PMC:7545501 / 16966-20503 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7545501","sourcedb":"PMC","sourceid":"7545501","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7545501","text":"Consideration of biosecurity, biosafety, health systems and catastrophic threats\nThe GHS Index treats biosafety and biosecurity as vital components of global health security. As such, the tool includes numerous indicators measuring country capacities in these areas. Admittedly, health priorities in many low/middle-income countries (LMICs) often differ from those of their wealthier counterparts, and many LMICs may have limited capacities to prioritise biosafety and biosecurity.17 However, the health and security risks associated with dual-use research, accidental releases of pathogens and deliberate misuse of biological materials are not equitably distributed across countries. LMICs are more likely to experience significant morbidity and mortality if these threats manifest, and unless steps are taken to monitor and strengthen their respective biosecurity and biosafety capacities, they will remain disproportionately vulnerable.\nThe GHS Index’s approach to biosecurity and biosafety aligns with that of the IHR (2005), which require core health system competencies that apply universally to all countries regardless of income level. It is worth noting, too, that while category 1 of the GHS Index includes many biosecurity and biosafety indicators, it is not weighted more heavily than other categories: category 1 scores as a whole account for only 16.3% of a country’s total score, while scores for biosecurity and biosafety indicators each determine approximately 2.6% of a country’s overall score. Including these indicators in the GHS Index also aligns with international health security norms, such as those articulated in the IHR (2005), the JEE, the World Organisation for Animal Health’s Performance of Veterinary Services Evaluations, the GHSA, the Biological Weapons Convention and the Cartagena Protocol on Biosafety. The Africa Centres for Disease Control and Prevention has also prioritised these capacities through its continent-wide Initiative on Strengthening Biosafety and Biosecurity, which aligns with both the JEE and IHR implementation.21\nThe GHS Index also measures domains not explicitly captured in other health security assessment tools, such as health system readiness and preparedness for global catastrophic biological risks (GCBRs). The Johns Hopkins Center for Health Security defines GCBRs as ‘events in which biological agents—whether naturally emerging or reemerging, deliberately created and released or laboratory engineered and escaped—could lead to sudden, extraordinary, widespread disaster beyond the collective capability of national and international governments and the private sector to control.’22 While the JEE’s biosafety and biosecurity indicators are undoubtedly vital metrics of GCBR preparedness, some health system capacities not sufficiently captured in the tool—such as abilities to test, approve and dispense new medical countermeasures—are also essential to GCBR prevention and mitigation. The GHS Index goes above and beyond the JEE in this regard, featuring a dedicated category focusing exclusively on health system capacities required to mitigate epidemic threats. This was the lowest-scoring category across all countries in the GHS Index: 131 countries ranked in the lowest tier of scores, highlighting critical vulnerabilities in global capacities to care for sick patients and protect health workers during public health emergencies, including GCBRs.1 A comprehensive list of GHS Index indicators measuring GCBR preparedness is provided in the inaugural 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