behind the report hope that it will be taken seriously by health ministers, international health bodies and other stakeholders as a blueprint for improvement. “The GHS Index finds that no country is fully prepared for naturally occurring, intentional or accidental infectious disease outbreaks,” said Jennifer Nuzzo, Associate Professor at the Bloomberg School and Senior Scholar at the Johns Hopkins Center for Health Security. “Knowing that there is work to do, countries can use the Index to identify gaps, build preparedness and best practices, and track progress over time.”

Fewer than seven per cent of countries were found to score highly when it came to prevention of the emergence or release of a pathogen, while only 19 per cent of countries received high marks when it came to early detection and reporting of potentially dangerous epidemics. Fewer than five per cent of countries scored highly when it came to rapid response to epidemics and mitigation of same, and in terms of having sufficiently robust health sectors to treat ill citizens and protect health worker, the average score across the board was only 26.4 out of 100.

The Index offers a number of recommendations for the international community and individual countries:

  • “The UN Secretary-General should call a heads-of-state-level summit by 2021 on biological threats, including a focus on financing and emergency response.”
  • “National governments should commit to take action to address health security risks.”
  • “Health security capacity in every country should be transparent and regularly measured, and results should be published at least once every two years.”
  • “Leaders should improve co-ordination in unsecure environments, especially linkages between security and public health authorities.”
  • “New financing mechanisms should be established to fill preparedness gaps, such as a new multilateral global health security matching fund and expansion of World Bank International Development Association allocations to include preparedness.”
  • “The UN Secretary-General should designate a permanent facilitator or unit for high-consequence biological events. Countries should test their health security capacities and publish after-action reviews, at least annually.”
  • “Governments and donors should take into account countries' political and security risk factors when supporting health security capacity development.”

“Whether they be natural, accidental or deliberate, infectious disease outbreaks can cause significant harm to health, peace and prosperity if countries are not adequately prepared,” said Tom Inglesby, Director of the Center for Health Security. “It is important for national leaders to understand the risks that infectious diseases pose and commit to making improvements in preparedness for these events.”