The 2019 Global Health Security Index
The GHS Index is the first comprehensive assessment of global health security capabilities in 195 countries. Read more about the Index and the international panel that helped develop it, download the report and data model, and watch our introductory video. The Global Health Security (GHS) Index is the first comprehensive assessment and benchmarking of health security and related capabilities across the 195 countries […]

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Hussein Hallak

The 2019 Global Health Security Index

The GHS Index is the first comprehensive assessment of global health security capabilities in 195 countries. Read more about the Index and the international panel that helped develop it, download the report and data model, and watch our introductory video.

The Global Health Security (GHS) Index is the first comprehensive assessment and benchmarking of health security and related capabilities across the 195 countries that make up the States Parties to the International Health Regulations (IHR [2005]). The GHS Index is a project of the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center for Health Security (JHU) and was developed with The Economist Intelligence Unit (EIU). These organizations believe that, over time, the GHS Index will spur measurable changes in national health security and improve international capability to address one of the world’s most omnipresent risks: infectious disease outbreaks that can lead to international epidemics and pandemics.

Why Is the GHS Index Needed?

It is likely that the world will continue to face outbreaks that most countries are ill positioned to combat. In addition to climate change and urbanization, international mass displacement and migration—now happening in nearly every corner of the world—create ideal conditions for the emergence and spread of pathogens. Countries also face an increased potential threat of accidental or deliberate release of a deadly engineered pathogen, which could cause even greater harm than a naturally occurring pandemic. The same scientific advances that help fight epidemic disease also have allowed pathogens to be engineered or recreated in laboratories. Meanwhile, disparities in capacity and inattention to biological threats among some leaders have exacerbated preparedness gaps.

The 2014 West Africa Ebola epidemic was a wake-up call. It prompted global leaders and the World Health Organization to realize that it’s not clear where the gaps are – or how to fill them. It also highlighted that leaders need better ways to understand and measure improvement in global capability to prevent, detect, and respond to infectious disease threats.

The GHS Index seeks to illuminate preparedness and capacity gaps to increase both political will and financing to fill them at the national and international levels.

Developing the GHS Index

To create the GHS Index, NTI, JHU, and the EIU project team—with generous grants from the Open Philanthropy Project, the Bill & Melinda Gates Foundation, and the Robertson Foundation—worked with an international advisory panel of 21 experts from 13 countries to create a detailed and comprehensive framework of 140 questions, organized across 6 categories, 34 indicators, and 85 subindicators to assess a country’s capability to prevent and mitigate epidemics and pandemics.

The GHS Index relies entirely on open-source information: data that a country has published on its own or has reported to or been reported by an international entity. The GHS Index was created in this way with a firm belief that all countries are safer and more secure when their populations are able to access information about their country’s existing capacities and plans and when countries understand each other’s gaps in epidemic and pandemic preparedness so they can take concrete steps to finance and fill them. The indicators and questions that compose the GHS Index framework also prioritize analysis of health security capacity in the context of a country’s broader national health system and other national risk factors.

The 140 GHS Index questions are organized across six categories:

  1. Prevention: Prevention of the emergence or release of pathogens
  2. Detection and Reporting: Early detection and reporting for epidemics of potential international concern
  3. Rapid Response: Rapid response to and mitigation of the spread of an epidemic
  4. Health System: Sufficient and robust health system to treat the sick and protect health workers
  5. Compliance with International Norms: Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms
  6. Risk Environment: Overall risk environment and country vulnerability to biological threats

Among its 140 questions, the GHS Index prioritizes not only countries’ capacities, but also the existence of functional, tested, proven capabilities for stopping outbreaks at the source. Several questions in the GHS Index are designed to determine not only whether a capacity exists, but also whether that capacity is regularly—for example, annually—tested and shown to be functional in exercises or real-world events.

The GHS Index also includes indicators of nations’ capacities and capabilities to reduce Global Catastrophic Biological Risks (GCBRs), which are biological risks of unprecedented scale that could cause severe damage to human civilization at a global level, potentially undermining civilization’s long-term potential. These are events that could wipe out gains in sustainable development and global health because of their potential to cause national and regional instability, global economic consequences, and widespread morbidity and mortality.



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