Methodology
How the edition was made: methods, the model card, the evidence cut and its age, the acceptance record and the glossary.
Contents
- ·Edition home
- ·Executive summary
- 1Health threats cross every line
- 2Key findings
- 3Systems and sectors at baseline
- 4Risks and capability
- 5High-consequence outbreak that overlaps reduced financing and thin surveillance
- 6Readings from the other desks
- 7The 2027 agenda
- 8Systems in depth
- AMethodology
- A.1 Methods
- A.2 Model card, Health Security System Model v0
- A.3 The baseline evidence cut
- A.4 Evidence age and coverage
- A.5 Evidence cards, two anchor sources
- A.6 Publication acceptance record
- A.7 Status words
- A.8 How the edition is made, released and corrected
- A.9 Glossary and abbreviations
- A.10 Technical annex
- BData appendix
- CReferences and record
- ·Complete edition, for print
A.1Methods
The global baseline uses published values and four simple derivations. Each is shown in full so that any reader can reproduce it.
| 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 |
| 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 |
| 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
| 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.
| 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 |
| 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 |
| 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
| 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
A.6Publication acceptance record
Editorial self-check at evidence close. Every applicable item carries a disposition; the remaining items are review, approval and deposit.
| 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
| 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
| 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 |
| 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
| 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