Preparedness in Africa: How it’s evolved and what's next
2026
Tracking progress and building resilience
African countries are building stronger systems to advance health security and sovereignty. However, the scale and speed of rising health threats call for urgent actions and increased investment.
Key takeaways
Africa’s health security capacity has improved, with gains across prevention, detection, and response. Scores in 52 of 54 countries and five of six categories improved by at least one point since 2021.
More frequent outbreaks, climate change, unstable funding, and political and security risks continue to increase vulnerability. Investment and partnership are more important than ever.
Biosecurity and biosafety capacities improved but remain critically low. As laboratory system capacities grow, matching investment in biosafety measures is essential to keep these systems safe and secure.
Biosurveillance capacity is growing—52 of 54 countries increased this capacity, including expansion of wastewater-environmental and genomic surveillance.
African countries have made substantial gains in medical countermeasure development and deployment since 2019, but a gap remains between those capacities. This presents a clear opportunity for targeted investment in workforce surge planning and deployment infrastructure.
Climate related health security capacity is improving. African countries are strengthening the infrastructure needed to respond to climate change–related infectious disease threats.
Regional health security infrastructure is strengthening, but unevenly. Fifty-two countries now have emergency operations centres, but only eight are tracking dangerous pathogen facility locations.
National health security financing commitments show signs of strain. While seven countries newly demonstrated evidence of such, 18 stopped providing public evidence of financing commitments.
41.5 out of 100
+9.1 From 2021
The average country score in the 2026 AHS Index is 41.5, up from 32.4 in 2021. Although the progress shown is encouraging, persistent gaps and vulnerabilities remain.
Averages by category
Prevention
Prevention of the emergence or release of pathogens, particularly those that may constitute a Public Health Emergency of International Concern.
31.1 +9.3 From 2021
Subcategories
38.0
Antimicrobial resistance (AMR)
Composite measure | Weighted average of the following indicators: 1.1.1-1.1.2
39.7
Zoonotic disease
Composite measure | Weighted average of the following indicators: 1.2.1-1.2.5
14.9
Biosecurity
Composite measure | Weighted average of the following indicators: 1.3.1-1.3.5
18.2
Biosafety
Composite measure | Weighted average of the following indicators: 1.4.1-1.4.2
1.9
Dual-use research and culture of responsible science
Composite measure | Weighted average of the following indicators: 1.5.1-1.5.2
45.8
Immunization
Composite measure | Weighted average of the following indicators: 1.6.1
59.3
Climate change adaptation and vector transmission
Composite measure | Weighted average of the following indicators: 1.7.1
Scores are out of 100
Detection and Reporting
Early detection and reporting of epidemics of potential international concern, which may spread beyond national or regional borders.
46.2 +20.0 From 2021
Subcategories
49.3
Laboratory systems strength and quality
Composite measure | Weighted average of the following indicators: 2.1.1-2.1.2
29.6
Laboratory supply chains
Composite measure | Weighted average of the following indicators: 2.2.1-2.2.2
64.2
Real-time surveillance and reporting
Composite measure | Weighted average of the following indicators: 2.3.1-2.3.3
47.0
Surveillance data accessibility and transparency
Composite measure | Weighted average of the following indicators: 2.4.1-2.4.5
19.4
Case-based investigation
Composite measure | Weighted average of the following indicators: 2.5.1-2.5.2
67.6
Epidemiology workforce
Composite measure | Weighted average of the following indicators: 2.6.1-2.6.2
Scores are out of 100
Rapid Response
Rapid response to and mitigation of the spread of an epidemic.
