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Baseline Edition 2026
Complete edition

Strategic Systems Report 2026: Health Security, One Health and Biosecurity

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ReportsSR-08

Strategic Systems

Health Security, One Health and Biosecurity 2026

Baseline Edition 2026NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINEGCRI for the Nexus Consortium

Imprint

Editor: Saeed Valadbaygi, Chief Steward and Managing Editor, the Global Centre for Risk and Innovation (GCRI)
Publisher of record: The Global Centre for Risk and Innovation (GCRI) for the Nexus Consortium, Toronto
Report number: NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE
Evidence close: 30 September 2026, cut DC-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-B0
Status: Draft under stewardship review; not yet released
DOI and UNI: Issued at deposit
Licence: CC BY 4.0 for Nexus-authored text, tables and figures; third-party material keeps its own licence
Cite as: Valadbaygi, S. (Ed.). (2026). 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). https://therisk.global/nexus-reports/editions/sr-08/

Contents

·
Executive summary
1
Chapter 1. Health threats cross every line
2
Chapter 2. Key findings
3
Chapter 3. Systems and sectors at baseline
4
Chapter 4. Risks and capability
5
Chapter 5. High-consequence outbreak that overlaps reduced financing and thin surveillance
6
Chapter 6. Readings from the other desks
7
Chapter 7. The 2027 agenda
8
Chapter 8. Systems in depth
A
Annex A. Methodology
B
Annex B. Data appendix
C
Annex C. References and record

Health Security, One Health and Biosecurity 2026
Executive summary

Executive summary

The edition on a few pages: the abstract, the key messages, the headline finding and what each steward reads in it.

6 min read1 figure0 tables14 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

S.1Abstract

Health security is the capacity to prevent, detect and respond to health threats that cross borders and species. The 2025 and 2026 evidence shows the same mechanisms at work in very different events. An outbreak of Bundibugyo virus disease, declared a public health emergency of international concern in May 2026, had reached 8,116 confirmed cases and 3,924 deaths in the Democratic Republic of the Congo by 27 September 2026, with no licensed vaccine or specific treatment⁴⁷. The amended International Health Regulations entered into force on 19 September 2025, and 11 of 196 States Parties rejected them⁴. The annex that the Pandemic Agreement needs was still under negotiation after the 2026 World Health Assembly²³. About one in six bacterial infections was resistant to treatment in 2023⁶. Over 60% of emerging infectious diseases reported globally come from animals¹³. Development assistance for health fell to USD 39 billion in 2025, 51% below its 2021 peak, and the United States left WHO on 22 January 2026²²²¹. This baseline reads these events as mechanisms, not as a list. It ranks no country or agency, attributes no outbreak or release and recommends no policy.

S.2Key messages

Six readings that frame the health security baseline, and the eight questions this edition answers, each with its status and source.

Yes: animal origin, drug resistance, immunity gaps and weak water and sanitation recur across events.⁶¹⁰¹³
Do health threats have common causes?Reported
Across health zones, provinces and borders; one DRC outbreak reached Uganda and a case abroad.²⁶⁴⁷
How do outbreaks spread?Reported
Partly: the amended IHR are in force; the Pandemic Agreement annex is not agreed.³⁴
Is the rulebook in place?Reported
13.5 million zero-dose children in 2025.⁸
How large is the immunity gap?Reported
About one in six infections resistant; data are missing for 48% of countries.⁶
How serious is drug resistance?Reported
Aid for health fell to USD 39 billion in 2025.²²
Does money matter?Reported
Emergencies end, and new ones begin; countermeasures lag.⁵⁴⁷
What did mpox and Ebola show?Reported
An outbreak that overlaps reduced financing and thin surveillance. SCN-SR08-OUT-01
What will 2027 test first?Expert input

S.3Headline finding

ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-003

By 27 September 2026 the DRC had 8,116 confirmed cases of Bundibugyo virus disease and 3,924 deaths across seven provinces, and no licensed vaccine or specific treatment exists.

Figure S.1Bundibugyo virus disease in the DRC, to 27 September 2026

Item	Bar, scaled to the largest value	Value
Confirmed cases		8,116
Confirmed deaths		3,924

Source: ECDC⁴⁷. Cumulative confirmed counts with a cut-off of 27 September 2026; the outbreak was still active.

The count is large and still rising, and the response rests on tools that are not yet licensed. WHO assessed the risk as high at national and regional levels and low at global level in May 2026, and the Director-General found that the event was not a pandemic emergency²⁴. WHO advised against travel and trade restrictions²⁵.

S.4At a glance

8,116confirmed cases

Ebola, DRC⁴⁷

11 of 196States Parties

rejected IHR amendments⁴

13.5million

zero-dose children, 2025⁸

1 in 6infections

resistant, 2023⁶

>60%

emerging diseases from animals¹³

39USD billion

DAH, 2025²²

S.5What each steward reads in it

GCRI · KEY T

Technical Truth

The evidence supports reading health security as one connected system.

GRF · KEY M

Public Meaning

For most people a health threat arrives as a closed clinic, a missed vaccine or a drug that no longer works.

GRA · KEY F

Capital Meaning

Readiness implications only. Aid for health has fallen, large funding needs remain for diseases such as tuberculosis, and emergency funds were small against the Ebola response in May 2026.

NEXUS

Synthesis

Health-security risk is well described event by event and thinly measured as a system.

S.6What this edition is, and is not

What this edition is

A baseline: the 2026 state of the world’s health security, One Health and biosecurity systems and the couplings through which it carries risk into other systems. It synthesises published evidence and ranks no country, company or asset.

What it is not

Not a health-security ranking, a threat attribution, a clinical or public-health guideline, a biosafety disclosure or an assessment of any government, laboratory or health agency. Outbreak response, laboratory oversight and treaty compliance rest with competent authorities.

What comes next

National, regional and sector evidence feeds the 2027 health security edition through the federation. Each edition reports what changed against this baseline: observations, source revisions, method changes, scenario updates and corrections.

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

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
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
2WHO (ed.), WHO Member States agree to extend negotiations on the Pathogen Access and Benefit Sharing annex, news release of 1 May 2026 (resumed sixth meeting 27 April to 1 May 2026; seventh meeting 6 to 17 July 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
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
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
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
21US Department of Health and Human Services (ed.), HHS Fact Sheet: U.S. Withdrawal from the World Health Organization (Executive Order 14155 of 20 January 2025; effective 22 January 2026), hosted on the CDC site. HHS, Washington. Observation year 2026. Accessed 2026-11-03.back
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
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
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
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
24WHO (ed.), WHO Director-General’s opening remarks at the media briefing on Ebola outbreak in DRC and Uganda, 20 May 2026 (Bundibugyo virus; not a pandemic emergency; Contingency Fund for Emergencies). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
25POST-CLOSE, context only: WHO (ed.), Disease Outbreak News 2026-DON607, 13 June 2026 (695 confirmed cases; risk assessment; continental response plan June to November 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

Health Security, One Health and Biosecurity 2026
Chapter 1

Health threats cross every line

Part I describes systems and their couplings. It ranks no country or operator and assesses no authority.

5 min read2 figures1 table10 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

1.1The questions this part answers

Key questions

Where is health security risk concentrated?
Which couplings carry health security shocks into other systems?
Which health security capabilities hold under compound stress?
What must 2027 evidence measure first?

In this part

Narrative
Headline finding
Lead figure
Five mechanism chapters
Twelve-domain reading
Sector screens
Dependency matrix
Risk objects
Capability ladder
Scenario
Three lenses
Portfolio

1.2The argument

Health security is usually reported by disease: Ebola, mpox, measles, resistant infections, bird flu. The 2025 and 2026 evidence reads them as one connected system. Animals pass infections to people, people carry them across borders, and health services decide whether a local outbreak stays local¹³⁴⁷.

The causes repeat. Over 60% of emerging infectious diseases reported globally come from animals¹³. Dengue reached 14.6 million reported cases in 2024¹¹. Cholera killed 7,870 people in 47 reporting countries in 2025, the highest toll since 1999¹⁰. Resistance rose across over 40% of monitored pathogen and drug combinations from 2018 to 2023⁶.

The response base is uneven. Development assistance for health fell to USD 39 billion in 2025, 51% below its 2021 peak²². The United States left WHO in January 2026²¹. The Pandemic Agreement annex is not agreed³. Meanwhile no licensed vaccine or specific treatment exists for Bundibugyo virus, the cause of the largest outbreak in this evidence set⁴⁷.

The edition therefore asks the same four questions of every event: what was the common cause, how did it spread, what was shared, and what threshold was crossed. It makes no attribution and ranks no country or agency.

Figure 1.1How far has development assistance for health fallen? USD billion

Aid for health in 2025 stood about half of its 2021 peak, with US financing falling 67% in 2025. The estimate is preliminary²².

Item	Bar, scaled to the largest value	Value
2021 peak		80
2025 preliminary estimate		39

Source: as cited in the note to this figure. Year 2025.

Figure ID FIG-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-01-003

39USD billion

development assistance for health, 2025²²

80USD billion

record level, 2021²²

51%

fall from the 2021 peak²²

67%

fall in US financing, 2025²²

1.3Twenty couplings between five systems

The health security-centred matrix types the twenty couplings between the five core systems, read for their health security content. Strengths are Nexus estimates (ESTIMATED) from the cited evidence and analogue events; they set the graph that 2027 evidence will test.

Figure 1.2Couplings between the five systems

Each line is one coupling from one system to another, drawn by the strength the edition assigns. Strengths are Nexus estimates from the cited evidence and analogue events.

Strong
Moderate
Weak

Source: this edition’s coupling matrix (Table 1.1); status Estimated.

Table 1.1Coupling matrix: from the row system to the column system
From, to	WAT	ENE	FOO	HLT	BIO
WAT Water	·	WEAK hydropower	MODERATE irrigation · food safety	STRONG cholera · safe supply	WEAK flows
ENE Energy	MODERATE pumping · treatment	·	MODERATE cold chain	STRONG facilities · vaccine cold chain	WEAK land use
FOO Food	WEAK withdrawals	WEAK bioenergy	·	STRONG nutrition · food safety · resistance	MODERATE land conversion · livestock
HLT Health	WEAK workforce	WEAK workforce	WEAK labour	·	WEAK residues
BIO Biodiversity	WEAK contamination	WEAK hydrology	MODERATE animal disease · pests	STRONG zoonoses	·
Strength: strong, moderate or weak; a Nexus estimate (status Estimated) from cited evidence and analogue events. The scale is defined in Annex A.

Transmission paths

01
BIO → HLT
An animal reservoir passes a pathogen to people, and local transmission begins.
Reported Marburg and Ebola outbreaks¹⁹⁴⁷
02
HLT → TRD
Travel and trade restrictions follow an outbreak although WHO advises against them.
Reported Ebola 2026²⁵
03
FIN → HLT
Falling aid weakens surveillance and response.
Inferred IHME 2025²²
04
WAT → HLT
Water and sanitation failure sustains cholera.
Reported cholera 2025¹⁰
05
FOO → HLT
Resistance in food and clinical settings limits treatment.
Inferred GLASS 2025⁶

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

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
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
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
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
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
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
21US Department of Health and Human Services (ed.), HHS Fact Sheet: U.S. Withdrawal from the World Health Organization (Executive Order 14155 of 20 January 2025; effective 22 January 2026), hosted on the CDC site. HHS, Washington. Observation year 2026. Accessed 2026-11-03.back
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
19WHO (ed.), Marburg virus disease, fact sheet (case fatality 24% to 88% in past outbreaks; Rwanda 2024: 66 cases and 15 deaths; fruit bat host). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
25POST-CLOSE, context only: WHO (ed.), Disease Outbreak News 2026-DON607, 13 June 2026 (695 confirmed cases; risk assessment; continental response plan June to November 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

Health Security, One Health and Biosecurity 2026
Chapter 2

Key findings

Twelve findings carry the health security baseline. They are grouped by coupling and never ranked. Each resolves to its source or, where Nexus analysis is involved, to its stated method.

6 min read1 figure0 tables17 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

2.1Headline finding

ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-003

By 27 September 2026 the DRC had 8,116 confirmed cases of Bundibugyo virus disease and 3,924 deaths across seven provinces, and no licensed vaccine or specific treatment exists.

Figure 2.1Bundibugyo virus disease in the DRC, to 27 September 2026

Item	Bar, scaled to the largest value	Value
Confirmed cases		8,116
Confirmed deaths		3,924

Source: ECDC⁴⁷. Cumulative confirmed counts with a cut-off of 27 September 2026; the outbreak was still active.

