Just about every newsletter in the past week or so, has had some mention of the mysterious coronavirus originating from Wuhan, China. Named the 2019 novel coronavirus (2019-nCoV), this upper-respiratory virus has caused more than 80 deaths and left more than a thousand ill according to the CDC and China’s National Health Commission– as of Jan. 26th, 2020.[i] Due to its potential international threat – cases have been reported in Thailand, Japan, South Korea, Taiwan, Vietnam, Singapore, Saudi Arabia and the US[ii] – there has been discussion of declaring a worldwide health emergency.
The World Health Organization, otherwise known as WHO, has the power to declare a Public Health Emergency of International Concern (PHEIC). The PHEIC was started in 2005 in response to outbreaks of SARS and the bird flu.[iii] Although the PHEIC did not start until 2005, WHO was established in 1948 as a specialized agency of the UN focused on international public health.[iv] WHO is headquartered in Geneva, Switzerland, but has 194 participating countries/areas from around the world.[v] Appointed in 2017, the current director general of WHO is Dr. Tedros Adhanom Ghebreyesus.[vi] It is in the director general’s discretion to convene a meeting of health experts from around the world, to determine whether to classify a public health concern as a PHEIC.[vii] So what specifically constitutes a PHEIC?
A PHEIC is determined by the director general of WHO and a committee of health experts from around the world, known as the International Health Regulations Committee (IHR).[viii] Since the creation of PHEIC in 2005, only five emergencies have been declared including the H1 influenza pandemic of 2009, the Ebola outbreak in West Africa from 2014-2016, the Polio outbreak in 2014, Zika outbreak in 2016, and the Ebola outbreak in Congo, beginning in 2019. [ix]
Defined as “an extraordinary event concerning public health,” a PHEIC has specific qualifications in order to be given the formal emergency declaration. According to WHO, the issue must 1) “constitute a public health risk to other States through the international spread of disease” and 2) “potentially require a coordinated international response.”[x] Both components contribute to an implied definition, denoting the situation to be “serious, unusual or unexpected; carrying implications for public health beyond the affected State’s national border; and possibly requiring immediate international action.” [xi]
As of Jan. 23rd, 2020, WHO has declared it “too early” to classify 2019-nCoV a PHEIC.[xii] This may be due to several factors considered by IHR. According to WHO, the IHR has a substantial focus on not only preventing the spread of disease outbreaks, but also on protecting the economies of affected countries. [xiii]Travel bans not only ban travel, but also trade. Extensive travel bans, therefore, can potentially harm trade extensively and damage the economy of involved countries. As the General Director specifies in his tweets, the coronavirus is “evolving and complex” and Dr. Ghebreyesus is “only prepared to make [the decision] with appropriate consideration of all the evidence.” [xiv]
In order to address the future implications to be expected from the 2019 novel coronavirus, one must look at possible outcomes. Essentially, WHO must perform a cost-benefit analysis, given the current status of the coronavirus and where it is projected to go. On the one hand, classification as a PHEIC could raise awareness and enable global donors to contribute funds but could also further the likelihood of economically harmful travel bans. On the other hand, failing to classify it as a PHEIC, would lessen potential overreaction to the virus, but would also heighten the risk of quick, international spread of the virus. The future effects of this virus are unknown, as are many aspects of the virus itself. Although it is easy to become caught up in the fear of the unknown, WHO and the IHR use a cost-benefit analysis of sorts and are very level-headed in these types of situations. While it may seem that the delay in labeling the virus shows a lack of urgency or concern, it actually shows tremendous analysis and an approach which weighs not only immediate effects but also externalities. In a world where conclusions are often drawn too quickly, WHO’s full-bodied approach toward the 2019 novel coronavirus issue shows that global well-being is being valued above all else.