Low scoring IHR core capacities in low-income and lower-middle-income countries, 2018–2020

Using publicly available SPAR data, we retrospectively reviewed scores from 2018 to 2020 among 73 WHO SPs who met World Bank classification as LIC or LMIC.4 SPAR data after 2020 were excluded due to indicator changes in the second edition being incomparable to previous years.5 SPAR scores were available for 13 core capacity areas composed of 1–3 individually scored indicators. Health service provision The health service provision capacity area consists of three indicators: case management, infection prevention and control (IPC)/water, sanitation and hygiene (WASH) standards and access to essential health services. Points of entry PoE capacity indicators showed improvement with fewer SPs at lower level 1 (PoEs identified for public risk assessment and PoE public health emergency contingency plan in development) and level 2 (some designated PoEs implementing routine core capacities with competent authorities and developed public health emergency contingency plans for biological hazards) in 2020 (47 to 36 SPs). Similar to the health service provision case management indicator, PoE capacity level 4 requires expansion of capacities and contingency plans to all-hazards events, of which only nine SPs had achieved by 2020.