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The Global Health Security Index: Another Look.

Peter G Goldschmidt1

  • 1World Development Group, Inc., Bethesda, MD, United States.

Frontiers in Epidemiology
|March 8, 2024
PubMed
Summary

The Global Health Security Index (GHSI) initially showed a counterintuitive link with COVID-19 deaths, but later correlated with lower mortality. Pandemic preparedness scores require assessing capabilities and predicting government actions.

Keywords:
COVID-19globalpandemicperformancepolicypreparednessresponsevalidity

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Area of Science:

  • Global Health Security
  • Epidemiology
  • Public Health Policy

Background:

  • The Global Health Security Index (GHSI) was released in October 2019 to assess national pandemic preparedness.
  • The COVID-19 pandemic emerged shortly after the GHSI's publication, prompting early assessments of its validity.
  • Initial studies correlated higher GHSI scores with increased COVID-19 per capita death rates, contrary to expectations.

Purpose of the Study:

  • To re-evaluate the relationship between the GHSI scores and COVID-19 outcomes in major European Union countries and the UK.
  • To examine how this correlation evolved over time during the pandemic.
  • To compare the GHSI's predictive power with other indicators like GDP and health system performance.

Main Methods:

  • Correlation analysis of GHSI scores with COVID-19 per capita death rates, case fatality rates, and excess mortality.
  • Analysis conducted at different time points: early pandemic, end of 2020, July 2021, and end of 2021.
  • Comparison of GHSI correlations with those of per capita GDP and the Health System Performance Index.

Main Results:

  • Early in the pandemic, a positive correlation was observed between GHSI scores and COVID-19 per capita deaths (r = 0.52, P < 0.05).
  • By July 2021, the correlation shifted, showing higher GHSI scores associated with lower COVID-19 per capita deaths (r = -0.55, P < 0.05) and case fatality rates (r = -0.74, P < 0.01).
  • GHSI demonstrated a strong negative correlation with excess mortality (r = -0.69, P < 0.01), comparable to per capita GDP (r = -0.71, P < 0.01).

Conclusions:

  • There may have been a premature rush to publish findings on the GHSI's validity.
  • The predictive accuracy of pandemic preparedness indices depends on forecasting governmental actions, which is challenging.
  • The GHSI's correlation with COVID-19 outcomes evolved, suggesting a complex relationship that requires long-term assessment.