How does the WHO fight global health emergencies?

Under the International Health Regulations (IHR), a legally binding framework drawn up in 2005 to prevent and mitigate health emergencies, WHO member states are required to monitor and report potential crises. Countries have historically been hesitant to report outbreaks, often because they’re fearful of economic repercussions. In 2003, for example, China denied for months that it was suffering an outbreak of the infectious disease that was eventually identified as SARS. Before the WHO declared China free of SARS in 2004, the disease killed more than three hundred people. In Ethiopia, Tedros himself was accused of downplaying cholera outbreaks while he was the country’s health minister; he denied these claims. In an extraordinary crisis, the WHO can declare a public health emergency of international concern (PHEIC), which it has done six times: during the 2009 swine flu (H1N1) epidemic; in reaction to a reversal of progress in eradicating polio in 2014; amid the 2014 Ebola outbreak in West Africa; during the 2016 Zika virus outbreak in the Americas; once the ongoing Ebola epidemic reached the city of Goma in the Democratic Republic of Congo in 2019; and amid the global outbreak of the new coronavirus in 2020.

During a PHEIC, the WHO issues nonbinding guidance to its members on how they should respond to the emergency, including on potential travel and trade restrictions. It seeks to prevent countries in the surrounding region and beyond from overreacting and inflicting undue economic harm on the country in crisis. The WHO has hoped this would encourage affected countries to report outbreaks in a timely manner. However, experts say that, despite the WHO’s guidance, many countries continue to impose damaging travel and trade restrictions, a problem that was laid bare during the Ebola and COVID-19 crises. In an emergency, the WHO also spells out treatment guidelines and acts as a global coordinator, shepherding scientific data and experts to where they are most needed. Additionally, the WHO provides guidance and coordination for emergencies that don’t rise to the level of a PHEIC. But declaring a PHEIC can help speed up international action and often encourages research on the disease in question, even if there is little risk of a pandemic. This was particularly true for the 2014 declaration for polio. At the same time, PHEIC declarations are contentious, and some argue that they can exacerbate ongoing outbreaks.

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