Clare Wenham
Associate Professor of Global Health Policy at the London School of Economics and Political Science
The idea of the PHEIC is to be a political tool to galvanise activity to mitigate the spread of the pathogen. However, what’s important is that we don’t actually have any robust evidence base as to what impact the PHEIC determination has or doesn’t have (we have been trying to get funding for this for years). The point being; that because we don’t know what impact as PHEIC does or doesn’t have, then it’s hard to say what impact something being redetermined a PHEIC or the emergency ending will have.
I think if you think about the criteria for the PHEIC
- Inusual or unexpected (well, it’s no longer that)
- Potential for cross border spread (yes, but does that matter if it’s in every country and endemic)
- Does it require a coordinated international response. This part is more tricky, as it’s arguably never had this, or not very well, with the rampant revert to nationalism. You could argue it still needs this, or the opposite, that governments managed on their own, with the caveats of how successful individual countries were in doing that, driven of course by structural factors.
During Ebola outbreaks, the end has been determined with the cessation of cases. At the end of Zika PHEIC it was determined over when it was thought that longer term planning and health system support was required. This week WHO have put out some longer term management plans, which speaks to how they are thinking about it. Obviously it’s not up to WHO to decide as a technical international organism, but the Emergency Committee gives technical advice to the Director-General who makes the decision to end or not.