ArticleBMJ global health2020
Validation analysis of Global Health Security Index (GHSI) scores 2019.
Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations of diabetes, hypertension and obesity with COVID-19 mortality: a systematic review and meta-analysis.BMJ global health · 2023Pooled it
- No Place to Hide? Regional Resilience and Vulnerability to Global Catastrophic Risk.Global challenges (Hoboken, NJ) · 2026Review
- Structural gradients in excess mortality during and after the COVID-19 pandemic: economic development, preparedness, and cross-national differences, 2020-2024.Journal of global health · 2026Article
- A Review and Future Directions for Global Public Health Security Assessment Tools.China CDC weekly · 2026Article
- Determinants and typologies of health system resilience: A data-driven framework for prioritising investment.PloS one · 2026Article
- Article
- Socioeconomic inequality and decomposition of core capacity in global health security: the role of health system.Journal of global health · 2025Article
- Countries' progress towards Global Health Security (GHS) increased health systems resilience during the Coronavirus Disease-19 (COVID-19) pandemic: A difference-in-difference study of 191 countries.PLOS global public health · 2025Article
- Article
- Did the COVID-19 quarantine policies applied in Cochabamba, Bolivia mitigated cases successfully? an interrupted time series analysis.Global health action · 2024Article
- Rethinking the methodology of global indexes for equitable evidence-informed policy towards sustainable development.Journal of global health · 2024Article
- Comparison of the Bulut Index-Beta method and Global Health Security Index: results from the world's countries.Turkish journal of medical sciences · 2024Article
- Host-Pathogen Interactions Influencing Zoonotic Spillover Potential and Transmission in Humans.Viruses · 2023Review
- Assessing the impact of regional laboratory networks in East and West Africa on national health security capacities.PLOS global public health · 2023Article
- What matters: non-pharmaceutical interventions for COVID-19 in Europe.Antimicrobial resistance and infection control · 2022Article
- Global mapping of epidemic risk assessment toolkits: A scoping review for COVID-19 and future epidemics preparedness implications.PloS one · 2022Article
- An Assessment of Systemic Factors and COVID-19 Mortality in Africa.International journal of public health · 2022Article
- Joint External Evaluation scores and communicable disease deaths: An ecological study on the difference between epidemics and pandemics.PLOS global public health · 2022Article
- Analysing COVID-19 outcomes in the context of the 2019 Global Health Security (GHS) Index.BMJ global health · 2021Article
- Explaining covid-19 performance: what factors might predict national responses?BMJ (Clinical research ed.) · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe COVID-19 pandemic powerfully demonstrates the consequences of biothreats. Countries will want to know how to better prepare for future events. The Global Health Security Index (GHSI) is a broad, independent assessment of 195 countries' preparedness for biothreats that may aid this endeavour. However, to be useful, the GHSI's external validity must be demonstrated. We aimed to validate the GHSI against a range of external metrics to assess how it could be utilised by countries.
methodsGlobal aggregate communicable disease outcomes were correlated with GHSI scores and linear regression models were examined to determine associations while controlling for a number of global macroindices. GHSI scores for countries previously exposed to severe acute respiratory syndrome (SARS), Middle East respiratory syndrome and Ebola and recipients of US Global Health Security Agenda (GHSA) investment were compared with matched control countries. Possible content omissions in light of the progressing COVID-19 pandemic were assessed.
resultsGHSI scores for countries had strong criterion validity against the Joint External Evaluation ReadyScore (rho=0.82, p<0.0001), and moderate external validity against deaths from communicable diseases (-0.56, p<0.0001). GHSI scores were associated with reduced deaths from communicable diseases (
conclusionThe GHSI shows promise as a valid tool to guide action on biosafety, biosecurity and systems preparedness. However, countries need to look beyond existing metrics to other factors moderating the impact of future pandemics and other biothreats. Consideration of anthropogenic and large catastrophic scenarios is also needed.
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