Abstract
The International Health Regulation—State Party Annual Reporting (IHR-SPAR) and the Global Health Security Index (GHSI)) have been developed to aid in strengthening national capacities for pandemic preparedness. We examine the relationship between country-level rankings on these two indices, along with two additional indices (the Universal Health Coverage Service Coverage Index and World Bank Worldwide Governance Indicator (n = 195)) and compared them to the country-level reported COVID-19 cases and deaths (Johns Hopkins University (JHU) COVID-19 Dashboard) through 17 June 2020. Ordinary least squares regression models were used to compare weekly reported COVID-19 case and death rates per million in the first 12 weeks of the pandemic between countries classified as low, middle, and high ranking on each index, while controlling for country socio-demographic information. Countries with higher GHSI and IHR-SPAR index scores experienced fewer reported COVID-19 cases and deaths, but only for the first 8 weeks after the country’s first case. For the GHSI, this association was further limited to countries with populations below 69.4 million. For both the GHSI and IHR-SPAR, countries with a higher sub-index score in human resources for pandemic preparedness reported fewer COVID-19 cases and deaths in the first 8 weeks after the country’s first reported case. The UHC-SCI and WGI country-level rankings were not associated with COVID-19 outcomes. The associations between GHSI and IHR-SPAR scores and COVID-19 outcomes observed in this study demonstrate that these two indices, although imperfect, may have value, especially in countries with a population under 69.4 million people for the GHSI. Preparedness indices may have value; however, they should continue to be evaluated as policymakers seek to better prepare for future global public health crises.
Keywords: pandemic preparedness, national indices, Covid-19, surveillance systems, health system
Contributor Information
David B Duong, Program in Global Primary Care and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Center for Primary Care, Harvard Medical School, Boston, MA, USA.
Andrew J King, Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Karen A Grépin, University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
Li Yang Hsu, Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Yong Yoo Lin School of Medicine, National University of Singapore, Singapore.
Jeremy F Y Lim, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Christine Phillips, College of Health and Medicine, Australian National University Medical School, Canberra, ACT, Australia.
Truc Thanh Thai, Department of Medical Statistics and Informatics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; Department of Training and Scientific Research, University Medical Center, Ho Chi Minh City, Vietnam.
Indumathi Venkatachalam, Department of Infectious Diseases, Singapore General Hospital, Singapore; Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore.
Florian Vogt, National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Esabelle Lo Yan Yam, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
Stephanie Bazley, College of Health and Medicine, Australian National University Medical School, Canberra, ACT, Australia.
Lydia Dai-Jia Chang, School of Public Health, University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
Rachel Flaugh, Harvard Medical School, Boston, MA, USA.
Baily Nagle, Harvard Medical School, Boston, MA, USA.
Johanan Dravium Ponniah, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Penny Sun, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Nicolas K Trad, Harvard Medical School, Boston, MA, USA.
Donald M Berwick, Institute for Healthcare Improvement, Boston, MA, USA.
Supplementary Material
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.