Ebola Country Risk Matrix
Summary
High Political Risk
Political
High High High Health Economic Sociocultural Risk
Risk
Risk
(≥ 5 red, few (≥ 2 red, all (≥ 4 red, few (≥ 2 red, few or no items are or no or no mitigating red or mitigating mitigating factors)
yellow)
factors)
factors)
Region/ Grouping
Country
Guinea
Heavily affected Liberia
countries
Sierra Leone
Angola
Burkina Faso
Central African Republic
Chad
Côte d'Ivoire
Democratic Republic of the Congo (DRC)
Sub-­‐Saharan Ethiopia
Africa
Guinea-­‐Bissau
Kenya
Mali
Niger Nigeria
Senegal
Somalia
South Africa
South Sudan
Zimbabwe
X
X
Political Stability/ Fragile Voice and Absence of States Index Accountability
(score Violence (scaled score (scaled score 10–120) 0–100)
0–100)
X
X
X
X
X
X
X
X
X
9.09
8.61
12.44
4.74
19.43
21.33
11.37
31.28
40.76
102.7
94.3
89.9
17.06
33.18
36.02
X
X
X
10.53
31.10
8.53
37.44
35.55
21.80
87.4
89.0
16.11
38.86
X
X
X
X
0.96
0.47
3.32
110.6
6.16
X
X
X
X
X
5.26
15.79
5.69
18.96
15.17
17.06
109.7
101.7
10.43
27.01
X
X
1.44
2.84
2.37
110.2
7.58
X
X
X
X
X
X
X
X
X
X
35.89
6.22
36.84
22.01
27.75
16.27
37.80
0.00
66.51
5.74
12.92
32.70
1.90
27.96
27.01
27.49
12.32
45.97
0.00
57.82
4.27
2.37
8.06
18.48
13.74
6.64
9.95
3.79
43.13
0.00
44.08
5.69
24.17
97.9
100.6
99.0
89.8
97.9
99.7
82.8
112.6
66.6
112.9
102.8
12.80
9.00
41.23
37.91
36.49
27.49
50.24
0.47
65.40
9.00
9.95
14.35
8.13
3.79
3.32
4.27
0.47
102.2
101.6
16.59
3.79
7.18
22.49
47.37
23.44
45.93
1.42
22.75
52.61
20.85
46.45
1.42
7.58
12.32
0.95
26.07
106.5
92.8
76.9
103.0
92.6
13.27
35.07
61.14
24.64
28.91
18.66
54.07
45.45
81.82
4.31
56.24
61.24
16.11
39.81
36.49
64.45
10.90
41.71
51.66
40.28
27.01
28.91
47.87
13.27
16.59
9.00
88.5
79.0
76.8
66.2
94.3
85.3
77.0
20.38
5.21
48.82
37.44
6.64
47.87
34.12
X
X
+
X
X
+
Iraq
Syria
X
X
X
South Asia
Afghanistan
Bangladesh
India
Pakistan
Sri Lanka
X
+
X
X
+
X
X
+
+
X
X
X
X
X
X
X
X
X
+
+ indicates that unavailable or missing indicator data did not permit complete assessment and may underestimate overall risk.
PE-­‐146_IndicatorFrameworkForEbolaRiskCountries.xlsx
Rule of Law
(scaled score 0–100)
X
X
Middle East
Cambodia
China
Indonesia
Southeast Asia Malaysia
Myanmar
Philippines
Thailand
Government Effectiveness
(scaled score 0–100) +
NOTE: A country was judged to be at HIGH political risk if at least two of the
five indicators registered as high risk; at LOW risk if at least three of the five
five indicators were low risk, with no high-­‐risk indicators; and otherwise at MEDIUM risk.
