Article Text

Download PDFPDF

Strengthening health security: an intuitive and user-friendly tool to estimate country-level costs
  1. Rebecca Katz1,
  2. Ellie Graeden2,
  3. Stephanie Eaneff2,
  4. Justin Kerr2
  1. 1 Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
  2. 2 Talus Analytics, Boulder, Colorado, USA
  1. Correspondence to Dr Rebecca Katz; Rebecca.Katz{at}


Member States of the WHO working to build capacity under the International Health Regulations (IHR) are advised to develop prioritised, costed plans to implement improvements based on the results of voluntary external assessments. Defining the costs associated with capacity building under the IHR, however, has challenged nations, funders and supporting organisations. Most current efforts to develop costed national action plans involve long-term engagements that may take weeks or months to complete. While these efforts have value in and of themselves, there is an urgent need for a rapid-use tool to provide cost estimates regardless of the level of expertise of the personnel assigned to the task. In this paper, we describe a tool that can—in a matter of hours—provide country-level cost estimates for capacity building under the IHR. This paper also describes how the tool can be used in countries, as well as the challenges inherent in any costing process.

  • health policies and all other topics
  • health policy
  • health systems
  • public health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor Seye Abimbola

  • Contributors RK conducted preliminary research that formed the basis for development of the tool. EG, JK and SE developed the online tool. RK, EG, JK and SE analysed and validated tool inputs. RK and EG drafted the manuscript. All authors contributed to editing the manuscript. RK is the guarantor of the study.

  • Funding Initial research and tool development was supported by the US Defense Threat Reduction Agency–Cooperative, Biological Engagement Program and the Department of State Biosecurity Engagement Program. The conceptual framework was strengthened through collaboration with the World Health Organization and its technical partners. Current efforts were supported by Open Philanthropy Project and Georgetown University Medical Center.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data associated with this paper are available at