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

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

Contents
  1. ·Edition home
  2. ·Executive summary
  3. 1Health threats cross every line
  4. 2Key findings
  5. 3Systems and sectors at baseline
  6. 4Risks and capability
    1. 4.1 Risk objects
    2. 4.2 Capability ladder
  7. 5High-consequence outbreak that overlaps reduced financing and thin surveillance
  8. 6Readings from the other desks
  9. 7The 2027 agenda
  10. 8Systems in depth
  11. AMethodology
  12. BData appendix
  13. CReferences and record
  14. ·Complete edition, for print

4.1Risk objects

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

  1. 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

  2. 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

  3. 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

  4. 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
FunctionRungLevelStrongest public evidence at baseline
Prevention and mitigationEXISTSimmunisation and food-safety programmes; coverage uneven89
Monitoring and observationADEQUATEWHO and regional agencies publish notices; 48% of countries did not report resistance data6
Early warningEXISTSIHR alert levels, now including a pandemic emergency tier4
Preparedness and planningEXISTSnational IHR authorities required by the amendments4
Redundancy and reservesLISTEDstockpiles and surge capacity not consolidated
ResponseDEMONSTRATEDthe mpox emergency ended after sustained decline; a 2025 Ebola outbreak ended523
Continuity of critical servicesLISTEDroutine services during outbreaks not consolidated
RecoveryLISTEDpost-outbreak recovery data not consolidated
AdaptationEXISTSOne Health joint plan of action for 2022 to 202615
Social protectionLISTEDsupport for affected households not consolidated
Finance and insuranceLISTEDpooled financing exists; amounts not verified here3122
Institutional coordinationEXISTSIHR, Quadripartite and the Pandemic Agreement process4133
Technical infrastructureEXISTSlaboratory and surveillance networks; high-containment laboratory oversight not bound3342
WorkforceLISTEDhealth and veterinary workforce not consolidated
Research capacityADEQUATEcandidate 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

  1. 47ECDC (ed.), Ebola disease outbreak caused by Bundibugyo virus, Democratic Republic of the Congo, update of 30 September 2026 (cases up to 27 September 2026: 8,116 confirmed and 3,924 deaths; seven provinces; 63 of 167 health zones; Uganda 20 confirmed cases). European Centre for Disease Prevention and Control, Stockholm. Observation year 2026. Accessed 2026-11-03.back
  2. 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
  3. 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
  4. 6WHO (ed.), WHO warns of widespread resistance to common antibiotics worldwide, news release of 13 October 2025 on the Global antibiotic resistance surveillance report 2025 (data year 2023; 104 reporting countries). World Health Organization, Geneva. Observation year 2023. Accessed 2026-11-03.back
  5. 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
  6. 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
  7. 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
  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.back
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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

Cite this chapter

Valadbaygi, S. (Ed.). (2026). Chapter 4: Risks and capability. In Strategic Systems Report 2026: Health Security, One Health and Biosecurity (Baseline Edition 2026, Report No. NR-STRATEGIC-HEALTHSECURITY-GLOBAL-2026-BASELINE) [Draft under review]. The Global Centre for Risk and Innovation (GCRI).

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

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The sectors behind Health Security, One Health and Biosecurity.

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

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Health and its partners

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

W · E · I · F · H · B

Sectors
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Relations
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  • Infrastructure → Water · pipes, dams and treatment works0.6
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