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Health Security inequalities in Non-EU European Countries: A Cross-National Comparative Assessment Using an

Mijahed Nasser Aljober¹, Adel A Nasser^1,2, Abed Saif Ahmed Alghawli³

¹Department of Artiﬁcial Intelligence, Modern Specialized University, Sana'a, Yemen.

|September 15, 2025

Summary

Health security (HeS) in non-EU Europe shows critical gaps in detection and reporting, with significant disparities across nations. Tailored policies and regional collaboration are vital to improve global health security performance.

Keywords:

CoCoSo Entropy weighting method K-means MCDM Non-EU European Countries clustering health security

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Area of Science:

Global Health Security
Public Health Policy
International Health Regulations

Background:

Health security (HeS) is crucial for informed health policies and public health outcomes in an interconnected world.
Effectiveness of HeS strategies varies significantly across regions, necessitating comparative analyses.
Non-EU European countries face unique challenges in maintaining robust health security.

Purpose of the Study:

To analyze health security in 27 non-EU European countries.
To identify key priorities, trends, and performance disparities in health security.
To benchmark performance against African and Eastern Mediterranean regions (EMR) for targeted interventions.

Main Methods:

Utilized Global Health Security Index indicators (2019, 2021, 2017-2021 data).
Applied an integrated Entropy-CoCoSo-K-means framework for analysis.
Conducted cross-regional comparisons and K-means clustering into five risk categories.

Main Results:

Detection and reporting emerged as the most critical HeS indicator (weight: 0.388), highlighting surveillance disparities.
Compliance with norms showed a notable increase, suggesting emerging regulatory gaps.
Significant performance disparities were found, with countries like Armenia, Norway, and the UK ranking "High," while Andorra, Monaco, San Marino, and Tajikistan were in the "Dangerous" cluster.

Conclusions:

Tailored policies are essential to address evolving HeS challenges in non-EU Europe.
Harmonizing surveillance, enhancing preventive measures, and bridging compliance gaps are critical.
Regional collaboration and resource reallocation are necessary to mitigate disparities and improve global health security.