43.9 +11.4 From 2021
Subcategories
33.4
Emergency preparedness and response planning
Composite measure | Weighted average of the following indicators: 3.1.1-3.1.3
22.9
Exercising response plans
Composite measure | Weighted average of the following indicators: 3.2.1-3.2.2
38.9
Emergency response operation
Composite measure | Weighted average of the following indicators: 3.3.1
14.8
Linking public health and security authorities
Composite measure | Weighted average of the following indicators: 3.4.1
61.7
Risk communication
Composite measure | Weighted average of the following indicators: 3.5.1-3.5.2
53.0
Access to communications infrastructure
Composite measure | Weighted average of the following indicators: 3.6.1-3.6.4
82.4
Trade and travel restrictions
Composite measure | Weighted average of the following indicators: 3.7.1-3.7.2
Scores are out of 100
Health System
Sufficient and robust health system to treat the sick and protect healthcare workers.
37.5 +13.2 From 2021
Subcategories
30.3
Health capacity in clinics, hospitals and community care centers
Composite measure | Weighted average of the following indicators: 4.1.1-4.1.2
35.7
Supply chain for health system and healthcare workers
Composite measure | Weighted average of the following indicators: 4.2.1-4.2.3
20.7
Medical countermeasures and personnel deployment
Composite measure | Weighted average of the following indicators: 4.3.1-4.3.2
43.8
Healthcare access
Composite measure | Weighted average of the following indicators: 4.4.1-4.4.3
27.8
Communications with healthcare workers during a public health emergency
Composite measure | Weighted average of the following indicators: 4.5.1
47.5
Infection control practices
Composite measure | Weighted average of the following indicators: 4.6.1
56.5
Capacity to test and approve new medical countermeasures
Composite measure | Weighted average of the following indicators: 4.7.1
Scores are out of 100
Norms
Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms.
49.0 +2.7 From 2021
Subcategories
70.4
IHR reporting compliance and disaster risk reduction
Composite measure | Weighted average of the following indicators: 5.1.1-5.1.2
51.4
Cross-border agreements on public health and animal health emergency response
Composite measure | Weighted average of the following indicators: 5.2.1
32.0
International commitments
Composite measure | Weighted average of the following indicators: 5.3.1-5.3.2
21.8
JEE and PVS
Composite measure | Weighted average of the following indicators: 5.4.1-5.4.2
50.5
Financing
Composite measure | Weighted average of the following indicators: 5.5.1-5.5.4
67.9
Commitment to sharing of genetic & biological data & specimens
Composite measure | Weighted average of the following indicators: 5.6.1
Scores are out of 100
Risk Environment
Overall risk environment and country vulnerability to biological threats.
41.4 -1.8 From 2021
Subcategories
41.3
Political and security risk
Composite measure | Weighted average of the following indicators: 6.1.1-6.1.7
43.1
Socio-economic resilience
Composite measure | Weighted average of the following indicators: 6.2.1-6.2.6
27.2
Infrastructure adequacy
Composite measure | Weighted average of the following indicators: 6.3.1-6.3.3
50.8
Environmental risks
Composite measure | Weighted average of the following indicators: 6.4.1-6.4.3
44.5
Public health vulnerabilities
Composite measure | Weighted average of the following indicators: 6.5.1-6.5.4
Scores are out of 100
What are our next steps?
No single country can face the next pandemic alone. When governments invest in preparedness, funders direct resources strategically, and partners collaborate on solutions, we all become safer.
Cross-cutting recommendations
Govern what you’re building:
- Require future investments in infectious disease research and pandemic preparedness and response to include biosecurity and biosafety resources and training.
- Develop a harmonized emergency use authorization framework to expedite regulatory pathways for medical countermeasures.
Strengthen the detection-to-action chain:
- Expand investment in emerging surveillance networks and early warning and detection systems, including wastewater and environmental surveillance and genomic surveillance.
- Strengthen water and sanitation infrastructure to prevent disease transmission and address climate-related health pressures.
- Formalize inter-country cooperation agreements that support the response to combat disease outbreaks.
Close the deployment and financing gaps:
- Build medical countermeasure deployment capacities to complement the push in manufacturing capabilities.
- Publicly commit to financing pandemic preparedness through domestic resources, global commitments (like the Pandemic Fund), and co-investment opportunities.
