Kathmandu School of Law Review

P-ISSN : 2091-2110, E-ISSN : 2773-8159, DOI : 10.46985, Publisher : Kathmandu School of Law, Nepal
Annual flagship journal of Kathmandu School of Law, Nepal

Volume 8, Issue 2, November 2020
Articles

Reforms Reaffirmed to Improve International Surveillance and Response Mechanism in WHO in the Post-Coronavirus Situation

PDF
  • Srijan Pant
Srijan Pant
Legal Intern at Infinity Law Firm
DOI: https://doi.org/10.46985/kslr.v8i2.2153

Published 2021-07-27

How to Cite

Pant , S. . (2021). Reforms Reaffirmed to Improve International Surveillance and Response Mechanism in WHO in the Post-Coronavirus Situation. Kathmandu School of Law Review, 8(2), 68–81. https://doi.org/10.46985/kslr.v8i2.2153
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

The emergence of COVID–19 has shown that the inability of WHO to have prompt disease surveillance could be callous to recognize and respond to the situation of Public Health Emergency of International Concern (PHEIC). While the paper traces out the timeline of WHO to perform its mandate in combating the spread of infectious diseases, coincidently it also explains the needs to improve the epidemic intelligence on the basis of coordinated international and national surveillance and response mechanisms. On the note, the post COVID – 19 situation requires WHO member states to strengthen the institution within the international order of global health governance. The only way to do so will be through effective and prompt global disease surveillance and response systems. Further, the article attempts to shed light on the current and previous reaction of WHO over the infectious diseases including COVID – 19. In the process, this article tries to suggest reforms within the IHR and WHO’s applicable effort to develop effective disease surveillance and prompt response systems.

PDF

Downloads

Download data is not yet available.

