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Ranked: Global Pandemic Preparedness by Country



Ranked: Global Pandemic Preparedness by Country

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Ranked: Global Pandemic Preparedness by Country

The world has experienced many pandemics throughout its history, but not every era has had the benefit of modern medicine and hindsight.

However, even with the readily available medical expertise and equipment that exists today, it is still unevenly distributed throughout the globe. Combine this with a highly interconnected global economy, and large populations are still at risk from infection.

Today’s chart pulls data from the 2019 Global Health Security Index, which ranks 195 countries on health security. It reveals that while there were top performers, healthcare systems around the world on average are fundamentally weak—and not prepared for new disease outbreaks.

Pathways for Commerce and Disease

Modern transportation and trade have linked the farthest stretches of the world to fuel a global economy. Physical distance plays less a limiting role and more an enabling one to form a flat world as Thomas Friedman put it, creating opportunities for commerce anywhere in the world.

A person can sell dishware from his home in Cusco, Peru, online to a customer in Muncie, Indiana, with products manufactured in China, from materials sourced in Africa.

While these connections sound sterile, there are people interacting with one another to procure, manufacture, package, and distribute the goods. The connections are not just through products, but also people and animals across many borders.

Now, add up the interactions within the global food supply chain with plants and livestock and tourism industries and place them under the pressures of climate change, urbanization, international mass displacement, and migration—and the volume and variety of opportunities for disease transmission and mutation becomes infinite.

The same pathways of global commerce become the transmission vectors for disease. A cough in Dubai can become a fever in London with one flight and one day.

You Cannot Manage What You Do Not Measure

Despite this, we still live with national healthcare systems that look inward towards national populations, with less of a focus on integrating what is happening with the outside world.

The Global Health Security (GHS) Index is the first comprehensive effort to assess and benchmark health security and related capabilities by nation, and it tracks six key factors to come up with an overall score for each of the 195 countries in the ranking:

  1. Prevention
    Prevention of the emergence or release of pathogens
  2. Detection and Reporting
    Early detection and reporting for epidemics of potential international concern
  3. Rapid Response
    Capability of rapidly responding to and mitigating the spread of an epidemic
  4. Health System
    Sufficient and robust and health system to treat the sick and protect health workers
  5. Compliance with Global Norms
    Compliance with international norms by improving national capacity, financing plans to address gaps
  6. Risk Environment
    Risk environment and country vulnerability to biological threats

Note: The GHS Index is a project of the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center for Health Security (JHU), and was developed with The Economist Intelligence Unit (EIU).

Country Overall Rankings

Overall, the rankings uncover a distressing insight. Global preparedness for both epidemics and pandemics is weak, with the average score in the index sitting at 40.2 out of 100.

The countries with the highest scores have effective governance and politics systems in place, while those with the lowest scores fall down for their inadequate healthcare systems—even among high-income countries.

Here are the 50 highest-ranking countries in the index:

RankCountryGHS Index Score
#1🇺🇸 United States83.5
#2🇬🇧 United Kingdom77.9
#3🇳🇱 Netherlands75.6
#4🇦🇺 Australia75.5
#5🇨🇦 Canada75.3
#6🇹🇭 Thailand73.2
#7🇸🇪 Sweden72.1
#8🇩🇰 Denmark70.4
#9🇰🇷 South Korea70.2
#10🇫🇮 Finland68.7
#34South Africa54.8
#35New Zealand54
#42Czech Republic52
#47Kyrgyz Republic49.3
#47Saudi Arabia49.3

You can view the complete rankings of all 195 countries on the GHS Index website.

Interestingly, 81% of countries score in the bottom tier for indicators related to biosecurity—and worse, 85% of countries show no evidence of having completed a biological threat-focused simulation exercise in conjunction with the World Health Organization (WHO) in the past year.

Confirmed COVID-19 Cases vs. Global Health Security Score

Many healthcare systems have had their security tested with the outbreak of COVID-19.

global health secutiry score vs covid19 cases

Although it is still extremely early, there appears to be a relationship between a nation’s health security and its ability to cope with pandemics.

Takeaways: A World Unprepared

While there may be top performers relative to other countries, the overall picture paints a grim picture that foreshadowed the current crisis we are living through.

“It is likely that the world will continue to face outbreaks that most countries are ill positioned to combat. In addition to climate change and urbanization, international mass displacement and migration—now happening in nearly every corner of the world—create ideal conditions for the emergence and spread of pathogens.” – The Global Health Security Index, 2019

The report outlined eight critical insights about global health security in 2019 that reveal some of the problems countries are now facing.

