The International Health Regulations (IHRs) highlight the importance of being able to prevent, detect and respond to public health risks. The authors were interested in the existing health security capacities against public health risks and events in different countries. They used 18 indicators from the IHR State Party Annual Reporting (SPAR) tool and associated data from national SPAR reports. The authors developed five indices: (1) prevent, (2) detect, (3) respond, (4) enabling function and (5) operational readiness. SPAR 2018 data were used for all of the indicators and countries were categorised into five levels across the indices: level 1 indicating the lowest level of national capacity and level 5 the highest. Of 182 countries, 28% had prevent capacities at levels 1 or 2, and 33% had response capacities at levels 1 or 2. 45% of countries had prevent capacities and 43% had response capacities at levels 4 or 5, suggesting that they are operationally ready. 76% of countries scored more highly in the detect index than for other indices. 24% of countries did not have an effective enabling function for public health risks and events (4% at level 1 and 20% at level 2). 56% of countries had level 4 or level 5 enabling function capacities in place. 18% of countries had low readiness (1% at level 1 and 17% at level 2), and 57% of countries were operationally ready to prevent, detect and control an outbreak of a novel infectious disease (36% at level 4 and 21% at level 5). Therefore half of all countries have strong operational readiness capacities in place, suggesting that an effective response to potential health emergencies such as COVID-19 could be enabled.
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