The outbreak of coronavirus that began in China and spread across the world, leaving more than 130 people dead, has raised alarm about the ability of countries to handle an epidemic or pandemic. The recent Global Health Security Index gives insights into which of 195 nations are ready to fight a major health emergency that could wreak havoc on the global economy.

The report’s bottom-line conclusion is that national health security is “fundamentally weak around the world” and no country is fully prepared for major disease disaster — though some, particularly in the developed world, are in a better position than others.

The latest index, released in October, found 13 countries in the “most prepared” group including the U.S. which is ranked first, followed by the U.K. and the Netherlands. Canada is in 5th place and France is 11th.

Group of Seven countries that are in the “more prepared” tier include Germany at 14, Japan at 21, and Italy at 31. China ranks at 51 and the world’s second-most populous country, India, places 57th. African nations are among the least prepared, the analysis showed.

The index is a joint project of the Johns Hopkins Center for Health Security, the Nuclear Threat Initiative, and The Economist Intelligence Unit.

Countries are assessed across six categories:

• Prevention of the emergence or release of pathogens

• Early detection and reporting for epidemics of potential international concern

• Rapid response to and mitigation of the spread of an epidemic

• Sufficient and robust health system to treat the sick and protect health workers

• Commitment to improving national capacity, financing plans to address gaps, and adhering to global norms

• Overall risk environment and country vulnerability to biological threats