Global health systems still fail to measure prevention and community trust: WHO

A new World Health Organization (WHO) report has raised concerns that countries around the world are still failing to measure public health in an integrated and coordinated way, leaving major gaps in preparedness for future crises. The report, Measuring Integrated Delivery of Essential Public Health Functions, was developed with support from institutions including the Public Health Agency of Canada, the International Association of National Public Health Institutes (IANPHI), the Robert Koch Institute in Germany, the United Kingdom Health Security Agency and Santé publique France.

The study argues that modern health threats, from pandemics and climate disasters to chronic diseases and humanitarian emergencies, require health systems that are connected, flexible and community-focused. Yet many countries continue to rely on fragmented monitoring systems that assess only isolated parts of public health instead of the whole picture.

According to the WHO, public health is not limited to hospitals and treatment. It also includes disease prevention, health promotion, emergency preparedness, surveillance, community engagement and health protection. These functions are closely linked and must work together if countries want to build resilient health systems.

COVID-19 Exposed Weaknesses in Health Monitoring

The report says the COVID-19 pandemic revealed serious weaknesses in how governments monitor and manage public health systems. Many countries had strong laboratory networks and emergency plans, but struggled with public trust, misinformation and maintaining routine health services during the crisis.

WHO found that existing monitoring systems often focused heavily on tracking infections and emergency responses while paying far less attention to community participation, health communication and prevention efforts. This imbalance made it harder for governments to respond effectively when public cooperation became essential.

The report warns that without better measurement systems, governments risk investing only in visible emergency infrastructure while ignoring the social and preventive aspects of public health that are equally important during crises.

Existing Global Tools Leave Major Gaps

To examine the problem, WHO reviewed seven widely used global health monitoring tools, including DHIS2, Integrated Disease Surveillance and Response (IDSR), the States Parties Self-Assessment Annual Reporting tool (SPAR), the Harmonized Health Facility Assessment, and emergency monitoring systems developed during the COVID-19 pandemic.

The review found that no single tool provides a complete picture of public health capacity. Emergency-focused systems perform well in tracking outbreaks and preparedness, while routine health systems mainly monitor hospital services, disease data and treatment outcomes. However, many tools fail to measure areas such as health literacy, behavioural change, public trust and social participation.

Health promotion emerged as one of the weakest areas of measurement. WHO says activities such as fighting misinformation, encouraging healthy behaviour and improving public awareness are still poorly tracked in most countries despite their importance during emergencies.

The report also highlights weaknesses in measuring health protection. While many systems monitor infectious diseases, they often fail to capture environmental risks, occupational hazards or the needs of vulnerable populations.

Community Engagement Becomes a Key Priority

One of the strongest messages in the report is the need to place communities at the centre of public health systems. WHO argues that communities should not be treated simply as recipients of services but as active partners in planning, preparedness and response.

The report notes that countries such as Sierra Leone improved outbreak management after integrating community engagement into health security monitoring following the Ebola crisis. During COVID-19, countries that involved local communities and improved communication were often better able to manage public trust and encourage participation in public health measures.

WHO says future monitoring systems must measure not only emergency response capacity but also whether communities are involved in decision-making, whether vulnerable groups are reached, and whether health services are trusted by the population.

WHO Calls for Integrated and Resilient Health Systems

To close the gaps, WHO proposes a six-step roadmap for governments. The plan includes securing political support, reviewing existing indicators, introducing new measures for missing public health functions, strengthening workforce capacity and integrating public health monitoring into routine health information systems.

The report highlights examples from countries such as Thailand, Brazil, Uganda and New Zealand, where governments have started linking public health functions with financing systems, digital health platforms and community-based monitoring.

WHO concludes that future health security will depend not only on emergency preparedness but also on stronger prevention systems, public trust, social participation and better coordination across sectors. Without integrated monitoring systems, the organization warns, countries may continue to appear prepared on paper while remaining vulnerable during real-world crises.