Draft, not yet released. In stewardship review. Not indexed until the first approved release.

Risks and capability

Four health risk objects open the portfolio. Order carries no rank. Each is read across driver, exposure, vulnerability, capacity, cascade and consequence.

6 min read0 figures1 table20 notesNR-SECTOR-HEALTH-GLOBAL-2026-BASELINE

Contents
  1. ·Edition home
  2. ·Executive summary
  3. 1Health is where the systems meet
  4. 2Key findings
  5. 3Systems and sectors at baseline
  6. 4Risks and capability
    1. 4.1 Risk objects
    2. 4.2 Capability ladder
  7. 5Outbreak, funding gap and heat season in fragile health systems
  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

4.1Risk objects

Each risk is read across the chain from hazard to consequence, with its status and evidence-quality level.

  1. ReportedEQL 4RSK-GS04-GOV-001

    Epidemic-prone zoonotic outbreak with cross-border spread

    Driver
    Bundibugyo virus disease, with no authorised vaccine or treatment56
    Exposure
    affected provinces, border countries, health workers and travellers
    Vulnerability
    late detection: WHO notes a continuing high rate of deaths in communities56
    Capacity
    contact tracing, IHR temporary recommendations, treatment trial2556
    Cascade
    BIO → HLT → FIN, TRD
    Horizon
    1 to 2 years

  2. ReportedEQL 4RSK-GS04-FIN-002

    Health financing contraction

    Driver
    reductions in development assistance for health403
    Exposure
    low-income and lower-middle-income countries; HIV, TB and immunisation programmes
    Vulnerability
    about 70% of 108 WHO country offices reported disruption; 24% reported higher out-of-pocket costs3
    Capacity
    domestic HIV funding rose 4% in 20257; domestic resource mobilisation
    Cascade
    FIN → HLT → FOO, DAT
    Horizon
    1 to 5 years

  3. ReportedEQL 4RSK-GS04-HLT-003

    Antimicrobial resistance

    Driver
    misuse of antibiotics, weak infection control and poor access to diagnostics10
    Exposure
    bloodstream, urinary and gastrointestinal infections; surgery and neonatal care
    Vulnerability
    resistance exceeds 70% for third-generation cephalosporins in some pathogens in the African Region11
    Capacity
    surveillance in 104 reporting countries; UN target of a 10% cut in deaths by 20301110
    Cascade
    HLT → FIN, FOO
    Horizon
    1 to 10 years

  4. InferredEQL 3RSK-GS04-CLI-004

    Heat and climate-sensitive disease

    Driver
    rising heat exposure and an El Niño event with a graded WHO response29
    Exposure
    older people, pregnant women, newborns, outdoor workers30
    Vulnerability
    facility cooling and power are not consolidated here
    Capacity
    national health adaptation plans and early warning systems growing29
    Cascade
    CLI → HLT → FOO, FIN
    Horizon
    1 to 5 years

4.2Capability ladder

Existence is not readiness. Each of the fifteen capability functions is placed on the ladder by the strongest public evidence for health at the global level.

Table 4.1Capabilities on the ladder of evidence: listed, exists, demonstrated, tested
FunctionRungLevelStrongest public evidence at baseline
Prevention and mitigationEXISTSvaccination averted an estimated 59 million measles deaths since 2000; coverage is below targets98
Monitoring and observationADEQUATE195 of 196 States Parties reported IHR capacity; surveillance scored 80; cause of death is known for about one third of deaths31
Early warningEXISTSoutbreak notices and an IHR Emergency Committee; heat-health indicators launched in October 2026562530
Preparedness and planningEXISTSIHR amended in 202523; post-close, context only: UN political declaration in October 202622
Redundancy and reservesLISTEDstockpiles of vaccines and treatments are not consolidated here; oral cholera vaccine output rose to about 80 million doses35
ResponseDEMONSTRATEDoutbreak response in the Democratic Republic of the Congo and 71 million cholera vaccine doses authorised5635
Continuity of critical servicesLISTEDservice disruption reported by about 70% of 108 country offices3
RecoveryEXISTSlife expectancy has not fully recovered since the pandemic; female life expectancy has1
AdaptationEXISTSnational health adaptation plans and early warning systems increasing29
Social protectionLISTED2.1 billion people with financial hardship; protection by country is not consolidated here2
Finance and insuranceEXISTShealth spending about 10.1% of world GDP in 2023; aid falling4240
Institutional coordinationEXISTSQuadripartite One Health plan; 73% of reports use multisectoral approaches193
Technical infrastructureLISTEDchemical events preparedness scored 53; laboratory and facility coverage is not consolidated here3
WorkforceEXISTSdensity 67.9 per 10 000; shortage of 11.1 million projected by 203039
Research capacityDEMONSTRATEDa treatment trial enrolling confirmed cases during the outbreak25; post-close, context only: a vaccine trial launched on 23 October 202624
A capability listed in policy is not a tested one; each rung is the strongest public evidence at baseline.

