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Prevent, Detect, and Respond are the principles of the GHSA. It is through these methods of action that will not only lessen the prevalence of diseases around the globe but also save millions of lives. These action plans are only enhanced through the use of global action and coordination.

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When we focus our attention on only one disease, we allow for other diseases to slip through the cracks. This image showcases exactly that during recent times. As the Covid-19 pandemic "gets better", we need to start rediscovering our fight against other diseases like Measles, H1N1, and many others that can be easily prevented through vaccines.

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This picture showcases the differing infection rates of Ebola within West Africa. With the Global Health Security Agenda, we want to mitigate further spread through the use of prevent, detect, and respond methods.

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This article describes the lessons learned from the Ebola virus and how it has since refined the definition of Global Health Security. Specifically, the virus has revealed to us "two intertwined aspects of health security—individual security sums up to collective security, and collective security means enhanced individual security" (Heymann et. al 2015 ). The article also describes the concept of better health equity in which Ebola had persistence differences in infection rates within regions.

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Global health security: the wider lessons from the west African Ebola virus disease epidemic

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The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security—its definition, meaning, and the practical implications for programmes ...

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The article uses both the GHSA and JEE in the context of the discovery of Covid-19 in China. It goes on to evaluate the correlation between a country's health preparedness and its mortality outcome. Surprisingly, the article found discrepancies within their data compared to their hypothesis. "However, both GHSI (r = 0.31) and JEE (r = 0.37) had a poor correlation with countries' COVID-19-related mortality outcome. Higher risk of importation of COVID-19 from China for a given country was negatively correlated with the time taken to detect the first case in that country (adjusted R2 = 0.63-0.66), while the GHSI and JEE had minimal predictive value" (Haidar et. al 2020). It is with this type of data and analysis that we can better population healthiness parameters within specific demographics and along with better future pandemic preparedness.

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doi: 10.1017/S0950268820002046.

Affiliations

¹ The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK.

² Institute of Health Informatics, University College London, London, UK.

³ Department of Statistics, Shahjalal University of Science and Technology, Sylhet3114, Bangladesh.

⁴ Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK.

⁵ Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Republic of Congo.

⁶ Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.

⁷ Department of Infection, Division of Infection and Immunity, UCL Centre for Clinical Microbiology, Royal Free Campus, London, UK.

⁸ NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.

Free PMC article

Free PMC article

doi: 10.1017/S0950268820002046.

Affiliations

¹ The Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, UK.

² Institute of Health Informatics, University College London, London, UK.

³ Department of Statistics, Shahjalal University of Science and Technology, Sylhet3114, Bangladesh.

⁴ Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK.

⁵ Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Republic of Congo.

⁶ Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.

⁷ Department of Infection, Division of Infection and Immunity, UCL Centre for Clinical Microbiology, Royal Free Campus, London, UK.

⁸ NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.

Abstract

Global Health Security Index (GHSI) and Joint External Evaluation (JEE) are two well-known health security and related capability indices. We hypothesised that countries with higher GHSI or JEE scores would have detected their first COVID-19 case earlier, and would experience lower mortality outcome compared to countries with lower scores. We evaluated the effectiveness of GHSI and JEE in predicting countries' COVID-19 detection response times and mortality outcome (deaths/million). We used two different outcomes for the evaluation: (i) detection response time, the duration of time to the first confirmed case detection (from 31st December 2019 to 20th February 2020 when every country's first case was linked to travel from China) and (ii) mortality outcome (deaths/million) until 11th March and 1st July 2020, respectively. We interpreted the detection response time alongside previously published relative risk of the importation of COVID-19 cases from China. We performed multiple linear regression and negative binomial regression analysis to evaluate how these indices predicted the actual outcome. The two indices, GHSI and JEE were strongly correlated (r = 0.82), indicating a good agreement between them. However, both GHSI (r = 0.31) and JEE (r = 0.37) had a poor correlation with countries' COVID-19-related mortality outcome. Higher risk of importation of COVID-19 from China for a given country was negatively correlated with the time taken to detect the first case in that country (adjusted R2 = 0.63-0.66), while the GHSI and JEE had minimal predictive value. In the negative binomial regression model, countries' mortality outcome was strongly predicted by the percentage of the population aged 65 and above (incidence rate ratio (IRR): 1.10 (95% confidence interval (CI): 1.01-1.21) while overall GHSI score (IRR: 1.01 (95% CI: 0.98-1.01)) and JEE (IRR: 0.99 (95% CI: 0.96-1.02)) were not significant predictors. GHSI and JEE had lower predictive value for detection response time and mortality outcome due to COVID-19. We suggest introduction of a population healthiness parameter, to address demographic and comorbidity vulnerabilities, and reappraisal of the ranking system and methods used to obtain the index based on experience gained from this pandemic.

Keywords: COVID-19; GHS index; JEE; pandemic preparedness; risk analysis; surveillance system.

Conflict of interest statement

The authors declare that they have no conflict of interest.

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national center for biotechnology information

# data[].attributes.attachment_link.title
The Global Health Security index and Joint External Evaluation score for health preparedness are not correlated with countries' COVID-19 detection response time and mortality outcome - PubMed

# data[].attributes.attachment_link.description
Global Health Security Index (GHSI) and Joint External Evaluation (JEE) are two well-known health security and related capability indices. We hypothesised that countries with higher GHSI or JEE scores would have detected their first COVID-19 case earlier, and would experience lower mortality outcome ...

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The Global Health Security Agenda is the global effort of 70+ countries, nonprofits, and private companies that hope to better the global ability to prevent, detect, and respond to the threats of infectious diseases through the use of their coordination. The effort is currently under a 5-year agreement in which the United States is playing a lead role within the endeavor. In addition, response tools like the JEE evaluation method have been essential in providing global health security.