  1. National health security is fundamentally weak globally. No country is fully prepared for epidemics or pandemics, and every country has important gaps to address.
  2. Countries are not prepared for a globally catastrophic biological event.
  3. There is little evidence that most countries have tested important health security capacities or shown that they would be functional in a crisis.
  4. Most countries have not allocated funding from national budgets to fill identified preparedness gaps.
  5. More than half of countries face major political and security risks that could undermine national capability to combat biological threats.
  6. Most countries lack basic health systems capacities critical for epidemic and pandemic response.
  7. Coordination and training are inadequate among veterinary, wildlife, and public health professionals and policymakers.
  8. Improving country compliance with international health and security norms is essential.

A Stark Reality

The intention of the Global Health Security Index is to encourage improvements in the planning and response to one of the world’s most omnipresent risks–infectious disease outbreaks. When this report was released in 2019, it revealed that even the highest ranking nations still had gaps to fill in preparing for a pandemic.

Of course, hindsight is 20/20. The COVID-19 outbreak has served as a wake-up call to health organizations and governments around the world. Once all of the curves have been flattened, the next version of this report will undoubtedly be viewed with renewed interest.

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Charted: The World’s Aging Population from 1950 to 2100

This graphic visualizes the world’s aging population, showing data for every country and territory around the world.



Charted: The World’s Aging Population from 1950 to 2100

As demographics continue to shift in the 21st century, the world’s aging population will continue to be a focal point for many global decision makers.

Most countries around the world have experienced population explosions, or are about to. Combine this with declining birth rates and falling mortality rates, and it’s clear that the global senior population will continue to reach new heights.

These graphics by Pablo Alvarez use data from the 2022 UN World Population Prospects to visualize this increasing aging population across countries.

The World’s Aging Population from 1950 to 2100

In 2022, there were 771 million people aged 65+ years globally, accounting for almost 10% of the world’s population.

This segment has been growing at an increasing rate, and it’s expected to hit 16% in 2050, and eventually 24% by 2100. Here’s what that’s projected to look like, for every country and territory.

