What is Public Health Emergency of International Concern (PHEIC)?
According to International Health Regulations (2005), the term ”Public Health Emergency of International Concern” is defined as “an extraordinary event which is determined, as provided in these regulations;
- to constitute a public health risk to other States through the international spread of disease; and
- to potentially require a coordinated international response”. This definition implies a situation that: is serious, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action.
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Determination of a public health emergency of international concern
The responsibility of determining whether an event is within this category lies with the WHO Director-General and requires the convening of a committee of experts – the IHR Emergency Committee. This committee advises the Director General on the recommended measures to be promulgated on an emergency basis, known as temporary recommendations. Temporary recommendations include health measures to be implemented by the State Party experiencing the PHEIC, or by other States Parties, to prevent or reduce the international spread of disease and avoid unnecessary interference with international traffic.
The Emergency Committee also gives advice on the determination of the event as a PHEIC in circumstances where there is inconsistency in the assessment of the event between the Director-General and the affected country/countries. The Emergency Committee continues to provide advice to the Director-General throughout the duration of the PHEIC, including any necessary changes to the recommended measures and on the determination of PHEIC termination. WHO maintains an IHR roster of experts and the members of an IHR Emergency Committee are selected from this roster and/or WHO expert advisory panels and committees. At least one member of the Emergency Committee should be an expert nominated by a State Party within whose territory the event arises.
International Health Regulations (2005), article 12 defines the determination of a public health emergency of international concern as;
- The Director-General shall determine, on the basis of the information received, in particular from the State Party within whose territory an event is occurring, whether an event constitutes a public health emergency of international concern in accordance with the criteria and the procedure set out in these Regulations.
- If the Director-General considers, based on an assessment under these Regulations, that a public health emergency of international concern is occurring, the Director-General shall consult with the State Party in whose territory the event arises regarding this preliminary determination. If the Director General and the State Party are in agreement regarding this determination, the Director-General shall, in accordance with the procedure set forth in Article 49, seek the views of the Committee established under Article 48 (hereinafter the “Emergency Committee”) on appropriate temporary recommendations.
- If, following the consultation in paragraph 2 above, the Director-General and the State Party in whose territory the event arises do not come to a consensus within 48 hours on whether the event constitutes a public health emergency of international concern, a determination shall be made in accordance with the procedure set forth in Article 49.
- In determining whether an event constitutes a public health emergency of international concern, the Director-General shall consider:
(a) information provided by the State Party;
(b) the decision instrument contained in Annex 2;
(c) the advice of the Emergency Committee;
(d) scientific principles as well as the available scientific evidence and other relevant information; and
(e) an assessment of the risk to human health, of the risk of international spread of disease and of the risk of interference with international traffic. - If the Director-General, following consultations with the State Party within whose territory the public health emergency of international concern has occurred, considers that a public health emergency of international concern has ended, the Director-General shall take a decision in accordance with the procedure set out in Article 49.
Purpose of International Health Regulations (2005)
The purpose and scope of the International Health Regulations (2005) are “to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade”. Because the IHR (2005) are not limited to specific diseases but apply to new and ever changing public health risks, they are intended to have long-lasting relevance in the international response to the emergence and spread of disease. The IHR (2005) also provide the legal basis for important health documents applicable to international travel and transport and sanitary protections for the users of international airports, ports, and ground crossings.
Declared public health emergencies of international concern till now;
- 2009 H1N1
- 2014 polio
- 2014 Ebola in West Africa
- 2016 Zika
- 2019 Ebola in the Democratic Republic of the Congo
- WHO declares the new coronavirus outbreak a Public Health Emergency of International Concern
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