Last Week, the World Health Organization Declared Coronavirus a Global Health Emergency. What Does That Mean?
The Public Health Emergency of International Concern designation was established in 2005—and has only been used five times since
The World Health Organization (WHO) has declared the current outbreak of coronavirus a global public health emergency, making it the sixth incident to date to warrant this designation.
In China, 14,411 cases of the virus have been confirmed as well as 304 deaths, according to the WHO situation report. Additionally, 146 cases have been identified across 23 countries outside of China. By definition, when outbreaks cross borders, WHO steps in to declare a global health emergency to authorize resource allocation.
"The main reason for this declaration is not because of what is happening in China, but because of what is happening in other countries," explained WHO director Tedros Adhanom Ghebreyesus in a press conference. "Our greatest concern is the potential for the virus to spread to countries with weaker health systems, and which are ill-prepared to deal with it."
Per WHO, a Public Health Emergency of International Concern (PHEIC) is defined as “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.”
This declaration will allow the WHO to convene an emergency committee of public health experts dedicated to the outbreak, writes Quartz’s Tim McDonnell. The team assesses the situation and is given the power to offer formal recommendations to help prevent further spread of the disease. By drawing more attention and resources to the situation, this declaration also helps coordinate international response to the outbreak.
The history of WHO’s Emergency of International Concern designation is rather recent, dating back to the 2005 SARS outbreak also in China. In the 15 years since, it's been used only five other times, including two outbreaks—Ebola in Democratic Republic of the Congo and polio in Pakistan, Cameroon and Syria—that are currently unresolved.
Here's a review of each of those pandemics:
Swine Flu Pandemic – 2009
First detected in April 2009, Swine Flu—caused by a novel strain of H1N1—was declared a pandemic by WHO in June of that year. At that point, 74 countries had reported cases of the infection. In 2013, an international group of scientists estimated that this pandemic may have killed up to 203,000 people globally—around 10 times higher than estimates made at the time of the crisis.
The flu began to recede later that year. After a vaccine was developed and administered, WHO declared the end of the pandemic in August 2010. It was later found, however, that WHO had followed the recommendations of doctors being paid by pharmaceutical companies that profited from selling vaccines and anti-virals, so cities were left with excessive stores of medication, explains Slate’s Rebecca Onion.
“This pandemic has turned out to be much more fortunate than what we feared a little over a year ago,” explained the WHO Director-General Margaret Chan at the time. “We have been aided by pure good luck. The virus did not mutate during the pandemic to a more lethal form.”
Ebola Outbreak in West Africa – 2014
Between 2013 and 2016, an Ebola outbreak centered in Sierra Leone, Guinea and Liberia resulted in over 28,616 cases and claimed around 11,310 lives in those areas. Additionally, there were 36 cases and 15 deaths reported in other countries, reports the Center for Disease Control and Prevention (CDC). The number of resulting deaths, according to Reuters, is more than all other Ebola outbreaks combined. With the situation deteriorating, the WHO declared the outbreak in West Africa a public health emergency on August 8, 2014.
Although the WHO declaration was lifted in March 2016, when the prevention programs and international efforts helped contain the outbreak, the impacts are still being felt in West Africa. Not only did it cost the economies of Sierra Leone, Guinea and Liberia an estimated $53 billion, but it also resulted in food shortages and insecurities that have impacted hundreds of thousands of people—and continue to do so today, according to a BioMed Central report.
Polio Outbreak – 2014
“In the first half of the 20th century, Americans lived in fear of the incurable paralytic poliomyelitis (polio) disease,” writes the Smithsonian’s Gilbert King. After effective vaccines were developed and distributed following the 1950s, this disease, which paralyzed young children, was practically eliminated.
However, in 2014, the WHO declared the resurgence of polio to be a public health emergency of international concern. "If unchecked, this situation could result in failure to eradicate globally one of the world's most serious vaccine preventable diseases," according to a WHO statement.
Polio had begun to make a comeback in 2013, when the number of polio-infected countries almost doubled, with countries in Central Asia, the Middle East and Central Africa facing the greatest risk. By April 2014, there were 68 recorded cases of the disease, much higher than the 24 reported cases during that same period the year before, reports the BBC. However, with widespread international response and immunization, today, the global incidence of Polio cases has decreased by 99 percent, according to the Global Polio Eradication Initiative.
Zika Outbreak – 2016
The fourth global public health emergency was declared in 2016, with the outbreak of the Zika virus. Although first discovered in 1947, the virus, spread by mosquitoes, broke out in Brazil in 2015. Pregnant mothers and newborn infants are most vulnerable to the disease. Experts later found a link between Zika and two other serious conditions: a birth defect called microcephaly that causes infants to be born with abnormally small heads and a neurological condition called the Guillain-Barré syndrome in which the immune system starts attacking the body’s nerves. As a result of these findings, WHO concluded that a global response is necessary, writes Stat’s Helen Branswell.
In November 2016, WHO declared that the outbreak is no longer a public health emergency. At that point, there had been over 2,300 confirmed cases of babies born with microcephaly, most of them in Brazil, although that figure it thought to be underestimated. The organization then shifted its focus to researching the disease and birth defects linked to it, reports CNN’s Debra Goldschmidt.
Ebola Outbreak in the Democratic Republic of Congo – 2019
Declared a public health emergency in July 2019, the outbreak of Ebola in the Democratic Republic of Congo is the second-largest resurgence of the disease, following the 2014 outbreak in West Africa. Since its detection in August 2018, WHO reports a total of 3,421 confirmed cases and 2,242 deaths.
Although cases have recently been declining, cases are still being found. “The outbreak is ongoing in a densely-populated region, which is also experiencing a long-lasting humanitarian and security crisis,” according to the European Centre for Disease Prevention and Control.
These characteristics result in greater reluctance by the community to accept response activities, and greater difficulty in adapting prevention practices to the needs of the region. Being the first Ebola crisis declared in a conflict zone, factors such as access to health centers, mistrust in the community and widespread displacement must be factored into the humanitarian response, writes The Guardian’s David Miliband.