Explainer: What is ‘Public Health Emergency of International Concern’?
Sai Krishna Muthyanolla
March 11, 2020
Novel Coronavirus Disease (COVID-19) has been declared a ‘public health emergency of international concern (PHEIC)’ by the WHO. But what is PHEIC? How & when is it declared? What are the past instances when PHEIC was declared? Here is a detailed explainer.
Since theNovel Coronavirus Disease (COVID-19) has been first reported on 31 December2019 in Wuhan (China),  it has spreadacross the globe, with around
110 countries reporting cases of COVID-19 as on 10 March 2020.
China currentlyaccounts for more than 3/4 of the total confirmed cases, followedby Italy, South Korea and Iran.  Morethan 4 thousand deaths are reported around the world due to COVID-19. On 07March 2020, the World Health Organization (WHO) released
a statement that the total number of confirmed cases crossed 1lakh (i.e. 100 thousand).
Because ofthe initial rapid spread in China, COVID-19 has been considered as an epidemic.However, with COVID-19 spreading to more than 100 countries, it is now being consideredas a pandemic. On 30 January 2020, WHO has taken cognizance of the spread ofthe disease around the world and the emergency committee convened by the WHODirector-General under International Health Regulations (IHR) (2005) has
declared COVID-19 as Public Health Emergency of International
Concern (PHEIC).
This wasthe second meeting of the Emergency Committee. In the first meeting held on22-23 February 2020, the Committee decided to hold off the declaration ofCOVID-19 as a PHEIC.
So, what is a PHEIC? When is it declared and who has the authority to declare something as a PHEIC? In this explainer, we explore these questions.
PHEIC is a
health emergency of International Nature
International Health Regulations (IHR) were adopted by the Health Assembly in 1969, to prevent the international spread of Diseases. In the aftermath of the emergency due to severe acute respiratory syndrome (SARS) outbreak during the early 2000s, the Health Assembly established an Intergovernmental Working group in 2003 to recommend revisions to the existing IHR. The 58th World Health Assembly adopted IHR (2005) on 23 May 2005.
IHR (2005) is an agreement between 196 countries to work together for global health security. The WHO plays the role of a coordinator. IHR (2005) provides the definition of PHEIC and the procedures to be followed to recognize a health emergency and the necessary action to be taken thereof.
As perIHR’s definition, PHEIC is:
‘An
extraordinary event which is determined to constitute a public health risk to
other States through the international spread of disease and to potentially
require a coordinated international response’.
Thisdefinition of PHEIC would imply that the situation is:
PHEIC is declared by DG-WHO based on multiple
consultations
The Director-General of WHO is required to seek the views of an IHR Emergency Committee to determine whether an event can be declared as a PHEIC.
However, prior to the declaration, the Director-General(DG) of WHO needs to have a consultation with the state party in whose boundaries an event is occurring. Like in the case of COVID-19, DG was required to have a consultation with China, since that is where the first instance of the disease was found.
Article 12 of IHR-2005 lays down the process to be followed when an event is initially recognised to be potentially a case of PHEIC. The process is as follows
The Director-General of WHO takes into consideration the following aspects to determine whether an event constitutes a Public Health Emergency :
DG-WHO isaided by the decision instrument as provided in Annexe-2 ofIHR-2005, to evaluate various aspects of the event and to arrive at a decision.
Constitution
& Procedure of Emergency Committee under Articles 48 & 49
Articles 48& 49 of Chapter-II in IHR-2005, lay down the working details ofconstituting an Emergency Committee (EC).
The EC isestablished by DG-WHO to provides its views on:
Thecomposition of the EC is determined by the DG-WHO and involves:
Procedure followed by the Emergency Committee
The recommendations provided are temporary in natureand are required to be reviewed every three months post which necessarymodifications or extensions are recommended.
In due course, based on the prevailing situation, the State parties can provide a proposal to the DG to terminate PHEIC or any specific temporary recommendations. They can present the same to Emergency Committee who would review and provide their views on termination of PHEIC.
So far 6 PHEIC declarations were made by the WHO
After the adoption of International Health Regulations(IHR)- 2005, by the 196 countries (which includes all the WHO member countries)and laying down the procedures to be following in determining a PHEIC, therehave been 6 instances wherein WHO has determined an event to be a PHEIC.
More than 4000
deaths reported as on 10 March 2020
As per the dashboard maintainedby the WHO,  more than 1.1 lakh confirmedcases have been reported across 110 nations as of 10 March 2020. Of these, atotal of 80,924 cases reported in China while more than 30 thousand confirmedcases are reported from across the rest of the world.
In China, morethan 3100 deaths were caused due to COVID-19 of which 3024 deaths were reportedfrom Hubei province, whose capital is Wuhan, the place where the outbreak wasfirst reported.
South Korea, Italy & Iran have reported more than 7 thousand confirmed cases each.  Though South Korea, Italy & Iran reported more than 7 thousand cases each, the death toll has been on the higher side in both Italy & Iran. More than 1000 cases were reported from seven countries including China. Four of these seven countries are from Europe.
Featured Image: Public Health Emergency of International Concern