How have PHEIC determinations changed since the COVID-19 pandemic? A document analysis of 101 WHO International Health Regulations Emergency Committees’ statements
Bibliographic record
Abstract
BACKGROUND: The World Health Organization (WHO) is chiefly responsible for declaring a Public Health Emergency of International Concern (PHEIC). The WHO makes the assessment on whether to declare a formal PHEIC if the event fulfils three criteria: (i) it is an extraordinary event, (ii) is a public health risk to other States through the international spread of disease, and (iii) potentially requires a coordinated international response. There have been seven PHEIC declarations, including for the 2009 H1N1 flu pandemic, Ebola and Polio outbreaks, the COVID-19 pandemic, and most recently, the mpox outbreak. While the WHO's approach to PHEIC declarations prior to COVID-19 has been previously analyzed, there has been limited scholarly attention to how the approach has shifted since the pandemic. Given that COVID-19 constitutes the most severe pandemic in a century, this study empirically assesses how the PHEIC declaration process has been impacted by, and what has changed during and after, the COVID-19 pandemic. METHOD: A document analysis of 101 WHO International Health Regulations Emergency Committees' (EC) statements was undertaken with inductive thematic analysis. The thematic analysis focused on identifying common patterns in the EC statements to ascertain changes to PHEICs since COVID-19. RESULTS: Three primary themes emerged from our analysis: (i) this work affirms previous findings that the rationale for a PHEIC declaration and the criteria used to declare PHEICs have been applied inconsistently; (ii) since the COVID-19 pandemic, there has been a greater focus in explaining and justifying the use of the three criteria for PHEIC declarations and terminations; and (iii) since the COVID-19 pandemic, there has been increased detail, discussion, and structure in IHR EC statements. DISCUSSION: This analysis suggests that changes to the PHEIC process are needed and we present two primary recommendations: first, to create a new standardized interpretation of PHEIC criteria; and second, for the WHO EC to reaffirm its commitment to clear and transparent communications. CONCLUSION: Given changes to the PHEIC declaration process following the COVID-19 pandemic, it is evident that reforms are necessary to ensure a more consistent, transparent, and effective global health response moving forward. Our recommendations, if adopted, could significantly enhance the WHO's ability to respond to future global health crises, ensuring more consistent and transparent decision-making in PHEIC declarations, and ultimately strengthening international preparedness and cooperation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.036 | 0.059 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.010 | 0.017 |
| Science and technology studies | 0.005 | 0.006 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".