Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index

Abstract

IntroductionRobust metrics for national-level preparedness are critical for assessing global resilience to epidemic and pandemic outbreaks. However, existing preparedness assessments focus primarily on public health systems or specific legislative frameworks, and do not measure other essential capacities that enable and support public health preparedness and response.MethodsWe developed an Epidemic Preparedness Index (EPI) to assess national-level preparedness. The EPI is global, covering 188 countries. It consists of five subindices measuring each country’s economic resources, public health communications, infrastructure, public health systems and institutional capacity. To evaluate the construct validity of the EPI, we tested its correlation with proxy measures for preparedness and response capacity, including the timeliness of outbreak detection and reporting, as well as vaccination rates during the 2009 H1N1 influenza pandemic.ResultsThe most prepared countries were concentrated in Europe and North America, while the least prepared countries clustered in Central and West Africa and Southeast Asia. Better prepared countries were found to report infectious disease outbreaks more quickly and to have vaccinated a larger proportion of their population during the 2009 pandemic.ConclusionThe EPI measures a country’s capacity to detect and respond to infectious disease events. Existing tools, such as the Joint External Evaluation (JEE), have been designed to measure preparedness within a country over time. The EPI complements the JEE by providing a holistic view of preparedness and is constructed to support comparative risk assessment between countries. The index can be updated rapidly to generate global estimates of pandemic preparedness that can inform strategy and resource allocation.

Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic

“…21 Other indirect consequences of previous infectious disease outbreaks include less healthcare utilisation and limited capacity for public health surveillance. [22][23][24] These impacts can persist long after the disease outbreak is contained. 25 However, much of the evidence available about these impacts on maternal and newborn health is either modelled or is from studies using secondary data such as population-based surveys and routine health management information system analysis.…”

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“… 11–13 A similar metric is the Epidemic Preparedness Index tool, also published in 2019 but with fewer countries and indicators included. 14 This present paper focuses on the GHSI.…”

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“…Several studies have reported improvements in disease surveillance in the African countries as a result of lessons learned from the 2014-2016 West Africa EVD outbreak [17][18][19][20]. Oppenheim et al [21] noted that West and Central African countries still have the lowest epidemic preparedness index. The latter assesses the capacity of institutions to detect, report and respond to outbreaks.…”