On Covid-19’s birthday becoming an official public health emergency, experts say it’s time to change

On Covid-19’s birthday becoming an official public health emergency, experts say it’s time to change

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“At the time, there were less than 100 cases of the disease that we now call Covid-19 and no deaths outside of China,” said WHO Director-General Tedros Adhanom Ghebreyesus on Friday. “This week we reached 100 million reported cases. More cases were reported in the past two weeks than during the first six months of the pandemic. A year ago, I said the world had a window of opportunity to prevent the widespread transmission of this new virus. . Some countries responded to that call, others did not. “

The rare emergency declaration, also known as PHEIC, is the highest alarm level under international law. Only six have been declared in history.

It is supposed to notify the world that urgent action is needed, but experts say the reason “some countries have responded to this call, others have not” is because the statement lacks strength.

The statement gives WHO “few powers of momentum and no funding,” according to Lawrence Gostin, professor of public health law at Georgetown University and the director of the World Health Organization Collaboration Center on Public Health Laws and Human Rights.

“The only power that a declared emergency provides is to make ‘recommendations’ to governments. But most governments, especially in the United States and Europe, have almost universally failed to adhere to (WHO) recommendations,” said Gostin.

WHO is evaluating how it can improve the system, and changes could happen during the World Health Assembly in May.

In this second year of the declaration, Gostin and other jurists argue that urgent reform is needed to give WHO much stronger authority and broader funding if such a statement ever works more effectively in a global health crisis.

How a public health situation becomes an emergency declaration

Countries should notify WHO in a short time if there is an event in their country that could trigger an emergency declaration. As specified in the International Health Regulations, certain diseases or public health events must pose a significant enough risk to require a coordinated international response.

As soon as a country notifies WHO of its health threat, WHO convenes a committee of experts that meets behind closed doors to review the data and listen to the testimony of the country that reported the threat. The committee then makes a recommendation to the Director-General of WHO, who makes the final decision.

If an emergency is declared, WHO creates a list of recommendations for governments to commit to preventing the spread of the disease. WHO also makes recommendations on how to share information.

If it’s in their own backyard, governments don’t like the statement

At the moment the policy is being drafted now, there are many disadvantages and disincentives for governments to provide WHO with public health information and no real advantages guaranteed, according to global health legislation expert Mara Pillinger.

“Governments tend to prefer that WHO does not call them and raise the biggest alarm, because it may not help them control the outbreak, but it may actually hinder the entry of supplies and humanitarian assistance into the country,” said Pillinger, a associate of the Global Health Policy & Politics Initiative of the O’Neill Institute for National and Global Health Legislation in Georgetown. “And it can have an economic cost.”

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In theory, the emergency declaration should sound the alarm and motivate other countries to act, not only to protect themselves, but also to help the country with the outbreak to control the problem so that it does not spread further.

Instead, an emergency declaration often causes other countries to restrict travel and trade against the country with the outbreak. That country suffers financially and travel restrictions are often ineffective, as they are applied too late or in a fragmented way, Pillinger said.

The declaration needs more authority

With an emergency declaration, nothing compels other countries to send technical or financial assistance to help that country fight or control the disease. Assistance is, on the contrary, a matter of political will and political coordination. China did not need the money from the Covid-19 outbreak, but Congo did when an emergency declaration was declared with an Ebola outbreak in 2018.

While WHO can make recommendations on how countries should respond to a threat to public health, it is the responsibility of each country to decide how to respond; how to work with WHO; how it will help the country at the center of the outbreak; and the WHO warning will be taken seriously.

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“It’s a bit like declaring a fire with five alarms, but imagine that you had a center responsible for ringing the alarm bell and then it was up to individual firefighters to decide whether or not to send trucks to the fire,” Pillinger said.

The statement also does not give WHO real authority to investigate the outbreak if the country does not want WHO to participate.

“Even now, WHO has just sent a team to China, one year late,” said Gostin. “WHO does not have the authority to independently verify country reports, which is why China was allowed to deceive the world about the spread of the new coronavirus in the community. The WHO team also has no legal authority to demand access to complete information from the Chinese government and scientists. “

The future of the emergency declaration

One step could be the help the United States has promised to give to WHO. The Biden administration reversed the Trump administration’s decision to withdraw from the organization. On January 21, the Director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, told WHO that the United States would “work constructively” to strengthen and significantly reform WHO.

Gostin believes that, as the world moves into the second year of the emergency declaration, the International Health Regulations need to be improved now to better manage the current Covid-19 crisis and help manage future pandemics.

“WHO should be able to mobilize the world in response to a pandemic,” said Gostin, noting that it was not really able to do that. “We have seen little global solidarity and indeed nationalism ‘alone’, especially ‘American one and only’.

“WHO’s mission is to lead a globally coordinated response to a pandemic,” said Gostin. “It never happened with Covid-19. That is why it is urgent to reform the International Health Regulations and to give WHO strong powers and ample funding ”.

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