Related Articles Health security capacities in the context of COVID 19 outbreak an analysis of International Health Regulations annual report data from 182 countries Lancet 2020 Mar 18 Authors Kandel N Chungong S Omaar A Xing J Abstract BACKGROUND Public health measures to prevent detect and respond to events are essential to control public health risks including infectious disease outbreaks as highlighted in the International Health Regulations IHR In light of the outbreak of 2019 novel coronavirus disease COVID 19 we aimed to review existing health security capacities against public health risks and events METHODS We used 18 indicators from the IHR State Party Annual Reporting SPAR tool and associated data from national SPAR reports to develop five indices 1 prevent 2 detect 3 respond 4 enabling function and 5 operational readiness We used SPAR 2018 data for all of the indicators and categorised countries into five levels across the indices in which level 1 indicated the lowest level of national capacity and level 5 the highest We also analysed data at the regional level using the six geographical WHO regions FINDINGS Of 182 countries 52 28 had prevent capacities at levels 1 or 2 and 60 33 had response capacities at levels 1 or 2 81 45 countries had prevent capacities and 78 43 had response capacities at levels 4 or 5 indicating that these countries were operationally ready 138 76 countries scored more highly in the detect index than in the other indices 44 24 countries did not have an effective enabling function for public health risks and events including infectious disease outbreaks 7 4 at level 1 and 37 20 at level 2 102 56 countries had level 4 or level 5 enabling function capacities in place 32 18 countries had low readiness 2 1 at level 1 and 30 17 at level 2 and 104 57 countries were operationally ready to prevent detect and control an outbreak of a novel infectious disease 66 36 at level 4 and 38 21 at level 5 INTERPRETATION Countries vary widely in terms of their capacity to prevent detect and respond to outbreaks Half of all countries analysed have strong operational readiness capacities in place which suggests that an effective response to potential health emergencies could be enabled including to COVID 19 Findings from local risk assessments are needed to fully understand national readiness capacities in relation to COVID 19 Capacity building and collaboration between countries are needed to strengthen global readiness for outbreak control FUNDING None PMID 32199075 PubMed as supplied by publisher