The world is unprepared for outbreaks of major infectious diseases, with Asian countries facing significant risks, according to Global Health Security (GHS) Index, 2019, released on Friday. According to the report, Thailand and South Korea were among the best-performing countries in Asia, while India was at 57th rank with a score of 46.5.

While Asian countries may be facing the most risks, the research pointed out that no country was fully prepared for the next epidemic or pandemic - only 13 of nearly 200 countries score in the top tier.

A project of the Nuclear Threat Initiative (NTI) and the Johns Hopkins University Center for Health Security, with research by The Economist Intelligence Unit, the GHS Index is the first comprehensive assessment of epidemic and pandemic threats globally.

Built around a framework of 140 detailed questions, the Index assesses each country’s capacity to prevent, detect and respond to health emergencies, as well as the efficacy of their health systems, commitment to global norms, and the political, socioeconomic and environmental risk factors that can limit response.

The average overall index score was a shade over 40 out of a possible score of 100, pointing to substantial weaknesses in preparedness. Even among the 60 high-income countries assessed, the average score was barely over 50, the report said.

Epidemics have been occurring with greater frequency. The 2014-16 Western Africa Ebola epidemic claimed more than 11,000 lives, and the outbreak of the disease, in the Democratic Republic of the Congo, killed another 2,100 in 2018-19, according to the World Health Organisation (WHO).

These emergencies and others, the report said, including the Zika epidemic in 2015-16, highlight the need to understand how countries can better prepare to face these threats. The Index, which serves as a barometer for global preparedness, is based on a central tenet: a threat anywhere is a threat everywhere.

“Our team of more than 100 researchers and reviewers assessed regulations and collected information, working in more than 50 languages across 195 countries—and all of this is publicly available. We hope the index will be a tool for leaders to make effective policy decisions," said Priya Bapat, The Economist Intelligence Unit project manager for the GHS Index.

The report pointed out that deadly infectious diseases can travel quickly, increased global mobility through air travel means that a disease outbreak in one country can spread across the world in a matter of hours. And, understanding a country’s readiness to manage an infectious disease emergency is in part a factor of global preparedness.

“Without a way of identifying gaps in the system, we’re much more vulnerable than we need to be. The index is specific enough to provide a roadmap for how countries can respond, and gives donors and funders a tool for directing their resources," said Leo Abruzzese, Senior Global Advisor for Public Policy at The Economist Intelligence Unit.

Findings from the 2019 GHS Index reveal that stronger health security conditions are not dependent on whether a country is wealthy, but are driven by a multitude of factors, including effective governance and a strong disease surveillance system. Indeed, gross domestic product (GDP) and GDP per head are not strong determinants of global health security. More than 100 high- and middle-income countries score below 50 in the index.

The report showed that even when emergency plans were in place, there was little evidence that countries have tested these capabilities to show they would be functional in a crisis. “At least 85% of countries showed no evidence of having completed a biological threat-focused simulation exercise with the WHO in the past year. Fewer than 5% of countries have a national requirement to test their emergency operations centres to respond to a health emergency on an annual basis," the report said.

“More than half of countries face major political and security risks that could undermine national capability to counter biological threats. In light of challenges in responding to the Ebola outbreak in the Democratic Republic of the Congo, political and security risks are clear barriers to effective response. Only 23% of countries score in the top tier for indicators related to their political system and government effectiveness, covering only about 14% of the world’s global population," it said.

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