RAND Corporation
PE-­‐146
1
Ebola Country Risk Matrix
Summary
High Political Risk
Economic
High High High Health Economic Sociocultural Risk
Risk
Risk
Wealth/Economic Development
(≥ 5 red, few (≥ 2 red, all (≥ 4 red, few (≥ 2 red, few or no Human items are or no or no GDP per Capita mitigating Development red or mitigating mitigating ($)
factors)
Index (0–1)
yellow)
factors)
factors)
Region/ Grouping
Country
Guinea
Heavily affected Liberia
countries
Sierra Leone
Angola
Burkina Faso
Central African Republic
Chad
Côte d'Ivoire
Democratic Republic of the Congo (DRC)
Sub-­‐Saharan Ethiopia
Africa
Guinea-­‐Bissau
Kenya
Mali
Niger Nigeria
Senegal
Somalia
South Africa
South Sudan
Zimbabwe
X
X
Total Foreign Direct Investment ($ millions) % of Roads That Are Paved
Communications
Knowledge Index
(composite score 0–10)
Mobile Cellular Internet Users (per 100 Subscriptions (per 100 people)
people)
X
X
X
X
X
X
X
X
X
527
454
809
0.392
0.412
0.374
24
1,061
579
9.8
6.2
8.0
1.22
*
0.97
63
60
44
1.6
4.6
1.7
X
X
X
5,668
684
0.526
0.388
-­‐4,284
374
*
4.1
1.08
1.91
62
66
19.1
4.4
X
X
X
X
333
0.341
1
2.7
*
29
3.5
X
X
X
X
X
1,046
1,521
0.372
0.452
1
370
0.8
8.1
*
1.54
36
95
2.3
2.6
X
X
454
0.338
2,098
1.8
*
44
2.2
X
X
X
X
X
X
X
X
X
X
498
504
994
715
413
3,006
1,072
*
6,618
1,221
905
0.435
0.396
0.531
0.407
0.337
0.504
0.485
*
0.658
*
0.492
952
14
514
410
631
5,609
298
107
8,118
*
400
12.8
27.9
14.1
18.0
20.6
15.0
29.2
11.8
17.3
*
19.0
1.27
*
2.88
1.86
*
2.20
2.70
*
5.21
*
2.17
27
74
71
129
39
73
93
49
147
25
96
1.9
3.1
39.0
2.3
1.7
38.0
20.9
1.5
48.9
*
18.5
6,670
*
0.642
0.658
2,852
*
84.3
*
*
2.77
96
56
9.2
26.2
678
829
1,499
1,299
3,280
0.468
0.558
0.586
0.537
0.750
69
1,501
28,153
1,307
915
*
9.5
47.4
65.3
81.0
*
1.49
3.06
2.45
3.63
70
67
71
70
95
5.9
6.5
15.1
10.9
21.9
1,008
0.584
0.719
0.684
0.773
0.524
0.660
0.722
1,345
347,849
18,444
11,582
2,621
3,859
12,649
6.3
49.6
55.4
79.7
*
9.9
98.5
1.71
4.37
3.11
6.10
0.96
3.94
5.21
134
89
122
145
13
105
138
6.0
45.8
15.8
67.0
1.2
37.0
28.9
X
X
+
X
X
+
Iraq
Syria
X
X
X
South Asia
Afghanistan
Bangladesh
India
Pakistan
Sri Lanka
X
+
X
X
+
X
X
+
+
X
X
X
X
X
X
X
X
X
+
+ indicates that unavailable or missing indicator data did not permit complete assessment and may underestimate overall risk.
PE-­‐146_IndicatorFrameworkForEbolaRiskCountries.xlsx
Transporation Networks
X
X
Middle East
Cambodia
China
Indonesia
Southeast Asia Malaysia
Myanmar
Philippines
Thailand
Degree of Globalization
+
6,807
3,475
10,514
*
2,765
5,779
NOTE: A country was judged to be at HIGH economic risk if at least four of the seven indicators registered
as high risk; at LOW risk if at least four of the seven indicators registered as low risk, with no high-­‐risk
indicators; or otherwise at MEDIUM risk.
* indicates that data for this indicator were not available.
