A Review and Future Directions for Global Public Health Security Assessment Tools

Fangyu Cheng¹, Chunping Wang¹, Yueyuan Li¹, Hongtao Wu^2,3,4,#

1. School of Public Health, Shandong Second Medical University, Weifang city, Shandong Province, China.

2. Health Emergency Center, Chinese Centers for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.

3. Center for Crisis Management Research, Tsinghua University, Beijing, China.

4.National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Centers for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.

^# Corresponding author: Hongtao Wu, wuht@chinacdc.cn.

In the context of globalization, national capacities for responding to public health emergencies are evaluated using various global assessment tools, most notably the externally derived Global Health Security Index (GHSI), the peer-reviewed Joint External Evaluation (JEE), and the self-reported States Parties Self-Assessment Annual Report (SPAR). These instruments are designed to strengthen emergency response systems worldwide. However, the dynamic transmission characteristics of the COVID-19 pandemic exposed significant discrepancies, as assessment scores from these tools did not consistently align with countries' actual pandemic response performance. This review examines the performance of these assessment tools throughout the pandemic and identifies three fundamental issues that undermined the effectiveness of GHSI, JEE, and SPAR evaluations. Although indicators across eight technical areas were revised following the pandemic, substantial modifications remain necessary to address the identified limitations. To enhance the utility of these assessment frameworks, systematic revisions are required in multiple domains: restructuring the indicator system architecture, diversifying data sources while expanding indicator dimensions, strengthening data verification protocols, refining weight allocation methodologies, incorporating real-time data streams, and ultimately establishing a dynamic monitoring and assessment system.

全球公共卫生安全评估工具：综述与展望

成方宇¹，王春平¹，李月圆¹，吴洪涛^2,3,4,#

1. 公共卫生学院，山东第二医科大学，潍坊市，山东省，中国；

2. 卫生应急中心，中国疾病预防控制中心(中国预防医学科学院)，北京，中国；

3. 应急管理研究基地，清华大学，北京，中国；

4. 传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心（中国预防医学科学院）北京，中国。

^# 通信作者: 吴洪涛，wuht@chinacdc.cn。

了解全球公共卫生安全相关的13种评估工具的现状，并以全球卫生安全指数（GHSI），联合外部评估（JEE）和缔约国自我评估年度报告（SPAR）三种工具为重点，分析其在新冠疫情期间评估效果不佳的主要原因，为未来改进提供参考。采用文献综述的方法，系统检索中英文数据库，纳入128篇密切相关文献，剖析GHSI、JEE和SPAR的局限性，比较新冠大流行前后评估指标的变化情况。GHSI、JEE和SPAR在新冠疫情期间对国家能力的评估结果与实际应对效果存在偏差，主要原因在于数据真实性和获取性不足，指标权重分配不合理，指标设计未能反映疫情动态发展以及未能纳入社会文化等因素。未来应系统修订指标体系框架，拓宽数据来源和维度，强化数据核实，优化权重分配，引入实时数据流，并最终构建动态监测评估系统。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.002

A Comprehensive Analysis of Capability Enhancement in National Emergency Response Teams for Infectious Diseases — China, 2023

Jing Zhao^1,&, Yuqun Wang^2,&, Bing Li¹, Guoqing Shi^1,#

1. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China;

2. School of Public Health, Shandong Second Medical University, Weifang City, Shandong Province, China.

^& Joint first authors.

^# Corresponding author: Guoqing Shi, shigq@chinacdc.cn.