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. 56WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (25 September 2026, data to 23 September 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
  2. 25WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo (28 August 2026, data to 26 August 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
  3. 40Apeagyei, A.E. et al., Tracking development assistance for health, 1990 to 2030: historical trends, recent cuts, and outlook, The Lancet, 2025; abstract read through Europe PMC. Institute for Health Metrics and Evaluation, Seattle. Observation year 2025 (estimate). Accessed 2026-11-03.back
  4. 3UN DESA Statistics Division (ed.), The Sustainable Development Goals Report 2026, Goal 3 storyline, Good health and well-being. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
  5. 7UNAIDS (ed.), Global HIV and AIDS statistics, fact sheet (2026 data release of 27 July 2026). Joint United Nations Programme on HIV/AIDS, Geneva. Observation year 2025. Accessed 2026-11-03.back
  6. 10WHO (ed.), Antimicrobial resistance, fact sheet (16 July 2026). World Health Organization, Geneva. Observation year 2023 (resistance) and 2022 (antibiotic use). Accessed 2026-11-03.back
  7. 11WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release on the Global antibiotic resistance surveillance report 2025 (13 October 2025). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
  8. 29POST-CLOSE, context only: WHO (ed.), Climate change is a growing health emergency, Lancet Countdown warns, departmental update summarising the 2026 Lancet Countdown on Health and Climate Change (28 October 2026; the report itself was not opened; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
  9. 30POST-CLOSE, context only: WHO, WMO, UNICEF and UNFPA (eds.), New global framework launched to track increasing health risks of extreme heat for pregnant women, newborns and children, news release (21 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
  10. 9WHO (ed.), Measles, fact sheet (15 July 2026). World Health Organization, Geneva. Observation year 2024 (deaths) and 2025 (coverage). Accessed 2026-11-03.back
  11. 8WHO (ed.), Immunisation coverage, fact sheet (15 July 2026; estimates with UNICEF). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  12. 1WHO (ed.), World Health Statistics 2026: A visual summary and report page (monitoring health for the SDGs, 13 May 2026). World Health Organization, Geneva. Observation year 2023 (deaths and life expectancy). Accessed 2026-11-03.back
  13. 23WHO (ed.), International Health Regulations: amendments, questions and answers (1 October 2024). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
  14. 22POST-CLOSE, context only: WHO (ed.), WHO welcomes adoption of United Nations political declaration on pandemic prevention, preparedness and response, news release (12 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva and New York. Observation year 2026. Accessed 2026-11-03.back
  15. 35WHO (ed.), WHO reports latest global trends in cholera, meningitis and plague, news release (29 September 2026). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  16. 2WHO (ed.), Universal health coverage (UHC), fact sheet (5 December 2025). World Health Organization, Geneva. Observation year 2023 (service coverage) and 2022 (financial hardship). Accessed 2026-11-03.back
  17. 42DATA VINTAGE AFTER CLOSE: World Bank (ed.), World Development Indicators, data service queried for current health expenditure (percentage of GDP), out-of-pocket expenditure and physicians per 1 000 people, world aggregate (database updated 2026-10-08). World Bank, Washington. Observation year 2023 (spending) and 2022 (physicians). Accessed 2026-11-03.back
  18. 19FAO, UNEP, WOAH and WHO (eds.), One Health Joint Plan of Action (2022 to 2026): working together for the health of humans, animals, plants and the environment, publication page (14 October 2022). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03.back
  19. 39POST-CLOSE, context only: WHO (ed.), One in four doctors nearing retirement age as WHO warns of global health workforce gap, news release on National health workforce accounts: health workforce levels and trends 2026 (19 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
  20. 24POST-CLOSE, context only: WHO (ed.), Disease Outbreak News: Ebola disease caused by Bundibugyo virus, Democratic Republic of the Congo, Kenya and Nigeria (23 October 2026, data to 20 October 2026; released after the 30 September evidence close and cited as the position at access). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

Cite this chapter

Valadbaygi, S. (Ed.). (2026). Chapter 4: Risks and capability. In Global Health Risk and Resilience Report 2026: Baseline Edition, The State of the World’s Health and One Health System. (Baseline Edition 2026, Report No. NR-SECTOR-HEALTH-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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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

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