Although the GHS Index measures capacities and identifies preparedness gaps, it cannot predict how leaders will use national assets when a crisis occurs. The COVID-19 pandemic revealed that some of the countries identified by the 2019 GHS Index to have the greatest health security capacities, such as the United States and the United Kingdom, so far have suffered some of the highest reported numbers of virus-related cases and deaths. The experiences of those two countries differs from the experiences of those that, regardless of income level or measured readiness, rapidly recognized the threat COVID-19 presented and acted quickly and coherently to use existing capacities or immediately develop new ones to contain the disease. National variations in COVID-19 experiences are still being analyzed, but factors such as trust in government, social cohesion, and politicization of public health responses likely are pivotal to each country’s success in addressing outbreaks.
Although the GHS Index cannot predict whether or how well countries will use the assets and capacities they have in a crisis, because some countries with high scores in the 2019 GHS Index failed to respond well to COVID-19, questions arise about how best to assess preparedness. To capture valuable information related to countries’ response to COVID-19 and ensure the GHS Index remains a critical tool for national and global leaders, researchers studied how countries performed on external assessments against their performance during the COVID-19 pandemic, based on excess deaths per capita.9 The analysis found that, more than a year into the pandemic, COVID-19 outcomes were significantly associated with a set of sociodemographic, political, and governance variables that were not measured in the 2019 GHS Index. As a result, researchers for the 2021 GHS Index measured additional variables that influenced country responses to the pandemic to capture the most comprehensive risk profile possible.
With those additions, the GHS Index should continue to be used as an assessment tool that improves understanding of the existing capacities countries have to prevent, detect, and respond to outbreaks, whether naturally occurring, accidental, or deliberate; it should not be used as a predictive model. The true impacts of an infectious disease threat (health, economic, and social) are shaped by many factors, including political decision making, the effective and strategic deployment of existing capacities, the rapid scale-up and use of new capacities created during a response, the type of disease, its mode of infection, and even chance.
Click here to download a graphic illustrating the evolution of the GHS Index.