WHO ‘between a rock and a hard place’ over coronavirus

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Before the World Health Organisation dares declare a the coronavirus a global emergency, it must weigh scientific imperatives against China’s political sensitivities, writes MedicalBrief.

Most of the WHO criteria for declaring a global emergency have been met, but it is awaiting clear evidence of a sustained spread of the new coronavirus outside China before doing so, Reuters Health reports some experts and diplomats as saying.

The UN agency is seeking to balance the need to ensure China continues to share information about the virus while also giving sound scientific advice to the international community on the risks, according to several public health experts and a Western diplomat who tracks the WHO’s work.

The WHO has declared five global emergencies in the past decade, including the ongoing Ebola epidemic in the Democratic Republic of Congo. Doing so can hurt host countries because it may lead to flight cancellations and travel or trade restrictions, dragging on the economy.

Some experts believe the Geneva-based health agency is in a difficult position, having drawn fire in the past for acting either too quickly or too slowly. “Essentially the WHO is between a rock and a hard place,” said Jeremy Farrar, an expert in infectious disease epidemics and director of the Wellcome Trust global health charity, in the report. Farrar noted that the organisation was criticised for having called an early emergency in 2009 for the H1N1 flu pandemic, which proved mild, and then for being too late in declaring the Ebola epidemic in West Africa in 2014.

In the latest case, the WHO declined to declare China’s coronavirus a public health emergency of international concern (PHEIC) twice last week, although its Emergency Committee was split “50-50” over whether to do so. “What was lacking for them to declare an international emergency were deaths abroad and human-to-human transmission outside of China,” said the Geneva-based diplomat following the agency is quoted in the report as saying.

WHO spokesperson Christian Lindmeier restated that the WHO’s criteria for a global emergency include a “serious or unusual” health situation that affects other countries and may require a coordinated international response. While the vast majority of the 4,500 or so confirmed cases and all 106 deaths so far have been in China, cases in Germany, Vietnam, Taiwan and Japan where the virus has spread person-to-person have heightened concerns.

The report says a declaration would lead to boosting public health measures, funding and resources to prevent and reduce global spread. It could include recommendations on trade and travel, although the WHO generally tries to avoid disruptive trade restrictions.

China has agreed that the WHO can send international experts there as soon as possible to increase understanding of the new coronavirus and guide the global response to the outbreak, the WHO said.

Full Reuters Health report

World Health Organisation material

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