A framework for supporting health capability-based planning: Identifying and structuring health capabilities.

The COVID-19 pandemic has highlighted that health security systems must be redesigned, in a way that they are better prepared and ready to cope with multiple and diverse health threats, from predictable and well-known epidemics to unexpected and challenging pandemics. A powerful way of accomplishing this goal is to focus the planning on health capabilities. This focus may enhance the ability to respond to and recover from health threats and emergencies, while helping to identify the level of resources required to maintain and build up those capabilities that are critical in ensuring the preparedness of health security systems. However, current attempts for defining and organizing health capabilities have some important limitations. First, such attempts were not designed to consider diverse scenarios and multiple health threats. Second, they provide a limited representation of capabilities and lack a systemic perspective. Third, they struggle to identify capability and resource gaps. In this article, we thus propose a new framework for identifying and structuring health capabilities and support health capability planning. The suggested framework has three main potential benefits. First, the framework may help policymakers in planning under high levels of uncertainty, by considering multiple realistic and stressful scenarios. Second, it can provide risk analysts with a more comprehensive representation of health capabilities and their complex relationships. Third, it can support planners in identifying resource and capability gaps. We illustrate the use of the framework in practice considering an outbreak scenario caused by three different health threats (COVID-19, Ebola, and Influenza viruses).

Deterrence against Terrorist Attacks in Sports-Mega Events: A Method to Identify the Optimal Portfolio of Defensive Countermeasures.

Sports mega-events, such as the Olympic Games or the Super Bowl, are attractive targets for terrorist organizations, due to their visibility, size, and number of people involved. Two characteristics of sports mega-events, however, make them distinctive in comparison with other well-studied target protection problems in counterterrorism analysis (such as transportation hubs or infrastructure facilities). First, defensive measures are often publicly known. Second, their finite horizon means that deterrence against any attack must be prioritized. In this article we thus propose a method that identifies the best portfolio of defensive measures the defense may adopt, given a fixed budget, to minimize the chances of suffering a terrorist attack during a sports mega-event. The method makes some relevant contributions to adversarial risk analysis: (i) it represents attackers that can choose among multiple attack scenarios and the no-attack scenario; (ii) it measures the deterrence effect caused by synergic portfolios of defensive measures; and (iii) it proposes an algorithm that identifies dominated portfolios and may, thus, overcome the scalability problems inherent to this portfolio optimization. We apply this method to a real-world defense problem, revisiting the defensive countermeasure planning for the 2016 Brazilian Olympic Games in Rio de Janeiro, Brazil. In the case study, we find a nonlinear relationship between budget expenditure and deterrence, as well as a decreasing marginal effectiveness use of resources after a given budget threshold, which would support a more efficient allocation of investments in the Games defense.