Evaluation of joint external evaluation to COVID-19 and other infectious diseases mortality outcomes in 96 countries

Background This study evaluated the effectiveness of Joint External Evaluation (JEE) scores with regard to coronavirus disease 2019 (COVID-19) and other infectious diseases performance in 96 countries. To propose a revised JEE tool, potential JEE indicators were also examined.Methods JEE data from 2016-2019 were linked with outcomes such as COVID-19 fatality rates and infections, as well as mortality rates for other infectious diseases. We also examined potential indicators such as the Sustainable Development Goals (SDGs) and Universal Health Coverage index to propose enhancements to the JEE tool. Multiple regression analysis was used to assess these associations.Results The average JEE score was 2.70 (SD=0.92) in 96 countries. Detection capabilities received the highest average score (3.23), while the other areas (2.30) section received the lowest scores. However, the analysis revealed that the JEE tool had limited predictive accuracy for COVID-19 outcomes. By contrast, the JEE scores showed a negative association with the performance of other infectious diseases. Notably, SDGs 2 (zero hunger), 4 (quality education) and 8 (decent work and economic growth) were strongly associated with better COVID-19 outcomes.Conclusion The JEE scores showed limited predictive value for COVID-19 mortality outcomes in 96 countries. The tool offers insights into health security, but needs revision to better handle future pandemics.