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Shanghai Model United Nations 2015 | Research Reports Forum: Security Council 2 Issue: Issue of PHEIC (Public Health Emergency of International Concern) Student Officer: Winnie Chen Position: President Introduction The PHEIC, Public Health Emergency of International Concern has been declared three times since its implementation in 2007. In order to be constitute as a PHEIC, it must be: “an extraordinary event which is determined, as provided in these Regulations: i. To constitute a public health risk to other States through the International spread of disease; and ii. To potentially require a coordinated international response. This definition implies a situation that: is serious, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action.” The decision of whether to declare a disease as a PHEIC is in the hands of the WHO DirectorGeneral and the experts in the International Health Regulation (IHR) Emergency Committee. After a PHEIC has been declared, the WHO Director-General will issue temporary recommendations for health measures for citizens as well as travelling restrictions. The implementation of PHEIC was in response to the SARS outbreak in 2005 and the lack of a globalized effort in solving the pandemic. Definition of Key Terms Pandemic An outbreak of a disease that is prevalent over a whole country or the world RR Topic| Page 1 of 6 Shanghai Model United Nations 2013 | Research Reports Background Information Even since the implementation of the PHEIC, it has been declared three times, once in 2009 for the H1N1 virus and twice in 2014 for Polio and Ebola. The efforts of PHEIC are mostly on a national level and rarely ever become known to the people, unless the States follow the IHR guideline and declare the disease as a national emergency. First PHEIC: Swine Flu H1N1, most commonly known as the Swine Flu became the first PHEIC after the establishing of the connection between IHR and PHEIC. The swine influenza is a respiratory disease that occurs in pigs and is not commonly transmitted from pigs to human. The outbreak started in April 2009 in the United States, then quickly spread to Mexico and all parts of the world. After the spread has become evident, the WHO declared an H1N1 pandemic, marking the first PHEIC. As a result of the Swine Flu, there were over 18,138 deaths across 214 countries by May 30, 2010. Response of WHO The warnings issued were standard, including the vaccination of travelers going and leaving countries that had a high risk of infection, as well as people within the nation. The IHR also requests nations with high risk of spreading the virus to declare the swine flu as a national health emergency and is that nation’s upmost importance to solve the issue at hand. In hindsight, one of the major criticisms of the IHR is the lack of proper surveillance and repercussion. Many of the countries that are in the category of high risk for transmission don’t have the proper facilities and simply the capacity to carry out the regulations and procedures set by the IHR, making the IHR pointless. Another major concern is with the swine flu incident was the violation of the IHR. Other than travel suggestions, the IHR also regulate trade and any unnecessary restrictions. However, multiple countries disregarded the IHR’s suggestion and took action in banning the imports of pork, which they suspected to be a source of H1N1, however this is not scientifically correct, causing a sudden decrease in trade. Despite the violation, no actions were taken to penalize such nations due to a lack of repercussion clause in the IHR. First PHEIC: Swine Flu Page 2 of 6 | RR Topic Shanghai Model United Nations 2015 | Research Reports Poliomyelitis or Polio is an infectious disease caused by the poliovirus. Although its emergence can be date back to Ancient Egypt, the hit of polio patients climbed to its maximum in 1950s. However, the discovery of the polio vaccine greatly decreased the number of polio patients around the world. Europe became “polio-free” in 2002 and till this day 80% of the world’s population live in polio-free regions. The PHEIC in May 2014 was alarmed by the increase of polio patients in Afghanistan in April 2014. Although the nation had previously adopted the attempt of the eradication of polio along with the world back in the 1950s, the vaccination rate began to die down due to a complication with the nation’s cultural and religious beliefs. At the time of the PHEIC, the nations that were considered countries in risk of spreading polio were Nigeria, Pakistan and Afghanistan. Response of WHO The response taken by the WHO was very similar to the one