It's in our nature to compare and rank countries regarding the Covid-19 pandemic. In 2020, it seemed as if countries like New Zealand and Australia could do no wrong—and the United States could do no right. Yet, over half a year into 2021, that no longer holds true.

New Zealand and Australia look more like the rest of the world

In Australia (and particularly in Sydney), Covid-19 cases are spiking.  Last week, the Australian state of New South Wales declared an emergency after an outbreak of the highly contagious delta variant. While Australia and New Zealand enjoyed a "quarantine free travel bubble" between both countries for months (as others stayed in lockdown), that bubble burst when Prime Minister Ardern imposed quarantine restrictions on travelers from Australia's New South Wales, Victoria, and South Australia. One major reason for this is obvious: Australia and New Zealand hold relatively low vaccination rates.

As of July 26th, around 31 percent of all Australian adults are either partially or fully vaccinated against Covid-19. Subsequently, 18 percent of Australians are partially vaccinated (one-shot), and only 13 percent are fully vaccinated (two shots). In New Zealand, around 19 percent of the adult population is either partially or fully vaccinated (6 percent partially and 13 percent fully). For comparison, these numbers lag far behind the United States with 56 percent of the adult population either partially or fully vaccinated (49 percent fully and 7.6 percent partially) and the United Kingdom with 69 percent of adults either partially or fully vaccinated (55 percent fully and 14 percent partial). Comparatively, the United Arab Emirates leads the world with nearly 78 percent of its adult population either partially or fully vaccinated (69 percent fully and 9 percent partially).

The American system is imperfect, but its pharmaceutical innovation leads the world

Even in the WIHI analysis on Covid-19 Pandemic Preparedness Performance ratings released in April 2021, New Zealand ranked 4th and Australia 11th overall, while the U.S. and U.K. lagged behind at 17th and 24th. In part, this was due to the comprehensive nature of the WIHI analysis, as it weighed multiple metrics – "Covid-19 Fatalities per Million," "Excess Deaths per 100,000," "Lockdown Stringency," "Global Integration," and "Vaccinations per 100 People" – for a single Element (that was only one part of a larger Dimension). Subsequently, where the U.S. and U.K. excelled were in the "Vaccinations per 100 People" metric (which you can click and sort the column on the chart below). When sorted by this metric, the U.S. ranked 4th and the U.K. 3rd, while New Zealand ranked 28th and Australia 26th.

As the pandemic progressed (in the three months since that article), we've seen how pharmaceutical prowess in both the U.K. and the U.S. have allowed for higher vaccination supplies for both countries. Given that AstraZeneca is a British company and Pfizer, Moderna, Johnson & Johnson, and Novavax are U.S. companies, initial access to these vaccines for each country makes sense.  In a separate WIHI Element labeled "Access to New Treatments" (that comprised 20 percent of the Choice Dimension), Australia ranked 12th, New Zealand 9th, the U.K. 4th, and the U.S. 1st. These various metrics illustrate the interconnected and complex nature of ranking world health systems.  Moreover, they also show the importance of evaluating countries holistically, as opposed to narrowly through only one metric (as is often done with "universal coverage" or "national health expenditures").

In a way, the Covid-19 pandemic showed one of the strengths of the WIHI analysis. Health systems, like public policy, evolve to meet the needs of the moment. Accordingly, the WIHI analysis is set to be updated frequently – likely on an annual or biannual basis. No country handled the Covid-19 pandemic perfectly. Depending on what one values most – e.g., economic freedom, public health and safety, vaccine availability, public vaccination rates – each country will perform better or worse given the unique circumstances the virus presents each country. Just as the virus evolves, so too will each nation's response to the pandemic.