O33 · Failure outcome · Named · Human Capital

Health system failure

Essential prevention and treatment are no longer reliably available and population health deteriorates beyond the system's capacity to manage.

Why it matters

Avoidable illness and death weaken households, public confidence and the workforce.

Signs it has been reached

Essential treatments become routinely unavailable
Preventable mortality rises persistently
Care backlogs exceed safe clinical limits

Met when

The mean score of these 2 capability groups falls a full band (3 points).

Population Health
Health System Capability

Held by all three panel models.

Read with care

Third illustrative run, on the second-pass scenario set. The capability scores are candidate ratings and the test settings were drafted with the scenario records in the second pass; neither has been adopted. Scores are from the GINC National Capability Index 2026, which describes them as candidate ratings. Exposure is set nation by nation from the CIA World Factbook 2025 and the scenario's regional exposure. Results show the method working on real scores; they are not findings about any nation. How the tests work.

Reverse stress test

Working backwards from this outcome to the scenarios and conditions most likely to produce it, nation by nation, over 10 years.

Nations with a route: 192; of 197
Typical likelihood: 0.5%; median nation, over 10 years
Leads most routes: Severe pandemic; 158 of 192 nations
Typical headroom: ×2.1; times Standard Severe, nearest single scenario

What produces it

Each nation’s most likely route, counted three ways: the scenario that does most of the work, the form the route takes, and the capability where a change would move the result most.

Lead scenario

Nations

Severe pandemic

Breadbasket failure

Core disaster

158

Form of the route

Nations

Two scenarios together

One scenario, with plans failing

183

Weakest buffer

Nations

Biotechnology & Health Technologies

Information Environment & Strategic Communication

Sovereign Capital & External Financial Power

Fiscal Capacity & Public Finance

Health System Capability

131

Likelihood, by region

One dot per nation. The bar marks each region’s mean. Further right is more likely.

North America
Europe
China
Indo-Pacific
South Asia
Gulf and Middle East
Africa
Latin America and Caribbean
Russia and Eurasia

Most likely: Djibouti 3.7%, Mauritania 2.6%, Haiti 2.3%, Algeria 2.2%, Saint Vincent & Grenadines 2.1%.

Does a strong starting point protect?

Each nation’s score on this basket today against the likelihood of the outcome.

North America
Europe
China
Indo-Pacific
South Asia
Gulf and Middle East
Africa
Latin America and Caribbean
Russia and Eurasia

All 197 nations

The route shown is the most likely one, and the basket column shows the band the nation would move to. A full band is the same fall for every nation: for a strong nation it is serious but leaves it well above where a weak nation starts. Where no route was found, the closest approach is the furthest any condition moved the basket, against the 3 points needed.

