Evidence-based health security: The nexus of governance and pandemic preparedness

Abstract

Background Pandemic preparedness continues to be an important focus of the global health security agenda. Many nations in the sub-Saharan African region remain at high risk for a major pandemic due to limited capacity and endemic co-morbid conditions in their populations. While the literature does suggest that state capacity influences health, no studies to date indicate an association between state capacity and pandemic disease distribution, particularly in the presence of other endemic diseases. Methods This mixed methods study will contribute to existing research by examining how economic and sociopolitical attributes of state capacity influence pandemic-prone disease distribution in sub-Saharan Africa. A convergent mixed methods design was used to collect and analyze quantitative state capacity attributes and prevention, and control using correlation in six sub-Saharan countries. Results of the quantitative study were triangulated through the use of an expert panel and results integrated for an overall interpretation and conclusion. Results Variables in the study showed statistically significant relationships between proxies of state capacity and the follow areas: control of pandemics and prevention of pandemics. The Expert Panel interviews illustrated convergence between the correlated results. Conclusions This study brought forward associations with expert confirmation suggestive of areas for national governments in sub-Saharan Africa to further review and improve. While many internal factors limit state capacity in these nations (e.g. human and fiscal resources), external funders may consider adding information from this study and other metrics to test progress. Key messages Evidence is valuable for pandemic preparedness planning. Nation state capacity is a factor in pandemic preparedness.