Implication

What would move it

Candidate vaccine results, the use of a licensed Ebola vaccine in a research protocol, spread to new provinces or countries and funding for the continental response plan would each move this finding.

2.2Health

ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-001
WHO adopted the Pandemic Agreement in May 2025; the 2026 World Health Assembly decided to continue negotiating its Pathogen Access and Benefit Sharing annex and to take the outcome to the Assembly in May 2027 or to a special session in 2026.¹²³
ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-002
The amended International Health Regulations entered into force on 19 September 2025, adding a pandemic emergency alert level; 11 of the 196 States Parties rejected the amendments.⁴
ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-003
Bundibugyo virus disease was declared a public health emergency of international concern in May 2026; by 27 September 2026 the DRC had 8,116 confirmed cases and 3,924 deaths across seven provinces, with no licensed vaccine or specific treatment.²⁴⁴⁷
ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-004
WHO ended the mpox emergency of international concern on 5 September 2025; over 80% of cases reported in the previous 12 months came from the WHO African Region.⁵
ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-HLT-005
An estimated 95,000 people died of measles in 2024, and in 2025 13.5 million children received no vaccine, with 84% receiving a first measles dose and 77% two doses.⁸⁹

2.3Biodiversity

ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-BIO-006
About one in six laboratory-confirmed bacterial infections was resistant to antibiotic treatment in 2023, and 48% of countries did not report resistance data.⁶
ReportedEQL 3NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-BIO-007
Over 60% of emerging infectious diseases reported globally come from animals, and there are over 200 known types of zoonoses.¹³¹⁴
ReportedEQL 3NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-BIO-008
Since 2024 and as of 1 March 2026, H5 had been detected in 1,088 dairy herds in 19 US states; the cumulative US human case count is NOT BOUND at the close.⁴⁸
ReportedEQL 2NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-BIO-011
The Biological Weapons Convention working group held its seventh session in December 2025 and was still examining a draft final report for the Tenth Review Conference, due in 2027.³²

2.4Finance

ReportedEQL 3NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-FIN-009
Development assistance for health fell to USD 39 billion in 2025, 51% below the 2021 peak of USD 80 billion, and US financing fell 67%.²²

2.5Development

ReportedEQL 4NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-DEV-010
The United States completed its withdrawal from WHO on 22 January 2026, ending funding, personnel and participation in WHO bodies.²¹

2.6Systemic

Expert inputEQL 2NRF-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-SYS-012
The leading compound pathway for 2027 testing is a high-consequence outbreak that overlaps reduced financing, thin surveillance and missing countermeasures. § scenario

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

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
24WHO (ed.), WHO Director-General’s opening remarks at the media briefing on Ebola outbreak in DRC and Uganda, 20 May 2026 (Bundibugyo virus; not a pandemic emergency; Contingency Fund for Emergencies). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
25POST-CLOSE, context only: WHO (ed.), Disease Outbreak News 2026-DON607, 13 June 2026 (695 confirmed cases; risk assessment; continental response plan June to November 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
1WHO (ed.), WHO Member States agree to extend negotiations on key annex to the Pandemic Agreement, news release of 28 March 2026 (sixth Intergovernmental Working Group meeting, 23 to 28 March 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
2WHO (ed.), WHO Member States agree to extend negotiations on the Pathogen Access and Benefit Sharing annex, news release of 1 May 2026 (resumed sixth meeting 27 April to 1 May 2026; seventh meeting 6 to 17 July 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
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
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
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
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
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
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
14WHO (ed.), Zoonoses, fact sheet (over 200 known types of zoonoses; no percentages given on the page). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
48FAO, WHO and WOAH (eds.), Updated joint FAO/WHO/WOAH public health assessment of recent high pathogenicity avian influenza A(H5) virus events in animals and people, 18 May 2026 (since 2024 and as of 1 March 2026, 1,088 dairy herds in 19 US states affected; human detections reported in Bangladesh, Mexico and the United States). Food and Agriculture Organization, World Health Organization and World Organisation for Animal Health, Rome, Geneva and Paris. Observation year 2026. Accessed 2026-11-03.back
32UNVERIFIED, not opened: Biological Weapons Convention Working Group on the strengthening of the Convention, seventh session, Geneva, 8 to 12 December 2025, and draft final report of 1 October 2025, taken from search-result summaries. Biological Weapons Convention Implementation Support Unit, Geneva. Observation year 2025. Accessed 2026-11-03.back
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
21US Department of Health and Human Services (ed.), HHS Fact Sheet: U.S. Withdrawal from the World Health Organization (Executive Order 14155 of 20 January 2025; effective 22 January 2026), hosted on the CDC site. HHS, Washington. Observation year 2026. Accessed 2026-11-03.back

Health Security, One Health and Biosecurity 2026
Chapter 3

Systems and sectors at baseline

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

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
Domain	Posture at baseline	Coupling	Status
WAT	Cholera killed 7,870 people in 47 reporting countries in 2025; water and sanitation failure carries disease.	WAT → HLT	Reported EQL 4
ENE	Health facilities and cold chains depend on power; no consolidated series here.	ENE → HLT	Inferred EQL 2
FOO	Food safety and nutrition shape outcomes; no consolidated series here.	FOO → HLT	Expert input EQL 2
HLT	The core system: 8,116 confirmed Ebola cases in the DRC; 13.5 million zero-dose children.	the core system	Reported EQL 4
BIO	Over 60% of emerging infectious diseases reported globally come from animals.	BIO → HLT	Reported EQL 3
CLI	Dengue reached 14.6 million cases in 2024; the link to climate is not read here.	CLI → HLT	Inferred EQL 2
INF	Laboratories, transport and communications carry samples and supplies; no consolidated series here.	INF ↔ HLT	Inferred EQL 2
FIN	Aid for health fell to USD 39 billion in 2025; TB needs USD 22 billion a year.	FIN → HLT	Reported EQL 3
DAT	48% of countries did not report resistance data in 2023; incident data are not on a common basis.	DAT ↔ HLT	Reported EQL 4
AIC	Computational tools for surveillance and design of biological agents; not read in this edition.	AIC → HLT	Expert input EQL 2
MIN	Medical supply chains depend on minerals and materials; chokepoint data sit in sibling editions.	MIN → HLT	Inferred EQL 2
TRD	WHO advised against travel and trade restrictions during the 2026 Ebola outbreak.	HLT ↔ TRD	Reported 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
Code	Sector	Baseline evidence	Exposure to watch	Evidence coverage
GS-00	Cross-system	health threats cross people, animals and borders¹³⁴⁷	outbreak with thin financing	PARTIAL
GS-01	Water	cholera deaths highest since 1999¹⁰	sanitation failure	PARTIAL
GS-02	Energy	facilities and cold chains depend on power	outage during outbreak	THIN
GS-03	Food and agrifood	food safety and animal disease	zoonotic spillover	THIN
GS-04	Health	Ebola, mpox, measles, resistance⁴⁷⁵⁹⁶	concurrent emergencies	GOOD
GS-05	Finance and economy	aid for health USD 39 billion²²	financing shock	PARTIAL
GS-06	Development	zero-dose children 13.5 million⁸	weak routine immunisation	GOOD
GS-07	Climate	dengue 14.6 million cases in 2024¹¹	vector range	THIN
GS-08	Disaster	outbreaks as compound disasters¹⁶	concurrent hazards	PARTIAL
GS-09	Infrastructure	transport and laboratories link outbreak zones	access and sample transport	THIN
GS-10	Cities	Kampala cases in 2026²⁶	urban spread	THIN
GS-11	Biodiversity	animal origin of over 60% of emerging diseases¹³	habitat and wildlife contact	PARTIAL
GS-12	Earth observation	environmental data for spillover risk	data links	THIN
GS-13	Cyber and digital	resistance data missing for 48% of countries⁶	surveillance data gaps	PARTIAL
GS-14	Policy	IHR amendments and Pandemic Agreement annex⁴³	ratification and compliance	GOOD
GS-15	Science	spillover and emergence science is mature³⁹⁴⁰⁴¹	data at operating scale	PARTIAL

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

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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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

Health Security, One Health and Biosecurity 2026
Chapter 4

Risks and capability

Four global risk objects open the portfolio. Order carries no rank. Each is read across driver, exposure, vulnerability, capacity, cascade and consequence; loss metrics are added only where they can be modelled.

5 min read0 figures1 table17 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

4.1Risk objects

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

ReportedEQL 4RSK-SR08-HLT-001
Cross-border outbreak without licensed countermeasures
Driver
a filovirus outbreak in a region with mobile populations⁴⁷
Exposure
health workers, urban areas, border districts
Vulnerability
no licensed vaccine or specific treatment
Capacity
contact tracing; isolation; research protocols⁴⁷
Cascade
HLT → TRD → FIN
Horizon
1 to 3 years
ReportedEQL 4RSK-SR08-HLT-002
Immunity gaps and measles resurgence
Driver
13.5 million zero-dose children and 77% two-dose measles coverage⁸
Exposure
children under five in under-vaccinated areas
Vulnerability
routine immunisation disrupted by conflict and financing cuts
Capacity
catch-up campaigns; routine services⁹
Cascade
HLT → HLT → FIN
Horizon
annual
ReportedEQL 4RSK-SR08-BIO-003
Drug-resistant infection
Driver
resistance rising in over 40% of monitored combinations⁶
Exposure
bloodstream and urinary infections; hospitals
Vulnerability
thin surveillance and treatment access
Capacity
surveillance network; stewardship⁷
Cascade
BIO → HLT → FIN
Horizon
1 to 5 years
InferredEQL 3RSK-SR08-BIO-004
Spillover from animals and novel influenza
Driver
animal origin of over 60% of emerging diseases; H5 in cattle, with hundreds of human cases reported to WHO over time¹³¹⁸⁴⁸
Exposure
farm and slaughter workers, wildlife contact
Vulnerability
animal and human surveillance links not bound
Capacity
One Health plan of action¹⁵
Cascade
BIO → HLT → TRD
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 at the global level, from a policy listing to performance in real events.

Table 4.1Capabilities on the ladder of evidence: listed, exists, demonstrated, tested
Function	Level	Strongest public evidence at baseline
Prevention and mitigation	EXISTS	immunisation and food-safety programmes; coverage uneven⁸⁹
Monitoring and observation	ADEQUATE	WHO and regional agencies publish notices; 48% of countries did not report resistance data⁶
Early warning	EXISTS	IHR alert levels, now including a pandemic emergency tier⁴
Preparedness and planning	EXISTS	national IHR authorities required by the amendments⁴
Redundancy and reserves	LISTED	stockpiles and surge capacity not consolidated
Response	DEMONSTRATED	the mpox emergency ended after sustained decline; a 2025 Ebola outbreak ended⁵²³
Continuity of critical services	LISTED	routine services during outbreaks not consolidated
Recovery	LISTED	post-outbreak recovery data not consolidated
Adaptation	EXISTS	One Health joint plan of action for 2022 to 2026¹⁵
Social protection	LISTED	support for affected households not consolidated
Finance and insurance	LISTED	pooled financing exists; amounts not verified here³¹²²
Institutional coordination	EXISTS	IHR, Quadripartite and the Pandemic Agreement process⁴¹³³
Technical infrastructure	EXISTS	laboratory and surveillance networks; high-containment laboratory oversight not bound³³⁴²
Workforce	LISTED	health and veterinary workforce not consolidated
Research capacity	ADEQUATE	candidate vaccines in trials for Bundibugyo virus⁴⁷
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

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
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
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
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
7WHO (ed.), Antimicrobial resistance, fact sheet (more than 4.7 million deaths associated with bacterial resistance in 2021; 10% reduction target by 2030). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
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
18WHO (ed.), Influenza (avian and other zoonotic), fact sheet of 21 January 2026 (hundreds of human cases; no cumulative count on the page). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
48FAO, WHO and WOAH (eds.), Updated joint FAO/WHO/WOAH public health assessment of recent high pathogenicity avian influenza A(H5) virus events in animals and people, 18 May 2026 (since 2024 and as of 1 March 2026, 1,088 dairy herds in 19 US states affected; human detections reported in Bangladesh, Mexico and the United States). Food and Agriculture Organization, World Health Organization and World Organisation for Animal Health, Rome, Geneva and Paris. Observation year 2026. Accessed 2026-11-03.back
15WHO, FAO, UNEP and WOAH (eds.), One Health Joint Plan of Action launched to address health threats to humans, animals, plants and environment, news release of 17 October 2022 (plan period 2022 to 2026; six action tracks). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03.back
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
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
23STAT (ed.), Congo’s last Ebola patient is discharged, article of 20 October 2025 (Kasai province outbreak declared 4 September 2025; 64 cases, 43 deaths; 42-day countdown). STAT, Boston. Observation year 2025. Accessed 2026-11-03.back
31UNVERIFIED, not opened: The Pandemic Fund (ed.), funding rounds and projects (US$499.6 million to 20 projects in the third round, February 2026; US$1.4 billion across three rounds), taken from search-result summaries; the site returned an access error. World Bank and WHO, Washington and Geneva. Observation year 2026. Accessed 2026-11-03.back
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
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
33UNVERIFIED, not opened: King’s College London and George Mason University, Global BioLabs Report 2023 (51 operating level-4 laboratories in 27 countries and 18 planned or under construction), taken from search-result summaries; the document text was not readable. Observation year 2023. Accessed 2026-11-03.back
42UNVERIFIED, not opened: WHO, Laboratory biosafety manual, fourth edition. World Health Organization, Geneva, 2020, cited from memory. Observation year 2020. Accessed 2026-11-03.back

Health Security, One Health and Biosecurity 2026
Chapter 5

High-consequence outbreak that overlaps reduced financing and thin surveillance

A conditional statement under stated assumptions, never a prediction.

