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

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.