The number of countries meeting the target has been increasing since 2017 from 32 countries to 58 in 2023. Countries are making incremental progress toward the target as well, in each year the number of countries that is close to meeting the target has increased as well. Between 2020 and 2021, the number of countries meeting the target dropped. This is not necessarily due to a drop in capacities, this is likely a reflection of the new indicators in the JEE 3^rd Edition.

The grey bar represents the number of countries that have completed a Joint External Evaluation but are not yet meeting the target.

Progression of GHSA Members Meeting the GHSA 2028 Overarching Target since 2017

Collectively, we are 42 countries away from reaching the GHSA 2028 overarching targets. 17 of the countries that have completed a Joint External Evaluation (JEE) are close to meeting the target. By targeting these countries for support and investment, we can quickly make progress towards this goal. Listed below are 17 countries that are within two technical areas of reaching the GHSA 2028 Overarching Targets, and the technical areas where an improvement of one capacity score will elevate them to “Meeting the Targets”.

Country (18)	TAs at a Score of 4 or Higher	Technical Areas Scoring 3
Belize	4	Surv, IPC
Côte d’Ivoire	3	Surv, HR, HEM, HSP, RC
Eritrea	3	Imm, PoE
Haiti	4	HEM, HSP
Lao People’s Democratic Republic	3	NLS, HSP, IPC, RC
Malawi	3	ZD, HEM, IPC
Maldives	3	Fin, AMR, NLS, HR, HS, RC
Mauritius	4	IHR, FS, PoE
Montenegro	3	LI, AMR, Umm, HEM, HSP
Pakistan	3	IHR, NLS
Philippines	4	LI, Fin, AMR, ZD, FS, NLS, Surv, HR, CE
Republic of Moldova	3	LI, IHR, ZD, NLS, HEM, HSP, IPC, RC, PoE
Sierra Leone	3	Fin, ZD
South Sudan	4	NLS, HEM, HSP
Tajikistan	3	BSBS, NLS, HR, RC, PoE
Timor-Leste	3	LU, Fin, IHR, AMR, ZD, NLS, HSP, IPC, RC
Togo	4	IHR, HR, HEM, HSP, IPC, PoE
Zimbabwe	4	Fin, ZD, NLS, HR, HEM

Bold countries are GHSA Members

Acronyms: LI=Legal Instruments, Fin=Financing, IHR=IHR Coordination, IHR Focal Point Functions and Advocacy, AMR=Antimicrobial Resistance, ZD=Zoonotic Disease, FS=Food Safety, BSBS=Biosafety and Biosecurity, Imm=Immunization, NLS=National Laboratory System, Surv=Surveillance, HR=Human Resources, HEM=Health Emergency Management, LPHSA=Linking Public Health and Security Authorities, HSP=Health Services Provision, IPC=Infection Prevention and Control, RC=Risk Communications, PoE=Points of Entry and Border Health, CE=Chemical Events, RE=Radiation Emergencies

Overview

To achieve the GHSA 2028 Overarching Target, a country must complete an evaluation of health security capacity. For the purposes of this analysis, we determine that first measurement must be the Joint External Evaluation (JEE).

Subsequent annual scores are measured using the States Parties Annual Report (SPAR) and Global Health Security Index (GHSI) to provide an informal update based on JEE indicators. The tools used to determine these updates change regularly. As of 2021, progress towards the GHSA 2028 overarching targets are measured against the technical areas of the 3^rd Edition of the JEE. The SPAR 2^nd Edition overlaps with 16 technical areas of the JEE. The GHSI provides updates to the remaining three technical areas (P4. Antimicrobial resistance, P8. Immunization, and R2. Linking public health and security authorities).

The data for this measurement was obtained from the World Health Organization’s Strategic Partnership for Health Security and Emergency Preparedness Portal (WHO SPH) and from the Nuclear Threat Initiative’s (NTI) Global Health Security Index . NTI’s GHSI provides a score out of 100 for multiple global health security technical areas. These are not country-reported but provide a more recent score for JEE technical areas that are not covered by the SPAR. We thank WHO and NTI for making their data available and thank the Accountability and Results Task Force for the development of these measurements.

These data sources are chosen because they are publicly available. SPAR data is collected at annually (as of 2010) and GHSI biennially (as of 2019). This methodology has been developed as a reasonable and reproducible estimate of progress toward the GHSA 2028 overarching targets using publicly available data. It is not intended to be a rigorous analysis.

Methods

1. Take the Baseline Measure as average score per technical area from the first JEE a country has conducted.
2. Measure Progress Indicators through converting subsequent average SPAR and GHSI scores to the most recent JEE indicators. For 2021 reports and onwards, these use JEE 3^rd Edition indicators. These are converted from a 100-point scale to a 5-point scale using the conversion chart listed below.
   • Before the GHSI, SPAR scores should be supplemented with the latest JEE scores technical areas not covered by the SPAR in 2017 and 2018.
   • SPAR scores should be supplemented with GHSI Scores for 2019 and onwards.
3. Identify countries with 5 or more technical areas with a score of ≥4 at that timepoint. Countries are classified according to the following definitions:
   • Meeting the Targets – Countries have at least five technical areas at a score of four or higher.
   • Close to the Targets – Countries have three or four technical areas at a score of four or higher.
   • Not Reaching the Targets – Countries have fewer than three technical areas at a score of four or higher.

Conversion Chart

Conversion Formulas

SPAR Conversions :

 

 

GHSI Index* :    

 

 

The GHSA hosted a webinar to highlight the learned experiences of conducting Joint External Evaluations (JEEs). The panel included speakers from Pakistan, Thailand, and Nigeria. Panelists provided a general overview of the JEE process, shared case studies and best practices from their personal country experiences in conducting recent JEEs, and answered audience Q&A questions.