2 min read0 figures0 tables2 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

5.1Assumptions

Scenario SCN-SR08-OUT-01: what is assumed, and what is held constant.

Baseline: the 2026 reference state in this edition
Drivers: a filovirus or novel influenza outbreak begins in a region with thin surveillance, while aid for health stays near its 2025 level
Analogues: Bundibugyo virus disease, 2026; mpox, 2024 and 2025⁴⁷⁵
Interventions: none modelled: the specification describes the unmitigated case
Run state: narrative specification; quantified run scheduled for 2027

5.2The cascade, step by step

1
BIO → HLT
a pathogen passes from an animal host to people; early cases go undetected
2026
2
HLT → HLT
transmission spreads across health zones and a city
2026
3
HLT → TRD
neighbouring states consider border and trade measures
2026
4
FIN → HLT
emergency funding is released in small steps against a larger need
2026
5
HLT → HLT
routine immunisation and care are displaced by the response
2025 · 2026
6
HLT → FIN
costs accumulate and later outbreaks meet a weaker base
2026

5.3The scenario as a table of steps

How the shock in scenario SCN-SR08-OUT-01 would travel through Health Security, One Health and Biosecurity’s coupled systems, step by step, under the assumptions the edition states.

Step	What happens	Source
01 Biodiversity to health	A pathogen passes from an animal host to people; early cases go undetected. Analogue or source: 2026.	Edition SR-08, scenario SCN-SR08-OUT-01, step 1
02 Health to health	Transmission spreads across health zones and a city. Analogue or source: 2026.	Edition SR-08, scenario SCN-SR08-OUT-01, step 2
03 Health to trade	Neighbouring states consider border and trade measures. Analogue or source: 2026.	Edition SR-08, scenario SCN-SR08-OUT-01, step 3
04 Finance to health	Emergency funding is released in small steps against a larger need. Analogue or source: 2026.	Edition SR-08, scenario SCN-SR08-OUT-01, step 4
05 Health to health	Routine immunisation and care are displaced by the response. Analogue or source: 2025 · 2026.	Edition SR-08, scenario SCN-SR08-OUT-01, step 5
06 Health to finance	Costs accumulate and later outbreaks meet a weaker base. Analogue or source: 2026.	Edition SR-08, scenario SCN-SR08-OUT-01, step 6

A teaching model of a conditional scenario under the edition’s stated assumptions: not a forecast, not a prediction and not a warning. Sources: Health Security, One Health and Biosecurity 2026, scenario SCN-SR08-OUT-01 (2026); Health Security, One Health and Biosecurity 2026, references (NR-CIT-1) (2026).

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

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
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

Health Security, One Health and Biosecurity 2026
Chapter 6

Readings from the other desks

The global baseline is read through each steward’s lens, then once as a whole. Each lens is a projection of reviewed findings, not a separate argument. The other desks’ own editions of this subject are listed first, as cross-references, not copies.

14 min read0 figures8 tables32 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

6.1The other desks’ editions of this subject

Federation: each desk writes its own edition for the subjects in its remit. Until a desk releases, its edition shows its frame and the reading this edition printed for it.

Desk	Edition	State
GCRI Systems Evidence	No edition of this subject at this desk in the 2026 Baseline cycle	Not in this cycle
GRF Public Deliberation	Outside this desk’s remit	Not in remit
GRA Capital Readiness	No edition of this subject at this desk in the 2026 Baseline cycle	Not in this cycle
Standards Progress	Outside this desk’s remit	Not in remit
Academy Capability	Outside this desk’s remit	Not in remit
Index Measurement	Outside this desk’s remit	Not in remit

6.2Three lenses

One edition, read by each steward. The lens of this site comes first.

GCRI · KEY T

Technical Truth

The evidence supports reading health security as one connected system. Common causes recur across diseases, outbreaks spread through shared borders and health services, and response is limited by thresholds such as missing countermeasures, funding and surveillance reach. Evidence is strongest for single events and weakest for cross-border data on a common basis.

HLT-003 · HLT-002 · BIO-006 · SYS-012

GRF · KEY M

Public Meaning

For most people a health threat arrives as a closed clinic, a missed vaccine or a drug that no longer works. The baseline asks that public debate treat prevention, response and recovery as shared, and keep immunisation and surveillance in view between emergencies.

HLT-003 · HLT-005 · BIO-006

GRA · KEY F

Capital Meaning

Readiness implications only. Aid for health has fallen, large funding needs remain for diseases such as tuberculosis, and emergency funds were small against the Ebola response in May 2026²²¹²²⁴. These show where finance-readiness evidence will matter. Nothing here is advice, a rating or an approval.

FIN-009 · DEV-010

NEXUS

Synthesis

Health-security risk is well described event by event and thinly measured as a system. The 2027 programme should bind surveillance coverage, test the outbreak and financing compound pathway, and map thresholds before the next large event.

SYS-012 · H-01 · H-02

6.3Standards, Academy and steward contributions

How the Nexus Standards drafts, the Risk Academy and the three stewards feed each quarterly edition for health security. The standards are a preparatory working draft (2026) and are cited as drafts, never as adopted standards.

Table 6.1The quarterly rhythm every edition follows
Quarter	Edition	Question	Boundary
Q1	State and Agenda	What matters this year, and what is the starting position?	observed baseline stays distinct from planned work
Q2	Evidence and Build	What new evidence and capability exist?	a configured capability is not a validated result
Q3	Stress Test and Readiness	What do scenarios and tests show?	simulated loss or performance is not observed impact
Q4	Annual Synthesis and Renewal	What changed in the year, and what renews?	release follows review, not event publicity deadlines

Table 6.2Who contributes what each quarter
Steward or body	Role	Contribution route
GCRI Canada	Lead Institution and Consortium Secretariat; publisher of record; technical truth (key T)	science and practice communities · GCRI gateway
The Global Risks Forum (GRF)	leadership, dialogue and the Universe programme; public meaning (key M)	policy, Universe and national adoption · GRF gateway
The Global Risks Alliance (GRA)	finance, insurance and development readiness; capital meaning (key F)	finance and insurance · GRA gateway
Nexus Standards	preparatory drafts on vocabulary, hazards, indicators and methods	Standards site · working groups HAZ, IND, MTH, FIN, AI
Risk Academy	learning pathways tied to the agenda questions	Academy gateway · learning by review
Reports strategic desks	health-security chapter inputs: GCRI evidence and GRA readiness	strategic editorial board

Standards drafts used in this edition

Risk vocabulary NRS-C1 (424 terms) for terms in the glossary
Hazard atlas NHS-1 1.1.0 (905 hazards in 120 families) for risk objects
Seven risk classes: global, catastrophic, existential, emerging, planetary, exponential, frontier-tech

Standards calendar to watch

Founding calls from 20 October 2026; working groups meet from 5 November 2026
Inaugural Global Standards Council session, 12 January 2027
Quarterly reviews in March, June, September and December, aligned with each edition

6.4GCRI reading: the model card

GCRI’s reading of this edition is its model card: what the national model is, what it computes and where it stops. It is printed in full in Annex A, with the methods it belongs to. Annex A, methodology

6.5Global Risks Forum reading: editorial essays

Four signed essays by the Reports editorial team set out the positions this edition takes. They are interpretation, labelled as such; the evidence they draw on is in the findings register.

Animals, people, food and water share pathogens, and borders and health services decide where they stop. Treating each disease alone understates how a gap in one place becomes a gap everywhere. This edition reads the network.

EDITORIAL ESSAY · 01

Health is one network

Emergencies end and new ones begin: the mpox emergency ended in September 2025 and the Bundibugyo emergency was declared in May 2026. Routine immunisation, surveillance and financing decide how large the next one becomes.

EDITORIAL ESSAY · 02

Between emergencies is where resilience is built

About one in six infections was resistant in 2023, and rising resistance rarely makes headlines. Missing data for 48% of countries makes the true picture harder to read.

EDITORIAL ESSAY · 03

Resistance is a slow emergency

The amended IHR are in force and the Pandemic Agreement is adopted, yet the annex that the agreement needs is not agreed, and some States Parties rejected the amendments. Rules need data, money and trust to work.

EDITORIAL ESSAY · 04

Rules are not the same as readiness

6.6Global Risks Alliance reading: 2027 health security readiness pack

The registers that open the 2027 global cycle. At baseline each is initialised from this edition.

Table 6.32027 health security readiness pack
Item	Register	State at baseline	First 2027 entry
E1	Global risk state delta	baseline set by this edition	changes against the baseline
E2	WEFH+B state delta	five global system readings set	indicator updates and freshness
E3	Agenda and Portfolio movement	eight agenda items · 6 proposed objects	admission decisions
E4	Federation delivery register	national chapters in preparation	national chapters
E5	Consortium capability register	national consortia forming	first contributions
E6	Leadership questions and challenges	none yet	first challenge log
E7	Foundry technical state	national environments prepared	first federation cut
E8	Publication candidates	twelve findings carried forward	PUBLISH · HOLD dispositions
E9	Universe readiness	one candidate mission	admission and role spine
E10	Correction register	none	first federation-wide cycle

Publication dispositions

Publish
Hold
Needs evidence
Restricted
Superseded

6.7Nexus Standards reading: standards and regulatory watch

Instruments and published guidance that shape the systems in this edition, by status on the retrieval date. The edition assesses no one’s compliance.

IN FORCE
ADOPTED
PUBLISHED · GUIDANCE
PUBLISHED · VOLUNTARY

Table 6.4Standards and regulatory watch
Instrument	Body	Scope	Status	Relevance
International Health Regulations (2005), amendments of 2024⁴	WHO	global	IN FORCE	alert levels
Pandemic Agreement, resolution WHA78.1³⁴	WHO	global	ADOPTED 2025	pandemic prevention
Pathogen Access and Benefit Sharing annex²	WHO	global	UNDER NEGOTIATION	sample and benefit sharing
Biological Weapons Convention³⁵	United Nations	global	IN FORCE	weapons ban
One Health Joint Plan of Action 2022 to 2026¹⁵	FAO, UNEP, WHO, WOAH	global	PUBLISHED · GUIDANCE	One Health
Global Action Plan on Antimicrobial Resistance⁷	WHO	global	PUBLISHED · GUIDANCE	resistance
Political declaration on antimicrobial resistance⁴⁴	United Nations	global	ADOPTED 2024	resistance targets
WHO Laboratory Biosafety Manual⁴²	WHO	global	PUBLISHED · GUIDANCE	laboratory biosafety
ISO 35001 biorisk management⁴³	ISO	global	PUBLISHED · VOLUNTARY	biorisk
Terrestrial Animal Health Code⁴⁵	WOAH	global	PUBLISHED · GUIDANCE	animal health
International Health Regulations (2005), original text³⁶	WHO	global	IN FORCE	baseline obligations

Changed since 2024

The amended International Health Regulations entered into force on 19 September 2025⁴
The 2026 World Health Assembly continued the Pandemic Agreement annex negotiations³
The mpox emergency of international concern ended on 5 September 2025⁵

To watch in 2027

Outcome of the Pathogen Access and Benefit Sharing annex at the next Assembly or a special session²³
Report of the Biological Weapons Convention working group to the Tenth Review Conference³²
Renewal of the One Health joint plan of action after 2026¹⁵

6.8Risk Academy reading: literature and evidence review, science and assessments

The review behind this edition covers health security assessments, peer-reviewed science and the institutional reports that bind its findings. Systematic reviews for each agenda item begin in 2027.

