COVID-19 “established and ongoing” but no longer PHEIC

At the fifteenth meeting of the International Health Regulations (IHR) Emergency Committee regarding the COVID-19 pandemic, held on 4th May 2023, the Committee members advised the WHO Director General that the pandemic is no longer a public health emergency of international concern (PHEIC). Acknowledging decreasing deaths and hospitalisations, as well as higher levels of population immunity, the Committee advised a transition to “long-term management” of the pandemic. Director General Dr Tedros Adhanom Ghebreyesus “concurs” with this advice.  

“With great hope I declare COVID-19 over as a global health emergency.”

High levels of immunity 

Although the global risk assessment is still considered “high”, the Committee recognised evidence of a reduction to this risk driven “mainly by high population-level immunity”.  Through infection, vaccination, or both, this immunity combines with “consistent virulence” of circulation variants and “improved clinical case management”.  

WHO provided updates on the status of global vaccination. The Committee was informed that across the world 13.3 billion doses of COVID-19 vaccines have been administered. Although 89% of health workers and 82% of adults over the age of 60 have completed the “primary series”, coverage in these groups is variable.  

Deliberating the status of the PHEIC 

The Committee reportedly considered the three criteria of a PHEIC. These are: 

1. Whether COVID-19 continues to constitute an extraordinary event 
2. If it continues to constitute a public health risk to other states through the international spread
3. Whether it potentially requires a coordinated international response. 

“Although SARS-CoV-2 has been and will continue circulating widely and evolving, it is no longer an unusual or unexpected event.” 

The Committee also celebrated the global enhancement of “functional capacities”, suggesting that the world has made “significant and impressive global progress” since the initial declaration of the PHEIC in January 2020. Although the PHEIC has been a “valuable instrument” to the global response, the Committee elected that “the time is right” to progress towards “long-term management”.  

“Reaching the point where COVID-19 can be considered as no longer constituting a PHEIC should be seen as accolade to international coordination and commitment to global health.”  

Recommendations 

The Director General issued the following temporary recommendations to Member States. For more details visit the WHO website. 

1. Sustain the national capacity gains and prepare for future events. 
2. Integrate COVID-19 vaccination into life course vaccination programmes. 
3. Bring together information from diverse respiratory pathogen surveillance data sources to allow for a comprehensive situational awareness. 
4. Prepare for medical countermeasures to be authorised within national regulatory frameworks to ensure long-term availability and supply.  
5. Continue to work with communities and leaders to achieve strong, resilient, and inclusive risk communications and community engagement (RCCE) and infodemic management programmes. 
6. Continue to life COVID-19 international travel related health measures.  
7. Continue to support research.  

Do you agree that now is the right time to move to “long -term management”, or would you prefer the WHO took a more cautious approach? 

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