The World Health Organization (WHO) sounded its highest alarm on 30 January 2020 a declaration called a 'public health emergency of international concern', or PHEIC, signalling that a pandemic might be imminent. Few countries heeded the WHO's call for testing, tracing and social distancing to curb the coronavirus. By mid March, it had spread around the world. Now, health officials and researchers are evaluating why the organization's warning system failed and how to overhaul it.
Many say the organization should have declared a PHEIC about a week earlier than it did. But the largest failing, researchers agree, is that so many countries ignored it. Two new preliminary investigations one from the WHO and another from an independent panel responsible for assessing the organization attempt to unravel why.
"The biggest issue to me is that for six to eight weeks after the PHEIC declaration, countries, except for in Asia, sat on their hands," says Joanne Liu, a former president of Medecins Sans Frontiers (also known as Doctors without Borders), who serves on the independent panel.
World health officials are evaluating potential improvements to the system during the WHO's executive board meeting, being held 18 26 January. Talks will continue in advance of the annual World Health Assembly in May, when any changes would occur. Some of the proposals include modifying the PHEIC alarm to have colour coded warning levels, and having countries sign on to a new treaty on preparing for pandemics.
The thorniest problem for the WHO, though, is how to persuade countries to heed its warnings. Liu says: "The real question is, what would it take for people to do something when a declaration happens?"
What's in a name?
The PHEIC alarm originated in 2005, when the WHO overhauled its decades old regulations about international health emergencies: 196 countries and territories agreed to alert the organization when outbreaks emerged, and gave it the power to declare a PHEIC. The WHO can sound this alarm if it deems an emergency extraordinary, if the emergency poses a risk to countries outside where it originated and if it requires an international response meaning, in some cases, that it could have pandemic potential. Since the revision, the WHO has declared a PHEIC six times (see 'Sound the alarm').
SOUND THE ALARM