GENEVA – What if you there were a single number assigned to each country that would provide a snapshot of its readiness for disease outbreaks?
You would have a quick take on where countries stand—and ideally where they need to improve. And if that number were updated every couple years, you’d also have a handy gauge on each country’s progress—or lack thereof.
You’d also have a simple motivating factor for government leaders. No one wants to be a cellar-dweller when it comes to protecting your population.
That’s the basic premise behind the Global Health Security Index project, which debuted at a Wednesday side event at the World Health Assembly. The project is a joint venture of the Nuclear Threat Initiative, the Johns Hopkins Center for Health Security and the Economist Intelligence Unit with funding from the Gates Foundation and others.
“Information is a tool that you can use to lobby your parliament [and] your cabinet to get those who appropriate the budget on their toes and to know we need action,” said Jane Aceng, Uganda’s Minister of Health. The GHSI is a “handy tool” to help persuade policymakers to invest in preparedness and other areas, rather than waiting for an outbreak to happen and then having to appropriate response funds.
“It takes time to get resources given to you. It takes forever,” Aceng said. “And while you are waiting, people are dying.”
The GHSI team spent a year consulting with experts from 12 countries to develop 140 questions across 6 categories of indicators that would point to a country’s ability to prevent, detect, and respond to infectious disease threats. It considers everything from a country’s political and socioeconomic risk factors to its health care system. The team stipulated that all data had to be publicly available.
Sample indicators include whether the country has an emergency operations center, whether it does regular drills and can be activated within 2 hours, said Beth Cameron, NTI’s Vice President, Global Biological Policy and Programs.
The index is meant to fill in the gaps of WHO’s Joint External Evaluation (JEE) mission reports, http://www.who.int/ihr/procedures/mission-reports/en/ which offer a similar status check but are voluntary (meaning some countries may not participate) and only carried out once every 4-5 years. The goal for the GHSI is to evaluate a country at least every 2 years
“We know we have cycles of panic and neglect,” Cameron said. “Indices are often very useful to keep political leaders focused on an issue and how to improve.”
The index team has piloted the index on 10 countries and plans to roll out the index for the world’s 193 countries by mid-2019, she said.
Scott Dowell, deputy director for Surveillance and Epidemiology at the Gates Foundation, said the index could reveal a country’s shortcomings before it is tested in the next outbreak. He recalled the speed with which H1N1 spread in Mexico and California in 2009. The virus exposed weak communications between surveillance systems and a limited ability to reach underserved populations.
“If there are weaknesses in surveillance systems and the ability to respond, [it] has consequences for everybody,” Dowell said.
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