WHO Measures Outbreak Preparedness of Countries Around the World

Half of all countries included in an analysis have strong operational capacity to prevent, detect and respond to outbreaks, though collaboration is needed among countries to strengthen global readiness, according to a paper published in The Lancet.

Investigators from the World Health Organization (WHO) in Switzerland used 18 data points from the International Health Regulations (IHR) State Party Annual Reporting (SPAR) from 2018 to review existing health security capacities against public health events around the world. The investigators developed 5 categories, including prevention, detection, response, enabling function, and operational readiness.

They also performed this analysis at the regional level, using the 6 geographical WHO regions. On their scale, 1 indicated the lowest level of national capacity and 5 indicated the highest level.

The IHR came to be in 2007 and since, countries have enhanced their abilities to prevent, detect and respond to public health emergencies.

The analysis included 182 countries. The study authors determined 28% (52 countries) had a low capacity to prevent a public health event, including an infectious disease outbreak. Many of those countries were classified as low-income or lower-middle-income countries per the World Bank, the study authors added. Additionally, there were 81 countries (45%) that had a “robust” prevention capacity.

There were 138 countries (76%) with the ability for robust detection capacities, designated levels 4 or 5, but the investigators noted an additional 34 countries were categorized as level 3 capacity, which indicated moderate development, they added.

A third of the countries in the analysis had low ability to respond to a public health event, including an infectious disease outbreak. Only 78 countries earned level 4 or 5 marks indicating high capacity to respond to a public health outbreak.

A quarter of the countries were earmarked at the lowest levels for enabling function. The investigators defined this as the availability and accessibility of financing mechanisms during emergencies in order to prevent, detect, and control infectious disease outbreaks. There were 102 countries that had the highest levels of resources and collaboration to prevent, detect, and respond to an event. The investigators also found 20% of the countries reached a level 3 for this category.

The investigators found that 57% of countries were operationally ready to prevent, detect, and control an event at the highest level, but an additional 25% of countries reached a level 3 for their capacities. There were 32 countries at a low capacity to produce this outcome in an outbreak.

When categorized by WHO regions, the investigators determined that 21 of the 47 African Region countries and 5 of the 23 countries in the Western Pacific Region had low operational readiness. Across all of the WHO regions, 104 of the 182 countries had an operational readiness at levels 4 and 5. No country within WHO regions of Africa or South-East Asia was at a level 5 for operational readiness.

“Many countries are struggling to sustain or develop their national preparedness capacities, primarily because of a lack of resources, competing national priorities, and a high turnover of health care workers,” the study authors concluded. “Only half of the countries analyzed in this study have the provision for adequate resources for emergencies, and these countries are mostly either high-income or middle-income countries… The outbreak of COVID-19 is another opportunity to review the preparedness of all countries and apply key recommendations from other major public health emergencies to better protect the world against future health emergencies.”