Review protocol

Question: What does the published evidence establish about the world’s health security, One Health and biosecurity systems and its couplings?
Sources searched: WHO and agency notices; outbreak updates; peer-reviewed emergence literature; burden and financing statistics
Window: releases available at evidence close, 30 September 2026
Selection: sources that bind or contextualise a finding in this edition
Next step: systematic reviews for agenda items 01 to 05 in 2027

Table 6.5Peer-reviewed science and assessments
Reference	Type	Year	Role	Used for
Jones et al.³⁹	journal article	2008	framework	emerging disease drivers
Allen et al.⁴⁰	journal article	2017	supports	zoonotic hotspots
Carlson et al.⁴¹	journal article	2022	framework	virus sharing and climate

Table 6.6Institutional flagships
Reference	Issuer	Year	Role	Used for
GPMB 2026 report¹⁶	GPMB	2026	supports	six emergencies in a decade
Global antibiotic resistance surveillance report 2025⁶	WHO	2025	supports	resistance share
Fifth mpox Emergency Committee statement⁵	WHO	2025	supports	mpox emergency end
Disease Outbreak News²⁵²⁶	WHO	2026	supports	Ebola Bundibugyo counts
One Health joint plan of action¹⁵	FAO, UNEP, WHO, WOAH	2022	context	One Health tracks

Table 6.7Statistics, burden and financing
Reference	Issuer	Year	Role	Used for
Financing Global Health 2025²²	IHME	2025	supports	aid for health
Antimicrobial resistance burden³⁰	GRAM and IHME	2024	context	resistance deaths
Excess mortality estimate²⁰	WHO	2022	supports	COVID-19 excess deaths
Tuberculosis fact sheet¹²	WHO	2025	supports	tuberculosis burden
Tracking development assistance for health⁴⁶	IHME and Lancet	2025	context	aid for health series
Pandemic Fund summary³¹	World Bank and WHO	2026	context	pooled financing

Table 6.8Standards, treaties and instruments
Reference	Issuer	Year	Role	Used for
International Health Regulations (2005), as amended⁴³⁶	WHO	2025	supports	alert levels
Pandemic Agreement, resolution WHA78.1³⁴	WHO	2025	supports	treaty text
Biological Weapons Convention³⁵	United Nations	1972	context	weapons ban
Working group papers³²	BWC States Parties	2025	context	strengthening the convention
Laboratory Biosafety Manual⁴²	WHO	2020	context	laboratory practice
ISO 35001⁴³	ISO	2019	context	biorisk management
Political declaration on resistance⁴⁴	United Nations	2024	context	resistance targets
Terrestrial Animal Health Code⁴⁵	WOAH	2024	context	animal disease standards

Where the evidence agrees

Animals are the origin of most emerging infectious diseases¹³
Immunity gaps and resistance raise the cost of outbreaks⁶⁸
Emergencies end, and new ones begin⁵⁴⁷

Where it is unsettled

How far any given outbreak will spread⁴⁷
How much the loss of aid will change surveillance and response²²
How many high-containment laboratories operate and under what oversight³³

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

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
12WHO (ed.), Tuberculosis, fact sheet (10.7 million people fell ill and 1.23 million died in 2024; funding figures). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
24WHO (ed.), WHO Director-General’s opening remarks at the media briefing on Ebola outbreak in DRC and Uganda, 20 May 2026 (Bundibugyo virus; not a pandemic emergency; Contingency Fund for Emergencies). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
34UNVERIFIED, not opened: WHO Pandemic Agreement, resolution WHA78.1, adopted by the Seventy-eighth World Health Assembly on 20 May 2025, cited from memory and from search summaries; the date was not read on a WHO page. World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03.back
2WHO (ed.), WHO Member States agree to extend negotiations on the Pathogen Access and Benefit Sharing annex, news release of 1 May 2026 (resumed sixth meeting 27 April to 1 May 2026; seventh meeting 6 to 17 July 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
35UNVERIFIED, not opened: Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on their Destruction, 1972, cited from memory. United Nations, Geneva. Observation year 1972. Accessed 2026-11-03.back
15WHO, FAO, UNEP and WOAH (eds.), One Health Joint Plan of Action launched to address health threats to humans, animals, plants and environment, news release of 17 October 2022 (plan period 2022 to 2026; six action tracks). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03.back
7WHO (ed.), Antimicrobial resistance, fact sheet (more than 4.7 million deaths associated with bacterial resistance in 2021; 10% reduction target by 2030). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
44UNVERIFIED, not opened: United Nations General Assembly, Political declaration of the high-level meeting on antimicrobial resistance, 2024, cited from memory. United Nations, New York. Observation year 2024. Accessed 2026-11-03.back
42UNVERIFIED, not opened: WHO, Laboratory biosafety manual, fourth edition. World Health Organization, Geneva, 2020, cited from memory. Observation year 2020. Accessed 2026-11-03.back
43UNVERIFIED, not opened: ISO 35001:2019, Biorisk management for laboratories and other related organisations. International Organization for Standardization, Geneva. Observation year 2019. Accessed 2026-11-03.back
45UNVERIFIED, not opened: WOAH (ed.), Terrestrial Animal Health Code, cited from memory. World Organisation for Animal Health, Paris. Observation year 2024. Accessed 2026-11-03.back
36UNVERIFIED, not opened: WHO, International Health Regulations (2005), third edition, cited from memory. World Health Organization, Geneva. Observation year 2005. Accessed 2026-11-03.back
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
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
32UNVERIFIED, not opened: Biological Weapons Convention Working Group on the strengthening of the Convention, seventh session, Geneva, 8 to 12 December 2025, and draft final report of 1 October 2025, taken from search-result summaries. Biological Weapons Convention Implementation Support Unit, Geneva. Observation year 2025. Accessed 2026-11-03.back
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
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
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
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
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
25POST-CLOSE, context only: WHO (ed.), Disease Outbreak News 2026-DON607, 13 June 2026 (695 confirmed cases; risk assessment; continental response plan June to November 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
30UNVERIFIED, not opened: GBD 2021 Antimicrobial Resistance Collaborators, Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet, 2024 (1.14 million attributable and 4.71 million associated deaths in 2021), taken from search-result summaries; the article returned an access error. Observation year 2021. Accessed 2026-11-03.back
20WHO (ed.), 14.9 million excess deaths were associated with the COVID-19 pandemic in 2020 and 2021, news release of 5 May 2022 (range 13.3 to 16.6 million). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
46UNVERIFIED, not opened: IHME and Lancet authors, Tracking development assistance for health, 1990 to 2030, The Lancet, 2025, published with Financing Global Health 2025, taken from search-result summaries. Observation year 2025. Accessed 2026-11-03.back
31UNVERIFIED, not opened: The Pandemic Fund (ed.), funding rounds and projects (US$499.6 million to 20 projects in the third round, February 2026; US$1.4 billion across three rounds), taken from search-result summaries; the site returned an access error. World Bank and WHO, Washington and Geneva. Observation year 2026. Accessed 2026-11-03.back
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
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
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
33UNVERIFIED, not opened: King’s College London and George Mason University, Global BioLabs Report 2023 (51 operating level-4 laboratories in 27 countries and 18 planned or under construction), taken from search-result summaries; the document text was not readable. Observation year 2023. Accessed 2026-11-03.back

Health Security, One Health and Biosecurity 2026
Chapter 7

The 2027 agenda

Eight bounded questions open the 2027 health security agenda. Each comes from a baseline finding, names the initiative that will carry it and the first output due in the 2027 health security edition.

5 min read0 figures6 tables3 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

7.1Questions for the operational series

H-01
How would a high-consequence outbreak that overlaps reduced financing and thin surveillance spread through health, food and trade at the same time?
INI-SR08-OUT-01 · outbreak compound loss; first output: dependency analysis for six regions.
H-02
Where does surveillance leave gaps that let an outbreak grow before it is detected?
INI-SR08-SUR-02 · surveillance coverage; first output: coverage map.
H-03
Which immunity gaps coincide with outbreak risk, and how fast do they close?
INI-SR08-IMM-03 · immunity gaps; first output: gap table.
H-04
How does drug resistance change the cost and course of common outbreaks?
INI-SR08-AMR-04 · resistance and response; first output: resistance overlay.
H-05
Where do human, animal and environmental data meet, and where do they not?
INI-SR08-ONE-05 · One Health data links; first output: data-link register.
H-06
Which states and agencies publish outbreak data on a comparable basis?
To be admitted in 2027; first output: coverage note.
H-07
How do conflict and displacement change the course of outbreaks and the protection of health care?
To be admitted in 2027; first output: scoping note.
H-08
Which health-security capabilities have been tested in real events, and which are only planned?
Health-security capability register; first output: rung evidence for 15 functions.

7.2Portfolio proposed for the Q1 2027 alignment

Five initiatives and one Universe mission candidate are proposed for the 2027 health-security portfolio. They are programme objects: no partner, funder or member is attached to them in this edition.

Table 7.1Objects proposed for the first operational quarter
ID	Object	Kind	Question	State
INI-SR08-OUT-01	Outbreak compound loss	Initiative	H-01	PROPOSED
INI-SR08-SUR-02	Surveillance coverage	Initiative	H-02	PROPOSED
INI-SR08-IMM-03	Immunity gaps	Initiative	H-03	PROPOSED
INI-SR08-AMR-04	Resistance and response	Initiative	H-04	PROPOSED
INI-SR08-ONE-05	One Health data links	Initiative	H-05	PROPOSED
MSN-SR08-2027-01	Outbreak and financing Universe mission	Mission	H-01	Candidate

7.3The pathway

The health security edition reads national health chapters, sector editions and the global edition through one governed evidence graph. At baseline the federation is designed and its first editions are drafted. This page states what exists today and what comes next.

01
National health chapters
health-security reading in each national edition
IN PREPARATION · national baselines
02
Sector editions
health, food, water, cyber
PLANNED · sector Baseline Editions
03
Health security system model
the global health system of systems
v0 SPECIFIED · v1 with federation evidence
04
Strategic links
SR-02 lifelines · SR-03 supply chains · SR-07 food, water and energy
PLANNED · strategic baselines
05
Universe
annual proving environment
CANDIDATE MISSION · mandate in 2027
06
Health Security Report
this series
BASELINE DRAFT · 2027 annual edition
07
Evidence and correction
one graph, many projections
OPEN · first correction cycle in 2027

7.4Universe 2027: evidence pack for the health security candidate mission

01
Mandate
02
Core Build · 1 month
03
Action · 1 week
04
Evidence seal
05
Portfolio correction
06
Next mandate

Table 7.2Universe 2027: evidence pack for the health security candidate mission
Item	Record	State	Timing
F1	Annual mandate record	PLANNED	after the Q2 2027 alignment
F2	Core Build record	PLANNED	one month before the exercise
F3	Exercise evidence	PLANNED	during the Action week
F4	Decision packets	PLANNED	exercise state only
F5	Proof receipts	PLANNED	scoped to each recorded check
F6	After-action report	PLANNED	within one quarter
F7	Upgrade docket	PLANNED	routed to the Portfolio
F8	Portfolio renewal	PLANNED	2027 health security annual edition
F9	Public synthesis	PLANNED	public-safe extracts only

Mission

ID: MSN-SR08-2027-01 · Outbreak and financing Universe mission
Role spine: Leadership sponsor · Institutional anchor · Mission lead: drawn from national pathways
Receiving actors: to be identified with the mandate

7.5Handoffs and routing

Where the baseline’s findings go next. A handoff routes a finding for awareness, review or work; it transfers no authority.