Country by Population Aged +65 Years195020222100
🇦🇫 Afghanistan2.85%2.39%16.03%
🇦🇱 Albania6.04%16.66%49.08%
🇩🇿 Algeria3.49%6.39%28.83%
🇦🇸 American Samoa2.38%7.27%45.41%
🇦🇩 Andorra10.02%14.98%37.04%
🇦🇴 Angola2.93%2.6%12.07%
🇦🇮 Anguilla3.69%10.71%37.49%
🇦🇬 Antigua and Barbuda4.14%10.63%35.4%
🇦🇷 Argentina4.13%11.92%31.79%
🇦🇲 Armenia8.17%13.15%36.13%
🇦🇼 Aruba1.77%16.15%36.51%
🇦🇺 Australia8.17%16.9%31.38%
🇦🇹 Austria10.42%19.81%33.93%
🇦🇿 Azerbaijan6.89%7.11%30.5%
🇧🇸 Bahamas4.76%8.89%29.58%
🇧🇭 Bahrain2.88%3.76%21.89%
🇧🇩 Bangladesh3.9%6.04%32.56%
🇧🇧 Barbados5.24%16.28%33.19%
🇧🇾 Belarus8.24%17.18%30.45%
🇧🇪 Belgium11.03%19.73%32.83%
🇧🇿 Belize3.57%5.09%29.21%
🇧🇯 Benin7.85%3.06%11.03%
🇧🇲 Bermuda5.71%20.41%37.73%
🇧🇹 Bhutan2.53%6.25%33.35%
🇧🇴 Bolivia6.11%4.85%21.75%
🇧🇶 Bonaire Sint Eustatius and Saba14.22%13.84%28.94%
🇧🇦 Bosnia and Herzegovina3.95%18.4%36.4%
🇧🇼 Botswana4.32%3.65%17.96%
🇧🇷 Brazil2.39%9.88%33.52%
🇻🇬 British Virgin Islands8.63%9.95%32.47%
🇧🇳 Brunei4.85%6.17%30.93%
🇧🇬 Bulgaria6.66%22.38%37.13%
🇧🇫 Burkina Faso2.01%2.53%13.07%
🇧🇮 Burundi3.22%2.48%13.23%
🇰🇭 Cambodia2.67%5.81%26.43%
🇨🇲 Cameroon3.47%2.67%11.89%
🇨🇦 Canada7.7%19.03%31.55%
🇨🇻 Cape Verde3.67%5.55%32.63%
🇰🇾 Cayman Islands6.05%8.17%28.75%
🇨🇫 Central African Republic5.%2.51%11.43%
🇹🇩 Chad4.33%2.01%9.64%
🇨🇱 Chile3.3%13.03%36.61%
🇨🇳 China5.04%13.72%40.93%
🇨🇴 Colombia3.22%9.%34.49%
🇰🇲 Comoros3.8%4.28%17.81%
🇨🇬 Congo3.36%2.72%11.99%
🇨🇰 Cook Islands2.94%11.73%29.75%
🇨🇷 Costa Rica2.97%10.83%36.99%
🇨🇮 Cote d'Ivoire2.21%2.4%10.86%
🇭🇷 Croatia7.82%22.36%37.03%
🇨🇺 Cuba4.36%15.81%36.31%
🇨🇼 Curacao5.82%14.95%30.46%
🇨🇾 Cyprus5.95%14.83%33.36%
🇨🇿 Czechia8.29%20.64%26.94%
🇨🇩 Democratic Republic of Congo3.77%2.92%10.62%
🇩🇰 Denmark9.04%20.49%30.45%
🇩🇯 Djibouti1.99%4.54%19.68%
🇩🇲 Dominica7.67%9.53%34.28%
🇩🇴 Dominican Republic2.72%7.4%30.47%
🇪🇨 Ecuador5.2%7.83%31.97%
🇪🇬 Egypt2.95%4.83%21.77%
🇸🇻 El Salvador3.93%8.22%36.02%
🇬🇶 Equatorial Guinea5.53%3.12%15.13%
🇪🇷 Eritrea3.2%4.01%19.86%
🇪🇪 Estonia10.56%20.58%34.15%
🇸🇿 Eswatini2.68%4.%16.26%
🇪🇹 Ethiopia3.01%3.14%18.6%
🇫🇴 Faeroe Islands7.59%17.92%26.91%
🇫🇰 Falkland Islands8.27%11.08%35.86%
🇫🇯 Fiji5.99%5.9%20.6%
🇫🇮 Finland6.63%23.27%34.04%
🇫🇷 France11.39%21.66%34.23%
🇬🇫 French Guiana7.96%5.98%21.13%
🇵🇫 French Polynesia3.%10.07%37.85%
🇬🇦 Gabon7.21%3.89%16.25%
🇬🇲 Gambia2.5%2.43%16.06%
🇬🇪 Georgia9.35%14.61%31.19%
🇩🇪 Germany9.46%22.41%33.72%
🇬🇭 Ghana4.62%3.55%15.91%
🇬🇮 Gibraltar6.94%20.84%37.63%
🇬🇷 Greece6.8%22.82%37.52%
🇬🇱 Greenland3.06%10.02%29.16%
🇬🇩 Grenada5.12%10.07%30.54%
🇬🇵 Guadeloupe5.51%20.04%34.45%
🇬🇺 Guam1.11%11.84%31.19%
🇬🇹 Guatemala2.31%4.91%28.05%
🇬🇬 Guernsey11.96%16.64%35.4%
🇬🇳 Guinea5.39%3.32%14.%
🇬🇼 Guinea-Bissau3.45%2.82%14.34%
🇬🇾 Guyana3.89%6.28%28.94%
🇭🇹 Haiti3.64%4.54%19.07%
🇭🇳 Honduras3.96%4.27%26.5%
🇭🇰 Hong Kong2.48%20.47%41.64%
🇭🇺 Hungary7.81%20.01%31.85%
🇮🇸 Iceland7.52%15.33%34.25%
🇮🇳 India3.1%6.9%29.81%
🇮🇩 Indonesia1.74%6.86%25.28%
🇮🇷 Iran5.22%7.62%33.72%
🇮🇶 Iraq2.79%3.41%18.44%
🇮🇪 Ireland10.99%15.14%32.48%
🇮🇲 Isle of Man13.9%22.29%31.8%
🇮🇱 Israel4.%12.04%25.97%
🇮🇹 Italy8.09%24.05%38.19%
🇯🇲 Jamaica3.83%7.45%44.05%
🇯🇵 Japan4.89%29.92%38.7%
🇯🇪 Jersey12.34%16.22%30.52%
🇯🇴 Jordan5.03%3.84%27.3%
🇰🇿 Kazakhstan6.47%8.04%19.58%
🇰🇪 Kenya5.28%2.87%16.98%
🇰🇮 Kiribati7.13%3.81%17.33%
🇽🇰 Kosovo5.33%10.19%43.35%
🇰🇼 Kuwait2.88%4.93%31.56%
🇰🇬 Kyrgyzstan7.91%4.54%21.08%
🇱🇦 Laos2.13%4.45%25.24%
🇱🇻 Latvia10.12%21.86%32.86%
🇱🇧 Lebanon7.24%9.89%32.11%
🇱🇸 Lesotho6.34%4.2%13.44%
🇱🇷 Liberia2.97%3.31%13.88%
🇱🇾 Libya5.21%4.86%27.77%
🇱🇮 Liechtenstein7.89%19.37%34.79%
