The Global Health Security (GHS) Index, a 2019 report co-authored by the Nuclear Threat Initiative, Johns Hopkins Center for Health Security, and the Economist Intelligence Unit, is the first comprehensive assessment of health security around the globe. This index evaluates the preparedness capabilities of the 195 countries that are part of the International Health Regulations (IHR, 2005), an agreement among 196 nations, including all World Health Organization member states, to collaborate for global health security.
The GHS Index ranks countries based on six categories (prevention, detection and reporting, rapid response, health system, compliance with international norms, and risk environment), further divided into 34 indicators and 85 sub-indicators. Each country’s capability is rated on a scale of 0 to 100, with 100 indicating the highest level of preparedness.
Scoring System and Key Findings
The scoring system of the GHS Index places countries into three tiers; those that score between 0 and 33.3 are in the bottom tier, between 33.4 and 66.6 in middle tier, and between 66.7 and 100 in the top tier.
According to the GHS Index, no country is entirely prepared for epidemics or pandemics – overall, global preparedness is fundamentally weak. The average score among all 195 countries is just 40.2 out of 100. Countries exhibit significant weaknesses related to prevention, detection, response, health systems, vulnerabilities to various risks, and adherence to international norms.
Ranking of Different Countries
The United States is at the forefront with a score of 83.5, followed by the UK (77.9), the Netherlands (75.6), Australia (75.5), and Canada (75.3). Thailand’s sixth-ranking makes it the highest-ranked Asian country. In contrast, Africa houses the majority of countries ranked “least prepared”. India, with a score of 46.5, falls in the middle tier, while China, where the recent coronavirus outbreak originated, is at the 51st place with a score of 48.2.
Addressing Health Security Risks: Recommendations
The report recommends that the UN Secretary-General convene a global summit on biological threats by 2021 to address financing and emergency responses. Additionally, it calls for national governments to take action and address health security risks. It also suggests development of new financing mechanisms to fill preparedness gaps, designation of a separate permanent unit for high-consequence biological events, and donors to consider countries’ political and security risk factors while supporting capacity development.
India’s Response to Health Emergencies
India’s preparedness for health emergencies has been insufficient; the outbreaks of influenza A (H1N1) since 2009 have clearly highlighted this need. The low expenditure of less than 1.5% of GDP on health by the government, coupled with a scarcity of health professionals, only adds to the problem. Moreover, an HSBC study ranks India as the most climate-vulnerable country due to severe temperature increases and rainfall declines, worsening its health status.
Looking Ahead: Probable Solutions
All states in India should undertake assessments to identify gaps in health facilities, diagnostic equipment, hygienic practices, and prevention and treatment protocols. Kerala’s effective handling of the deadly Nipah virus in 2018 exemplifies the importance of investing in education and health over the long term.
India also needs to prioritize protecting biodiversity, as nearly two-thirds of known pathogens and three-quarters of new ones are spread from animals to humans, often due to increased human-wildlife interaction, land-use changes, and climate change.