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The value proposition of the Global Health Security Index
  1. Sanjana J Ravi1,
  2. Kelsey Lane Warmbrod1,
  3. Lucia Mullen1,
  4. Diane Meyer1,
  5. Elizabeth Cameron2,
  6. Jessica Bell2,
  7. Priya Bapat3,
  8. Michael Paterra3,
  9. Catherine Machalaba4,
  10. Indira Nath5,
  11. Lawrence O Gostin6,
  12. Wilmot James7,
  13. Dylan George8,
  14. Simo Nikkari9,
  15. Ernesto Gozzer10,
  16. Oyewale Tomori11,12,
  17. Issa Makumbi13,
  18. Jennifer B Nuzzo1
  1. 1Johns Hopkins Center for Health Security, Baltimore, Maryland, USA
  2. 2Nuclear Threat Initiative, Washington, DC, USA
  3. 3Economist Intelligence Unit, London, UK
  4. 4EcoHealth Alliance, New York, New York, USA
  5. 5Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
  6. 6O’Neill Institute for National and Global Health Law, Georgetown Law, Washington, DC, USA
  7. 7Institute for Social and Economic Research and Policy, Columbia University, New York, New York, USA
  8. 8In-Q-Tel, Arlington, Virginia, USA
  9. 9Centre for Biothreat Preparedness, Helsinki, Finland
  10. 10Universidad Peruana Cayetano Heredia, Lima, Peru
  11. 11The Nigerian Academy of Science, Lagos, Nigeria
  12. 12College of Veterinary Surgeons of Nigeria, Abuja, Nigeria
  13. 13Republic of Uganda Ministry of Health, Kampala, Uganda
  1. Correspondence to Dr Sanjana J Ravi; sanjana{at}


Infectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)—the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries—recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index’s approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index’s emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice.

  • health policy
  • health systems
  • public health
  • health systems evaluation

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:

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  • Handling editor Seye Abimbola

  • Twitter @LuciaMullen17, @wilmotjames

  • Contributors SJR conceived of the manuscript and was the primary drafter and editor. KLW, LM, DM, EC, JB, PB, MP, CM, IN, LOG, WJ, DG, SN, EG, OT, IM and JBN provided writing assistance, reviewed drafts and offered revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available in a public, open access repository.

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