Table 7.3Handoffs and routing
Finding	Routed to	Purpose	Class
HLT-003 · outbreak	INI-SR08-OUT-01	outbreak compound loss	PUBLIC
HLT-002 · IHR amendments	sector editions	instrument map	PUBLIC
HLT-005 · immunity gaps	INI-SR08-IMM-03	immunity gaps	PUBLIC
BIO-006 · resistance	INI-SR08-AMR-04	resistance and response	PUBLIC
BIO-007 · animal origin	INI-SR08-ONE-05	One Health data links	PUBLIC
FIN-009 · aid for health	INI-SR08-SUR-02 · key F review	surveillance coverage	PUBLIC
BIO-011 · biosecurity	sector editions	instrument map	PUBLIC
SYS-012 · compound pathway	MSN-SR08-2027-01	Universe candidate	CONSORTIUM

Table 7.4Routing rules by publication class
Class	Where it goes	Who can see it
PUBLIC	the published edition and its evidence bundle	anyone
CONSORTIUM	governed rooms of the federation	consortium members under agreement
CONTROLLED	need-to-know channels	named competent actors only

7.6Feeds and signal register

Table 7.5Feeds watched from 2027
Feed	Producer	Latency	Feeds into
Disease Outbreak News	WHO	per event	HLT-003
Weekly threat reports	ECDC	weekly	HLT-003
H5 public health assessment	FAO, WHO and WOAH	periodic	BIO-008
Resistance surveillance report	WHO	annual	BIO-006
Immunisation coverage estimates	WHO and UNICEF	annual	HLT-005
Development assistance for health	IHME	annual	FIN-009
Emergency Committee statements	WHO	per event	HLT-004

Escalation routes

none · keep monitoring
research question
project
risk object
annual publication
signal report

Table 7.6Signals at baseline
ID	Signal	Corroboration	Systems	Route
SIG-SR08-001	Bundibugyo outbreak across seven DRC provinces in 2026⁴⁷	CORROBORATED	HLT · TRD	risk object RSK-SR08-HLT-001
SIG-SR08-002	Aid for health at half its 2021 peak²²	CORROBORATED	FIN · HLT	research question H-01
SIG-SR08-003	Pandemic Agreement annex not agreed in May 2026³	CORROBORATED	HLT · DEV	research question H-02

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

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
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
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

Health Security, One Health and Biosecurity 2026
Chapter 8

Systems in depth

One section per system: its state at evidence close, its exposures and what the operational series will watch.

8 min read0 figures5 tables16 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

8.1Common causes

One cause can strike many places at once: an animal reservoir, a resistant organism, a broken water system or a vector. The shared cause matters more than the disease.

>60%

of emerging infectious diseases reported globally come from animals¹³

14.6million

dengue cases reported in 2024¹¹

1 in 6

bacterial infections resistant, 2023⁶

Table 8.1Evidence at baseline
Instance	Mechanism in action	Evidence	Status
Animal origin	over 60% of emerging diseases reported globally come from animals	¹³	Reported
Vector-borne spread	dengue cases reached 14.6 million in 2024, a record for a twelve-month period	¹¹	Reported
Drug resistance	resistance rose in over 40% of monitored combinations, 2018 to 2023	⁶	Reported
Water and sanitation failure	cholera: 451,499 cases and 7,870 deaths in 47 countries in 2025	¹⁰	Reported

Pathways in this mechanism

BIO → HLT spillover
WAT → HLT cholera
FOO → HLT food safety

Evidence to bind in 2027

common-cause tagging of outbreaks
frequency of concurrent causes

Related editions

GLB Global Systems
SR-02 Critical Infrastructure and Lifeline Systems
SR-03 Global Supply Chains, Trade and Chokepoints
SR-07 Food–Water–Energy Security
GS-04 Health and One Health
GS-03 Food and Agrifood Systems

8.2Domino effects

A failure in one place removes protection in the next. Outbreaks cross health zones, provinces and borders, and immunity gaps turn small outbreaks into large ones.

64of 167 health zones

affected in the DRC, 27 September 2026⁴⁷

20confirmed cases

Uganda, May to June 2026⁴⁷

13.5million

zero-dose children, 2025⁸

Table 8.2Evidence at baseline
Instance	Mechanism in action	Evidence	Status
Spread inside a country	seven provinces and 63 of 167 health zones by 27 September 2026	⁴⁷	Reported
Spread across borders	Uganda had 20 confirmed cases and one imported case was reported in France by early July	²⁶⁴⁷	Reported
Immunity gaps	13.5 million zero-dose children; 95,000 measles deaths in 2024	⁸⁹	Reported
Missing countermeasures	no licensed vaccine or specific treatment for Bundibugyo virus	⁴⁷	Reported

Pathways in this mechanism

HLT → HLT outbreak spread
HLT → TRD restrictions
FIN → HLT response funding

Evidence to bind in 2027

timing of spread between zones
health worker infection data

Related editions

GLB Global Systems
SR-02 Critical Infrastructure and Lifeline Systems
SR-03 Global Supply Chains, Trade and Chokepoints
SR-07 Food–Water–Energy Security
GS-04 Health and One Health
GS-03 Food and Agrifood Systems

8.3Inter-systemic feedbacks

Health depends on money and data, and outbreaks press back on both. Lower financing weakens surveillance, and larger outbreaks draw down emergency funds.

39USD billion

development assistance for health, 2025²²

22USD billion

a year needed for tuberculosis targets¹²

48%

of countries did not report resistance data, 2023⁶

Table 8.3Evidence at baseline
Instance	Mechanism in action	Evidence	Status
Financing to outbreak	aid for health USD 39 billion in 2025, 51% below the 2021 peak	²²	Reported
Outbreak to emergency funding	an additional USD 3.4 million from the WHO Contingency Fund for Emergencies by 20 May 2026, a total of USD 3.9 million	²⁴	Reported
Funding gap in endemic disease	tuberculosis: USD 22 billion needed a year; USD 4.8 billion domestic and USD 1.1 billion international in low- and middle-income countries	¹²	Reported
Surveillance reach	48% of countries did not report resistance data in 2023	⁶	Reported

Pathways in this mechanism

FIN → HLT financing
HLT → FIN emergency spending
DAT → HLT surveillance data

Evidence to bind in 2027

preparedness financing outside aid
effect of funding cuts on surveillance

Related editions

GLB Global Systems
SR-02 Critical Infrastructure and Lifeline Systems
SR-03 Global Supply Chains, Trade and Chokepoints
SR-07 Food–Water–Energy Security
GS-04 Health and One Health
GS-03 Food and Agrifood Systems

8.4Shared vulnerabilities

Different threats share the same weak points: missing countermeasures, resistant organisms, thin laboratory oversight and a narrow donor base.

11of 196

States Parties rejected the 2024 IHR amendments⁴

>40%

of E. coli resistant to third-generation cephalosporins⁶

67%

fall in US financing for health, 2025²²

Table 8.4Evidence at baseline
Instance	Mechanism in action	Evidence	Status
Missing countermeasures	no licensed vaccine or specific treatment for Bundibugyo virus disease	⁴⁷	Reported
Common resistance	over 40% of E. coli and over 55% of K. pneumoniae resist third-generation cephalosporins	⁶	Reported
High-containment laboratories	51 operating level-4 laboratories and 18 planned or under construction in a 2023 tracker	³³	Reported
Donor concentration	US financing for health fell 67% in 2025	²²	Reported

Pathways in this mechanism

HLT → HLT shared tools
FIN → HLT donor base
INF ↔ HLT laboratories

Evidence to bind in 2027

laboratory oversight data
dependence on a few donors and suppliers

Related editions

GLB Global Systems
SR-02 Critical Infrastructure and Lifeline Systems
SR-03 Global Supply Chains, Trade and Chokepoints
SR-07 Food–Water–Energy Security
GS-04 Health and One Health
GS-03 Food and Agrifood Systems

8.5Thresholds and tipping

A system can absorb stress until a threshold is crossed. Alert levels, outbreak-end rules and resistance targets mark such thresholds for health security.

17May 2026

Ebola emergency declared; not a pandemic emergency²⁴

42days

countdown to end the 2025 Kasai outbreak²³

10%

target cut in resistance-associated deaths by 2030⁷

Table 8.5Evidence at baseline
Instance	Mechanism in action	Evidence	Status
Pandemic emergency tier	the Director-General found that the Ebola emergency was not a pandemic emergency	²⁴	Reported
Outbreak end rule	a 42-day countdown after the last patient left care in the 2025 Kasai outbreak	²³	Reported
Emergency exit	the mpox emergency ended on 5 September 2025 after sustained decline	⁵	Reported
Resistance target	a 10% cut in bacterial resistance-associated deaths by 2030	⁷	Reported

Pathways in this mechanism

HLT → HLT alert thresholds
FIN → HLT response funding
BIO → HLT spillover thresholds

Evidence to bind in 2027

thresholds for compound outbreaks
surveillance coverage needed to detect early

Related editions

GLB Global Systems
SR-02 Critical Infrastructure and Lifeline Systems
SR-03 Global Supply Chains, Trade and Chokepoints
SR-07 Food–Water–Energy Security
GS-04 Health and One Health
GS-03 Food and Agrifood Systems

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

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
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
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
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
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
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
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
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
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
12WHO (ed.), Tuberculosis, fact sheet (10.7 million people fell ill and 1.23 million died in 2024; funding figures). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
24WHO (ed.), WHO Director-General’s opening remarks at the media briefing on Ebola outbreak in DRC and Uganda, 20 May 2026 (Bundibugyo virus; not a pandemic emergency; Contingency Fund for Emergencies). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
33UNVERIFIED, not opened: King’s College London and George Mason University, Global BioLabs Report 2023 (51 operating level-4 laboratories in 27 countries and 18 planned or under construction), taken from search-result summaries; the document text was not readable. Observation year 2023. Accessed 2026-11-03.back
23STAT (ed.), Congo’s last Ebola patient is discharged, article of 20 October 2025 (Kasai province outbreak declared 4 September 2025; 64 cases, 43 deaths; 42-day countdown). STAT, Boston. Observation year 2025. Accessed 2026-11-03.back
7WHO (ed.), Antimicrobial resistance, fact sheet (more than 4.7 million deaths associated with bacterial resistance in 2021; 10% reduction target by 2030). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
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

Methodology

How the edition was made: methods, the model card, the evidence cut and its age, the acceptance record and the glossary.

11 min read0 figures13 tables6 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

A.1Methods

The global baseline uses published values and four simple derivations. Each is shown in full so that any reader can reproduce it.

Table A.1Methods
No.	Derivation	Calculation	Result
(1)	States Parties that did not reject the 2024 IHR amendments	196 minus 11	185
(2)	Confirmed deaths per confirmed case, DRC, to 27 September 2026	3,924 ÷ 8,116	≈ 0.48, crude
(3)	Share of children without two measles doses, 2025	100 minus 77	≈ 23%
(4)	Cholera deaths per 100 reported cases, 2025	7,870 ÷ 451,499 × 100	Reported

Table A.2Coupling strength scale (matrix and model card)
Strength	Definition
STRONG	a disruption in the source system has historically changed the target system’s service or output within one season, in more than one region
MODERATE	an effect is documented but buffered or slower
WEAK	an effect is plausible but not documented at global scale

Table A.3Status grammar
Label	Rule
Reported	value as issued by its source, with year
Inferred	reasoned from cited evidence; never a measurement
Estimated	Nexus analytical value with stated method
Scenario	conditional on stated assumptions
Expert input	structured editorial judgement awaiting evidence

A.2Model card, Health Security System Model v0

Model ID: MDL-SR08-HEALTHSECURITY · v0.1
Purpose: represent health security as a connected network and the mechanisms by which health threats spread between people, animals, food, water and the institutions that respond
Family: graph-based system of systems
Inputs: the cited sources of this edition; no proprietary data
Method: expert-specified coupling strengths (STRONG · MODERATE · WEAK) from assessments and analogue events
Validation: none yet, first validation against federation evidence in 2027
Uncertainty: qualitative; strengths are hypotheses, not measurements
Domain of validity: global scale; not for asset-, site- or country-level use
Reproducibility: strength table and sources published in this edition

20couplings

typed in v0

4strong

documented within one season

5moderate

documented, buffered

11weak

plausible, undocumented

A.3The baseline evidence cut

Every Nexus edition is published from a frozen evidence cut. The global baseline cut is documentary: it pins the exact edition of every source cited. Federation cuts begin with the first national Foundry cuts in 2027.

Cut ID: DC-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-B0
Type: baseline documentary cut
Resolution policy: pinned · as of 30 September 2026
Sources pinned: 48 cited sources, each at the edition and access date in the references
Model runs: none at baseline, analytical values are stated with their method
Digest: computed at freeze and recorded in the publication record
Supersedes: nothing, first cut of the series
Superseded by: the 2027 health security annual cut

Lineage

01
source edition
02
pinned citation
03
finding
04
page
05
publication record

Table A.4From the baseline cut to the federation cut
Element	Baseline 2026	2027 global annual
Sources	cited global publications, pinned by edition	national, regional and sector cuts through one graph
Analysis	stated methods and editorial estimates	typed analysis specifications
Models	Health Security System Model v0 specification	model runs with receipts
Findings	twelve baseline findings	findings re-bound to federation evidence
Review	five passes scheduled	five passes on the exact digest

A.4Evidence age and coverage

A 2026 global edition rests on evidence observed in many different years. This page shows each time base, so that no single year label hides older evidence.

