When a disease, like monkeypox, spreads throughout the world, it is up to the World Health Organization (WHO) to decide what weight to give the epidemic and whether or not it should be considered a public health emergency of global concern.
As early as the black plague in Europe in the 14th century, there have been documented efforts made on a global scale to control epidemics. Since then, laws have been created and improved to keep up with the appearance of new diseases and the expanding complexity of a world that is becoming more interconnected.
Numerous illnesses have the potential to afflict big populations. However, not every illness is a public health emergency.
An epidemic’s severity depends on a number of variables.
These factors include the level of contagiousness and potential for rapid spread, the severity of the infection, the case fatality rate (the proportion of infected people who die), the accessibility of vaccines or treatments (it’s more serious if there are none), the effect on travel and trade, and the socioeconomic context.
What it causes
When the WHO declares a “public health emergency of international significance,” many things happen.
The first is that it denotes a determination to contribute global resources to the reaction.
The second is that it makes additional International Health Regulations requirements possible. These were derived from the mid-nineteenth-century International Sanitary Regulations, which were used to manage cholera epidemics. At this time, there was growing concern about unjustified commercial intervention as well as the social and economic impacts of pandemic diseases across international borders.
The WHO called the rules the “International Health Regulations” in 1969. After that, changes were made in 1973 and 1981. Even yet, they merely offered a framework for cholera, yellow fever, and plague. The guiding principles underlying them were maximum protection against the global spread of illnesses and minimal disruption of global trade.
The regulations underwent official amendment in 1995, and six new types of reportable illnesses were proposed: acute hemorrhagic fever syndrome,
Acute neurological syndrome, acute jaundice syndrome, acute respiratory syndrome, acute diarrhoeal syndrome, and other notifiable syndromes are examples of acute syndromes.
Additionally, five criteria were suggested to assess if a cluster of symptoms was urgent and of global significance. Rapid community spread, an unexpectedly high case fatality rate, a newly recognised syndrome, strong political and media profile, and trade or travel restrictions were among them.
Following the 2003 SARS epidemic, the regulations underwent their most recent amendment in 2005.
The five significant changes from the previous version were as follows: – a significant expansion of the regulations’ reach – the establishment of requirements for states to build minimal core surveillance and response capacities – the authorization of WHO to access and use non-governmental sources of surveillance data – the authorization of WHO to declare a public health emergency of international concern and to issue recommendations to states-parties on how to respond to it – and – the inclusion of the word “international” in the title.
The rules specify how an emergency is to be handled. This entails creating a list of specialists in all pertinent disciplines of competence who have been appointed by the director general of WHO.
From this list, an emergency committee is then selected to provide guidance. The committee must make decisions regarding a variety of matters related to controlling the outbreak. This includes determining if a situation qualifies as a global emergency and when it needs to be resolved.
broader than a health concern
But the laws have a limited scope. Due of a lack of resources, many nations are unable to comply with them.
Numerous emergency-related issues pertain to civil society, participation in the community, law and order, and border control rather than specific health issues. For instance, during the 2014 Ebola outbreak, a health promotion team was murdered in Guinea because the locals were wary of outsiders visiting their hamlet. In certain nations, there was civil disturbance during COVID-19. When deciding whether to declare a public health emergency of worldwide concern, the WHO takes all of these factors into account.