🇱🇹 Lithuania8.65%20.8%32.79%
🇱🇺 Luxembourg9.71%15.03%31.55%
🇲🇴 Macao3.11%13.%32.39%
🇲🇬 Madagascar3.25%3.35%16.21%
🇲🇼 Malawi3.06%2.61%15.61%
🇲🇾 Malaysia4.91%7.5%30.78%
🇲🇻 Maldives3.14%4.78%35.61%
🇲🇱 Mali2.78%2.38%11.%
🇲🇹 Malta7.42%19.13%38.26%
🇲🇭 Marshall Islands5.68%4.56%17.8%
🇲🇶 Martinique5.85%22.77%37.31%
🇲🇷 Mauritania1.44%3.22%15.03%
🇲🇺 Mauritius3.18%12.79%33.76%
🇾🇹 Mayotte6.61%2.88%18.15%
🇲🇽 Mexico2.99%8.32%34.88%
🇫🇲 Micronesia (country)4.11%6.16%27.59%
🇲🇩 Moldova7.56%12.98%26.36%
🇲🇨 Monaco15.64%35.92%30.16%
🇲🇳 Mongolia3.87%4.61%26.18%
🇲🇪 Montenegro7.85%16.55%34.16%
🇲🇸 Montserrat7.92%17.7%33.05%
🇲🇦 Morocco2.86%7.72%29.97%
🇲🇿 Mozambique3.13%2.57%13.43%
🇲🇲 Myanmar3.21%6.82%23.69%
🇳🇦 Namibia4.1%3.97%15.38%
🇳🇷 Nauru8.98%2.5%15.87%
🇳🇵 Nepal2.74%6.09%29.51%
🇳🇱 Netherlands7.76%20.31%32.89%
🇳🇨 New Caledonia5.%11.02%31.61%
🇳🇿 New Zealand9.09%16.31%33.2%
🇳🇮 Nicaragua2.71%5.29%28.92%
🇳🇪 Niger.92%2.4%9.76%
🇳🇬 Nigeria3.%2.97%12.31%
🇳🇺 Niue4.79%15.16%22.55%
🇰🇵 North Korea2.72%11.71%30.49%
🇲🇰 North Macedonia5.87%14.91%36.56%
🇲🇵 Northern Mariana Islands2.95%10.81%32.09%
🇳🇴 Norway9.52%18.44%31.65%
🇴🇲 Oman3.05%2.76%23.96%
🇵🇰 Pakistan5.48%4.27%17.23%
🇵🇼 Palau8.59%9.93%21.48%
🇵🇸 Palestine4.77%3.53%23.44%
🇵🇦 Panama3.57%8.77%30.03%
🇵🇬 Papua New Guinea1.09%3.19%16.81%
🇵🇾 Paraguay3.73%6.26%26.51%
🇵🇪 Peru3.43%8.41%30.33%
🇵🇭 Philippines3.56%5.44%23.38%
🇵🇱 Poland5.22%18.55%35.69%
🇵🇹 Portugal7.%22.9%36.28%
🇵🇷 Puerto Rico3.63%22.93%48.9%
🇶🇦 Qatar3.5%1.52%15.01%
🇷🇪 Reunion3.81%13.28%32.4%
🇷🇴 Romania7.16%18.64%32.22%
🇷🇺 Russia4.8%15.8%27.86%
🇷🇼 Rwanda2.76%3.2%17.36%
🇧🇱 Saint Barthlemy7.3%10.61%43.89%
🇸🇭 Saint Helena8.63%28.66%32.61%
🇰🇳 Saint Kitts and Nevis5.36%10.13%29.79%
🇱🇨 Saint Lucia3.59%9.23%33.39%
🇲🇫 Saint Martin (French part)4.47%11.14%30.08%
🇵🇲 Saint Pierre and Miquelon6.34%17.32%33.4%
🇻🇨 Saint Vincent and the Grenadines7.71%10.86%32.34%
🇼🇸 Samoa2.52%5.22%18.75%
🇸🇲 San Marino10.15%20.47%35.73%
🇸🇹 Sao Tome and Principe3.92%3.76%15.6%
🇸🇦 Saudi Arabia3.32%2.81%30.28%
🇸🇳 Senegal3.42%3.14%16.54%
🇷🇸 Serbia6.15%20.56%37.55%
🇸🇨 Seychelles10.68%8.16%28.84%
🇸🇱 Sierra Leone3.02%3.14%15.52%
🇸🇬 Singapore2.29%15.12%36.51%
🇸🇽 Sint Maarten (Dutch part)12.03%10.57%34.51%
🇸🇰 Slovakia6.63%16.98%33.4%
🇸🇮 Slovenia7.52%20.96%33.59%
🇸🇧 Solomon Islands4.03%3.47%15.29%
🇸🇴 Somalia2.6%2.57%10.75%
🇿🇦 South Africa4.06%5.89%20.55%
🇰🇷 South Korea2.74%17.49%44.44%
🇸🇸 South Sudan3.48%2.89%13.11%
🇪🇸 Spain7.23%20.27%38.72%
🇱🇰 Sri Lanka8.76%11.54%35.73%
🇸🇩 Sudan3.03%3.5%13.28%
🇸🇷 Suriname4.09%7.39%25.8%
🇸🇪 Sweden10.19%20.25%31.83%
🇨🇭 Switzerland9.49%19.31%32.61%
🇸🇾 Syria7.66%4.68%24.62%
🇹🇼 Taiwan2.11%16.71%37.32%
🇹🇯 Tajikistan4.34%3.47%19.43%
🇹🇿 Tanzania2.2%3.1%14.97%
🇹🇭 Thailand3.21%15.21%39.17%
🇹🇱 Timor3.14%5.21%25.42%
🇹🇬 Togo4.29%3.13%11.77%
🇹🇰 Tokelau4.7%8.66%25.03%
🇹🇴 Tonga4.6%6.22%21.65%
🇹🇹 Trinidad and Tobago3.93%11.52%32.67%
🇹🇳 Tunisia4.4%9.02%31.24%
🇹🇷 Turkey3.77%8.64%33.9%
🇹🇲 Turkmenistan5.84%5.15%21.55%
🇹🇨 Turks and Caicos Islands5.79%10.34%28.25%
🇹🇻 Tuvalu4.98%6.48%16.15%
🇺🇬 Uganda2.87%1.69%14.33%
🇺🇦 Ukraine7.54%18.81%33.2%
🇦🇪 United Arab Emirates3.35%1.83%15.77%
🇬🇧 United Kingdom10.84%19.17%32.56%
🇺🇸 United States8.18%17.13%30.47%
🇻🇮 United States Virgin Islands7.54%20.42%39.11%
🇺🇾 Uruguay8.23%15.58%35.98%
🇺🇿 Uzbekistan5.87%5.14%22.24%
🇻🇺 Vanuatu5.65%3.74%16.29%
🇻🇪 Venezuela2.29%8.61%27.71%
🇻🇳 Vietnam4.13%9.12%30.02%
🇼🇫 Wallis and Futuna1.76%13.47%32.98%
🇪🇭 Western Sahara2.82%5.84%23.73%
🇾🇪 Yemen3.98%2.66%18.25%
🇿🇲 Zambia2.76%1.75%12.66%
🇿🇼 Zimbabwe3.18%3.32%14.22%
🌐 World5.13%9.82%24.03%

