All Countries Remain Dangerously Unprepared for Future Epidemic, Pandemic Threats

The conclusions of the 2021 GHS Index are the result of a revised framework and updated data collection conducted between August 2020 and June 2021 that allowed researchers to glean hard truths about preparedness for future threats while assessing health security capacities during the ongoing pandemic. The Index assessed countries across six categories, 37 indicators, and 171 questions using publicly available information. The Index benchmarks health security in the context of other factors critical to fighting outbreaks, such as political and security risks, the broader strength of the health system, and country adherence to global norms.

“It can be difficult for countries to know how best to use their very limited resources to meaningfully protect themselves against future pandemics,” said Johns Hopkins Center for Health Security Deputy Director Anita Cicero. “The Global Health Security Index can be used as a guidepost to identify and address yawning preparedness gaps with the ultimate goal of reducing health and economic impacts when the next public health crisis comes along.”

Top Findings
In addition to its overall finding that all countries remain dangerously unprepared for meeting future epidemic and pandemic threats, the GHS Index finds:

·  Most countries, including high-income nations, have not made dedicated financial investments in strengthening epidemic or pandemic preparedness.

·  155 out of 195 countries have not allocated national funds within the last three years to improve capacity, outside of public health emergencies, to address epidemic threats; and, among those who have, only two low-income countries have. Improving capacity requires a multi-year financial commitment, not just an increase in funding during a crisis.

·  Most countries saw little or no improvements in maintaining a robust, capable, and accessible health system for outbreak detection and response.

·  70% of countries show insufficient health capacity in clinics, hospitals, and community health centers.

·  Political and security risks have increased in nearly all countries, and those countries with the fewest resources have the highest risk and greatest preparedness gaps.

·  161 countries have low to moderate levels of public confidence in their government.

·  Countries are continuing to neglect the preparedness needs of vulnerable populations, exacerbating the impact of health security emergencies.

·  Only 33 countries have an overarching emergency preparedness and response plan in place that includes considerations for vulnerable populations.

·  Countries are not prepared to prevent globally catastrophic biological events that could cause damage on a larger scale than COVID-19.

·  176 countries have not published and implemented an overarching national public health emergency response plan for diseases with epidemic or pandemic potential.

Top Recommendations
Based on these findings, and building on the 2019 GHS Index, the 2021 GHS Index includes an action plan for countries, international organizations, the private sector, and philanthropies to improve capacities and ensure the world is prepared for the next pandemic. Top recommendations include: countries should allocate health security funds in national budgets and conduct assessments, using the 2021 GHS Index as a reference to developing a national plan to identify their risks and fill gaps; international organizations should use the Index to identify countries most in need of additional support; the private sector should use the Index to look for opportunities to partner with governments; and philanthropies and funders should develop new financing mechanisms and use the Index to prioritize resources.

This report is the second edition of the GHS Index. It was developed in consultation with an international panel of 18 experts from 13 countries. The project included a year-long data collection and validation process by 80 Economist Impact researchers located around the world and opportunities for governments to validate data.