References

  1. Marcos Cueto, Theodore M. Brown & Elizabeth Fee, The World Health Organization; A History, Cambridge University Press, United Kingdom, 2019, p. 33.
  2. Constitution of the World Health Organization, adopted on 22nd July 1946, International Health Conference, Basic Documents, Forty-fifth edition, Supplement, October 2006, art. 1.
  3. This was first proposed by the Chinese and Brazilian delegation in the UN Conference of San Francisco during the state ratification to officially create the WHO. See A. Kamradt Scott, Managing Global Health Security: The WHO and Disease Outbreak Control, Palgrave Macmillan, United Kingdom, 2015, p. 25.
  4. International surveillance means the efficiency of WHO network to access, detect and extract raw information about the potential health risks. Response system denotes the ability of WHO to coordinate the efforts of member states to combat the disease including stockpiling of medical necessities and supply to the affected areas as well as provide technical guidance to national authorities through a recommendation to prevent the outbreak of diseases.
  5. Adoption of International Sanitary Resolution, 25 May 1951, WHA Res. 4.75, WHO Regulations No.2.
  6. This regulation included six ‘notifiable’ diseases including – cholera, plague, typhus, smallpox, yellow fever, and relapsing fever.
  7. Scott (n 3), p. 20.
  8. Ibid.
  9. The four phases were, prepare, attack, consolidate and maintain. See ‘Report on the Inter – Regional Conference on Malaria and on the Expert Committee of Malaria’, WHO, 1956, Athens, pp. 3–4.
  10. Ibid.
  11. International surveillance means the efficiency of WHO network to access, detect and extract raw information about the potential health risks. Response system denotes the ability of WHO to coordinate effort of member states to combat the disease including stockpiles medical necessity and supply to the affected areas as well as provide technical guidance to national authorities through recommendation to prevent the outbreak of diseases.
  12. Established by the Interim Commission of WHO.
  13. ‘Recommendation of Expert Committee on Malaria’, WHO, 1948, p.5.
  14. Scott (n 3), 49.
  15. ‘Review of Work during 1956: Annual Report of the Director- General’, WHO, 1975, Geneva, pp. 190 – 220.
  16. Scott (n 3), p. 59.
  17. Ibid.
  18. Joshua Ledeberg, Robert E. Shope & Stanley C. Oaks (eds), Emerging infections: Microbial Threats to Health in the United States, National Academy of Sciences, United States, 1992, p. 131.
  19. David L. Heymann & Guenael R. Rodier, ‘Global Surveillance of Communicable Diseases’, Emerging Infectious Diseases, volume 4:3, 1998, p.362, 365.
  20. Communicable Disease Prevention and Control: New, Emerging, and Re-Emerging Infectious Diseases, 12 May 1995, WHA Res. 48.13.
  21. During the 1990s, the WHO was seen as a failing institution unable to prevent the crisis of Tuberculosis, AIDS and Cholera in Latin America, Plague in Surat, India. This raised attention that ISR and WHO’s outbreak policy need urgent reforms. See Scott (n 3), p.106; See also Revision and Updating of the International Health Regulations, 12 May 1995, WHA Res.48.7.
  22. Thomas W. Grein et al, ‘Rumors of Disease in the Global Village: Outbreak Verification’, Emerging Infectious Diseases, volume 6:2, 2000, pp. 97 – 99.
  23. Revision and Updating of the International Health Regulations (n 21).
  24. ‘Global Outbreak Alert and Response: Report of a WHO Meeting’, WHO, 2000, Geneva.
  25. Grein et al. (n 22), p. 98.
  26. ‘Report on Global Surveillance of Epidemic-prone Infectious Diseases’, WHO, 2000, Geneva, p. 98.
  27. This was further clarified by reports released from the director’s general in 2007. See ‘A Safer Future: Global Public Health Security in the 21st Century’, WHO, 2007, Geneva, p. 8 – 11; Revision of the International Health Regulation, 23 May 2005, WHA 58.3.
  28. This did not limit the IHR application to limited notifiable diseases and covered illness or medical conditions irrespective of origin or source that presented or could present significant harm to humans or crisis potentially requiring a coordinated international response. See International Health Regulations, 2005, 3rd eds., WHO: 2016, art. 1.
  29. Ibid.
  30. Ibid, art. 12.
  31. Information of public health situation by affected states, advice from an ad hoc technical expert group known as the Emergency Committee; scientific principles, available scientific evidence, and other related information; an assessment of the risk to human health, of the risk of international spread, and of the risk of interference with international traffic. See Ibid, art. 12.
