OPINION:
This week marks two years since the World Health Organisation first labelled the Covid-19 outbreak a pandemic. More than 6 million deaths have been recorded globally; the true figure could be four times that.
With the Omicron wave subsiding in some regions and around 4.4 billion people fully vaccinated, many countries are attempting a return to normal. Thoughts are now turning to when the agency might officially de-escalate this extraordinary health crisis and signal the worst is over.
Despite the veneer of normality, we are still officially in a Public Health Emergency of International Concern (or Pheic). Unlike the "pandemic" tag, referring to worldwide spread, this declaration by WHO on January 30, 2020, carries legal heft under international health regulations. The siren is meant to spur countries to action, including surveillance and mandatory case reporting. Once declared, they are reappraised every three months, against three criteria. "If the committee decides the outbreak is no longer unusual and unexpected, no longer risking international spread and no longer requiring a co-ordinated international effort, the Pheic ends," says Clare Wenham, researcher in global health policy at the London School of Economics.
But, as her research has shown, those criteria have been applied inconsistently in the six Pheics declared since the mechanism came into effect. A polio outbreak that was ruled as one in 2014 remains classified as such, despite most cases being concentrated in a handful of regions. Retaining a Pheic, Wenham says, "means people have to do something about it". Lifting that status on Covid might jeopardise the ongoing immunisation drive in low-income countries; drugmakers, for example, have agreed to make antiviral pills affordable until the emergency ends.