taken for the first PHEIC in 2009. Travel restrictions were issued by the IHR, so were the direct instructions for nations to establish polio as a current health emergency. Despite the good will, many people questioned the action of this particular PHEIC as it drew unnecessary attention and caused unnecessary panics around the world. As mentioned earlier, strands of the poliovirus was found solely in those three nations, making the world wonder whether this was indeed a PHEIC of global importance. The main issue with this PHEIC is the question of the diseases chosen to become a PHEIC. As mentioned earlier, the poliovirus is not a new strand of diseases that went out of control without a plausible solution, as the vaccine was discovered more than five decades ago, therefore raising the question of how many type of diseases will be and could be included in the PHEIC and whether it will still be as effective if more and more diseases are included. First PHEIC: Swine Flu Sub-headings must be in Arial size 11, bold, and in this colour. You may continue writing text in the same format as the rest of the document. Please remember that the beginning of each paragraph must be indented. Response of WHO Title must be in Arial size 11, bold and italicized, and in this colour. Please indent the title, as well as all of the text. Spacing must remain same as throughout the document. Also, every picture incorporated in the report must contain captions. The captions can be brief descriptions of the content and relevance of the picture (preferably not more than a sentence long). You must put all captions in Arial size 9, bold and italicized. RR Topic| Page 3 of 6 Shanghai Model United Nations 2013 | Research Reports Major Countries and Organizations Involved World Health Organization Commonly known as WHO, the United Nations organization helps direct health emergency around the world. For most pandemics, it helps set regulation, provide travel recommendation, and provide financial support for nations in face of a health emergency. WHO is also in charge of planning and implementing both the IHR and the PHEIC. Timeline of Events Date Description of event 15 June 2007 Official Implementation of the PHEIC and IHR April 2009 First PHEIC: Swine Flu May 2014 Second PHEIC: Polio August 2014 Third PHEIC: Ebola Relevant UN Treaties and Events Ever since the original implementation of the PHEIC, there have been no more further efforts, at least from the U.N. to resolving the issue at hand. Previous Attempts to solve the Issue In addition to the lack of U.N. resolutions and treaties, there has also been a lack of efforts in general in solving the issues with the IHR. Even though there has been criticism, the voices have not been heard loud enough by the WHO and the Emergency Committee to make any significant Page 4 of 6 | RR Topic Shanghai Model United Nations 2015 | Research Reports changes. Possible Solutions The issues at hand include the lack of surveillance, repercussion for violations of the IHR and the ambiguity of the extent of the IHR. The possible solutions include providing financial aid and reconstruction of the facilities for nations in risk of transmission. Right now, the IHR is also lacking repercussion for violation of the regulations, for this, financial sanctions may be possible for MEDCs, but would only deteriorate the situation if dealing with MEDCs. However, if financial sanctions are to be implemented, then they should be after the health emergency has passed. At last, the PHEIC extend should also be carefully defined, considered and revised in the IHR. Bibliography “Poliomyelitis.” Wikipedia. Wikimedia Foundation, n.d. Web. 02 Feb. 2015. “WHO Statement on the Meeting of the International health Regulations Emergency Committee concerning the International Spread of Wild Poliovirus.” WHO. World Health Organization, 5 May 2014. Web. 05 Feb. 2015. “WHO Declares Second PHEIC.” IHR 2005: From the Global to the Local – Blog. George Washington University, 9 May 2014. Web. 05 Feb. 2015. Schlanger, Zoë. “What Happens if the WHO Declares Ebola an ‘Emergency of International Concern’?” Newsweek. Newsweek, 7 Aug. 2014. Web. 05 Feb. 2015. “Influenza A Virus Subtype H1N1.” Wikipedia. Wikimedia Foundation, n.d. Web. 05 Feb. 2015 “IHR Procedures Concerning Public Health Emergencies of International Concern (PHEIC).” WHO. World Health Organization, n.d. Web. 05 Feb. 2015. RR Topic| Page 5 of 6 Shanghai Model United Nations 2013 | Research Reports “Statement on the 1st Meeting of the IHR Emergency Committee on the 214 Ebola outbreak in West Africa.” WHO. World Health Organization, 8 Aug. 2014. Web. 05 Feb. 2015. Page 6 of 6 | RR Topic