Public Health Emergency of International Concern

Article

August 15, 2022

A public health emergency of international concern (PHEIC) is a declaration by the World Health Organization (WHO), made when "an extraordinary event occurs which is determined to constitute a risk to public health in other States because of the risk of international spread of disease and may require coordinated international action", in accordance with the International Health Regulations.

Background

Following the SARS epidemic in 2002-2003, the WHO adopted in 2005 a revision of the International Health Regulations (IHR). The latter reinforces the duties of the State in terms of disease surveillance and action. Finally, it obliges each State to assess and notify the WHO of the health risks observed on its territory. It comes into force in 2007, as an instrument of international law applying to 196 countries, of which 194 are member states of the WHO.

Definitions and procedure

A USPPI is defined in the IHR as "an extraordinary event which is determined to pose a risk to public health in other States because of the risk of international spread of disease and which may require coordinated international action. ". This definition implies a situation combining the following characteristics: serious, sudden, unusual or unexpected; with public health repercussions beyond the borders of the affected country; may require immediate international action. Created in 2005, the IHR Emergency Committee is an advisory committee whose members are appointed by the Director General of WHO, from a list of international experts at the request of a State Party of the organization. The members of this committee have technical knowledge in the field of disease control, virology, vaccines or the epidemiology of infectious diseases. A USPPI is not confined to infectious diseases alone, it can relate to events caused by chemical agents or radioactive materials. However, as of December 2020, all reported USPPIs have been for viral infections. This emergency committee meets to assess an event and give its opinions and proposals on: If the event constitutes a public health emergency of international concern; Temporary recommendations that could be taken by the country affected by a USPPI, or by other countries at risk to prevent the international spread of the disease, and to avoid unnecessary disruption to international trade and travel; Termination of the USPPI. Based on these opinions, the final decision whether or not to declare a USPPI, and any recommendations, is made by the Director General of the WHO. Temporary recommendations from a USPPI expire automatically after three months. Every three months, the emergency committee meets to decide whether to extend the same period with any modifications to the recommendations.

Past Statements

Seven USSPIs were declared between 2007 and 2022. The first concerns the 2009 influenza A(H1N1) pandemic. The one concerning the Zika virus in 2016 is the first for an arbovirosis. The longest duration of application of a USSPI (renewal every three months) is that concerning poliomyelitis in 2014, still in progress as of July 2022.

Events that did not give rise to a declaration

USPPI's statements are not only motivated by the event's ability to cause international human suffering, but also to disrupt international trade. Events that attract public attention do not necessarily meet the reporting criteria, especially if the risks of propagation are