‘No country is fully equipped to deal with epidemics, pandemics’

The new Global Health Security (GHS) Index has warned that no country is fully equipped to deal with the next global pandemic.

The inaugural GHS Index released on October 24, 2019, found severe weaknesses in all 195 countries’ abilities to prevent, detect, and respond to significant disease outbreaks.

The report was developed by 21 international panels of experts, which include Nigeria’s Professor of Virology and Former President, Nigerian Academy of Science (NAS), Oyewale Tomori.

The GHS Index said an outbreak of a flu-like illness could sweep across the planet in 36 hours and kill tens of millions due to our constantly-traveling population.

The 2019 GHS Index is the first comprehensive assessment of global health security capabilities in 195 countries that make up the States Parties to the International Health Regulations (IHR 2005).

The average overall GHS Index score for 2019 is slightly over 40, out of a maximum score of 100. Among the 60 highest-income countries assessed, the DHS average score is 51.9.

But the GHS Index ranked Nigeria as the 96th least prepared nation out of 195 countries with 37.8 per cent below worn-turn Sierra Leone. According to the 2019 GHS Index, Nigeria is not prepared for the next global epidemic or/and pandemics.

It noted that the majority of African nations were the “least prepared” of all the countries due to poor immunisation.

In their recommendations, the team said governments must ringfence money for putting preparations in place and do routine simulation exercises.

They also called for more private investment into countries’ pandemic preparations and said the United Nations (UN) must do more to coordinate responses across international borders.

Also, an earlier assessment of Nigeria’s capacity to prevent, detect, and respond to these public health threats, called the Joint External Evaluation (JEE), conducted in June 2017, found Nigeria was not prepared. The assessment, however, identified that Nigeria has substantial room to develop its health security capacities.

Also, a review of health care systems already in place across the world by the report found just 13 countries had the resources to put up a fight against an “inevitable” pandemic.

Top ten ranked countries include United States (U.S.) as the most prepared country with 83.5; United Kingdom (U.K.) with 77.9; the Netherlands with 75.6; Australia with 75.5; Canada with 75.3; Thailand with 73.2; Sweden 72.1; Denmark 70.4; South Korea 70.2; and Finland with 68.7.

The experts warned given how fast the outbreak is likely to spread even these nations might struggle to curb the disease.

The least ranked countries are: Gabon as the 186th ranked country with 20.0; Guinea Bissau with 20.0; Syria with 19.9; Kiribat with 19.2; Yemen with 18.5; Marshall Islands with 18.2; São Tomé and Príncipe with 17.7; North Korea with 17.5; Somalia 16.6; and Equatorial Guinea as the least ranked country at 195th position with 16.2.

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). These organisations believe that, over time, the GHS Index will spur measurable changes in national health security and improve the international capability to address one of the world’s most omnipresent risks: infectious disease outbreaks that can lead to international epidemics and pandemics.

To create the GHS Index, NTI, JHU, and the EIU project team—with generous grants from the Open Philanthropy Project, the Bill & Melinda Gates Foundation, and the Robertson Foundation—worked with an international advisory panel of 21 experts from 13 countries to create a detailed and comprehensive framework of 140 questions, organized across six categories, 34 indicators, and 85 sub-indicators to assess a country’s capability to prevent and mitigate epidemics and pandemics.

Associate professor at the Bloomberg School and senior scholar at the Center for Health Security, Jennifer Nuzzo, said in a press release the GHS Index, developed over 2.5 years, with guidance from an International Panel of Experts from 13 countries, can be used by health ministers and international organizations, philanthropists and funders, academics and researchers.

“The GHS Index finds that no country is fully prepared for naturally occurring, intentional, or accidental infectious disease outbreaks,” Nuzzo said.

“Knowing that there is work to do, countries can use the index to identify gaps, build preparedness and best practices, and track progress over time.”

The GHS Index assessed countries across six categories, 34 indicators, and 140 questions, using only open-source information and data from international organisations, including the World Health Organisation (WHO), the World Organisation for Animal Health (WOAH), the Food and Agriculture Organisation of the United Nations (UN), and the World Bank.

The GHS Index found that:
*Fewer than seven percent of countries score in the highest tier in the category assessing the prevention of the emergence or release of pathogens.

*Only 19 percent of countries receive top marks (scoring a 66.7 out of 100 or higher) in the category assessing early detection and reporting of epidemics of potential international concern.

*Fewer than five percent of countries score in the highest tier in rapid response to and mitigation of the spread of an epidemic.

*With an average score of 26.4 out of 100, having a sufficient and robust health sector to treat the sick and protect health workers was the lowest-scoring category.

But the Director-General of the Nigeria Centre for Disease Control (NCDC) had told The Guardian: “Compared to July 2014, we are much better prepared for an Ebola outbreak. You know about outbreak preparedness, you don’t actually prepare for an Ebola outbreak. You prepare for those outbreaks that happen commonly and through the response to common incidents you prepare for the unusual. Since 2014, we have focused on building the new national public health institute in Nigeria called the NCDC and through this organisation we have built our capabilities across the various aspects of preparedness. So when you talk about preparedness, you talk about three broad areas of engagement- first, the prevention, detection, and response.”

The 2014 West Africa Ebola epidemic was a wake-up call. It prompted global leaders and the World Health Organization to realise that it is not clear where the gaps are – or how to fill them. It also highlighted that leaders need better ways to understand and measure improvement in the global capacity to prevent, detect, and respond to infectious disease threats. The GHS Index seeks to illuminate preparedness and capacity gaps to increase both political will and financing to fill them at the national and international levels.

The GHS Index also includes indicators of nations’ capacities and capabilities to reduce Global Catastrophic Biological Risks (GCBRs), which are biological risks of unprecedented scale that could cause severe damage to human civilization at a global level, potentially undermining civilization’s long-term potential. These are events that could wipe out gains in sustainable development and global health because of their potential to cause national and regional instability, global economic consequences, and widespread morbidity and mortality.

The report comes a month after a group headed by a former World Health Organisation (WHO) chief issued a stark warning that Disease X was on the horizon.

A report last month called A World At Risk listed dozens of illnesses which the experts suggested had the potential to trigger an outbreak which could spiral out of control, among them the plague, Ebola, Zika virus and Dengue.

Meanwhile, an independent commission of experts endorsed by the WHO has concluded that wild poliovirus type 3 (WPV3) has been eradicated worldwide. Following the eradication of smallpox and wild poliovirus type 2, this news represents a historic achievement for humanity.

Director-General of the World Health Organization and Chair of the Global Polio Eradication Initiative (GPEI) Polio Oversight Board, Dr. Tedros Adhanom Ghebreyesus, said: “The achievement of polio eradication will be a milestone for global health. Commitment from partners and countries, coupled with innovation, means of the three wild polio serotypes, only type one remain.

“We remain fully committed to ensuring that all necessary resources are made available to eradicate all poliovirus strains. We urge all our other stakeholders and partners to also stay the course until final success is achieved.”