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What is a Public Health Emergency of International Concern?

By Staff Writer

July 19, 2019

The World Health Organisation (WHO) on 17 July 2019 officially declared the Ebola outbreak in DR Congo a Public Health Emergency of International Concern (PHEIC). This declaration was made about one year after the outbreak began in the African country. But what does it mean?

the Ebola outbreak in DR Congo a Public Health Emergency of International Concern (PHEIC). This declaration was made about one year after the outbreak began in the African country. But what does it mean?

A PHEIC is a formal declaration by WHO of “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”, formulated when a situation arises that is “serious, sudden, unusual or unexpected”, which “carries implications for public health beyond the affected State’s national border” and “may require immediate international action”.

Under the 2005 International Health Regulations (IHR), States have a legal duty to respond promptly to a PHEIC.

The declaration is promulgated by an Emergency Committee (EC) which is made up of international experts operating under the IHR (2005), which was developed following the SARS outbreak of 2002/2003.

Between 2009 and 2019, there have been five PHEIC declarations and they are: the 2009 H1N1 (or swine flu) pandemic, the 2014 polio declaration, the 2014 outbreak of Ebola in Western Africa, the 2015–16 Zika virus epidemic and, as of 17 July 2019, the 2018–19 Kivu Ebola epidemic.

It is worthy to note that SARS, smallpox, wild type poliomyelitis, and any new subtype of human influenza, are always a PHEIC and do not require an IHR decision to declare them as such.

A PHEIC is not only confined to infectious diseases, and may cover an emergency caused by a chemical agent or a radio nuclear material.

What it essentially means is a “call to action” and “last resort” measure.

Most epidemics and emergencies will not gain public attention or fulfil the criteria to be a PHEIC. ECs were not convened for the cholera outbreak in Haiti, chemical weapons use in Syria or the Fukushima nuclear disaster in Japan.

Of the outbreaks reported to the WHO for consideration of PHEIC declaration, the 2018–19 Kivu Ebola epidemic was declined for the third time on 14 June 2019, when the number of deaths from Ebola in the Democratic Republic of the Congo (DRC) had reached 1,405 by 11 June 2019 and when a couple of cases of Ebola in neighbouring Uganda had been confirmed.

In July 2019, following a confirmed case of Ebola in Goma, the capital of North Kivu, the reconvening of a fourth EC was announced and the WHO officially announced it as a PHEIC on 17 July 2019.