Region

Route

All 197 nations

Find a nation

197 of 197 nations

Rank	Nation	Region	Basket	Likelihood	3 years	Most likely route	Headroom	Breaks first	Lever
1	Djibouti	Africa	4.5 Nascent → Inception	3.7% Possible	1.1%	Breadbasket failure Severe+Severe pandemic Severe	×1.5 S10	Population Health	Biotechnology & Health Technologies 0.2
2	Mauritania	Africa	4.3 Nascent → Inception	2.6% Possible	0.8%	Breadbasket failure Severe+Severe pandemic Severe	×1.8 S10	Population Health	Biotechnology & Health Technologies 1.2
3	Haiti	Latin America and Caribbean	3.3 Nascent → Inception	2.3% Possible	0.7%	Breadbasket failure Severe+Core disaster Severe	×1.6 S07	Population Health	National Resilience & Crisis Management 2.4
4	Algeria	Africa	9.3 Transitional → Foundational	2.2% Possible	0.7%	Breadbasket failure Major+Severe pandemic Severeplans fail	×2.2 S10	Population Health	Biotechnology & Health Technologies 4.4
5	Saint Vincent & Grenadines	Latin America and Caribbean	7.3 Foundational → Nascent	2.1% Possible	0.6%	Breadbasket failure Severe+Severe pandemic Severe	×1.7 S10	Population Health	Biotechnology & Health Technologies 0.4
6	Equatorial Guinea	Africa	4.2 Nascent → Inception	1.8% Possible	0.5%	Breadbasket failure Severe+Severe pandemic Severe	×1.8 S10	Population Health	Biotechnology & Health Technologies 0.4
7	Congo	Africa	4.5 Nascent → Inception	1.8% Possible	0.5%	Breadbasket failure Severe+Severe pandemic Severe	×1.8 S10	Population Health	Biotechnology & Health Technologies 0.8
8	Kiribati	Indo-Pacific	4.8 Nascent → Inception	1.8% Possible	0.5%	Breadbasket failure Severe+Severe pandemic Severe	×1.6 S10	Population Health	Biotechnology & Health Technologies 0
9	Venezuela	Latin America and Caribbean	6.2 Foundational → Nascent	1.8% Possible	0.5%	Breadbasket failure Major+Severe pandemic Severeplans fail	×1.6 S10	Population Health	Fiscal Capacity & Public Finance 2.8
10	Nauru	Indo-Pacific	4.5 Nascent → Inception	1.7% Possible	0.5%	Breadbasket failure Major+Severe pandemic Severeplans fail	×1.4 S10	Population Health	Biotechnology & Health Technologies 0
11	Cuba	Latin America and Caribbean	13.2 Established → Transitional	1.7% Possible	0.5%	Breadbasket failure Major+Severe pandemic Severeplans fail	×2.2 S10	Population Health	Fiscal Capacity & Public Finance 4.5
12	North Korea	Indo-Pacific	5.3 Nascent → Inception	1.6% Possible	0.5%	Breadbasket failure Major+Severe pandemic Extreme	×1.6 S10	Population Health	Fiscal Capacity & Public Finance 1.8
13	Eritrea	Africa	4.3 Nascent → Inception	1.6% Possible	0.5%	Breadbasket failure Major+Core disaster Extreme	×2.1 S07	Health System Capability	Financial System Depth & Access 1.6
14	Sudan	Africa	3.8 Nascent → Inception	1.6% Possible	0.5%	Breadbasket failure Severe+Severe pandemic Severe	×1.6 S06	Population Health	Sovereign Capital & External Financial Power 1.2
15	Libya	Africa	5.8 Nascent → Inception	1.6% Possible	0.5%	Breadbasket failure Major+Severe pandemic Severeplans fail	×1.5 S10	Population Health	Biotechnology & Health Technologies 1.4
16	Comoros	Africa	4.2 Nascent → Inception	1.5% Possible	0.4%	Breadbasket failure Extreme+Core disaster Major	×1.8 S06	Population Health	Sovereign Capital & External Financial Power 1.8
17	San Marino	Europe	12.7 Established → Transitional	1.5% Possible	0.4%	Regional war spillover Major+Severe pandemic Severeplans fail	×1.4 S10	Population Health	Biotechnology & Health Technologies 0
18	Argentina	Latin America and Caribbean	11.5 Transitional → Foundational	1.4% Possible	0.4%	Breadbasket failure Major+Severe pandemic Severeplans fail	×2.3 S10	Population Health	Information Environment & Strategic Communication 8
19	Monaco	Europe	13.2 Established → Transitional	1.4% Possible	0.4%	Regional war spillover Major+Severe pandemic Severeplans fail	×1.5 S10	Population Health	Biotechnology & Health Technologies 1.2
20	Andorra	Europe	13.0 Established → Transitional	1.4% Possible	0.4%	Regional war spillover Major+Severe pandemic Severeplans fail	×1.5 S10	Population Health	Biotechnology & Health Technologies 0.2
21	Seychelles	Africa	10.7 Transitional → Foundational	1.3% Possible	0.4%	Breadbasket failure Major+Severe pandemic Severeplans fail	×1.7 S10	Population Health	Biotechnology & Health Technologies 0.8
22	Palestine	Gulf and Middle East	6.7 Foundational → Nascent	1.3% Possible	0.4%	Breadbasket failure Extremeplans fail	×1.8 S06	Population Health	Sovereign Capital & External Financial Power 2.8
23	Iran	Gulf and Middle East	10.7 Transitional → Foundational	1.3% Possible	0.4%	Breadbasket failure Severe+Core disaster Majorplans fail	×2.1 S06	Population Health	Sovereign Capital & External Financial Power 4.6
24	Benin	Africa	5.0 Nascent → Inception	1.2% Possible	0.4%	Breadbasket failure Extremeplans fail	×1.8 S06	Population Health	Sovereign Capital & External Financial Power 3.6
25	Togo	Africa	5.3 Nascent → Inception	1.2% Possible	0.4%	Breadbasket failure Extremeplans fail	×1.8 S06	Population Health	Sovereign Capital & External Financial Power 3.2

Showing 1–25 of 197 nations · page 1 of 8

Neighbouring outcomes

Download every nation and outcome (CSV)All outcomes and settings

A failure outcome is met when the basket falls a full band, which is three points. A prosperity outcome is met when the basket rises half a band, 1.5 points: in this model gains from a scenario are smaller and slower than losses, so the bar is set lower and the difference is stated.