The recently released Global Health Security (GHS) Index provides a comprehensive assessment and comparison of health security and related capacities across 195 countries. The GHS Index is developed by the Nuclear Threat Initiative, a nonprofit global security organization aimed at mitigating nuclear and biological threats, and the Johns Hopkins Center, which recognizes the significant role of communication in public health.
Distinct Methods of GHS Index Ranking
The GHS Index evaluates based on six distinct categories: prevention of pathogens’ emergence or release, early detection and reporting for potential international epidemics, rapid response to epidemics, robust health systems, compliance with international norms and the overall risk environment and country vulnerability to biological threats.
The ranking system ranges from 0 to 100, with 100 being the highest level of preparedness. It consists of three tiers: low (0–33.3), moderate (33.4–66.6) and high (66.7–100).
India’s Position in GHS Index
In this index, India scored 42.8 out of 100, marking a slight drop of 0.8 points since 2019. In contrast, neighboring countries like Bangladesh, Sri Lanka, and Maldives improved their scores by 1-1.2 points.
Worldwide Performance in GHS Index
The global performance dipped to an average GHS score of 38.9 in 2021, down from 40.2 in 2019. Disturbingly, no country managed to score in the top tier, and none scored above 75.9.
The Level of Global Preparedness Against Future Epidemics
Despite expectations that infectious diseases could significantly impact the global economy over the next decade, the index highlights that countries of all income levels remain perilously underprepared to tackle future epidemics and pandemics.
Global Insufficiencies in Health Capacities
All countries were found to lack sufficient health capacities, leaving them susceptible to future health emergencies. Approximately 65% of countries assessed had not formulated a comprehensive national public health emergency response plan for potential epidemics or pandemics.
Lack of Medical Countermeasures and Financial Investment
The GHS Index revealed that 73% of countries did not have the means to fast-track the approval of medical countermeasures, such as vaccines and antiviral drugs, during a public health emergency. Further, most countries, including high-income ones, failed to make dedicated financial investments to strengthen epidemic or pandemic preparedness. Close to 79% of the assessed countries had not allocated national funds for improving their epidemic response capacities within the past three years.
Declining Public Confidence in Governments
The index also highlighted declining public trust in governments, with an overwhelming 82% of countries having low to moderate levels of public confidence in their governments. Trust in government is a crucial element for successful responses to health crises.
Recommendations for Improved Global Health Security
According to the GHS Index, countries should allocate health security funds in their national budgets and conduct assessments using the GHS Index. Additionally, international organizations should identify those countries most in need of additional support. The private sector could also collaborate with governments, and philanthropies and funders should create new financing mechanisms and prioritize resources using the GHS Index.
Status of India’s Healthcare Response
India is significantly underprepared for epidemics, as evidenced by the influenza A (H1N1) outbreaks since 2009 and the recent Covid-19 pandemic. The government’s health expenditure remains low, at less than 1.35% of the GDP, compared to the standard for middle-income countries. The availability of healthcare professionals is also substandard — with one doctor per 1,445 Indians, lower than the WHO’s prescribed norm of one doctor for every 1,000 people. Further compounding India’s health challenges is climate change, with over 80% of the population living in districts vulnerable to climate events.