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EIU study: Singapore ill-prepared to stand against disease outbreak, more so than Malaysia and Thailand

According to the Economist Intelligence Unit (EIU) report, Singapore is less prepared compare to neighbouring countries such as Thailand and Malaysia to stand against a major infectious disease outbreak. EIU highlighted this as it published the Global Health Security (GHS) Index on Friday (25 Oct).

Of the 195 countries studied, 13 countries, including South Korea and Thailand obtained the top scores, which suggest that there is no country that can fully withstand and deal with major deadly disease outbreaks such as Ebola.

With an index score of 58.7 of 100, Singapore ranked 24th of the 195 countries. A higher index score is indicative of a better state of preparation, according to the EIU study.

South Korea ranked 9th at 70.2 score, Malaysia ranked 18th at 62.2 score and Thailand ranked 6th and 73.2. The top 13 nations obtained scores of at least 67 on the index.

For the 195 countries, the average overall GHS Index score was 40.2.

The three top ranking countries are the US at 83.5, Britain at 77.9 and Netherlands at 75.6.

The average score for high-income countries was 51.9, which shows that on the whole, countries are ill-prepared to deal with large-scale pandemics and epidemics.


The EIU study assessed the national health security capacities and capabilities by having the 195 countries answer 140 detailed questions, from which their level of preparedness could be gauged.

The six scoring parameters include: prevention, detection, response, health system, commitment to improve, and vulnerability to biological threats.

The first category, prevention, is defined as the prevention of the emergence or release of pathogens. Singapore ranked 23 with a score of 56.2.

The second category, early detection and reporting, is defined as the detection and reporting for epidemics of potential international concern, which can spread beyond national or regional borders. Singapore ranked 40 with a score of 64.5.

The third category, rapid response, is defined as the rapid response to, and the mitigation of, the spread of an epidemic. Singapore ranked 11 with a score of 64.6.

The fourth category, health system, is defined as a country having a sufficient and robust health system to treat the sick in the event of an outbreak and protect health workers. Singapore ranked 38 with a score of 41.4.

The fifth category, compliance with international norms, is defined as a country’s commitments to improving national capacity, financing plans to address gaps, and adhering to global norms. Singapore ranked 101 with a score of 47.3.

The sixth category, risk environment is defined as a country’s overall risk environment and country vulnerability to biological threats. Singapore ranked 15 with a score 80.9.


For biosafety, Singapore obtained full score with an index of 100, with the global average at 22.8. For biosecurity, Singapore scored rather low at 28, but this score is still higher than the global average of 16. Biological accidents is denoted by biosafety where as possible deliberate acts involving biological agents is denoted by biosecurity.

For the oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential, along with other dual-use research, Singapore scored zero. Most countries similarly scored low as well, with the average global score at 1.7.

Another two aspects the country did well was data integration between the human, animal and environmental health sectors with a score of 100 when the global average was 29.7. Added to this, for laboratory systems, Singapore scored 83.3 when the global average was 54.4.

Regarding epidemiology workforce, which is the branch of medicine pertaining to the incidence, distribution and possible control of diseases and other factors relating to health, Singapore scored 25, which was significantly below the global average of 42.3.

In addition to all of this, the country scored zero for the incidence, distribution and possible control of diseases and other factors relating to health, compared to the 54.4 global average.


The EIU also found that a country’s wealth does not affect the strength of health security conditions. In fact, many factors, such as a strong disease surveillance system and effective governance do lead to stronger health security conditions. For instance, not less than 100 middle and high-income countries scored less than 50 in the index.

The EIU study also found that in 2019, there was no evidence among 85 per cent of countries of them having completed a biological threat-focused simulation exercise with the World Health Organisation (WHO).

Less than 5 per cent of countries are also found to have a national requirement to annually test their emergency operations centres in response to a health emergency.

Major security and political risks adversely affect national capability to combat biological threats in more than half of the surveyed countries as they are “clear barriers to effective response”.

Those who obtained the top score for indicators pertaining to government effectiveness and political system account for only 23 per cent of countries, which further accounts for about 14 per cent of the world’s global population.


The EIU highlighted that the frequency of epidemics occurrence has increased.

From 2014 to 2016, the World Health Organisation figures that more than 11,000 people died due to the Western Africa Ebola epidemic. From 2018 to 2019, the Ebola epidemic killed 2,100 people in the Democratic Republic of the Congo.

“These emergencies and others, including the Zika epidemic in 2015-16, highlight the need to understand how countries can better prepare to face these threats,” the EIU report stated.

Championing the tenet that “A threat anywhere is a threat everywhere”, the index is a barometer for global preparedness.

In this modern day of global mobility through air travel, deadly infectious diseases can travel quickly which enables a pandemic outbreak to “spread across the world in a matter of hours.”

The EIU’s senior global adviser for public policy, Leo Abruzzese remarked that “The index is specific enough to provide a roadmap for how countries can respond, and gives donors and funders a tool for directing their resources.” He added that without a way of identifying gaps within the system, there is excess vulnerability.


According to the Ministry of Health (MOH) spokesperson on Friday (24 Jan), the ministry is currently reviewing the report.

“An independent assessment by the World Health Organization and other international experts under the Joint External Evaluation that Singapore underwent in April 2018 had unanimously agreed that Singapore has demonstrated strong leadership and a highly developed capacity to detect and respond to potential public health emergencies…Nevertheless, we will continue to strengthen our capabilities to prevent, detect and respond promptly and effectively to public health threats, and address any gaps that may exist,” he concluded.

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