RAND Corporation
PE-­‐146
2
Ebola Country Risk Matrix
Summary
Sociocultural
High Political Risk
High High High Health Economic Sociocultural Risk
Risk
Risk
Population (≥ 5 red, few (≥ 2 red, all (≥ 4 red, few (≥ 2 red, few Density or no items are or no or no (per km2) Region/ Grouping
Country
Guinea
Heavily affected Liberia
countries
Sierra Leone
Angola
Burkina Faso
Central African Republic
Chad
Côte d'Ivoire
Democratic Republic of the Congo (DRC)
Sub-­‐Saharan Ethiopia
Africa
Guinea-­‐Bissau
Kenya
Mali
Niger Nigeria
Senegal
Somalia
South Africa
South Sudan
Zimbabwe
Median Age
Urbanization (% of population)
36
49
39
42
28
mitigating factors)
mitigating factors)
X
X
X
X
X
X
X
X
X
X
48
45
84
-­‐1
10
2
25.3
42.9
44.5
*
*
*
18.3
18.3
18.8
X
X
X
17
62
1
-­‐2
70.6
28.7
*
33.6
16.0
16.8
X
X
X
X
X
7
0
36.8
*
19.3
40
X
X
X
X
X
X
X
10
64
-­‐1
-­‐3
37.3
41.0
*
*
15.5
18.8
22
53
X
X
30
0
61.2
X
X
X
X
X
X
X
X
X
X
94
61
78
13
14
191
73
17
44
*
37
0
-­‐4
-­‐1
-­‐2
0
0
-­‐3
-­‐7
6
17
-­‐12
77
124
X
X
+
X
X
+
Iraq
Syria
X
X
X
South Asia
Afghanistan
Bangladesh
India
Pakistan
Sri Lanka
X
+
X
X
+
X
X
+
+
X
X
X
X
X
X
X
X
X
+
+ indicates that unavailable or missing indicator data did not permit complete assessment and may underestimate overall risk.
PE-­‐146_IndicatorFrameworkForEbolaRiskCountries.xlsx
Trust (scaled score 0–150)
red or yellow)
Middle East
Cambodia
China
Indonesia
Southeast Asia Malaysia
Myanmar
Philippines
Thailand
mitigating factors)
Population Mobility Adult (net migration Literacy per 1,000 (age ≥ 15)
people)
+
17.1
41
39.0
74.3
72.1
33.5
15.5
51.1
52.1
*
93.7
*
83.6
*
55.2
*
20.0
44.8
*
29.8
54.2
*
38.0
*
24.9
17.5
18.8
18.5
16.5
15.1
17.9
17.9
16.1
25.2
18.3
18.5
19
49
25
38
18
46
43
39
64
18
33
-­‐3
11
79.0
85.1
82.6
*
19.1
21.9
69
57
47
1,203
421
236
327
-­‐6
-­‐5
-­‐1
-­‐2
-­‐4
31.7
58.8
62.8
54.7
91.2
*
47.7
52.5
65.0
*
15.6
24.0
25.5
21.6
30.5
26
33
32
38
18
86
-­‐5
0
-­‐1
5
-­‐3
-­‐3
-­‐2
73.9
99.6
92.8
93.1
92.6
95.4
96.4
15.6
120.9
16.9
17.7
*
20.1
83.1
23.5
34.6
26.9
26.1
27.8
22.3
35.4
20
54
52
73
33
45
48
145
138
90
82
330
131
NOTE: A country was judged to be at high sociocultural risk if at least one of the four
color-­‐coded indicators registered as high risk; at LOW risk if at least two indicators registered as low risk, with no high-­‐risk indicators; or otherwise at MEDIUM risk.
* indicates that data for this indicator were not available.