Some of the places with high elderly shares today include high-income countries like Japan (30%), Italy (24%), and Finland (23%).

The lowest shares are concentrated in the Middle East and Africa. Many countries have just 2% of their population aged 65 years and older, such as Qatar, Uganda, and Afghanistan.

But over time, almost all countries are expected to see their older population segments grow. In just three decades, it is estimated that one-in-four European, North American, and Asian residents will be over 65 years of age.

By 2100, a variety of Asian countries and island nations facing low population growth are expected to see more than one-third of their populations aged 65 years or older, including South Korea and Jamaica at 44%. However, it’s actually Albania that’s the biggest outlier overall, with a projected 49% of its population to be aged 65 and older by 2100.

Passing the Generational Torch

The challenge of an aging population is set to impact all sectors of society, including labor and financial markets, demand for housing and transportation, and especially family structures and intergenerational ties.

One way to help grasp the nature of transition is to note the changing ratio between seniors and young children in the world population, as seen in the below crossover diagram:

Elderly population surpass that of children aged 5 and below

Dropping fertility rates, in addition to improved child and infant mortality rates, are known to have played a major role in the plateauing population of children.

However, not all countries have witnessed this crossover yet, as it usually coincides with higher levels of economic development.

As countries such as India, Brazil, and South Africa reach higher levels of per capita income, they will be likely to follow down the paths of more advanced economies, eventually experiencing similar demographic fates and challenges.

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