The National Emergency Response Team of Infectious Disease (NERID) constitutes the cornerstone of China's public health emergency response infrastructure. This study systematically evaluates NERID's current management practices and capacity-building initiatives, examining regional variations to establish an evidence base for advancing team modernization and standardization. We conducted a comprehensive questionnaire survey of all 20 NERID teams in China during November 2023. Descriptive analyses examined four core domains: team construction, management systems, capacity building, and emergency response operations. Two novel metrics were developed to quantify preparedness activities: the Training Intensity Index and the Drill Intensity Index. This investigation represents the first nationwide assessment of NERID development and management, encompassing 20 teams distributed across seven geographic regions. Critical findings demonstrated that full-time staff comprised only 21.1% of management personnel, while equipment standardization remained insufficient, with unified coding systems implemented in merely 45% of teams. Substantial regional disparities emerged in training and drill activities. Teams averaged two training sessions and three drills annually, with mean participation of 79 and 45 individuals per session, respectively. These metrics yielded a Training Intensity Index of 125 person-times per year and a Drill Intensity Index of 121 person-times per year. Although NERID has established nationwide coverage, significant deficiencies persist in dedicated personnel management and digital infrastructure development. Beyond strengthening routine training and drills, implementing comprehensive multi-scenario and multi-mode exercises is essential to enhance operational readiness and response capabilities.

国家突发急性传染病防控队管理与能力建设现状调查与分析

赵婧^1,&，王雨群^2,&，李冰¹，施国庆^1,#

1. 传染病湖源预警与智能决策全国重点实验室，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

2. 公共卫生学院，山东第二医科大学，潍坊市，山东省，中国。

^& 共同第一作者。

^# 通信作者：施国庆，shigq@chinacdc.cn。

国家突发急性传染病防控队（NERID）是我国公共卫生应急体系的核心力量。本研究旨在阐明当前NERID在队伍管理与能力建设方面的现状，分析其区域差异，为推进队伍的现代化与标准化建设提供理论依据。研究围绕队伍组建、管理体系、能力建设及应急处置四个维度展开描述性分析，并构建了训练强度指数与演练强度指数。本研究于2023年11月首次在全国范围内对20支NERID的发展与管理状况进行了综合评价。研究发现管理人员中专职人员比例仅为21.1%；设备标准化程度仍有不足，例如仅45%的队伍建立了统一的物资编码体系；培训与演练亦存在明显的区域差异。具体而言，各队伍年均开展培训2次、演练3次，平均每次参与人数分别为79人与45人，据此计算的训练强度指数为125（人·次/年），演练强度指数为121（人·次/年）。尽管NERID已实现全国覆盖，但在专职人员管理、信息化建设等方面仍存在显著短板。未来不仅需加强常态化的培训演练，更应开展多情景、多模式的综合演练以全面提升实战能力。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.003

Construction of Evaluation Indicators for the Public Health System in Primary and Secondary Schools — Beijing, China, 2024–2025

Xinyu Hou¹, Mei Gu¹, Jingxuan Zhao¹, Jia Yang^1,#

1. School of Public Health, Capital Medical University, Beijing, China.

^# Corresponding author: Yang Jia, yangjia@ccmu.edu.cn.

To construct a set of evaluation indicators suitable for the public health system in primary and secondary schools in Beijing, this study aimed to provide a basis for objectively assessing the current status of system development and identifying future directions for improvement. An indicator pool was established based on literature reviews and expert consultation. The indicator system was then refined and finalized through two rounds of the Delphi method, and the weights of the indicators were determined using the analytic hierarchy process.  The expert participation rate reached 100%, and the average expert authority coefficient was 0.87. The indicator coordination coefficient W was statistically significant (P<0.001). Ultimately, an evaluation system comprising 5 first-level indicators, 15 second-level indicators, and 39 third-level indicators were developed. The indicator system constructed in this study shows good expert consistency and credibility. It can effectively pinpoint key components of system development, providing a scientific foundation for optimizing resource allocation and supporting ongoing improvement.

中小学公共卫生体系评价指标构建 — 北京市，中国，2024–2025年

侯新宇¹，顾梅¹，赵婧萱¹，杨佳^1,#

1. 公共卫生学院，首都医科大学，北京，中国。

^# 通信作者：杨佳，yangjia@ccmu.edu.cn。

构建一套适用于北京市中小学公共卫生体系评价指标，为客观评价该体系建设现状与改进方向提供参考。基于文献研究和专家咨询建立指标池，该研究通过两轮德尔菲法筛选并确定指标体系，再借助层次分析法确定指标权重。专家积极系数为100%，权威系数均值为0.87，指标协调系数 W具有统计学显著性（P＜0.001），最终建立包含5个一级指标、15个二级指标、39个三级指标的评价体系。本研究所构建的指标体系具有良好的专家一致性和可信度，可有效识别体系建设中的关键环节，为优化资源配置和推动持续改进提供科学依据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.004

