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Systems and sectors at baseline

6 min read0 figures2 tables16 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

Contents
  1. ·Edition home
  2. ·Executive summary
  3. 1Health threats cross every line
  4. 2Key findings
  5. 3Systems and sectors at baseline
    1. 3.1 Where each system stood at evidence close
    2. 3.2 Domain posture
    3. 3.3 Sector screens
  6. 4Risks and capability
  7. 5High-consequence outbreak that overlaps reduced financing and thin surveillance
  8. 6Readings from the other desks
  9. 7The 2027 agenda
  10. 8Systems in depth
  11. AMethodology
  12. BData appendix
  13. CReferences and record
  14. ·Complete edition, for print

3.1Where each system stood at evidence close

HLT · Outbreak

Confirmed Ebola Bundibugyo cases, DRC

8,116

to 27 September 2026; 3,924 deaths.

Reported2026ECDC47

HLT · Rules

States Parties rejecting the 2024 IHR amendments

11of 196

in force from 19 September 2025.

Reported2025WHO4

HLT · Immunity

Zero-dose children

13.5million

two-dose measles coverage 77%.

Reported2025WHO8

BIO · Resistance

Bacterial infections resistant to treatment

1 in 6

laboratory-confirmed infections.

Reported2023WHO6

FIN · Financing

Development assistance for health

39USD billion

51% below the 2021 peak.

Reported2025IHME22

SYS · Treaty

Pandemic Agreement annex, next decision point

May 2027

or a special session in 2026.

Reported2026WHO3

3.2Domain posture

Each of the twelve coupled domains is read through health security, in words, not scored. The coupling column names the dependency that carries health security risk into each domain.

Table 3.1Each domain read in words, not scored
DomainPosture at baselineCouplingStatus
WATCholera killed 7,870 people in 47 reporting countries in 2025; water and sanitation failure carries disease.WAT → HLTReported EQL 4
ENEHealth facilities and cold chains depend on power; no consolidated series here.ENE → HLTInferred EQL 2
FOOFood safety and nutrition shape outcomes; no consolidated series here.FOO → HLTExpert input EQL 2
HLTThe core system: 8,116 confirmed Ebola cases in the DRC; 13.5 million zero-dose children.the core systemReported EQL 4
BIOOver 60% of emerging infectious diseases reported globally come from animals.BIO → HLTReported EQL 3
CLIDengue reached 14.6 million cases in 2024; the link to climate is not read here.CLI → HLTInferred EQL 2
INFLaboratories, transport and communications carry samples and supplies; no consolidated series here.INF ↔ HLTInferred EQL 2
FINAid for health fell to USD 39 billion in 2025; TB needs USD 22 billion a year.FIN → HLTReported EQL 3
DAT48% of countries did not report resistance data in 2023; incident data are not on a common basis.DAT ↔ HLTReported EQL 4
AICComputational tools for surveillance and design of biological agents; not read in this edition.AIC → HLTExpert input EQL 2
MINMedical supply chains depend on minerals and materials; chokepoint data sit in sibling editions.MIN → HLTInferred EQL 2
TRDWHO advised against travel and trade restrictions during the 2026 Ebola outbreak.HLT ↔ TRDReported EQL 3

3.3Sector screens

All sixteen sectors are screened for their dependence on health security, on the same grammar as every national edition. The evidence column describes coverage of the baseline evidence, not the performance of the sector.

Table 3.2Sectors: baseline evidence and the exposure to watch
CodeSectorBaseline evidenceExposure to watchEvidence coverage
GS-00Cross-systemhealth threats cross people, animals and borders1347outbreak with thin financingPARTIAL
GS-01Watercholera deaths highest since 199910sanitation failurePARTIAL
GS-02Energyfacilities and cold chains depend on poweroutage during outbreakTHIN
GS-03Food and agrifoodfood safety and animal diseasezoonotic spilloverTHIN
GS-04HealthEbola, mpox, measles, resistance47596concurrent emergenciesGOOD
GS-05Finance and economyaid for health USD 39 billion22financing shockPARTIAL
GS-06Developmentzero-dose children 13.5 million8weak routine immunisationGOOD
GS-07Climatedengue 14.6 million cases in 202411vector rangeTHIN
GS-08Disasteroutbreaks as compound disasters16concurrent hazardsPARTIAL
GS-09Infrastructuretransport and laboratories link outbreak zonesaccess and sample transportTHIN
GS-10CitiesKampala cases in 202626urban spreadTHIN
GS-11Biodiversityanimal origin of over 60% of emerging diseases13habitat and wildlife contactPARTIAL
GS-12Earth observationenvironmental data for spillover riskdata linksTHIN
GS-13Cyber and digitalresistance data missing for 48% of countries6surveillance data gapsPARTIAL
GS-14PolicyIHR amendments and Pandemic Agreement annex43ratification and complianceGOOD
GS-15Sciencespillover and emergence science is mature394041data at operating scalePARTIAL

