The 14th meeting of the International Health Regulations (IHR) Emergency Committee regarding COVID-19 took place on Friday 27th January 2023. The advice offered by the Committee was accepted by WHO Director-General Dr Tedros Adhanom Ghebreyesus, who agrees that the “event continues to constitute a public health emergency of international concern (PHEIC)”. Furthermore, he offered a set of Temporary Recommendations based on the Committee’s suggestions.
The meeting
The meeting took place three years after the determination of the COVID-19 PHEIC in January 2020, which Dr Tedros Adhanom Ghebreyesus acknowledged as he welcomed Members and Advisors over video call.
A statement from WHO suggests that “while the world is in a better place than it was during the peak of the Omicron transmission one year ago, more than 170,000 COVID-19 related deaths have been reported globally within the last eight weeks”. Further to this, “surveillance and genetic sequence” have experienced a global decline.
As health systems struggle with COVID-19, influenza, and RSV, we are also encountering “workforce shortages, and fatigued health workers”. Although “vaccines, therapeutics, and diagnostics” are essential in the fight against severe disease, the response in “too many countries” is “hobbled”.
Professor Didier Houssin, Chair of the Emergency Committee, introduced the objectives of the meeting as “to provide views to the Director-General on whether the COVID-19 pandemic continues to constitute a PHEIC, and to review temporary recommendations to States Parties”.
The Committee was informed of the global vaccine administration total of 13.1 billion doses of COVID-19 vaccines. Across the world, 89% of health workers and 81% of older adults are believed to have “completed the primary series”.
Committee Members “expressed concern” about the continued risk posed by COVID-19, with challenges such as “insufficient vaccine uptake in low- and middle-income countries” and “uncertainty associated with emerging variants”. Although the Omicron sub-lineages are “highly transmissible”, the Committee recognised that “there has been a decoupling between infection and severe disease” compared to previous variants of concern. The importance of “improved surveillance and reporting” was emphasised.
PHEIC
The Committee Members agreed that COVID-19 “remains a dangerous infectious disease” with “capacity to cause substantial damage to health and health systems”. Therefore, the continuation of a PHEIC was considered in view of maintaining global attention to the disease. Although the pandemic “may be approaching an inflexion point”, long-term public health action is “critically needed”.
In order to move forward from a PHEIC, WHO and international partners would need to collaborate and commit to “developing and implementing sustainable, systematic, long-term prevention, surveillance, and control action plans”. Thus, the Committee promoted a proposal for “alternative mechanisms” to maintain focus after the termination of the PHEIC.
What is advised?
The Director-General issued a series of recommendations to all States Parties, which are set out below.
- Maintain momentum for COVID-19 vaccination to achieve 100% coverage of high-priority groups guided by the evolving SAGE recommendations on the use of booster doses. State Parties should plan for integration of COVID-19 vaccination into part of life-course immunisation programmes.
- Improve reporting of SARS-CoV-2 surveillance data to WHO. Better data are required to detect, assess, and monitor emerging variants, as well as to identify changes to epidemiology and understand the disease burden across regions.
- Increase uptake and ensure long-term availability of medical countermeasures. Furthermore, States Parties should consider preparing for medical countermeasures to be authorised within normal national regulatory frameworks.
- Maintain strong national response capacity and prepare for future events to avoid the occurrence of a panic-neglect cycle.
- Continue working with communities and their leaders to address the infodemic and to effectively implement risk-based public health and social measures.
- Continue to adjust any remaining international travel-related measures, based on risk assessment.
- Continue to support research for improved vaccines that reduce transmission and have broad applicability, as well as research into the nature of post COVID-19 condition.
At the World Vaccine Congress in Washington 2023 we will explore how vaccines and public health measures can continue to pave the way for our emergence from the PHEIC. To join us, get your tickets today.