RAND Corporation
PE-­‐146
3
Ebola Country Risk Matrix
Summary
High Political Risk
Health
High High High Health Economic Sociocultural Risk
Risk
Risk
Medical Care Workforce
Medical Care Expenditures
Medical Care Public Health Experience
Infrastructure
(≥ 5 red, few (≥ 2 red, all (≥ 4 red, few (≥ 2 red, few Nurses and Hospital Health or no Physicians Health Health items are or no or no Midwives Beds per Centers per mitigating per 1,000 Expenditure Expenditure red or mitigating mitigating per 1,000 10,000 100,000 factors)
People
(% of GDP) per Capita ($)
yellow)
factors)
factors)
People
People
People
Region/ Grouping
Country
Guinea
Heavily affected Liberia
countries
Sierra Leone
Angola
Burkina Faso
Central African Republic
Chad
Côte d'Ivoire
Democratic Republic of the Congo (DRC)
Sub-­‐Saharan Ethiopia
Africa
Guinea-­‐Bissau
Kenya
Mali
Niger Nigeria
Senegal
Somalia
South Africa
South Sudan
Zimbabwe
X
X
X
X
X
X
X
X
0.1
0.0
0.0
0.0
0.3
0.2
0.3
0.8
X
X
X
0.2
0.0
*
6.3
15.5
15.1
32
65
96
4.15
1.13
1.26
1.7
0.6
*
0.4
3.5
6.2
190
38
*
10.35
0
0
1
6
102
64
93
88
X
X
X
X
0.0
0.3
1.0
3.8
18
2.09
0
0
96
23
X
X
X
X
X
*
0.1
*
0.5
*
*
2.8
7.1
25
88
0.00
12.18
0
1
0
0
89
71
48
88
X
X
X
X
X
X
X
X
X
+
X
+
*
0.2
0.6
0.8
0.4
0.1
1.6
0.4
0.1
4.9
*
1.3
*
6.3
1.0
1.4
0.1
*
*
0.3
*
*
*
1.7
15
X
X
*
0.0
0.0
0.2
0.1
0.0
0.4
0.1
0.0
0.8
*
0.1
5.6
X
X
+
X
3.8
5.9
4.7
5.8
7.2
6.1
5.0
*
8.8
2.6
*
0.6
1.5
1.4
1.9
1.3
1.5
0.2
0.4
0.7
0.8
0.7
0.1
0.2
1.7
0.6
1.6
0.2
1.9
0.2
1.2
0.6
*
0.4
0.9
1.9
1.4
3.3
1.0
*
2.1
X
X
+
X
X
+
Iraq
Syria
X
X
X
South Asia
Afghanistan
Bangladesh
India
Pakistan
Sri Lanka
X
X
+
X
X
X
X
X
X
X
X
X
+
+ indicates that unavailable or missing indicator data did not permit complete assessment and may underestimate overall risk.
PE-­‐146_IndicatorFrameworkForEbolaRiskCountries.xlsx
DPT Infant Natural Vaccination Prior Ebola Disasters Mortality Rate (% of Outbreaks with > 1,000 Rate per Childrren Since 1976 Deaths in the 1,000 Live Ages 12–23 Past 20 Years
Births
months with third dose) 0
0
65
63
0
0
54
89
0
0
107
92
X
X
Middle East
Cambodia
China
Indonesia
Southeast Asia Malaysia
Myanmar
Philippines
Thailand
X
X
X
Health Health Service Outcomes
Delivery
+
6
0
86
72
18
30
45
42
25
94
51
*
645
27
*
*
0.00
5.63
6.55
5.68
5.71
*
0.61
*
0.58
*
10.59
0
1
0
1
0
0
0
0
1
3
0
0
0
2
1
1
3
0
1
0
0
2
44
78
48
78
60
74
44
90
33
64
55
72
80
76
74
70
58
92
42
65
45
95
3.6
3.4
226
105
*
*
0
0
0
0
28
12
68
41
0.5
0.6
0.7
0.6
3.6
8.6
3.6
4.0
3.1
3.1
51
26
61
39
89
1.19
0.02
*
0.87
0
0
0
0
0
6
3
10
3
1
70
33
41
69
8
71
97
72
72
99
0.7
3.8
0.9
1.9
*
1.0
2.1
5.4
5.4
3.0
3.9
1.8
4.6
3.9
51
322
108
410
20
119
215
7.02
*
3.56
*
1.06
*
*
0
0
0
0
0
3
0
0
*
3
0
1
6
1
33
11
25
7
40
24
11
92
99
85
97
75
94
99
NOTE: A country was judged to be at high health risk if at least five of the ten indicators registered as high risk; at LOW risk if at least five of the ten indicators registered as low risk, with no more than one high-­‐risk indicator; or otherwise at MEDIUM risk. * indicates that data for this indicator were not available.
