RIO DE JANEIRO, BRAZIL – The World Health Organization (WHO) emergency committee decided yesterday afternoon, January 30th, in Geneva to declare a global health emergency due to the outbreak of the Wuhan coronavirus.
The decision comes 30 days after the first alert to the new disease, released by China on December 31st, and after the number of people affected by the pathogen multiplied by 13 in the past week, to 7,818 confirmed cases and 170 dead, according to the latest WHO data.
Of these, 82 patients were diagnosed in 18 countries outside China -Finland, India and the Philippines were the last to join the list on Wednesday. There have been no fatalities outside the Asian country.
This is the sixth time the WHO has taken such action, after influenza A worldwide (in 2009), polio in the Middle East and Ebola in West Africa (2014), Zika in America (2016) and against Ebola in the Democratic Republic of Congo last July. In 2002, the WHO failed to reach a similar decision against SARS as the mechanisms for this were not yet well defined.
The latest version of the International Health Regulations was adopted in 2005, and its global health emergency provisions are largely inherited from that crisis.
Last Friday, after two days of meetings and with its 16 members on two separate occasions, the emergency committee decided not to declare a global health emergency, considering that the 2019-nCoV coronavirus outbreak was then something “significant” but not a global emergency, according to Didier Houssin, chairman of the committee.
Much has changed since then. The virus continued to spread uncontrollably, not only in terms of the number of people and countries affected but also when the first contagions were recorded outside China – in Germany, Japan, Vietnam, Taiwan, and the United States – which removed one of the main arguments used by the committee.
According to the International Health Regulations, the declaration of a global health emergency should occur when an event “represents a risk to the public health of other states as a result of the international propagation of a disease,” and this “could require a coordinated international response”.
To assess whether the event is sufficiently severe, factors such as its “public health significance,” the “unusual or unforeseen nature,” the “possibilities of international spread,” and the “risk of restrictions on travel or trade,” among others, are taken into account.
The declaration of a global health emergency means, as established in the same regulation – compulsory for the countries that have signed it, which are in practice all the members of the UN – the coordination between the countries under the WHO framework in the development and application of preventive measures and contingency plans, something that extends its effects to issues of tremendous economic, political and social repercussions, such as the closing and control of borders, restrictions on the movement of people and goods and the adoption of all types of preventive measures, among other points.
The emergency committee’s decision not to declare the alert last week had caused growing uncertainty throughout the world. “By deciding nothing, the committee created a void of international authority, which is the WHO’s expected role. This has prompted governments and companies to start taking decisions on their own with no coordination,” said Daniel López Acuña, former director of Health Action in Crisis at the WHO and current associate professor at the Andalusian School of Public Health.
The disorderly evacuation of citizens from other countries, the closing of borders – Russia yesterday closed the 4,300 kilometers it shares with China – and the subsequent decision of many airlines to stop flying to China is “precisely what should not be done”. “This is the worst-case scenario. The economic consequences of these disorganized restrictions are devastating. That is why the WHO must lead the way,” adds López Acuña.
China’s own reluctance was among the reasons that slowed the declaration of a global health emergency, according to the sources interviewed. “The WHO has experienced enormous internal pressure,” says am anonymous source in the body.
“Beijing tried to show the world that the criticism it received two decades ago over the management of the SARS is a thing of the past. That it could manage this crisis by its own means. And while it is true that it adopted measures of great significance and adequately, it is also a fact that this outbreak has been no longer an internal affair for days,” concede these sources.
“Governments tend to be resistant to declaring a global health warning when it affects them. They feel they are being singled out, punished, disqualified … In fact, they must understand that this is done because the issue has crossed borders and international action is required,” López Acuña said.
The WHO’s trip to China in recent days – headed by Director-General Tedros Adhanom Ghebreyesus and Michael J. Ryan, the body’s emergency officer – was construed as “preparing the ground” to declare an emergency without bothering Beijing.
At the collective press conference on his return to Geneva, Ryan already pointed to the change in the body’s position: “194 countries unilaterally and individually adopting measures based on their own risk assessments is a recipe for great potential political, economic and social disaster,” said the WHO Emergency Officer.
Regarding the potential to declare a global health emergency, Ryan said that “the great advantage of this approach is that the measures adopted by all countries may be simultaneously aligned,” which allows “implementing measures based on scientific evidence that slow the spread of the virus while minimizing the impact on travel and trade”.
The WHO is further contemplating amending the current global health emergency declaration system. “The current operation is ‘yes or no’ and we need to review this,” said Ghebreyesus, who was more favorable to a “warning light approach that could help because amber is the signal that something needs to be done, but it’s not yet red”.
Source: El Pais