- Establish a global pandemic spending tracker and endorse minimum financing benchmarks for pandemic prevention, preparedness, and response.
Recommendations for
- Require all future investments in infectious disease research and pandemic preparedness and response to include biosecurity and biosafety resources and training.
- Develop a national biosecurity and biosafety strategy, with guidance at the continental or regional level.
- Establish and expand biosecurity and biosafety workplace training programs, implementing training requirements and recertification standards.
- Develop dual-use research of concern oversight frameworks to be implemented at the national level, with guidance at the continental or regional level.
- Require DNA synthesis screening at the point of procurement.
- Improve collaboration between health and security sectors to bolster biosecurity capacities.
- Establish a continental AI Safety Institute with responsibility for biosecurity and biosafety governance of AI-related tools and technology.
- Continue Africa’s positive momentum toward Biological Weapons Convention ratification and submission of confidence-building measures.
- Prioritize and expand investment in electronic and ongoing surveillance and reporting systems.
- Close critical gaps in laboratory supply chains to ensure reliable diagnostic capacity during routine surveillance and outbreak response.
- Support regions and countries with limited surveillance and reporting capacity, particularly in Central Africa.
- Expand investment in emerging surveillance approaches and early warning and detection capacity, along with commensurate investment in decision-making tools to translate data into action.
- Expand public–private partnerships to strengthen shared digital infrastructure for biosurveillance.
- Support scalable solutions to reduce costs and improve access to surveillance tools and diagnostics.
- Formalize intercountry cooperation agreements such as Memoranda of Understanding that support the response to infectious disease outbreaks that cross borders.
- Continue to support regional structures to help countries cooperate to prevent, detect, and respond to infectious disease outbreaks.
- Create additional opportunities for the public health workforce on the continent to build networks across countries.
- Implement financing strategies across the health and security sectors to accelerate geographically diversified MCM development, manufacturing, and deployment.
- Build robust MCM deployment capacities—such as workforce surge planning, last-mile distribution, and non-pharmaceutical intervention implementation frameworks modeled on initiatives like the 100 Days Mission—to complement the strong push on MCM development.
- Prioritize the development of a harmonized emergency-use authorization framework as an integral component of the operationalization of the Africa Medicines Agency (AMA).
- Strengthen regional MCM pooled procurement through the African Pooled Procurement Mechanism and leverage African Vaccine Manufacturing Accelerator’s financing mechanisms to prioritize manufacturing investments in countries and regions with the greatest gaps in MCM development capacity.
- Establish at least one personal protective equipment manufacturing hub for each region, with stockpiles for essential long-shelf-life products.
- Countries should incorporate the African Medicines Agency Treaty to allow national regulators to formally rely on AMA outputs.
- Strengthen water and sanitation infrastructure to prevent disease transmission.
- Adopt a One Health approach to disease surveillance by establishing and maintaining infectious disease surveillance systems within wildlife, poultry, and livestock populations.
- Conduct vulnerability risk assessments in collaboration with ministries of finance that specifically identify the potential economic impacts of climate change–related natural hazards, including infectious diseases.
- Support countries in identifying specific climate change–related infectious disease risks.
- Country leaders and governments should make public and demonstrable commitments to financing pandemic prevention, preparedness, and response (PPR).
- Establish a systematic, publicly accessible, global pandemic spending tracker and endorse minimum pandemic PPR financing benchmarks.
2026 Africa Health Security Index
Explore the Data
The AHS Index data supports decision-making across sectors. Governments can use the AHS Index data to plan and prepare. International and regional organizations International and regional organizations, philanthropies and other funders, and the private sector can each use the country-level data to monitor health capacities, advocate for action, and inform targeted investment.
Partners & Supporters
The AHS Index is developed by NTI, the Brown University Pandemic Center, Economist Impact, and Science for Africa Foundation, in collaboration with the University of the Witwatersrand (Johannesburg, South Africa), and University of Tunis El Manar (Tunis, Tunisia). Funding is provided by the Gates Foundation.
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