GHS Index

The Global Health Security (GHS) Index¹ demonstrates that the world is not prepared for epidemics and pandemics. To identify countries that are more vulnerable to the spread of an outbreak like COVID-19, the GHS Index team analyzed a subset of indicators within the GHS Index against global flight data². This model demonstrates country capacity to detect and respond to an emerging outbreak, as well as a country’s risk of introduction to one. The analysis identifies more vulnerable countries—those with the lowest scores for this subset of GHS Index indicators—and plots them against highest travel volume and population³.

To conduct the analysis, the team selected a subset of indicators within four of the six categories of the GHS Index, which are most relevant to country vulnerability to an outbreak like COVID-19, after it arises. This subset includes indicators on country capacity to detect and respond and on overall health systems strength, as well as those related to political security and socioeconomic risk.

Using this subset of GHS Index indicators, the team calculated the global average score to be 35.9 out of a possible 100 points. This extremely low average demonstrates how ill-prepared the world is to detect and respond to an emerging outbreak. Of the 195 countries included in the GHS Index, 172 scored even more poorly when assessed on this subset of indicators than when assessed on all the indicators in the overall GHS Index.

Finally, to assess country vulnerability in the face of an outbreak like COVID-19, the country scores were analyzed against the total volume of domestic and international travelers per year, using flight data for all 195 countries (Figure 1).

Figure 1. Scores of a subset of indicators within the GHS Index plotted to model each country’s vulnerability to emerging outbreaks against the number of annual international and domestic travelers within the country, using published flight data. The color of the dot represents the United Nations region, and the size of the dot represents the population of the country. Three countries—Andorra, Liechtenstein, and San Marino—are accessed through airports in other countries and, therefore, are not shown.

Seventy-three countries are identified as more vulnerable to emerging outbreaks, with scores under 50 and have an annual volume of travelers more than 1 million (Figure 2). 

• China and Italy have the most travelers of the countries within this grouping, with scores of 48.5 out of 100 and 45 out of 100, respectively.
• Other countries in this grouping include United Arab Emirates, Russia, Colombia, Egypt, Iran, and Nigeria. These countries show lower capacity to detect and respond to an emerging outbreak than other countries with a similar number of travelers.

Figure 2. Scores of a subset of indicators within the GHS Index to model a country’s vulnerability to emerging outbreaks plotted against the number of annual international and domestic airline travelers within country, filtered to include only countries with a score of less than 50 and a volume of travelers greater than one million. The color of the dot represents the United Nations region and the size of the dot represents the population of the country.

Twenty-seven out of 195 countries are identified as the most vulnerable to emerging outbreaks, with scores under 33 and have an annual volume of travelers more than one million (Figure 3).

• In this group, Venezuela and Pakistan have the highest number of flights, followed by Ukraine.
• Libya, Algeria, Syria, and Yemen scored significantly lower than other countries with a similar number of travelers.

Figure 3. Scores of a subset of indicators within the GHS Index to model a country’s vulnerability to emerging outbreaks plotted against the number of annual international and domestic airline travelers within country, filtered to include only countries with a score of less than 33 and a volume of travelers greater than one million. The color of the dot represents the United Nations region and the size of the dot represents the population of the country.

For additional information, individual country pages showing a larger number of indicators are available for each of the 195 countries and can be found by searching the GHS Index website for a specific country. These country pages include scores for all questions asked of the research across six categories. There also is a one-page downloadable copy of each country page.

Download the GHS Index to see a full set of 33 recommendations to promote global health security. The GHS Index report offers 33 individual recommendations related to the overarching data findings across its six categories, to include a subset of high-level recommendations which can be found here.

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)

References

1. Global Health Security Index, 2019. f1-stage-nti-ghs.pantheonsite.io
2. Mao et al, “Modeling monthly flows of global air travel passengers: An open-access data resource.” 2015. https://doi.org/10.1016/j.jtrangeo.2015.08.017
3. United Nations, Department of Economic and Social Affairs, “Population Division (2019). World Population Prospects.” 2019. https://unstats.un.org/unsd/methodology/m49/overview/

For a list of indicators used for this analysis, click here.