Table A.5Evidence age and coverage
Indicator	Observed	Released	Cadence	Next release
Ebola Bundibugyo counts	to 27 Sep 2026	Oct 2026	weekly	next ECDC update
IHR amendments	2025	Sep 2025	one-off	none scheduled
Annex negotiations	2026	May 2026	per session	May 2027 or special session
Resistance surveillance	2023	Oct 2025	annual	next WHO report
Immunisation coverage	2025	Jul 2026	annual	Jul 2027
Measles deaths	2024	Jul 2026	annual	next WHO estimate
US dairy herds with H5	to 1 Mar 2026	May 2026	periodic	next joint assessment
Aid for health	2025	Jul 2025	annual	next IHME report
Excess deaths from COVID-19	2020 to 2021	May 2022	one-off	no update used
Biosafety laboratory counts	2023	2023	periodic	not verified

Table A.6Coverage by system at baseline
System	Coverage	Thinnest dimension
Outbreaks	PARTIAL	cross-border comparable data
Immunisation	GOOD	subnational coverage
Drug resistance	PARTIAL	countries not reporting
Animal origin	PARTIAL	animal and environment data linked to human cases
Governance	GOOD	annex outcome
Financing	PARTIAL	preparedness financing outside aid
Biosecurity	THIN	laboratory oversight data
Conflict and health care	THIN	verified attacks on health care

Table A.7Designed empty states: what is not bound, what would fill it and why
Field	Source that would fill it	Blocker
Cross-border outbreak data on a common basis and in near real time	WHO, regional agencies and national authorities	reporting formats and cut-offs differ; no consolidated series
Ebola Bundibugyo counts after the 27 September 2026 cut-off	ECDC and WHO updates; UKHSA weekly report³⁷	the outbreak was still active; later counts are listed by the source but were not read in full, and the UKHSA figures come from a search summary
Africa CDC continental emergency declaration	Africa CDC³⁸	taken from search-result summaries; the Africa CDC page was not opened
Exact date of the Bundibugyo emergency declaration	WHO Director-General statement	the briefing page says early on the Sunday before 20 May 2026 without a date; secondary sources give 16 or 17 May
Number of Biological Weapons Convention States Parties	UN Office for Disarmament Affairs	the membership page did not load with a count
Number and oversight of high-containment laboratories	Global BioLabs tracker, newer edition	only the 2023 edition was found, from search summaries; the document text was not readable
Pandemic Fund allocations and co-investment	Pandemic Fund and World Bank	the site returned an access error; figures come from search summaries
Resistance burden from the GRAM study itself	Lancet article and IHME	the article returned an access error; the WHO fact sheet figure for associated deaths was read instead
Attacks on health care by year	WHO surveillance system for attacks on health care	the dashboard figures did not load
Animal outbreaks of avian influenza by country	WOAH situation reports	the figures sit in a report that was not opened
Signature and ratification status of the Pandemic Agreement	WHO treaty pages	not retrieved; the annex is not agreed
Preparedness financing outside development assistance	national budgets and multilateral funds	no consolidated series found
Capability rungs beyond response	ministries, agencies, laboratories	not reviewed

A.5Evidence cards, two anchor sources

Issued by the European Centre for Disease Prevention and Control. Weekly. Role: binds HLT-003. Coverage: DRC provinces and health zones. Counts have a cut-off of 27 September 2026.

EVD-SR08-001

ECDC update on Bundibugyo virus disease⁴⁷

Issued by the World Health Organization. Annual. Role: binds BIO-006. Data year 2023; 104 reporting countries.

EVD-SR08-002

WHO global antibiotic resistance surveillance report 2025⁶

Table A.8Quality dimensions at baseline
Dimension	EVD-SR08-001	EVD-SR08-002
Completeness	confirmed cases only; suspected cases reported separately	48% of countries did not report
Timeliness	weekly, with a cut-off days before issue	about 2 years after the data year
Revision	cumulative counts revised	trend over 2018 to 2023
Method transparency	case definitions stated by the sources	surveillance network method stated
External validation	national and WHO reporting	agency review

Evidence cards to follow in 2027

ECDC⁴⁷: later updates after the 27 September cut-off
WHO⁶: pathogen and drug tables
WHO³: annex text when agreed
CDC¹⁷: post-close, context only; US human H5 count to bind in the next edition

A.6Publication acceptance record

Editorial self-check at evidence close. Every applicable item carries a disposition; the remaining items are review, approval and deposit.

Table A.9Publication acceptance record
Group	Area	Items	Pass	N/A	Pending
D1	Identity and scope	8	8	0	0
D2	Source and data	12	9	1	2
D3	Analysis and models	12	3	8	1
D4	Findings and claims	9	8	0	1
D5	Figures, tables, maps	10	6	2	2
D6	Editorial and citations	10	8	0	2
D7	Review and approval	13	0	0	13
D8	Artefact and design	12	7	0	5
D9	Registry and release	9	0	0	9

Publication gate

Conditions met: 14 of 23 at evidence close
Blocking problems: none recorded
Open conditions: reviews, approval of the exact digest, deposit, registry pointer

Not applicable at baseline

Model runs: first runs in Q1 2027
Maps: plates in Q2 2027
Waivers: none

A.7Status words

Table A.10The status every value carries
Status	What it means
Observed	Measured directly and published by the source.
Reported	Published statistics of an official or institutional source.
Declared	Stated by the body concerned; not independently measured.
Estimated	A Nexus estimate from cited evidence, with its method in Annex A.
Modelled	Produced by a stated model from cited inputs.
Inferred	Reasoned from cited evidence; not measured.
Forecast	A projection by the cited source.
Simulated	A simulation result under stated assumptions.
Scenario	A conditional statement under stated assumptions; never a prediction.
Expert input	Expert judgement, recorded with its basis.
Candidate	Proposed for a later edition; not yet evidence.
Evidence-quality levels (EQL 1 to 5) grade the source behind a value; they are not a score of the subject.

A.8How the edition is made, released and corrected

Every edition is built from a sealed evidence cut, reviewed under three keys, signed and deposited before any site shows it as published; corrections go to Nexus Standards as change proposals and feed the next cut.

Step	What happens	Source
01 Evidence arrives from the pillars	Foundry seals observations and indicator series, Universe hands over after-action and scenario findings, and contributions are screened at every gateway, including this site’s.
02 The cut is sealed	On the cut date the evidence is pinned under one identifier, so anyone can rebuild the edition from exactly what it was built on.
03 The edition is assembled	The edition is drafted from its template and content pack. Agents may draft; they never publish and never decide.
04 The keys turn	At the publisher of record the truth key comes first: every value is checked against its source or stated method before the meaning and capital keys turn. No edition moves on until every key has been turned by a named steward.
05 The gate opens	A named approver releases one exact digest of the edition; any change after this point is a new version, never a silent edit.
06 Signed and deposited	The PDF, the web edition and the data bundle are signed together with a manifest and an RO-Crate description, and deposited on Zenodo with a concept and a version DOI.
07 Published on its desk’s site	Only then does the edition show as published on its desk’s Reports site, and the Collection lists it as a part.
08 Corrections go to Standards	Method and correction findings go to Nexus Standards as change proposals; citations, corrections and new contributions feed the next evidence cut.

A teaching model of the process, not a forecast and not a record of any run; dates and counts on this page come from the programme record. Sources: Reports governance at GCRI Canada (2026); Zenodo, repository of record for Reports deposits (2026).

Lifecycle, one state at a time: Draft, Computed, Evidence bound, Reviewed, Approved for release, Published, Corrected, Superseded. This edition is a draft.

A.9Glossary and abbreviations

Table A.11Series terms
Term	Meaning
Baseline Edition	the inaugural annual edition that fixes the reference state for the series
WEFH+B	water, energy, food, health and biodiversity, the national nexus core
Coupling	a typed dependency through which one system transmits to another
Protection gap	the share of losses not covered by insurance
Capability ladder	LISTED → EXISTS → ADEQUATE → TESTED → DEMONSTRATED
EQL	evidence-quality level, 1–5
Evidence cut	a frozen resolution of exact sources and versions
NNC · NLC · NWG	National Nexus Consortium · National Leadership Council · National Working Groups

Table A.12Abbreviations used in this edition
Abbreviation	Expansion
AMR	antimicrobial resistance
BSL	biosafety level
CDC	US Centers for Disease Control and Prevention
DAH	development assistance for health
DON	Disease Outbreak News
DRC	Democratic Republic of the Congo
ECDC	European Centre for Disease Prevention and Control
GLASS	Global Antimicrobial Resistance and Use Surveillance System
GPMB	Global Preparedness Monitoring Board
IHR	International Health Regulations
PABS	Pathogen Access and Benefit Sharing
PHEIC	public health emergency of international concern

A.10Technical annex

Table A.13Technical annex
Item	Annex	Contents	Status
A.1	Indicator definitions	the global indicator set, with units and sources	IN THIS EDITION
A.2	Coupling strengths	the twenty-cell matrix and its rationale	IN THIS EDITION
A.3	Scenario specification	SCN-SR08-OUT-01 assumptions and signposts	IN THIS EDITION
A.4	Capability placements	rung evidence for fifteen functions	IN THIS EDITION
A.5	Model diagnostics	first runs and validation	2027
A.6	Sensitivity analyses	influence of coupling strengths	2027
A.7	Regional notes	regional health-security cards	WITH REGIONAL EDITIONS
A.8	Review statements	pass-by-pass review record	AT RELEASE

A.1 · indicator definition: confirmed outbreak case

Construct: a person with a laboratory-confirmed infection with the outbreak pathogen, reported to the responsible agency
Unit: cases, cumulative
Method: national case definitions; laboratory confirmation
Source: ECDC update⁴⁷
Uncertainty: testing reach limits confirmation; suspected cases are reported separately
Known limits: does not record unreported cases or onset dates

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

37UNVERIFIED, not opened: POST-CLOSE, context only: UK Health Security Agency, Outbreaks under monitoring, week 41, week ending 11 October 2026 (9,066 confirmed cases and 4,381 deaths in the DRC), taken from a search-result summary. Observation year 2026. Accessed 2026-11-03.back
38UNVERIFIED, not opened: Africa CDC, declaration of a Public Health Emergency of Continental Security for the Bundibugyo outbreak, May 2026, taken from search-result summaries. Africa Centres for Disease Control and Prevention, Addis Ababa. Observation year 2026. Accessed 2026-11-03.back
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
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
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
17POST-CLOSE, context only: Post-close, context only: CDC (ed.), A(H5) Bird Flu: Current Situation (72 human cases since February 2024; page updated 15 October 2026). US Centers for Disease Control and Prevention, Atlanta. Observation year 2026. Accessed 2026-11-03.back

Data appendix

The indicator set with its sources, the source registers, the licences of every kind of material and the formats of the edition.

10 min read0 figures8 tables21 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

B.1The indicator set

Table B.1Global baseline indicator set
Indicator	Value	Unit	Year	State	Source
Ebola Bundibugyo confirmed cases, DRC	8,116	cases	to 27 Sep 2026	Reported	⁴⁷
Ebola Bundibugyo confirmed deaths, DRC	3,924	deaths	to 27 Sep 2026	Reported	⁴⁷
Health zones affected, DRC	63 of 167	zones	to 27 Sep 2026	Reported	⁴⁷
States Parties rejecting IHR amendments	11 of 196	States Parties	2025	Reported	⁴
Zero-dose children	13.5	million	2025	Reported	⁸
Two-dose measles coverage	77	%	2025	Reported	⁸
Measles deaths	95,000	deaths	2024	Reported	⁹
Infections resistant to treatment	≈ 1 in 6	share	2023	Reported	⁶
Bacterial AMR-associated deaths	> 4.7	million	2021	Reported	⁷
Cholera cases	451,499	cases	2025	Reported	¹⁰
Cholera deaths	7,870	deaths	2025	Reported	¹⁰
Dengue cases	> 14.6	million	2024	Reported	¹¹
Tuberculosis, people falling ill	10.7	million	2024	Reported	¹²
Development assistance for health	39	USD billion	2025	Reported	²²
US dairy herds with H5 detections since 2024	1,088	herds	to 1 Mar 2026	Reported	⁴⁸

Indicators, CSV Indicators, JSON

B.2Global source register

The governed source set behind this edition. Each source keeps its authority, coverage, cadence and role; categories describe origin, not truth.

