Public health emergency
1. What is a public health emergency of international concern?
Formally, a PHEIC — pronounced "fake" — 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." It’s a political tool used by the WHO to sound the alarm about a serious disease that has caught the world off guard and put people's health in danger. It is meant to draw countries' immediate attention to galvanize resources and stop the disease from spreading further across borders.
2. Who decides to declare a public health emergency?
The WHO convenes a panel of experts under the International Health Regulations (which are a set of laws that govern global responses to pandemics involving 196 member countries). These experts — dubbed an "emergency committee" meet and assess the risk posed by a disease outbreak and then advise the WHO Director General about whether to declare a PHEIC, who then decides whether to take action.
3. How often does the WHO declare these emergencies?
Not very often. The WHO has only declared a public health emergency three times since the International Health Regulations were enacted in 2007. The first time was in 2009, with the outbreak of the H1N1 swine flu pandemic. The second time was in May 2014, when polio seemed to surge again, threatening the eradication effort. The third time, in August 2014, came as the Ebola outbreak in West Africa was growing out of control. Notably, the emergency committee decided not to declare the MERS virus a PHEIC.
Zika declaration is the fourth PHEIC in history. It is also the first time the WHO has issued such a warning over a mosquito-borne disease.
4. Why are these declarations so rare?
PHEIC is a political tool used to focus the world's attention on a health crisis. Using this declaration too often would weaken its significance. One of the key considerations in declaring a PHEIC is whether the disease threat is dire enough for countries to be forced into enacting travel and trade restrictions. These can be devastating to local economies.
Even if the WHO only warns people to limit or delay travel to affected regions (instead of outright travel restrictions), health emergency declarations are often associated with economic losses.
Because of the Ebola crisis, the World Bank Group estimated that the West African countries at the center of the outbreak — Guinea, Liberia, and Sierra Leone — lost out on about $1.6 billion in economic growth in 2015. Similarly, the South American countries hit by swine flu suffered economic losses ranging from 0.5 to 1.5 percent of their GDPs.
5. Zika does not even cause symptoms in most people. So why did the WHO declare a PHEIC?
It is really Zika's link with microcephaly that prompted the PHEIC. So, it's not the Zika virus itself that prompted the PHEIC, per se, but it's the virus' potential to harm newborns, even though this link is not yet fully established or understood.
6. Beyond economic repercussions, do these declarations have any impact?
Naming a PHEIC does not mean the countries battling an outbreak will suddenly be flooded with funds and support from the WHO. In Ebola, the three worst-affected countries also happened to be some of the poorest on the planet. The emergency declaration escalated media attention and global focus on the disease. It helped wake up the world to the gravity of West Africa's outbreak. It helped bring resources from wealthier countries into West Africa, and slowly the global effort got the outbreak under control.
7. What will this health emergency mean for Latin America?
The WHO is not recommending any restrictions on travel and trade. This puts them at odds with the CDC, which advised pregnant women to avoid travel to Zika-infected countries.
For now, the WHO is alerting countries to the threat of Zika and advising health officials to coordinate a public health response. This involves taking measures to strengthen surveillance of Zika cases and associated birth and neurological complications, controlling mosquito populations that carry the virus, and expediting the development of a vaccine as well as improved diagnostic tests for the virus. A PHEIC also means the WHO will closely track and monitor the disease and issue regular media updates about the outbreak. It'll draw global attention to the disease, and probably encourage governments and health agencies in and out of Latin America to research Zika and send resources to places that need them in order to help stop the virus from traveling further.