  32. Prof. Sara E. Davies of Griffith University also acknowledged the new reporting expectations from the member states after the revision of IHR in 2005. See S. E. Davies et al., Disease Diplomacy: International norms and global health security, John Hopkins University Press, United States of America, 2015, p. 74.
  33. International Health Regulations, 2005 (n 28), art. 6.
  34. Ibid, art. 7.
  35. Ibid, art. 10.
  36. Ibid, art. 9.
  37. A.J Kucharski et al., ‘Early dynamics of transmission and control of COVID-19: a mathematical modeling study’, Lancet Infect. Diseases, volume 20, 2020, pp. 553, 555.
  38. Chaolin Huang et al., ‘Clinical features of patients infected with 2019 novel Coronavirus in Wuhan, China’ The Lancet, volume 395, 2020, p. 497.
  39. Dapo Akande, ‘Episode 2: The Podcast! WHO let the Bats Out?’, European Journal on International Law, 6 May 2020, available at https://www.ejiltalk.org/ejil-the-podcast-who-let-the-bats-out/, accessed on 3 July 2020.
  40. ‘Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)’, WHO, Geneva, 30 January 2020.
  41. The committee discussed that there were very few cases outside of China and the severity was unknown. Therefore, the committee did not see the necessity to declare a situation constituting PHEIC. See ‘Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)’, WHO, Geneva, 23 January 2020.
  42. A.J Kucharski (n 37), pp. 555 – 558.
  43. M. Apuzzo et al., ‘How the world missed Covid -19’s Silent Spread’ The New York Times, Munich, 27 June 2020, available at https://www.nytimes.com/2020/06/27/world/europe/coronavirus-spreadasymptomatic.html, accessed on 3 July 2020.
  44. International Health Regulations, 2005 (n 28), art. 9.
  45. Ibid, art. 10.
  46. Ibid, art. 9.
  47. Ibid., art. 13.
  48. Ibid., part III.
  49. This involves consulting with key partners within the UN system such as World Trade Organization (WTO), International Civil Aviation Organization (ICAO) and Food and Agriculture Organization (FAO) as well as international aid agencies including World Bank, Asian Development Bank (ADB). See ‘International Health Regulations (2005): Areas of work for implementation’, WHO, 2007, Lyon, p. 18.
  50. International Health Regulations, 2005 (n 28), art. 43(3).
  51. Ibid, arts. 41 & 42.
  52. WHO Constitution (n 2), arts. 21 & 22.
  53. Statement on the second meeting of the International Health Regulations (n 40).
  54. Countries included influential health suppliers US, India and Germany. See Soumaya Keynes & Chad P. Bown, ‘Episode 125: Coronavirus and Trade Restrictions’, Peterson Institute for International Economics,2020, available at https://www.tradetalkspodcast.com/podcast/125-coronavirus-and-trade-restrictions/, accessed on 3 July 2020..
  55. Caroline Foster, ‘Justified Border Closures do not violate the International Health Regulations 2005’, EJIL Talks ,11 June 2020, available atejiltalk.org/justified-border-closures-do-not-violate-theinternationalhealth-regulations-2005/, accessed on 3 July 2020.
  56. Statement on the second meeting of the International Health Regulations (n 40).
  57. Lawrence O. Gostin, Roojin Habibi, & Benjamin Mason Meier, ‘Has Global Health Law Risen to Meet the Coronavirus Challenge? Revisiting the IHR to prepare for Future threats’, Journal of Law, Medicine & Ethics, volume 48:2,2020, p.4.
  58. M.E. Turner, ‘Coronavirus Syposium: The Declaration of a PHEIC in International Law’, OpinioJuris Post, 31 March 2020, available at http://opiniojuris.org/2020/03/31/COVID-19-symposium-the-declarationofa-public-health-emergency-of-international-concern-in-international-law/, accessed on 3 July 2020.
  59. Steven J Hoffman & Sarah L Silverberg, ‘Delays in Global Disease Outbreak Responses: Lessons from H1N1, Ebola and Zika’, American Journal on Public Health, volume 10:3, 2017, pp. 329, 330.
  60. U.S Department of Health and Human Services, ‘2014 – 2016 Ebola Outbreak in West Africa’, Centers for Disease Control and Prevention, 8 March 2019, available at https://www.cdc.gov/vhf/ebola/history/20142016-outbreak/index.html, accessed on 3 July 2020.
  61. Hoffman (n 59).
  62. Timothy J. Brookes, Omar A. Khan, Behind the Mask: How the World Survival SARs. The First Epidemic of the Twenty first Century, Johns Hopkins University Press, United States of America, 2007, p.180.
