By Jean-Pierre A.
Africa’s Health Security Capacity Has Improved, but No Country is Adequately Prepared and Biosecurity and Biosafety Remain Critically Low.
New Africa Health Security Index reveals how rising threats and health emergencies, including Central Africa’s current Ebola outbreak, could erode progress
A new Africa Health Security (AHS) Index, released this week against the backdrop of a devastating Ebola disease outbreak, reveals significant gaps in critical health infrastructure despite important progress in health security capacity in recent years.
The AHS Index spotlights how African governments and partner investments in the aftermath of the COVID-19 pandemic have paid off. The continent is nearly 30 percent more prepared than it was five years ago, according to the Index, yet an average score of only 41.5 out of 100 reveals gaps that could allow crises to become catastrophes at a time when threats and risk factors continue to escalate.
Developed by a coalition of African and global research organisations and public health and security experts, the AHS Index assessed all 54 African countries based on answers to 190 questions. These questions benchmark health security alongside other factors critical to preventing, detecting, and responding to outbreaks, including the strength of each country’s health systems, commitment to global norms, and the local political and risk environment. The Index was designed by the coalition to meet African priorities and equip leaders with evidence to address current and future risks.
The Index findings show that progress is real and broad-based, with 52 out of 54 countries showing improved scores by at least one point. The continent-wide averages improved in all top-level Index categories except risk environment. However, despite these gains, some underlying indicators declined.
“The AHS Index is a game changer for an exceptionally diverse continent with wide differences in national incomes, climate, governance, and social conditions. It measures our unique strengths and strategic opportunities and provides the evidence base for African controlled health investments and policy decisions,”said Judith Omumbo, Head of Partnerships and Resource Mobilisation for the Science for Africa Foundation, a co-lead of the AHS Index. “It can guide domestic policy priorities and international collaboration opportunities, ensuring that countries in Africa lead, rather than follow, in global health security initiatives.”
The Index also found improvements in biosecurity and biosafety capacity across Africa, but capacity in those areas still remains alarmingly low. The average biosecurity score is 14.9, the biosafety average 18.2, and the dual-use research of concern average is 1.9 out of 100. Lab infrastructure is expanding, but it is outpacing safety and security oversight mechanisms.
“The measurable increase in capacity is the result of dedication, hard work, and investment in the health security of Africa over recent years, but much more is needed. Substantial gaps remain that can mean the difference between a small outbreak and an international pandemic. Investments made today will determine Africa’s capacity to address the health threats of tomorrow,”said Dr. Wilmot James, senior adviser to the Brown University Pandemic Center and a former Member of Parliament and Shadow Minister of Health in South Africa. “Recent declines in overseas development assistance underline the need for governments to prioritise resources and strengthen the systems that address health emergencies.”
Other findings :
Biosurveillance capacity is growing: 53 out of 54 countries had increased biosurveillance capacity, though progress varied by region. Wastewater and environmental surveillance has expanded to 52 countries and genomic sequencing capacity in 48 countries, but programs vary in maturity.
Medical countermeasure development is outpacing deployment: Capacity for life-saving medical countermeasures (MCM) such as vaccines and therapeutics rose across all five regions. However, countries have better capacities to develop MCM (average score: 56.5 out of 100) than to deploy them (20.7 out of 100). Similarly, while 85 percent of countries have an agency to approve new MCMs, only 22 percent have public plans to handle supply surges during emergencies.
Climate-related health security capacity is improving: Access to water and sanitation infrastructure to better manage risks linked to climate change has increased, and countries have more capacity to prevent, detect, and rapidly respond to zoonotic diseases with more legislation, surveillance, data sharing, and emergency response planning.
Regional health security infrastructure is strengthening, but unevenly: In response to regional capacity building efforts, the number of countries meeting field epidemiologist staffing thresholds nearly doubled: Fifty-two countries now have Emergency Operations Centres, and 36 have animal health emergency agreements. However, only eight countries are tracking dangerous pathogen facility locations.
National health security financing commitments show signs of strain: The average score dipped from 52.5 to 50.5 out of 100. Eighteen countries no longer show evidence of active financing commitments, although seven new countries do.
“African governments have made measurable progress in health security capacity, and the data show it,” said Christine E. Wormuth, president and CEO of the Nuclear Threat Initiative. “Growing biological risks and a challenging security environment expose countries to outbreaks, accidents, and deliberate threats. Strengthening public health is both a national and regional security priority.”