RAND Corporation
PE-­‐146
4
Indicator Threshold Values
Threshold Values
High Political Risk
All red or yellow (at least 2 red indicators)
Population Density (per km2) Low: <50
Medium: 50–99
High: >100
High Economic Risk
At least 4 indicators red and few (if any) green mitigating factors
Population Mobility (net migration per 1,000 people)
Low net migration: Between -­‐5 and 5
Medium: +/-­‐ 6
High: +/-­‐ > 10
High Sociocultural Risk
2 red indicators or more with no green mitigating factors (e.g., high literacy rate)
Adult Literacy (age ≥ 15)
Low: <50%
Medium: 50–75%
High: >75%
High Health Risk
At least 5 red indicators and few (if any) green mitigating factors
Trust (scaled score 0–150)
Low: <25
Medium: 25–75
High: >75
Median Age
Low: <20
Medium: 21–30
High: >30
Urbanization (% of population)
Low-­‐income countries: typically around 30%
High-­‐income countries: typically around 80%
Physicians per 1,000 People
Low: <0.5
Medium: 0.5–1.0
High: >1.0
Nurses and Midwives per 1,000 People
Low: <0.5
Medium: 0.5-­‐1.0
High: >1.0
Hospital Beds per 10,000 People
Low: <1
Medium: 1–2
High: >2
Government Effectiveness
(scaled score 0–100) Rule of Law
(scaled score 0–100)
Political
Political Stability/Absence of Violence (scaled score 0–100)
Fragile States Index (score 10–120) Voice and Accountability
(scaled score 0–100)
Economic
Wealth/Economic Development
GDP per Capita ($)
Human Development Index (0–1)
Degree of Globalization
Total Foreign Direct Investment ($ millions) Transporation Networks
% of Roads That Are Paved
Knowledge Index (composite score 0–10)
Communications
Mobile Cellular Subscriptions (per 100 people)
Internet Users (per 100 people)
Domain
Scaled score from 0–100
<20: poor governance
20–50: adequate governance
>50: solid governance
Scaled score from 0–100
<20: Little to no rule of law
20–50: Some rule of law
>50: Solid rule of law
Scaled score from 0–100 <20: Little to no stability
20–50: Moderate stability
>50: Stable
10–79: High warning level or below
80–99: Alert or very high warning level
100–120: Very high or high alert level
<20: Little to no voice or accountability
20–50: Moderate amount of voice and accountability
>50: Solid levels of voice and accountability
Low: <$1,000
Medium: $1,000–$6,000
High: >$6,000
Low: <0.5 Medium: 0.5–0.7 High: >0.7
Low: <500
Medium: 500–5,000
High: >5,000
Low: >10%
Medium: 10–50%
High: >50%
Indicator
Sociocultural Indicator
Medical Care Workforce
Medical Care Expenditures
Low: <2.5
Medium: 2.5–5.0
High: >5.0
Medical Care Infrastructure
Public Health Experience
Health Outcomes
Low: <50
Medium: 50–100
High: >100
Low: <20
Medium: 20–40
High: >40
Health Expenditure (% of GDP)
Health Expenditure per Capita ($)
Health
Summary
Domain
Health Centers per 100,000 People
Prior Ebola Outbreaks Since 1976
Natural Disasters with > 1,000 Deaths in the Past 20 Years
Infant Mortality Rate per 1,000 Live Births
DPT Vaccination Rate (% of Health Service Childrren Ages 12–23 months Delivery
with third dose) RAND Corporation
PE-­‐146
Threshold Values
Low: <4%
Medium: 4–8%
High: >8%
Low: <50
Medium: 50–100
High: >100
Low: <5
Medium: 5–10
High: >10
1–2: some experience with Ebola
>2: extensive experience with Ebola
Low: <3
Medium: 3–5
High: >5
Low: <20
Medium: 20–70
High: >70
Low: <60%
Medium: 60–90%
High: >90%
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