rapid response no country scored in the top tier for this category with 58 scoring below average for rapid response to and mitigation of the spread of an epidemic only 69 countries have an overarching national public health emergency response plan in place that addresses planning for multiple communicable diseases with epidemic and pandemic potentialindia scores 303 in this category which is below the global average of 376 and ranks 139 in the list it lags behind in three sectors linking public health and security authorities access to communications infrastructure and trade and travel restrictions finland tops the list with a score of 707 health system the average score in this category is 315 out of 100 with 73 countries scoring in the bottom tier 020 69 countries have insufficient capacity at health clinics hospitals and community centers 91 of countries do not have a plan program or guidelines in place for dispensing medical countermeasures such as vaccines and antiviral drugs for national use during a public health emergency altogether the health systems category shows little progress since 2019 and identifies serious gaps in capacity in nationallevel medical workforce facilities and healthcare accessindia scores 15 points above the global average in this category at 461 and ranks 56 in the list it has a perfect score in two sectors communications with healthcare workers during a public health emergency and infection control practices it however lags far behind in terms of healthcare access the us once again tops the list with a score of 752 commitments to improving national capacity financing and global norms 23 countries 19 of which are high or uppermiddleincome countries have not submitted their international health regulations reports to the world health organization who and only four countries have identified funding in their national budgets to address gaps identified in their who joint external evaluation jee the 2021 ghs index shows a lack of progress toward enhanced global coordination and lagging commitment to international norms which are important for accountability and necessary for collective action in addressing the most challenging aspects of health securityindias score is at par with the global average in this category at 472 and ranks 92 in the list it has a perfect score in international commitments but lags behind in two sectors ihr reporting compliance and crossborder agreements on public and animal health emergency response the us again tops the list with a score of 879 risk environment as seen with covid19 national risk environment factors such as orderly transfer of power social unrest international tensions and trust in medical and health advice from the government can have an outsized impact on a countrys response to a public health threat 114 countries demonstrate a moderate to very high threat of international disputes or tensions that would have a negative effect on daily operationsincluding public services governing and civil societywith 24 highincome countries scoring below the global averageindia scores slightly above the global average in this category at 602