GENEVA — The coronavirus pandemic is by far the worst global public health emergency declared under a 13-year-old international law for deadly disease outbreaks, World Health Organization Director General Tedros Adhanom Ghebreyesus said on Monday.
“This is the sixth time a global health emergency has been declared under the International Health Regulations, but it is easily the most severe,” the United Nations health agency chief told a press briefing. “Almost 16 million cases have now been reported to WHO, and more than 640,000 deaths. And the pandemic continues to accelerate. In the past 6 weeks, the total number of cases has roughly doubled.”
WHO’s International Health Regulations, which took effect in June 2007, are legally binding among 196 nations. They lay out nations’ rights and obligations towards disease outbreaks and other acute public health risks.
When an extraordinary threat emerges, WHO can formally declare it to be a “public health emergency of international concern.” That imposes safeguards and requirements for nations to follow.
Before the emergence of COVID-19, first detected in late December in Wuhan, China, the five previous international public health emergencies were the 2009 H1N1 swine flu pandemic; 2014 international spread of poliovirus; 2014 Ebola outbreak in Sierra Leone, Liberia and Guinea; 2015 to 2016 Zika virus outbreak in the Americas; and 2018 to 2019 Ebola outbreak in Congo, close to Rwanda, Uganda and South Sudan.
Nine events have come before WHO’s International Health Regulations Emergency Committee as potential emergencies, in meetings some have viewed as “nontransparent and contradictory to the International Health Regulations,” according to an analysis published in BMJ Global Health in June.
Some colleagues and I just published an article on the first comprehensive review of WHO IHR Emergency Committee meetings and PHEIC designations in BMJ Global Health https://t.co/iLIviQYKad @JHSPH_CHS @LawrenceGostin @JenniferNuzzo @Ep1Chrissy @anita_cicero
— Lucia Mullen (@LuciaMullen17) June 16, 2020
Study finds inconsistency and opacity
The three events that the committee decided did not constitute emergencies were the MERS, or Middle East respiratory syndrome cases reported from 2012 to 2013; the worst yellow fever epidemic in decades in Central Africa in 2016; and an outbreak of Ebola cases in eastern Congo in 2018.
“Striving for more consistency and transparency in EC justifications would benefit future deliberations and provide more understanding and support for the process,” wrote lead author Lucia Mullen, an epidemiologist, and four other authors of the study.
Tedros noted that this coming Thursday will mark six months since WHO declared the coronavirus outbreak to be a global public health emergency because it had become an “extraordinary event” that represented a risk to nations other than China, and required a coordinated global response to fight it.
He recalled there were less than 100 confirmed infections outside of China, and no deaths, when WHO declared the outbreak to be an international emergency on January 30. COVID-19 has since transformed the world, infecting more than 16.3 million people and killing 650,000 worldwide.
“The bottom line is that one of the most fundamental ingredients for stopping this virus is determination, and the willingness to make hard choices to keep ourselves and each other safe,” said Tedros. “The COVID-19 pandemic is illustrating that health is not a reward for development, it’s the foundation of social, economic and political stability.”