Measuring Global Health Security: Comparison of Self- and External Evaluations for IHR Core Capacity

In 2016, the World Health Organization moved from using only a self-assessment to monitor national implementation of the International Health Regulations (IHR) to introducing an external evaluation process. In this article, we use preliminary findings from the published Joint External Evaluations to identify if and how the external evaluations differ from IHR self-assessments conducted in the same year. We found that of the 32 countries for which data were available, external assessment scores are consistently 1 to 1.5 points lower than self-assessment scores. This shows the importance of external evaluations and emphasizes that even more must be done to build sufficient capacity to prevent, detect, and respond to public health emergencies around the world.