Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index

IntroductionRobust 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.MethodsWe 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.ResultsThe 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.ConclusionThe 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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Using the Turning Point Model State Public Health Law

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2003.tb00765.x ◽

2003 ◽

Vol 31 (S4) ◽

pp. 88-89

Author(s):

Lawrence O. Gostin ◽

Glen Safford ◽

Deborah Erickson

Keyword(s):

Public Health ◽

Health Systems ◽

Turning Point ◽

Planning Process ◽

National Level ◽

Health Law ◽

Point Model ◽

Public Health Systems ◽

State And Local ◽

Local Levels

The Turning Point Initiative is an initiative for which the Robert Wood Johnson (RWJ) and W.K. Kellogg foundations partnered in order to fund a group of states and a number of communities within each of those states to work through a planning process to look at ways to strengthen their public health systems at the state and local levels. Out of that process, the states and communities would come together at the national level to talk about what they had been learning and what the issues were. There were a number of issues that resonated with all of the states.

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What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

BMC Public Health ◽

10.1186/s12889-019-7707-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 14

Author(s):

Jennifer B. Nuzzo ◽

Diane Meyer ◽

Michael Snyder ◽

Sanjana J. Ravi ◽

Ana Lapascu ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Health System ◽

Natural Hazards ◽

Health Systems ◽

Scoping Review ◽

Disease Outbreaks ◽

World Health ◽

Infectious Disease Outbreaks ◽

System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

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Cracks in the System: The Effects of the Coronavirus Pandemic on Public Health Systems

The American Review of Public Administration ◽

10.1177/0275074020941667 ◽

2020 ◽

Vol 50 (6-7) ◽

pp. 455-466 ◽

Cited By ~ 1

Author(s):

Kate Tulenko ◽

Dominique Vervoort

Keyword(s):

Public Health ◽

United States ◽

Health Systems ◽

Disease Outbreaks ◽

State Level ◽

The United States ◽

Public Health Services ◽

Health Security ◽

Public Health Systems ◽

The Impact

The novel coronavirus disease 2019 (COVID-19) pandemic has rapidly wrought havoc on the world, exposing the gaps in public health systems of countries that were previously considered most prepared for infectious disease outbreaks. Notably, despite being ranked highest on the Global Health Security Index, the United States has been severely hit with nearly two million confirmed cases and one hundred thousand deaths by the end of May 2020. In addition to the public health fragmentation from the federal to the state level and lagging regulations, early reports highlight substantial socioeconomic disparities and health system barriers contributing to the spread and impact of the pandemic in the United States. In this review, we explore the impact of COVID-19 on public health systems by assessing systems through the lens of the Centers for Disease Control and Prevention’s Ten Essential Public Health Services. Building on prepandemic and COVID-19 observations and lessons, we propose recommendations moving forward to prepare for future waves and other disease outbreaks.

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Genome sequencing and its use in public health responses to COVID-19

Microbiology Australia ◽

10.1071/ma21012 ◽

2021 ◽

Vol 42 (1) ◽

pp. 44

Author(s):

John-Sebastian Eden

Keyword(s):

Public Health ◽

Infectious Disease ◽

Genome Sequencing ◽

Influenza Pandemic ◽

Disease Outbreaks ◽

Lessons Learned ◽

Public Health Response ◽

Infectious Disease Outbreaks ◽

Aids Epidemic ◽

1918 Influenza

Human history has been shaped by the heavy burden of infectious disease pandemics. Yet, despite the bitter lessons learned from history, even those in living memory such as the 1918 influenza pandemic and HIV/AIDS epidemic, COVID-19 stands unique in the sudden, immense health and economic impacts to the global human population. While the costs have been great, and the long-term consequences are still being revealed, the urgent need for action has also brought forward rapid developments and innovations to combat COVID-19 and better prepare us for future infectious disease outbreaks. One such area has been the widespread adoption of whole genome sequencing to inform public health responses. Genome sequencing during the COVID-19 pandemic has become key to tracking the spread of SARS-CoV-2 at all scales, to such a degree that terms such as genomics, mutations, variants and clusters are now common vernacular to politicians, health officials and the general public. This article provides a commentary on the genesis and evolution of SARS-CoV-2 genome sequencing, and its critical on-going role in the public health response to the COVID-19 pandemic.