Domains bound by the register

Table B.3Global source register
Source	Category	Coverage	Period	Cadence	Role
ECDC Ebola update⁴⁷	EU agency	DRC and region	2026	weekly	outbreak counts
WHO Disease Outbreak News²⁵²⁶	UN agency	DRC and Uganda	2026	per event	outbreak counts
WHO IHR notice⁴	UN agency	global	2025	one-off	rules in force
WHO Assembly notices¹²³	UN agency	global	2026	per session	annex status
WHO GLASS report⁶	UN agency	global	2023	annual	resistance
WHO immunisation and measles fact sheets⁸⁹	UN agency	global	2024 to 2025	annual	immunity
FAO, WHO and WOAH H5 assessment⁴⁸	UN agencies	global	2024 to 2026	periodic	dairy herd detections
IHME Financing Global Health²²	research institute	global	2025	annual	aid for health
WHO cholera, dengue, TB fact sheets¹⁰¹¹¹²	UN agency	global	2024 to 2025	annual	disease burden
GPMB reports¹⁶	independent board	global	2026	annual	preparedness monitoring

B.3Regional reading, ten regional clusters

Map plates follow with the regional Baseline Editions, when boundary sources and public-safe resolutions are bound. This page gives the regional reading in table form and ranks no region.

Table B.4Regional reading, ten regional clusters
Region	Principal hazards	Systems most exposed	Baseline evidence
North America	H5 in dairy herds; measles	animal health, immunity	FAO, WHO and WOAH⁴⁸; WHO⁹
South America	dengue; vector-borne spread	vector control, water	WHO dengue sheet¹¹
Europe	imported cases; surveillance; resistance	surveillance, borders	ECDC⁴⁷; WHO²⁶
Eurasia	regional evidence not bound	not bound	not bound
Middle East and North Africa	protection of health care in conflict	health care, water	WHO Assembly update³
Africa	Ebola Bundibugyo; mpox; cholera; Marburg	outbreak response, water	ECDC⁴⁷; WHO⁵¹⁰¹⁹
South Asia	resistance; wild polio in Pakistan and Afghanistan	immunity, surveillance	WHO⁶²⁹
East Asia	regional evidence not bound	not bound	not bound
ASEAN	regional evidence not bound	not bound	not bound
Oceania-Pacific	regional evidence not bound	not bound	not bound

B.4Regional card: eastern DRC and neighbours

region
outbreak
cross-border
no licensed countermeasure

Systems in view: health, trade, travel, water
Defining events: Bundibugyo virus disease emergency declared in May 2026²⁴
Couplings: BIO → HLT; HLT → TRD; FIN → HLT
Capability evidence: contact follow-up and trial protocols under way²⁵⁴⁷
Gaps: cross-border data; unreported cases; countermeasures
Agenda items: H-01 · H-02

The DRC reported 8,116 confirmed cases and 3,924 deaths in seven provinces; Uganda reported 20 confirmed cases earlier in 2026 [47].

OUTBREAK

Counts to 27 September 2026

No licensed vaccine or specific treatment exists; candidate products are in trials and a licensed Ebola vaccine is being used in a research protocol [47].

RESPONSE

Countermeasures

In June 2026 WHO assessed risk as very high in the DRC, high in Uganda and neighbouring countries and low globally [25].

RISK

Assessment

B.5How countries appear in the global edition

Countries enter the health security edition through the health chapters of their own national editions, on one card grammar. They are read against peer distributions and thresholds, never placed in a league table.

Table B.5How countries appear in the global edition
Card field	What it shows	Source
WEFH+B state	each core system against peer distribution bands	national edition
Couplings	the national dependency matrix	national edition
Risk objects	the national risk portfolio	national edition
Capability rungs	the national capability ladder	national edition
Evidence age	oldest and newest source dates	national source register

Editions in the 2026 Baseline programme

26national

countries and unions

10regional

clusters

16global

flagship and sector

14strategic

systems reports

20frontier

technology reports

How to read a country card

Each system is shown against the distribution of its peers, with thresholds where they exist
Couplings and risk objects come from the country’s own national edition
Capability rungs record evidence, not a judgement of institutions
Evidence age is printed, so older national data are visible as such

Table B.6National Baseline Editions in the 2026 programme
Wave	Countries and unions	State
W0	Canada	ISSUED
W1	United States, United Kingdom, France, Germany, Italy, Japan, European Union, Switzerland	PLANNED
W2	Mexico, Brazil, Argentina, Türkiye, Russian Federation, Saudi Arabia, United Arab Emirates, South Africa, Senegal, Kenya, African Union, India, China, Republic of Korea, Indonesia, Singapore, Australia	PLANNED

B.6Licences

Table B.7Licences of each kind of material
Material	Licence
Text	CC BY 4.0
Data	on the licence of each source; Nexus tables CC BY 4.0
Figures	Nexus figures CC BY 4.0; third-party as credited
Maps	boundary source and licence printed on each plate
Metadata	CC0 1.0, as Zenodo publishes it
Third-party data, figures and text	The source’s own licence, credited where it is used; never relicensed
Nexus-authored text, tables and figures: CC BY 4.0 (SPDX CC-BY-4.0). Map plates print their boundary source and licence.

B.7Formats and provenance

Table B.8This edition in every format
Format	Kind	State	What it is	Identifier
Web edition	HTML	On this site	Draft in stewardship review; every value resolves to its source.	NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-v1.0.0
Print edition	PDF	At release	A4 portrait · screen, print and archival PDF, signed with the web edition at release.	NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-v1.0.0
Indicator data	CSV · JSON	On this site	15 indicators with unit, year, status and source; the machine-readable copy ships with the evidence bundle at release.	NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE data release v1
Figures	SVG · PNG	On this site	4 on the web edition: headline figure, figure 1.3, coupling instrument, capability ladder.	FIG-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-*
Slides	PDF	Not recorded	No slide deck is recorded for this edition.
Evidence brief	HTML · PDF	Not recorded	No evidence brief is recorded for this edition.
Dataset with DOI	DataCite	At release	Concept and version DOI are minted at deposit; none is recorded yet.

Provenance

Edition pack: The edition’s content pack (JSON), from which the print and web editions are built
Evidence cut: DC-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-B0, closed 30 September 2026
Reproducibility: sourced values cited; analytical values reproducible from stated parameters
Self-check: 14 of 23 at evidence close; a fail on any item blocks release
Review: five passes scheduled before release (in Annex C)
Publisher of record: GCRI for the Nexus Consortium
Corrections: Registry correction pathway; upheld corrections are published as notices with a new version

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

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
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
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
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
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
7WHO (ed.), Antimicrobial resistance, fact sheet (more than 4.7 million deaths associated with bacterial resistance in 2021; 10% reduction target by 2030). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03.back
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
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
12WHO (ed.), Tuberculosis, fact sheet (10.7 million people fell ill and 1.23 million died in 2024; funding figures). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
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
48FAO, WHO and WOAH (eds.), Updated joint FAO/WHO/WOAH public health assessment of recent high pathogenicity avian influenza A(H5) virus events in animals and people, 18 May 2026 (since 2024 and as of 1 March 2026, 1,088 dairy herds in 19 US states affected; human detections reported in Bangladesh, Mexico and the United States). Food and Agriculture Organization, World Health Organization and World Organisation for Animal Health, Rome, Geneva and Paris. Observation year 2026. Accessed 2026-11-03.back
25POST-CLOSE, context only: WHO (ed.), Disease Outbreak News 2026-DON607, 13 June 2026 (695 confirmed cases; risk assessment; continental response plan June to November 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
1WHO (ed.), WHO Member States agree to extend negotiations on key annex to the Pandemic Agreement, news release of 28 March 2026 (sixth Intergovernmental Working Group meeting, 23 to 28 March 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
2WHO (ed.), WHO Member States agree to extend negotiations on the Pathogen Access and Benefit Sharing annex, news release of 1 May 2026 (resumed sixth meeting 27 April to 1 May 2026; seventh meeting 6 to 17 July 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
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
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
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
19WHO (ed.), Marburg virus disease, fact sheet (case fatality 24% to 88% in past outbreaks; Rwanda 2024: 66 cases and 15 deaths; fruit bat host). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03.back
29WHO (ed.), Poliomyelitis, fact sheet (endemic transmission in areas of Afghanistan and Pakistan; Emergency Committee statements). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back
24WHO (ed.), WHO Director-General’s opening remarks at the media briefing on Ebola outbreak in DRC and Uganda, 20 May 2026 (Bundibugyo virus; not a pandemic emergency; Contingency Fund for Emergencies). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.back

References and record

Every source the edition rests on, the publication record, the corrections log and the open record.

15 min read0 figures1 table0 notesNR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE

C.148 sources

NR-CIT-1, editor first. A DOI is linked where the source has one; Nexus records carry a UNI once the catalogue allocates it (NS-1).

