Tracking Health Security Progress and Building Resilience in Africa

“What gets measured gets done.” This principle is widely embraced in public health and global health security. Data helps leaders make informed decisions, prioritize investments, and strengthen accountability.

The 2026 Africa Health Security (AHS) Index was developed with that principle and goal in mind. This independent assessment of health security capacities across Africa provides leaders with evidence so they can direct resources and strengthen resilience against future epidemic and pandemics threats.

To mark the release of the Index, NTI, the Brown University Pandemic Center, Economic Enterprise, and Science for Africa Foundation hosted a discussion to highlight the Index’s findings. The conversation brought together African and global experts who outlined remaining capacity gaps and offered recommendations to advance health security across the continent.

Why the AHS Index matters 

As Africa faces increasingly complex health threats, including an ongoing Ebola outbreak in Central Africa, climate-driven health risks, and biosecurity concerns associated with advancing technologies, understanding preparedness gaps and opportunities for improvement has never been more important.

“My hope is that this Index will serve as a valuable tool for governments, partners, and donors across the region, helping guide public health investments that strengthen regional preparedness.”

— NTI President and CEO Christine E. Wormuth

Africa’s health security progress on display

African countries are making great progress by strengthening health systems and investing in core capacities:

• The average score was 41.5 out of 100, a 9.1-point increase from 32.4 in 2021
• Gains were recorded across the prevention, detection and reporting, rapid response, and health systems categories
• Fifty-two of the 54 African countries improved their overall scores by at least one point since 2021

However, there are several areas of shared vulnerability:

• The average score in the risk environment category has been on the decline since 2019, underscoring persistent security, infrastructure, and public health vulnerabilities
• Despite improvements, biosecurity and biosafety capacities remain a challenge across the continent, with average scores of 14.9 and 18.2 out of 100, respectively. This underscores a need to strengthen systems and investment
• The region remains vulnerable to climate change, with 54% of African countries at high or very high risk of economic disruption from natural disasters

Building sustainable health security capacities

Sustained progress and strengthened health security requires collective action from governments, regional organizations, funders, multilateral organizations, and the private sector. 

“The development of the Index was tailored to the African context, and it is encouraging to see significant improvements in regional health security capacities. The next important step is to ensure that these enhanced capacities are effectively implemented to counter the ever-evolving health security threats.”

— Shanelle Hall, principal advisor to Director General H.E. Dr. Jean Kaseya of the Africa Centres for Disease Control

To help guide these efforts, the Index offers several recommendations, including:

• Ensuring future investments in infectious disease research, pandemic preparedness, and response includes dedicated biosafety and biosecurity resources and training
• Strengthening pandemic preparedness financing through public commitments, domestic resources, global mechanisms such as the Pandemic Fund, and co-investment opportunities
• Expanding emerging surveillance networks and early warning and detection systems, including wastewater and environmental surveillance, while formalizing inter-country cooperation agreements to support outbreak response
• Developing harmonized emergency use authorization frameworks and sustainable medical countermeasure deployment capacities to accelerate access to health technologies and complement regional manufacturing efforts

Review the full list of recommendations

Built through partnership and collaboration

The Index is the result of a collaborative effort that combined global expertise with African leadership. This created an assessment that was tailored to the continent’s unique health security needs.

Developed by the Nuclear Threat Initiative (NTI), Economist Enterprise, the Brown University Pandemic Center and the Science for Africa Foundation, the Index builds on previous methodologies that were refined to incorporate regional priorities. The research findings were validated by the University of Tunis El Manar and the University of Witwatersrand. The AHS Index Reference Group — African public health and policy experts — provided strategic guidance, helping ensure the Index reflected the priorities and regional realities across the continent.

The AHS Index is an objective, evidence-based tool that helps countries and organizations set priorities and identify where investments can have the greatest impact.

As health threats become more complex and interconnected, maintaining momentum will require sustained investment, stronger partnerships, and continued political commitment.