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When does the WHO sound its highest alert?




A Public Health Emergency of International Concern (PHEIC) is a rarely used top alert available to the World Health Organization for dealing with a global disease outbreak.

The WHO on Saturday declared the increase in monkeypox a PHEIC after experts reviewed the situation at an emergency committee meeting two days ago.

Here’s a look at how the decision was made and PHEIC’s past announcements:

What is PHEIC?
The conditions that must be met are set out under the International Health Regulations (IHR) of 2005 – a legal framework defining the rights and obligations of countries in handling public health incidents that may cross borders.

A PHEIC is defined in the regulations as “an exceptional event that is determined to constitute a public health risk to other states through the international spread of disease and potentially requires a coordinated international response”. .

The definition means that the situation is serious, sudden, unusual or unexpected, has implications for public health beyond the border of the affected country, and may require immediate international action.

emergency committee
WHO’s 16-member emergency committee on monkeypox is chaired by Jean-Marie Ocho-Belle of the Democratic Republic of the Congo, former director of WHO’s Vaccines and Immunization Department.

The committee brings together virologists, vaccinologists, epidemiologists and experts in the fight against major diseases.

It is co-chaired by Nicola Low, an associate professor of epidemiology and public health medicine from the University of Bern.

The other 14 members are from institutions in Brazil, Britain, Japan, Morocco, Nigeria, Russia, Senegal, Switzerland, Thailand and the United States.

Eight advisors from Canada, the DRC, South Africa, Sweden, Switzerland and the United States also participate in the meetings.

The emergency committee provided WHO chief Tedros Adhanom Ghebreyesus with an assessment of the risk to human health, the risk of international spread and the risk of interference with international traffic.

But consensus was unable to be reached on whether or not to trigger the highest alert, Tedros said on Saturday, so the WHO chief had to decide for himself.

WHO has declared PHEIC six times in the past:

2009: H1N1 swine flu

The epidemic was first detected in Mexico and then quickly spread to the United States and the rest of the world.

May 2014: Poliovirus

Declared after a surge in cases of wild polio and circulating vaccine-derived poliovirus. Apart from COVID, it is still the only PHEIC.

August 2014: Ebola

Outbreak in West Africa that spread to Europe and the United States.

February 2016: Zika virus

The pandemic started in Brazil and badly affected the US. The only PHEIC declared on mosquito borne virus.

July 2019: Ebola

The second Ebola PHEIC outbreak was in Kivu in eastern DRC.

January 2020: Covid-19

When announced – outside China where the virus first emerged – there were fewer than 100 cases and no deaths.

covid-19 despair
The COVID-19 PHEIC announcement came after the third meeting of the emergency committee on the virus spreading. In the meetings held on January 22 and 23, 2020, it was decided that the outbreak does not constitute PHEIC.

Despite the announcement, only after March 11, Tedros described the rapidly deteriorating situation as a pandemic, causing many countries to wake up to the threat.

The sluggish global response is still at WHO headquarters and raises questions about whether the PHEIC system under the IHR was fit for purpose.

As of March 11, the number of cases outside China had risen, with more than 118,000 people having caught the disease in 114 countries, and 4,291 people having lost their lives, following a jump in deaths in Italy and Iran.

“The warning in January was more important than the announcement in March,” WHO emergencies director Michael Ryan said on the second anniversary of the pandemic’s declaration.

“People weren’t listening. We were ringing the bell and people weren’t acting.

(This story has not been edited by NDTV staff and is auto-generated from a syndicated feed.)