Public health emergencies can catch the world off guard, threatening not only health systems but also economies and social structures globally. We have all seen how swiftly diseases like COVID-19 and Ebola can spread, causing widespread disruption. When such threats emerge, organisations like the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC) step in to help manage the situation. But how exactly do these organisations respond? What powers do they hold, and how do they coordinate with governments to combat these crises?
This blog post will explore how the WHO and the Africa CDC declare public health emergencies, why these declarations are important, and the challenges that come with making such decisions.
What is a Public Health Emergency?
Before we dive into how these organisations work, let’s clarify what we mean by a public health emergency. According to the International Health Regulations (IHR) 2005, a Public Health Emergency of International Concern (PHEIC) is “an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to require a coordinated international response.”
In simpler terms, a PHEIC is declared when a disease or health event spreads beyond borders and threatens global health, requiring international cooperation to manage it effectively.
While viral outbreaks like COVID-19 and Ebola are the most common reasons for a PHEIC declaration, other causes like chemical agents or radioactive materials can also trigger such declarations.
The Role of WHO in Declaring a Public Health Emergency
The World Health Organization plays a crucial role in global health, and one of its most important responsibilities is the power to declare a PHEIC.
This power is governed by the International Health Regulations (IHR), which is an international agreement involving 196 countries aimed at helping the world prevent and respond to public health risks that cross borders.
But how does the WHO decide when to declare a PHEIC?
The Emergency Committee: When a potential health threat arises, the WHO Director-General consults the IHR Emergency Committee, a group of experts who provide recommendations. This committee analyses the situation, looking at factors like how contagious the disease is and the potential risks it poses to human health and international travel.
Scientific Evidence: The WHO relies on scientific principles and evidence to assess the severity of the situation. For example, during the COVID-19 pandemic, the spread of the virus and its impact on health systems worldwide was thoroughly evaluated before a PHEIC was declared.
State Party Information: Countries affected by the health event must provide detailed information to the WHO about the nature and scale of the outbreak, which the WHO considers in its decision-making.
Once the Director-General decides to declare a PHEIC, this signals the international community to take urgent action. It can lead to increased financial aid from donors, the implementation of travel restrictions, and the ramping up of efforts to contain the disease.
The Africa CDC: A Key Player in African Health Security
While the WHO operates on a global scale, the Africa CDC focuses specifically on the African continent. The Africa CDC is part of the African Union (AU) and was established to help African nations prevent and respond to health threats, especially those that could spread across borders within Africa.
The Africa CDC was created with the understanding that Africa faces unique health challenges. To help manage these, the organisation has the authority to declare a Public Health Emergency of Continental Security (PHECS). Like the WHO, this declaration alerts the global health community to mobilise resources and work together to combat the threat.
How Africa CDC Declares a Public Health Emergency
Unlike the WHO, the Africa CDC operates under the mandate of the African Union. Its powers are outlined in its Statute, which allows it to declare health emergencies that specifically affect Africa. Before making such a declaration, the Africa CDC collaborates closely with the affected member states and relevant stakeholders.
One of the most significant differences between the WHO and the Africa CDC is that the Africa CDC’s mandate is focused solely on the African continent. Although the Africa CDC does not have the same global reach as the WHO, it is a powerful force within Africa for organising and implementing health responses.
For example, the Africa CDC declared the Mpox outbreak in 2024 as a Public Health Emergency of Continental Security (PHECS), which was the first time they exercised this authority. The declaration allowed Africa CDC to coordinate a response across multiple African nations, ensuring that health resources were directed where they were needed most.
Comparing the WHO and Africa CDC
While the WHO and the Africa CDC share the goal of protecting public health, their approaches and powers differ.
Global vs. Continental: The WHO’s PHEIC declarations have worldwide implications. They have the power to mobilize the international community and enforce health regulations worldwide.
The Africa CDC, however, focuses only on Africa, responding to threats that affect the continent.
Legal Frameworks: The WHO operates under the International Health Regulations (IHR) 2005, which are legally binding for all 196 participating countries. This gives the WHO significant leverage in coordinating international responses. On the other hand, the Africa CDC operates under the African Union’s framework, and while it has the authority to declare a PHECS, it relies on the cooperation of African governments to implement health measures.
Consultation Process: The WHO relies on the IHR Emergency Committee, which provides a structured process for consulting scientific experts and stakeholders before making a declaration.
The Africa CDC, while collaborating with member states, does not have the same detailed procedural framework as the WHO for making decisions
Challenges in Declaring Public Health Emergencies
Declaring a PHEIC or a PHECS is not without its challenges. While these declarations are crucial for coordinating international and regional responses, they can also lead to unintended consequences.
Economic Impacts: Declaring a public health emergency can hurt economies, particularly in countries that rely on tourism and trade. For instance, during the 2003 SARS outbreak, the Chinese economy suffered significant losses due to a sharp decline in tourism and trade. In Africa, tourism took a major hit after the 2016 Ebola outbreak, affecting economies far beyond the regions where the disease was present.
Political Sensitivities: Declaring a PHEIC can be a political minefield. Countries may resist such declarations for fear of stigmatisation, travel bans, or economic consequences. For example, during the early stages of COVID-19, some countries hesitated to report their outbreaks, concerned about the economic fallout from such revelations.
Resource Mobilization: Once a public health emergency is declared, the challenge often shifts to securing the necessary financial, logistical, and technical resources. During the COVID-19 pandemic, the inequitable distribution of vaccines highlighted how difficult it can be to mobilise resources effectively, especially in low-income countries.
Misinformation: Public health emergencies often? generate misinformation, which can undermine response efforts. During the COVID-19 pandemic, misinformation about the virus spread rapidly, making it harder for health authorities to control the outbreak.
Looking Ahead: The Importance of Cooperation
As global health challenges continue to evolve, cooperation between organisations like the WHO and the Africa CDC will become even more critical. Both institutions play essential roles in safeguarding public health, and their coordinated efforts can make a real difference in managing cross-border health threats.
Strengthening ties between these organisations, along with national governments and other stakeholders, will help ensure that future health emergencies are met with a swift, effective, and well-coordinated response.
Conclusion
Both the WHO and the Africa CDC have the authority to declare public health emergencies, but their scopes and processes differ. The WHO operates on a global scale, while the Africa CDC focuses on protecting the African continent. Both organisations face challenges in making these declarations, from political resistance to economic impacts and misinformation. However, their ability to mobilise resources and coordinate responses is vital to mitigating the effects of public health emergencies.
As we continue to face global health threats, the need for strong, cooperative efforts between the WHO, Africa CDC, and other international partners will remain paramount in ensuring that public health is protected worldwide.