1WHO (ed.), WHO Member States agree to extend negotiations on key annex to the Pandemic Agreement, news release of 28 March 2026 (sixth Intergovernmental Working Group meeting, 23 to 28 March 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in chapter 2
2WHO (ed.), WHO Member States agree to extend negotiations on the Pathogen Access and Benefit Sharing annex, news release of 1 May 2026 (resumed sixth meeting 27 April to 1 May 2026; seventh meeting 6 to 17 July 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in the summary, chapter 2, chapter 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. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 7
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. Cited in the summary, chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
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. Cited in the summary, chapter 2, chapter 3, chapter 4, chapter 5, chapter 6, chapter 8
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. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
7WHO (ed.), Antimicrobial resistance, fact sheet (more than 4.7 million deaths associated with bacterial resistance in 2021; 10% reduction target by 2030). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03. Cited in chapter 4, chapter 6, chapter 8
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. Cited in the summary, chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
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. Cited in chapter 2, chapter 3, chapter 4, chapter 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. Cited in the summary, chapter 1, chapter 3, chapter 8
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. Cited in chapter 1, chapter 3, chapter 8
12WHO (ed.), Tuberculosis, fact sheet (10.7 million people fell ill and 1.23 million died in 2024; funding figures). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6, chapter 8
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. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 8
14WHO (ed.), Zoonoses, fact sheet (over 200 known types of zoonoses; no percentages given on the page). World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 2
15WHO, FAO, UNEP and WOAH (eds.), One Health Joint Plan of Action launched to address health threats to humans, animals, plants and environment, news release of 17 October 2022 (plan period 2022 to 2026; six action tracks). World Health Organization, Geneva. Observation year 2022. Accessed 2026-11-03. Cited in chapter 4, chapter 6
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. Cited in chapter 3, chapter 6
17POST-CLOSE, context only: Post-close, context only: CDC (ed.), A(H5) Bird Flu: Current Situation (72 human cases since February 2024; page updated 15 October 2026). US Centers for Disease Control and Prevention, Atlanta. Observation year 2026. Accessed 2026-11-03.
18WHO (ed.), Influenza (avian and other zoonotic), fact sheet of 21 January 2026 (hundreds of human cases; no cumulative count on the page). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in chapter 4
19WHO (ed.), Marburg virus disease, fact sheet (case fatality 24% to 88% in past outbreaks; Rwanda 2024: 66 cases and 15 deaths; fruit bat host). World Health Organization, Geneva. Observation year 2024. Accessed 2026-11-03. Cited in chapter 1
20WHO (ed.), 14.9 million excess deaths were associated with the COVID-19 pandemic in 2020 and 2021, news release of 5 May 2022 (range 13.3 to 16.6 million). World Health Organization, Geneva. Observation year 2021. Accessed 2026-11-03. Cited in chapter 6
21US Department of Health and Human Services (ed.), HHS Fact Sheet: U.S. Withdrawal from the World Health Organization (Executive Order 14155 of 20 January 2025; effective 22 January 2026), hosted on the CDC site. HHS, Washington. Observation year 2026. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2
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. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 6, chapter 7, chapter 8
23STAT (ed.), Congo’s last Ebola patient is discharged, article of 20 October 2025 (Kasai province outbreak declared 4 September 2025; 64 cases, 43 deaths; 42-day countdown). STAT, Boston. Observation year 2025. Accessed 2026-11-03. Cited in chapter 4, chapter 8
24WHO (ed.), WHO Director-General’s opening remarks at the media briefing on Ebola outbreak in DRC and Uganda, 20 May 2026 (Bundibugyo virus; not a pandemic emergency; Contingency Fund for Emergencies). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in the summary, chapter 2, chapter 6, chapter 8
25POST-CLOSE, context only: WHO (ed.), Disease Outbreak News 2026-DON607, 13 June 2026 (695 confirmed cases; risk assessment; continental response plan June to November 2026). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03. Cited in the summary, chapter 1, chapter 2, chapter 6
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. Cited in the summary, chapter 3, chapter 6, chapter 8
27ESCMID (ed.), Bundibugyo virus disease outbreak in the Democratic Republic of the Congo and Uganda, day-100 update of 28 August 2026 (end of the Uganda outbreak confirmed 27 August 2026). European Society of Clinical Microbiology and Infectious Diseases, Basel. Observation year 2026. Accessed 2026-11-03.
28POST-CLOSE, context only: ECDC (ed.), Ebola (Bundibugyo virus disease) in the Democratic Republic of the Congo, update of 5 October 2026 (cases up to 2 October 2026: 8,442 confirmed and 4,080 deaths; seven provinces; vaccine candidates). European Centre for Disease Prevention and Control, Stockholm. Observation year 2026. Accessed 2026-11-03.
29WHO (ed.), Poliomyelitis, fact sheet (endemic transmission in areas of Afghanistan and Pakistan; Emergency Committee statements). World Health Organization, Geneva. Observation year 2026. Accessed 2026-11-03.
30UNVERIFIED, not opened: GBD 2021 Antimicrobial Resistance Collaborators, Global burden of bacterial antimicrobial resistance 1990 to 2021: a systematic analysis with forecasts to 2050, The Lancet, 2024 (1.14 million attributable and 4.71 million associated deaths in 2021), taken from search-result summaries; the article returned an access error. Observation year 2021. Accessed 2026-11-03. Cited in chapter 6
31UNVERIFIED, not opened: The Pandemic Fund (ed.), funding rounds and projects (US$499.6 million to 20 projects in the third round, February 2026; US$1.4 billion across three rounds), taken from search-result summaries; the site returned an access error. World Bank and WHO, Washington and Geneva. Observation year 2026. Accessed 2026-11-03. Cited in chapter 4, chapter 6
32UNVERIFIED, not opened: Biological Weapons Convention Working Group on the strengthening of the Convention, seventh session, Geneva, 8 to 12 December 2025, and draft final report of 1 October 2025, taken from search-result summaries. Biological Weapons Convention Implementation Support Unit, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 2, chapter 6
33UNVERIFIED, not opened: King’s College London and George Mason University, Global BioLabs Report 2023 (51 operating level-4 laboratories in 27 countries and 18 planned or under construction), taken from search-result summaries; the document text was not readable. Observation year 2023. Accessed 2026-11-03. Cited in chapter 4, chapter 6, chapter 8
34UNVERIFIED, not opened: WHO Pandemic Agreement, resolution WHA78.1, adopted by the Seventy-eighth World Health Assembly on 20 May 2025, cited from memory and from search summaries; the date was not read on a WHO page. World Health Organization, Geneva. Observation year 2025. Accessed 2026-11-03. Cited in chapter 6
35UNVERIFIED, not opened: Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on their Destruction, 1972, cited from memory. United Nations, Geneva. Observation year 1972. Accessed 2026-11-03. Cited in chapter 6
36UNVERIFIED, not opened: WHO, International Health Regulations (2005), third edition, cited from memory. World Health Organization, Geneva. Observation year 2005. Accessed 2026-11-03. Cited in chapter 6
37UNVERIFIED, not opened: POST-CLOSE, context only: UK Health Security Agency, Outbreaks under monitoring, week 41, week ending 11 October 2026 (9,066 confirmed cases and 4,381 deaths in the DRC), taken from a search-result summary. Observation year 2026. Accessed 2026-11-03.
38UNVERIFIED, not opened: Africa CDC, declaration of a Public Health Emergency of Continental Security for the Bundibugyo outbreak, May 2026, taken from search-result summaries. Africa Centres for Disease Control and Prevention, Addis Ababa. Observation year 2026. Accessed 2026-11-03.
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. Cited in chapter 3, chapter 6
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. Cited in chapter 3, chapter 6
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. Cited in chapter 3, chapter 6
42UNVERIFIED, not opened: WHO, Laboratory biosafety manual, fourth edition. World Health Organization, Geneva, 2020, cited from memory. Observation year 2020. Accessed 2026-11-03. Cited in chapter 4, chapter 6
43UNVERIFIED, not opened: ISO 35001:2019, Biorisk management for laboratories and other related organisations. International Organization for Standardization, Geneva. Observation year 2019. Accessed 2026-11-03. Cited in chapter 6
44UNVERIFIED, not opened: United Nations General Assembly, Political declaration of the high-level meeting on antimicrobial resistance, 2024, cited from memory. United Nations, New York. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
45UNVERIFIED, not opened: WOAH (ed.), Terrestrial Animal Health Code, cited from memory. World Organisation for Animal Health, Paris. Observation year 2024. Accessed 2026-11-03. Cited in chapter 6
46UNVERIFIED, not opened: IHME and Lancet authors, Tracking development assistance for health, 1990 to 2030, The Lancet, 2025, published with Financing Global Health 2025, taken from search-result summaries. Observation year 2025. Accessed 2026-11-03. Cited in chapter 6
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. Cited in the summary, chapter 1, chapter 2, chapter 3, chapter 4, chapter 5, chapter 6, chapter 7, chapter 8
48FAO, WHO and WOAH (eds.), Updated joint FAO/WHO/WOAH public health assessment of recent high pathogenicity avian influenza A(H5) virus events in animals and people, 18 May 2026 (since 2024 and as of 1 March 2026, 1,088 dairy herds in 19 US states affected; human detections reported in Bangladesh, Mexico and the United States). Food and Agriculture Organization, World Health Organization and World Organisation for Animal Health, Rome, Geneva and Paris. Observation year 2026. Accessed 2026-11-03. Cited in chapter 2, chapter 4

C.2Publication record

Publication

Title: Strategic Systems Report 2026: Health Security, One Health and Biosecurity, Baseline Edition
Series: Reports · Strategic Systems Series SR-08
Edition: Baseline Edition 2026 · inaugural annual
Version: v1.0.0 · draft for stewardship review
Publication ID: NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-v1.0.0
Evidence close: 30 September 2026
Publication date: October 2026
DOI: concept and version DOI at deposit

Publisher

Publisher of record: The Global Centre for Risk and Innovation (GCRI), for the Nexus Consortium
Place: Toronto
Editor: Saeed Valadbaygi, Chief Steward and Managing Editor
Stewards: GCRI · technical truth · GRF · public meaning · GRA · capital meaning
Licence: text CC BY 4.0; data on the terms of each source
Language: English (en-GB) source edition
Correspondence: Registry correction pathway · editorial office

Colophon

Format: A4 portrait · screen, print and archival PDF
Typefaces: Space Grotesk (display) · Geist (text) · IBM Plex Sans Italic (standfirsts) · IBM Plex Mono (data)
Design standard: Reports Foundational Edition, Volume I, Part VII
Accessibility: tagged PDF and HTML targets; text alternatives for every figure
Production: Reports editorial team, GCRI

Release path for this version

Table C.1Release path for this version
Step	What happens	When
Draft	editorial self-check complete at evidence close	October 2026
Steward review	five passes on the exact draft (keys T · M · F · N)	Q4 2026
Approval	publication authority approves the exact digest	before release
Deposit	concept and version DOI minted; registry pointer set	at release
Succession	the 2027 health security edition reports changes against this baseline	2027

Current version: v1.0.0 draft, stewardship review
Previous edition: none, first edition of the series
Next edition: NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2027-v1.0.0

Latest version: resolve the concept DOI or the registry record
Correction route: Registry correction pathway
Notice types: erratum · addendum · supersession · withdrawal

C.3Corrections log

0correction notices. No edition has been released yet, so none can be corrected; the log below lists each edition’s current version.

Edition	Version	Date	State	Change	Notice
SR-08	NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-v1.0.0	October 2026	Draft	Baseline Edition 2026, inaugural annual edition,	None

Notice types: erratum, addendum, supersession, withdrawal. A correction is a new version with a published notice; the earlier version stays resolvable, and no edition is ever edited in silence.

C.4Open record

This edition’s open record

Publication ID: NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE-v1.0.0
Desk identifier and series alias: NR-STR-SR-08-2026-BL
Collection: None
DOI: Concept and version DOI at deposit, on Zenodo with DataCite metadata
Versions: Each correction is a new version (isNewVersionOf); the concept DOI resolves to the latest
Bundle: RO-Crate 1.2 with CITATION.cff, CodeMeta and PROV-O provenance; a signed manifest
Licence: CC BY 4.0 (SPDX CC-BY-4.0) for original material; metadata CC0 1.0

Credit and identity

ORCID: Your iD in the deposit and the contribution record; DataCite can then add the work to your ORCID record
ROR: Your organisation by its ROR identifier, never by a typed name alone
CRediT: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Validation, Visualisation, Writing, review and editing
Account: None needed to contribute; never a password

Find and follow

Search the open indexes for Health Security, One Health and Biosecurity; software is cited by its SWHID from Software Heritage, and a quantified scenario run is preregistered on OSF before it is run. Annotation is your choice: Hypothesis opens this page in its own viewer.

Mirrors and harvest

The DOI is canonical. At release each signed bundle is also given an IPFS content identifier and a bloxberg anchor as mirrors; both are listed in the record once they exist. Zenodo exposes every record over OAI-PMH, and reviews and endorsements can arrive through COAR Notify where the repository supports it.

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C.5Where this edition sits among the six pillars

Foundry seals the evidence and Universe tests it; Reports publishes it; Standards takes its corrections and Academy teaches from it.

F03 Sealed observations and indicator series Foundry Sealed observations and indicator series behind a profile (closeout).
F04 After-action and scenario findings for Universe After-action and scenario findings for chapters 10 and 13 (after action review).
F05 National Portfolio movement for chapter Foundry National Portfolio movement for chapter 11 (after action review).
Applied in editions Standards Nexus Standards: applied in editions.
SR-08 edition Reports Health Security, One Health and Biosecurity 2026, published in every format with its sources, citation and corrections.
F06 Method and correction findings as change Standards Method and correction findings as change proposals (correction).
F12 Q4 synthesis informs the next-year Universe Q4 synthesis informs the next-year mandate (renewal).
Taught in the open Academy Risk Academy: taught in the open.

What Foundry and Universe hand to this edition, and what it hands to Standards, Universe and Academy. From the programme spine; SR-08 is a drafted Baseline Edition, so these handoffs run from its first operational quarter.

Handoff	Between	What crosses, and when
F03	Foundry to Reports	Sealed observations and indicator series behind a profile (closeout).
F04	Universe to Reports	After-action and scenario findings for chapters 10 and 13 (after action review).
F05	Foundry to Reports	National Portfolio movement for chapter 11 (after action review).
Ring	Nexus Standards to Reports	Nexus Standards: applied in editions.
F06	Reports to Nexus Standards	Method and correction findings as change proposals (correction).
F12	Reports to Universe	Q4 synthesis informs the next-year mandate (renewal).
Ring	Reports to Risk Academy	Risk Academy: taught in the open.

S.1Abstract

S.2Key messages

S.3Headline finding

S.4At a glance

S.5What each steward reads in it

Technical Truth

Public Meaning

Capital Meaning

Synthesis

S.6What this edition is, and is not

What this edition is

What it is not

What comes next

Notes

1.1The questions this part answers

Key questions

In this part

1.2The argument

1.3Twenty couplings between five systems

Transmission paths

Notes

2.1Headline finding

Implication

What would move it

2.2Health

2.3Biodiversity

2.4Finance

2.5Development

2.6Systemic

Notes

3.1Where each system stood at evidence close

Confirmed Ebola Bundibugyo cases, DRC

States Parties rejecting the 2024 IHR amendments

Zero-dose children

Bacterial infections resistant to treatment

Development assistance for health

Pandemic Agreement annex, next decision point

3.2Domain posture

3.3Sector screens

Notes

4.1Risk objects

Cross-border outbreak without licensed countermeasures

Immunity gaps and measles resurgence

Drug-resistant infection

Spillover from animals and novel influenza

4.2Capability ladder

Notes

5.1Assumptions

5.2The cascade, step by step

5.3The scenario as a table of steps

Notes

6.1The other desks’ editions of this subject

6.2Three lenses

Technical Truth

Public Meaning

Capital Meaning

Synthesis

6.3Standards, Academy and steward contributions

Standards drafts used in this edition

Standards calendar to watch

6.4GCRI reading: the model card

6.5Global Risks Forum reading: editorial essays

EDITORIAL ESSAY · 01

EDITORIAL ESSAY · 02

EDITORIAL ESSAY · 03

EDITORIAL ESSAY · 04

6.6Global Risks Alliance reading: 2027 health security readiness pack

Publication dispositions

6.7Nexus Standards reading: standards and regulatory watch

Changed since 2024

To watch in 2027

6.8Risk Academy reading: literature and evidence review, science and assessments

Review protocol

Where the evidence agrees

Where it is unsettled

Notes

7.1Questions for the operational series

7.2Portfolio proposed for the Q1 2027 alignment

7.3The pathway

7.4Universe 2027: evidence pack for the health security candidate mission