The Index, to be published in full next month, measures infant mortality, life expectancy, healthcare spending along with a range of governance indicators. It finds that on all these indicators public health statistics in Sierra Leone are dismal. The country has 0.4 hospital beds per person and health spending in the country is $205 per person. Health outcomes, as a result, are dire: Sierra Leone has the second highest rate of tuberculosis in the world (674 per 100,000 people), and the highest incidence of infant mortality at 117.4 per 1,000 live births.

The 2014 Legatum Prosperity Index™, the signature annual report from the Legatum Institute, ranks Guinea and Liberia, the other two countries most affected by the outbreak of Ebola, also near the bottom (134th and 129th respectively).

The Index, which ranks countries in terms of wealth and well-being, paints an alarming picture of countries in the region, whose population runs the risk of contagion. Nigeria, the Ivory Coast and Mali are similarly ill-equipped for an outbreak. Nigeria is ranked 132nd on the Health sub-index, Ivory Coast is ranked 128th and Mali is ranked 123rd.

Will these countries in West Africa prove any better at responding to an epidemic?

The report will say that across all 142 countries those with higher spending on healthcare see lower levels of infant mortality and higher life expectancy. However, it is not simply spending that drives up standards in healthcare. The United States spends far more on healthcare than any other country in the world (nearly $9,000 per person) yet the average American lives 78.7 years, 4.7 years less than the average resident of Hong Kong, the territory with the highest life expectancy and spending of $2,144 per person.

The UK is in the top 20 countries in the world when it comes to health indicators, coming 19th out of 142 countries. As a nation we spend $3,495 per person with a life expectancy of 81.5.

James Barty, Senior Adviser to the Legatum Institute, says “Ebola is a warning that low levels of health provision create the conditions for outbreaks such as this to spread. The countries that do not have the health and governance infrastructure in place to deal with the outbreak—such as Sierra Leone, Guinea and Liberia—are suffering the most. We must not only help to contain the outbreak but ensure that the healthcare systems are upgraded in such a way that it cannot happen again."


Notes to Editors 

1) The full version of the 2014 Legatum Prosperity Index™ will be published on Tuesday, 4 November 2014

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