  63. ‘Ground Zero in Guinea: The Outbreak Smoulders – Undetected – For more than Three Months: A Retrospective on the First Cases of the Outbreak’, WHO, 2014, available at https://www.who.int/csr/ disease/ebola/ebola-6-months/guinea/en/, accessed on 3 July 2020..
  64. International Health Regulations, 2005 (n 28), art. 15(1).
  65. Ibid., art. 12(4).
  66. Ibid., art. 9.
  67. Ibid., art. 9.
  68. ‘International Health Regulations 2005: Areas of work for implementation’, WHO, June 2007, Lyon, p. 3.
  69. Gian Luca Burci, ‘The International Association Calls for Greater Cooperation and Investment to address Pandemic Outbreaks’, The Graduate Institute Geneva, 9 April 2020, available at https://graduateinstitute.ch/communications/events/international-law-association-calls-greater-cooperation-and-investment, accessed on 3 July 2020.
  70. Reparation for Injuries Suffered in the service of the United Nations, Advisory Opinion,1949, ICJ Rep. 174, 182, p. 5.
  71. ‘Brazil: Bolsonaro Sabotages Anti-COVID-19 Efforts: President Flouts Health Authorities’ Advice, Undermines Access to Information’, Human Rights Watch, Sao Paulo, 10 April 2020, available at https://www.hrw.org/news/2020/04/10/brazil-bolsonaro-sabotages-anti-COVID-19-efforts, accessed on 3 July 2020.
  72. IHR, arts. 42 & 43.
  73. WHO, International Health Regulations 2005: Areas of work for implementation (n 68), 5.
  74. Ibid, 16.
  75. ‘Technical Framework in support to IHR 2005 Monitoring and Evaluation: Joint External Evaluation Tool ‘, WHO, 2005, France, p.8.
  76. S. Davies, ‘Internet Surveillance and disease outbreaks ‘,in Simon Rushton, Jeremy R. Youde (eds), The Politics of Surveillance and Response to Disease Outbreak, Routledge Publication, United Kingdom, 1st eds., 2015, pp. 226 – 238.
  77. Roojin Habibi et al., ‘Do not violate the International Health Regulations during the CORONAVIRUS Outbreak’, The Lancet, volume 395:10225, 2020, pp.664- 665.
  78. Regulations adopted under Article 21 shall come into force for all Members after due notice has been given of their adoption by the Health Assembly except for such Members as may notify the Director-General of rejection or reservations within the period stated in the notice. See WHO Constitution, art. 22.
  79. WHO Constitution (n 2), art. 23.
  80. Lawrence O Gostin, Mary C Debartolo& Eric A Friedman, ‘The International Health Regulations 10 Years On: The Governing Framework for Global Health Security’, The Lancet, Volume 386, 2015, p. 2225.
  81. Suerie Moon, ‘Debate: It’s time for us all to fund the World Health Organization’, The Graduate Institute Geneva, 28 April 2020, available at https://graduateinstitute.ch/communications/news/debate-its-time-usallfund-world-health-organization, accessed on 3 July 2020.
  82. E. Joshi, ‘Government increases budget for the health sector to Rs. 90. 69 million’ The Kathmandu Post,Kathmandu, 28 May 2020,available at https://kathmandupost.com/money/2020/05/28/government-increases-budget-for-the-health-sector-to-rs90-69 billion#:~:text=The%20government%20 has%20raised%20the,of%20the%20Covid%2D19%20pandemic, accessed on 3 July 2020.
  83. Suerie Moon, (n 81).
  84. Teo Armus, ‘Trump threatens to permanently cut WHO funding, leave body if changes aren’t made within 30 days’, The Washington Post, Washington DC, 19 May 2020, available at https://www.washingtonpost.com/nation/2020/05/19/who-funding-trump/, accessed on 3 July 2020..
  85. Dr. Margaret Chan explained the authority of WHO, describing agency’s Ebola Operations. See Sheri Fink, ‘WHO leader describes the Agency’s Ebola Operations’, The New York Times, New York, 4 September 2014, available at https://www.nytimes.com/2014/09/04/world/africa/who-leader-describes-the-agencys-ebola-operations.html, accessed on 3 July 2020.
  86. The reforms in 2005 did not change WHO’s efforts to give priority to the non – states information and assessment information in that regard as evident from the case of Coronavirus.
  87. Lidia Morawska, Donald K Milton, ‘It is time to Address Airborne Transmission of Coronavirus’, Clinical Infectious Diseases p. 2311, volume 71:9, 2020.
  88. The disease occurring from these transmissions are Zoonoses. See Katherine F Smith et al., ‘Global rise in human infectious disease outbreaks’, The Royal Society Publishing, volume 11:101, 2014, pp. 1, 5.
  89. Gian Luca Burci, (n 69).
  90. Ali Tejpar et al., ‘Canada’s Violation of International Law during the 2014 – 16 Ebola Outbreak’, The Canadian Yearbook of International Law, volume 54, 2016, pp.366, 382.