Notes

Numbers are the edition’s reference numbers, so a note reads the same in every chapter. The full list, with every source and its licence, is in Annex C. Annex C, references

  1. 47ECDC (ed.), Ebola disease outbreak caused by Bundibugyo virus, Democratic Republic of the Congo, update of 30 September 2026 (cases up to 27 September 2026: 8,116 confirmed and 3,924 deaths; seven provinces; 63 of 167 health zones; Uganda 20 confirmed cases). European Centre for Disease Prevention and Control, Stockholm. Observation year 2026. Accessed 2026-11-03.back
  2. 4WHO (ed.), Amended International Health Regulations enter into force, news release of 19 September 2025 (11 of 196 States Parties rejected; pandemic emergency level; National IHR Authorities). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  3. 8WHO (ed.), Immunisation coverage, fact sheet (WUENIC estimates for 2025, released 15 July 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  4. 6WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release of 13 October 2025 on the Global antibiotic resistance surveillance report 2025 (data year 2023; 104 reporting countries). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
  5. 22IHME (ed.), Financing Global Health 2025, news release of 15 July 2025 (development assistance for health USD 39 billion in 2025; USD 80 billion peak in 2021; US financing down 67%), read through a syndicated release. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025. Accessed 2026-11-03.back
  6. 3WHO (ed.), Seventy-ninth World Health Assembly daily update, 19 May 2026 (decision to continue the annex negotiations; outcome to the Eightieth Assembly in May 2027 or a special session in 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
  7. 13WHO (ed.), One Health, fact sheet (Quadripartite; over 60% of emerging infectious diseases reported globally come from animals). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  8. 10WHO (ed.), Cholera, fact sheet (451,499 cases and 7,870 deaths reported from 47 countries in 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  9. 5WHO (ed.), Fifth meeting of the International Health Regulations (2005) Emergency Committee regarding the upsurge of mpox 2024, statement published 30 October 2025 (Director-General determination of 5 September 2025). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  10. 9WHO (ed.), Measles, fact sheet (95,000 deaths in 2024; coverage in 2025; page dated 15 July 2026). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
  11. 11WHO (ed.), Dengue and severe dengue, fact sheet of 21 August 2025 (more than 14.6 million cases in 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
  12. 16Global Preparedness Monitoring Board (ed.), A World on the Edge: Priorities for a Pandemic-Resilient Future, 2026 report (reports page read; six emergencies of international concern in the past decade). GPMB, Geneva. Observation year 2026. Accessed 2026-11-03.back
  13. 26WHO (ed.), Disease Outbreak News 2026-DON612, 3 July 2026 (1,481 confirmed cases and 454 deaths; one imported case in France). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
  14. 39UNVERIFIED, not opened: Jones, K.E. et al., Global trends in emerging infectious diseases, Nature 451, 990 to 993, 2008, cited from memory. Springer Nature. Observation year 2008. Accessed 2026-11-03.back
  15. 40UNVERIFIED, not opened: Allen, T. et al., Global hotspots and correlates of emerging zoonotic diseases, Nature Communications 8, 1124, 2017, cited from memory. Springer Nature. Observation year 2017. Accessed 2026-11-03.back
  16. 41UNVERIFIED, not opened: Carlson, C.J. et al., Climate change increases cross-species viral transmission risk, Nature 607, 555 to 562, 2022, cited from memory. Springer Nature. Observation year 2022. Accessed 2026-11-03.back

Cite this chapter

Valadbaygi, S. (Ed.). (2026). Chapter 3: Systems and sectors at baseline. In Strategic Systems Report 2026: Health Security, One Health and Biosecurity (Baseline Edition 2026, Report No. NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE) [Draft under review]. The Global Centre for Risk and Innovation (GCRI).

Every citation form of the whole report, BibTeX and RIS included, is on the edition home. Cite this report

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Sector signature

The sectors behind Health Security, One Health and Biosecurity.

A reading aid: the sectors the findings run through and how strongly they depend on each other.

Select corners · hover lines6 / 15 relations

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Health and its partners

Health gives workforce for operations to infrastructure (0.3), farm labour to food (0.3) and utility workforce to water (0.2).

W · E · I · F · H · B

Sectors
4 of 6
Relations
6 of 15
Coupling
0.42 share of total

Strongest relations in play

  • Water → Food · irrigation0.8
  • Food → Health · nutrition0.7
  • Infrastructure → Water · pipes, dams and treatment works0.6
  • Water → Health · drinking water and sanitation0.7
Teaching values for a typical city-region, not measurements for any place. Coupling is the summed strength of the relations in play, as a share of all fifteen.
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