The Global Health Security Index: Another Look

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.