The vulnerability of a country to a major infectious disease outbreak is a function of at least three factors, including characteristics the pathogen (e.g. mode of transmission or virulence), characteristics of the population (e.g. presence of high-risk groups and level of immunity), and the capacity of the affected country to respond (e.g. strength of the health system and level of economic development). Understanding the geographic distribution of vulnerabilities to a future pandemic is a key part of pandemic preparedness and response. To that end, core partners within the PSCN are engaged in complimentary efforts to map and understand the global pandemic risks and vulnerabilities, particularly WHO and WFP.
WHO has developed a conceptual severity framework for influenza pandemics that describes the severity of a pandemic by way of indicators related to transmission, virulence and impact (TVI) of the disease in particular settings. This approach helps to define several key pieces of information: how many people will get sick, how fast new cases are accruing, how many and what groups of people will become severely ill and die (e.g. age groups or groups at risk for severe outcomes); and what the impact on the health care sector will be. However, the severity of a pandemic will depend on the specific countries affected. A global pandemic that spreads widely across multiple regions of the world will affect countries with very different health system capacities. Assessing the potential impact of a pandemic on the health care sector is complex because it must reflect country-level diversity and the interaction of a number of interdependent factors. Therefore, to compliment the TVI approach, work is underway to develop country vulnerability profiles to understand unique, country-level circumstances related the health care sector.
WFP and its partners have developed Logistics Capacity Assessments (LCAs) - a longstanding tool for WFP logistics that has direct application to pandemic preparedness. The LCAs capture information about supply chain systems and capacities in countries vulnerable to disasters and cover some 80 countries where challenging conditions and bottlenecks have been pre-identified. LCAs, as a tool, can inform contingency and emergency response planning before and at the onset of a crisis. These assessments are periodically updated and can be expanded to study specific subjects (e.g. cold chain capacities for pharmaceuticals and pathology samples) in vulnerable countries at high risk of an epidemic.
The PSCN has also examined other practical ways of determining countries that are vulnerable to pandemic risk. For example, utilizing lists of countries covered by major public health programmes is a straightforward approach for assessing pandemic risk that leverages existing global health efforts. Examples include:
- The Global Vaccine Alliance (GAVI) covers 49 countries based on a Gross National Income (GNI) of less than USD 1.58 per capita.
- The WHO's Pandemic Influenza Preparedness (PIP) covers 98 countries eligible for free vaccine supply.
- The World Bank's new Pandemic Emergency Facility will focus on 77 countries eligible for assistance from the International Development.