Student-Oriented Competency Building Module: Implications for the Improvement of Global Health Education

Chen Chen ¹, Hong Chen ², Xiaohua Wang ³, Wei Ding ^4,5, Jiayi Yang⁶, Yi Cai ^7,#

1. Department of Global Health, School of Public Health, Wuhan University, Wuhan City, Hubei Province, China;

2. Center for Global Public Health, Chinese Centers for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China;

3. Center for Project Supervision and Management, National Health Commission, Beijing, China;

4. National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China;

5. Université Côte d'Azur, ESPACE UMR 7300, Nice, France;

6. Secretariat Office of the Research Center on Building a Community with a Shared Future for Humanity, the Center for Global Biosecurity Governance, China Foreign Affairs University, Beijing, China;

7. Wuhan University Institute of International Law, Wuhan City, Hubei Province, China.

^# Corresponding authors: Yi Cai, yc131@whu.edu.cn.

In response to growing uncertainty in global health driven by geopolitical tensions, pandemics, and climate-related challenges, global health education must evolve to equip students with theoretical knowledge and core competencies, such as leadership, cross-cultural communication, and strategic thinking. This study reviews the updates to the International Health Project Management (IHPM) course and examines its three key changes: introducing a student-oriented teaching module, incorporating teamwork and role-play to promote autonomy and accountability; expanding geographic flexibility to encourage broader strategic thinking; and strengthening team dynamics through clearer role definitions and targeted support mechanisms. Students formed project teams, established internal regulations, and selected global health scenarios for project design. This revised approach fostered in-depth discussions that encouraged open-minded thinking, enabling students to move beyond disease-focused content to strategic systemic considerations. Greater group ownership also improved collaboration and accountability, addressing common teamwork challenges such as role confusion and uneven participation. However, the analytical depth varied depending on students’ disciplinary backgrounds. Finally, we argue that a tiered curriculum that moves from theory to capacity building can better support student growth. Overall, these findings highlight the potential of student-oriented approaches to strengthen leadership, cross-cultural communication, and strategic-thinking, competencies essential for contributing to a shared future for global health.

学生导向的胜任力建设模式：改进全球健康教育的启示

陈晨¹，陈虹²，王晓华³，丁玮^4,5，杨嘉宜⁶，蔡毅^7,#

1. 全球健康系，公共卫生学院，武汉大学，武汉市，湖北省，中国；

2. 全球公卫中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

3. 国家卫生健康委项目资金监管服务中心，北京，中国；

4. 寄生虫病预防控制所（中国热带病研究中心），中国疾病预防控制中心，上海，中国；

5. 法国蔚蓝海岸大学，尼斯，法国；

6. 人类命运共同体研究中心秘书处，外交学院，北京，中国；

7. 国际法研究所，武汉大学，武汉市，湖北省，中国。

^# 通信作者：蔡毅，yc131@whu.edu.cn。

在地缘政治紧张、传染病大流行与气候风险叠加的背景下，全球健康教育需同时强化理论学习与领导力、跨文化沟通、战略思维等核心胜任力。本研究基于全球健康本科《国际卫生项目管理》课程更新，总结三项改革：一是引入以学生为中心的教学模块，通过团队合作与角色扮演提升自主性与责任意识；二是拓展项目情境的地理选择，促进更广视角的战略性思考；三是以清晰的岗位职责和配套支持机制，强化团队运行。实施中，学生自组团队、制定规则并开展情景化项目设计，课堂讨论更深入，思考从“疾病导向”扩展到系统与策略层面；团队共同责任感提升了协作与问责，缓解了角色混乱与参与不均。但学生的分析深度受学科背景影响。我们建议构建“理论—能力建设”的分层课程体系，以更好支持学生成长。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.001