Africa Health Security Index Shows Progress But Critical Gaps Remain

A new assessment of health security across Africa reveals a continent that has made genuine strides in preparing for disease outbreaks—yet remains dangerously unprepared. The Africa Health Security Index, released this week as Central Africa grapples with an active Ebola outbreak, measured all 54 African nations against 190 benchmarks covering everything from laboratory capacity to disease surveillance systems to the political will to respond to crises. The results are mixed in a way that matters: progress is real and measurable, but the gaps that remain could transform a contained outbreak into a continental catastrophe.

The numbers tell a story of momentum interrupted by persistent weakness. Over the past five years, African governments and their international partners have invested heavily in health security infrastructure in the wake of COVID-19. That work has paid off. The continent is nearly 30 percent better prepared than it was half a decade ago. Fifty-two of the 54 countries assessed showed improvement. Yet the average preparedness score across Africa sits at just 41.5 out of 100—a number that sounds less like progress and more like a warning. No single country achieved adequate overall preparedness. The index was developed by a coalition of African research organizations, global health experts, and security analysts specifically to measure African priorities rather than impose external standards, and it shows a continent that has built momentum but not yet reached safety.

The most alarming findings concern the infrastructure that prevents biological accidents and deliberate threats. Biosecurity capacity averaged 14.9 out of 100. Biosafety—the protocols that keep dangerous pathogens contained—averaged 18.2. The capacity to oversee dual-use research, work that could theoretically be weaponized, barely registered at 1.9 out of 100. This matters because African nations are expanding their laboratory infrastructure rapidly. New facilities are coming online across the continent. But the safety systems and security protocols that should accompany those labs are lagging far behind. Lab capacity is growing faster than the ability to keep what's inside those labs from escaping or being misused.

Other areas show more encouraging trajectories. Fifty-three of 54 countries have expanded their ability to detect disease outbreaks through biosurveillance. Wastewater surveillance—a tool that proved invaluable during COVID-19—now operates in 52 countries. Genomic sequencing, the ability to identify and track virus variants, exists in 48 countries. These are the systems that catch outbreaks early, before they spread. Yet even here, progress masks uneven capacity. Some countries have mature, well-resourced programs. Others have the infrastructure but lack the funding or training to operate it effectively.

A different kind of gap emerged in medical countermeasures—vaccines, therapeutics, and treatments. African nations have built stronger capacity to develop these tools, with an average score of 56.5 out of 100. But deploying them during an emergency is another matter entirely. The deployment score averages just 20.7 out of 100. Eighty-five percent of countries have an agency to approve new vaccines or drugs. Only 22 percent have concrete plans for how to manufacture, distribute, and administer those tools at scale when a crisis hits. The ability to make something is not the same as the ability to get it to the people who need it.

Regional cooperation has strengthened, though unevenly. The number of countries meeting staffing standards for field epidemiologists—the boots-on-the-ground disease detectives—has nearly doubled. Fifty-two countries now have Emergency Operations Centres, the command centers that coordinate outbreak response. Thirty-six countries have formal agreements with animal health agencies, recognizing that most emerging diseases jump from animals to humans. Yet only eight countries are tracking where the most dangerous pathogens are stored. The infrastructure exists in pieces, but the connections between those pieces remain fragile.

Financing presents a shadow over these gains. The average score for health security financing commitments dropped from 52.5 to 50.5 out of 100. Eighteen countries no longer show evidence of active, sustained funding for health security work. Seven new countries have stepped up their commitments, but the net movement is backward. International development assistance for health is declining globally. African governments will need to prioritize domestic resources for health security, but many face competing demands and limited budgets. The question now is whether the progress of the past five years can be sustained without the external funding that helped build it.

The timing of this index release—amid an active Ebola outbreak in Central Africa—underscores what's at stake. The gaps identified in the assessment are not theoretical. They are the difference between a contained outbreak and a spreading one, between a regional crisis and a continental emergency. African leaders now have evidence of where their systems are strong and where they are vulnerable. The challenge is whether they will use that evidence to drive investment and policy change, or whether the momentum of recent years will slow as funding tightens and attention drifts.