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Civic programmatic participation in public health: the case of Argentina

Cadernos de Saúde Pública ◽

10.1590/0102-311x00243218 ◽

2019 ◽

Vol 35 (suppl 2) ◽

Author(s):

Tulia G. Falleti ◽

Santiago L. Cunial

Keyword(s):

Public Health ◽

World Health Organization ◽

Health Systems ◽

Social Dynamics ◽

National Level ◽

World Health ◽

Public Health Systems ◽

The Social ◽

The World ◽

Health Organization

Abstract: Since the Alma Ata World Health Organization Conference in 1978, countries around the world have adopted institutions that promote the participation of citizens in their public health systems. The main objectives of this article are two-fold. First, we describe the origins and implementation of a national-level civic participatory program that was in place in Argentina in the mid-2000s: the Local Participatory Projects (Proyectos Locales Participativos). Second, we analyze the 201 local participatory projects that were carried out in Argentina between 2007 and 2008. We study health and environmental problems that prompt people’s participation in the program and the social dynamics through which such participation is executed.

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Legal Responses to Communal Rejection in Emergencies

The Journal of Law Medicine & Ethics ◽

10.1111/jlme.12061 ◽

2013 ◽

Vol 41 (2) ◽

pp. 529-534

Author(s):

James G. Hodge ◽

Daniel G. Orenstein ◽

Kim Weidenaar ◽

Nick Meza ◽

Laura Van Buren ◽

...

Keyword(s):

Public Health ◽

Hurricane Katrina ◽

Gulf Coast ◽

Influenza Pandemic ◽

Disease Outbreaks ◽

H1n1 Influenza ◽

Hurricane Sandy ◽

Infectious Disease Outbreaks ◽

Public Health Emergencies ◽

Legal Responses

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing and services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected.

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Implementing extreme weather event advice and guidance in English public health systems

Journal of Public Health ◽

10.1093/pubmed/fdw094 ◽

2016 ◽

Author(s):

Jonathan Wistow ◽

Sarah Curtis ◽

Angie Bone

Keyword(s):

Public Health ◽

Health Systems ◽

Extreme Weather ◽

Extreme Weather Event ◽

Weather Event ◽

Public Health Systems

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Maternal health services in China’s western rural areas: uptake and correlates

China Agricultural Economic Review ◽

10.1108/caer-12-2014-0148 ◽

2016 ◽

Vol 8 (2) ◽

Cited By ~ 5

Author(s):

Chengfang Liu ◽

Linxiu Zhang ◽

Yaojiang Shi ◽

Huan ZHOU ◽

Alexis Medina ◽

...

Keyword(s):

Public Health ◽

Maternal Health ◽

Health Services ◽

Health Systems ◽

Uptake Rate ◽

Rural Areas ◽

Design Methodology ◽

Maternal Health Services ◽

Western China ◽

Public Health Systems

Purpose Many public health systems have struggled with the dual questions of (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it. The objective of this study is to assess the uptake rate of a new set of maternal health services in poor rural areas of China. Design/methodology/approach The analysis is based on the survey responses of women’s representatives and village cadres from almost 1000 villages in June 2012 as part of a wide-scale public health survey in Sichuan, Gansu and Yunnan provinces in the western part of China. Findings We find that the uptake rate of maternal health services (including in-hospital delivery, antenatal care visits and post-partum care visits) in poor rural areas of western China are far below average in China, and that the rates vary across provinces and ethnic groups. Our analyses demonstrate that distance, income, ethnicity and availability appear to be systematically correlated with low uptake rates of all maternal health services. Demand-side factors seem to be by far the most important sources of the differences between subpopulations. We also find that there is potential for creating a Conditional Cash Transfer program to improve the usage of maternal health services. Originality/value We believe that our results will contribute positively to the exploration of answers to the dual questions that many public health systems have struggled with (1) why the uptake rate of maternal health services is low among some subpopulations; and (2) how to raise it.

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