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. 2019 Jan 29;4(1):e001157.
doi: 10.1136/bmjgh-2018-001157. eCollection 2019.

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

Ben Oppenheim  1 , Mark Gallivan  1 , Nita K Madhav  1 , Naor Brown  1 , Volodymyr Serhiyenko  1 , Nathan D Wolfe  1 , Patrick Ayscue  1
Affiliations

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

Ben Oppenheim et al. BMJ Glob Health. .

Abstract

Introduction: Robust 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.

Methods: We 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.

Results: The 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.

Conclusion: The 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.

Keywords: epidemics; health systems; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Epidemic Preparedness Index (EPI) design.
Figure 2
Figure 2
Global distribution of Epidemic Preparedness Index (EPI) scores, with countries binned by k-means clustering (1=most prepared, 5=least prepared).
Figure 3
Figure 3
Scatterplot of Joint External Evaluation (JEE) scores against Epidemic Preparedness Index (EPI) (A) and International Health Regulations (IHR) (B) scores.
Figure 4
Figure 4
Kaplan-Meier curves of country outbreak reporting timeliness by Epidemic Preparedness Index (EPI) cluster.
See this image and copyright information in PMC

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