Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index
Identifieur interne : 000370 ( Main/Merge ); précédent : 000369; suivant : 000371Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index
Auteurs : Ben Oppenheim ; Mark Gallivan ; Nita K. Madhav ; Naor Brown ; Volodymyr Serhiyenko ; Nathan D. Wolfe ; Patrick AyscueSource :
- BMJ Global Health [ 2059-7908 ] ; 2019.
Abstract
Robust metrics for national-level preparedness are critical for assessing global resilience to epidemic and pandemic outbreaks. However, existing preparedness assessments focus primarily on public health systems or specific legislative frameworks, and do not measure other essential capacities that enable and support public health preparedness and response.
We developed an Epidemic Preparedness Index (EPI) to assess national-level preparedness. The EPI is global, covering 188 countries. It consists of five subindices measuring each country’s economic resources, public health communications, infrastructure, public health systems and institutional capacity. To evaluate the construct validity of the EPI, we tested its correlation with proxy measures for preparedness and response capacity, including the timeliness of outbreak detection and reporting, as well as vaccination rates during the 2009 H1N1 influenza pandemic.
The most prepared countries were concentrated in Europe and North America, while the least prepared countries clustered in Central and West Africa and Southeast Asia. Better prepared countries were found to report infectious disease outbreaks more quickly and to have vaccinated a larger proportion of their population during the 2009 pandemic.
The EPI measures a country’s capacity to detect and respond to infectious disease events. Existing tools, such as the Joint External Evaluation (JEE), have been designed to measure preparedness within a country over time. The EPI complements the JEE by providing a holistic view of preparedness and is constructed to support comparative risk assessment between countries. The index can be updated rapidly to generate global estimates of pandemic preparedness that can inform strategy and resource allocation.
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DOI: 10.1136/bmjgh-2018-001157
PubMed: 30775006
PubMed Central: 6352812
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Madhav</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Brown, Naor" sort="Brown, Naor" uniqKey="Brown N" first="Naor" last="Brown">Naor Brown</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Serhiyenko, Volodymyr" sort="Serhiyenko, Volodymyr" uniqKey="Serhiyenko V" first="Volodymyr" last="Serhiyenko">Volodymyr Serhiyenko</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Wolfe, Nathan D" sort="Wolfe, Nathan D" uniqKey="Wolfe N" first="Nathan D" last="Wolfe">Nathan D. Wolfe</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Ayscue, Patrick" sort="Ayscue, Patrick" uniqKey="Ayscue P" first="Patrick" last="Ayscue">Patrick Ayscue</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">30775006</idno><idno type="pmc">6352812</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352812</idno><idno type="RBID">PMC:6352812</idno><idno type="doi">10.1136/bmjgh-2018-001157</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000956</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000956</idno><idno type="wicri:Area/Pmc/Curation">000956</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000956</idno><idno type="wicri:Area/Pmc/Checkpoint">000093</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000093</idno><idno type="wicri:source">PubMed</idno><idno type="RBID">pubmed:30775006</idno><idno type="wicri:Area/PubMed/Corpus">000168</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000168</idno><idno type="wicri:Area/PubMed/Curation">000168</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000168</idno><idno type="wicri:Area/PubMed/Checkpoint">000171</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000171</idno><idno type="wicri:Area/Ncbi/Merge">001F26</idno><idno type="wicri:Area/Ncbi/Curation">001F26</idno><idno type="wicri:Area/Ncbi/Checkpoint">001F26</idno><idno type="wicri:Area/Main/Merge">000370</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index</title><author><name sortKey="Oppenheim, Ben" sort="Oppenheim, Ben" uniqKey="Oppenheim B" first="Ben" last="Oppenheim">Ben Oppenheim</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Gallivan, Mark" sort="Gallivan, Mark" uniqKey="Gallivan M" first="Mark" last="Gallivan">Mark Gallivan</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Madhav, Nita K" sort="Madhav, Nita K" uniqKey="Madhav N" first="Nita K" last="Madhav">Nita K. Madhav</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Brown, Naor" sort="Brown, Naor" uniqKey="Brown N" first="Naor" last="Brown">Naor Brown</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Serhiyenko, Volodymyr" sort="Serhiyenko, Volodymyr" uniqKey="Serhiyenko V" first="Volodymyr" last="Serhiyenko">Volodymyr Serhiyenko</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Wolfe, Nathan D" sort="Wolfe, Nathan D" uniqKey="Wolfe N" first="Nathan D" last="Wolfe">Nathan D. Wolfe</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Ayscue, Patrick" sort="Ayscue, Patrick" uniqKey="Ayscue P" first="Patrick" last="Ayscue">Patrick Ayscue</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">BMJ Global Health</title><idno type="eISSN">2059-7908</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Robust metrics for national-level preparedness are critical for assessing global resilience to epidemic and pandemic outbreaks. However, existing preparedness assessments focus primarily on public health systems or specific legislative frameworks, and do not measure other essential capacities that enable and support public health preparedness and response.</p></sec><sec><title>Methods</title><p>We developed an Epidemic Preparedness Index (EPI) to assess national-level preparedness. The EPI is global, covering 188 countries. It consists of five subindices measuring each country’s economic resources, public health communications, infrastructure, public health systems and institutional capacity. To evaluate the construct validity of the EPI, we tested its correlation with proxy measures for preparedness and response capacity, including the timeliness of outbreak detection and reporting, as well as vaccination rates during the 2009 H1N1 influenza pandemic.</p></sec><sec><title>Results</title><p>The most prepared countries were concentrated in Europe and North America, while the least prepared countries clustered in Central and West Africa and Southeast Asia. Better prepared countries were found to report infectious disease outbreaks more quickly and to have vaccinated a larger proportion of their population during the 2009 pandemic.</p></sec><sec><title>Conclusion</title><p>The EPI measures a country’s capacity to detect and respond to infectious disease events. Existing tools, such as the Joint External Evaluation (JEE), have been designed to measure preparedness within a country over time. The EPI complements the JEE by providing a holistic view of preparedness and is constructed to support comparative risk assessment between countries. The index can be updated rapidly to generate global estimates of pandemic preparedness that can inform strategy and resource allocation.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Morse, Ss" uniqKey="Morse S">SS Morse</name></author><author><name sortKey="Mazet, Ja" uniqKey="Mazet J">JA Mazet</name></author><author><name sortKey="Woolhouse, M" uniqKey="Woolhouse M">M Woolhouse</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Smolinski, Ms" uniqKey="Smolinski M">MS Smolinski</name></author><author><name sortKey="Hamburg, Ma" uniqKey="Hamburg M">MA Hamburg</name></author><author><name sortKey="Lederberg, J" uniqKey="Lederberg J">J Lederberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jones, Ke" uniqKey="Jones K">KE Jones</name></author><author><name sortKey="Patel, Ng" uniqKey="Patel N">NG Patel</name></author><author><name sortKey="Levy, Ma" 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