Abstract
Pandemics have the potential to incur significant health and economic impacts, and can reach a large number of countries from their origin within weeks. Early identification and containment of a newly emerged pandemic within the source country is key for minimising global impact. To identify a country’s potential to control and contain a pathogen with pandemic potential, we compared the quality of a country’s healthcare system against its global airline connectivity. Healthcare development was determined using three multi-factorial indices, while detailed airline passenger data was used to identify the global connectivity of all countries. Proximities of countries to a putative ‘Worst Case Scenario’ (extreme high-connectivity and low-healthcare development) were calculated. We found a positive relationship between a country’s connectivity and healthcare metrics. We also identified countries that potentially pose the greatest risk for pandemic dissemination, notably Dominican Republic, India and Pakistan. China and Mexico, both sources of recent influenza and coronavirus pandemics were also identified as among the highest risk countries. Collectively, lower-middle and upper-middle income countries represented the greatest risk, while high income countries represented the lowest risk. Our analysis represents an alternative approach to identify countries where increased within-country disease surveillance and pandemic preparedness may benefit global health.
Highlights
Pandemics have the potential to incur significant health and economic impacts, and can reach a large number of countries from their origin within weeks
The United States of America (USA) saw the highest connectivity for the period considered recorded in August 2014, whereas China saw its highest connectivity in July 2014
While Rand and Global Health Burden (GBD) indices were developed for different purposes (GBD to understand the level of healthcare development within each country and Rand to understand the global level of pandemic preparedness) and use different metrics, we found that both represented healthcare in a holistic manner and suited our aim of identifying potentially more vulnerable systems
Summary
Pandemics have the potential to incur significant health and economic impacts, and can reach a large number of countries from their origin within weeks. To identify a country’s potential to control and contain a pathogen with pandemic potential, we compared the quality of a country’s healthcare system against its global airline connectivity. Our analysis represents an alternative approach to identify countries where increased within-country disease surveillance and pandemic preparedness may benefit global health. Understanding the global resilience of healthcare systems to pandemic and outbreak emergence events is, a crucial step in allocating resources to improve surveillance and public health interventions[4]. In 2016, the cost of a pandemic was estimated at $60 billion per year, greatly outweighing the cost of improving country preparedness (estimated at $4.5 billion per year), and only representing a fraction of the spending for financial crises prevention[5] It has been estimated in 2021 that the SARS-CoV-2 pandemic may generate global economic losses of up to $8.8 t rillion[6]. With increasing global connectivity, understanding the implications of a possible pandemic source is beneficial to the global community
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