Statement on the fifteenth assembly of the IHR (2005) Emergency Committee on the COVID-19 pandemic

The WHO Director-General thought-about the recommendation offered by the Committee relating to the proposed Temporary Recommendations and issued them as per the beneath assertion. The WHO Director-General will convene an IHR Review Committee to advise on Standing Recommendations for the long-term administration of the SARS-CoV-2 pandemic, making an allowance for the 2023-2025 COVID-19 Strategic Preparedness and Response Plan. During this transition, States Parties are suggested to proceed following the issued Temporary Recommendations. The Director-General expressed his honest gratitude to the Chair, the Members, and the Advisors of the Committee for his or her engagement and recommendation over the last three years.

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Proceedings of the assembly

The WHO Director-General, Dr Tedros Adhanom Ghebreyesus, welcomed Members and Advisors of the Emergency Committee, who have been convened by videoconference. He famous that the variety of weekly reported deaths and hospitalizations proceed to lower, however expressed concern that surveillance reporting to WHO has declined considerably, that there continues to be inequitable access to life-saving interventions, and that pandemic fatigue continues to develop. The Director-General introduced the publication of the 2023-2025 COVID-19 Strategic Preparedness and Response Plan which is designed to information international locations in transitioning to long-term administration of COVID-19. This plan outlines vital actions for international locations to contemplate for 5 areas: collaborative surveillance, neighborhood safety, secure and scalable care, access to countermeasures, and emergency coordination. The Director-General thanked Professor Houssin for his management in guiding the Committee over the past three years and every of the Committee Members and Advisors for his or her experience, dedication, and dedication.

The Office of Legal Counsel’s consultant briefed the Committee Members and Advisors on their roles, duties, and mandate below the related articles of the IHR. The Ethics Officer from the Department of Compliance, Risk Management, and Ethics reminded Members and Advisers of their responsibility of confidentiality as to the assembly discussions and the work of the Committee, in addition to their particular person duty to speak in confidence to WHO in a well timed method any pursuits of a private, skilled, monetary, mental, or business nature that will give rise to a perceived or direct battle of curiosity. No conflicts of curiosity for the attending Members and Advisors have been recognized. 

The Chair of the Emergency Committee, Professor Didier Houssin, launched the aims of the assembly: to offer views to the WHO Director-General on whether or not the COVID-19 pandemic continues to represent a PHEIC and to evaluate Temporary Recommendations to States Parties. 

While the worldwide threat evaluation stays excessive, there may be proof of lowering dangers to human well being pushed primarily by excessive population-level immunity from an infection, vaccination, or each; constant virulence of presently circulating SARS-CoV-2 Omicron sub-lineages in comparison with beforehand circulating Omicron sub-lineages; and improved scientific case administration. These elements have contributed to a big world decline within the weekly variety of COVID-19 associated deaths, hospitalizations, and admissions to intensive care items because the starting of the pandemic. While SARS-CoV-2 continues to evolve, the presently circulating variants don’t seem like related to elevated severity.

WHO offered updates on the standing of worldwide vaccination and concerns of implications for the potential termination of a PHEIC. The Committee was knowledgeable that, globally, 13.3 billion doses of COVID-19 vaccines have been administered. Currently, 89% of well being staff and 82% of adults over 60 years have accomplished the first sequence (the preliminary one or two doses really useful as per the vaccine schedule), though protection in these precedence teams varies in numerous areas.  

As requested by the Committee, the WHO Secretariat offered overviews of the standing of integration of COVID-19 surveillance into the Global Influenza Surveillance and Response System and alternatives to streamline this; the method for issuing Standing Recommendations below the IHR; and the potential regulatory implications for Emergency Use Listed (EUL) when a PHEIC is terminated. As the Director-General will proceed to authorize the usage of EUL process, the termination of the PHEIC shouldn’t have an effect on access to vaccines and diagnostics which have already obtained an EUL. States Parties will nonetheless be capable to access these vaccines and diagnostics (offered the producers proceed manufacturing). COVAX can even proceed to offer funded doses and supply help all through 2023 consistent with demand. This continuity can allow a easy transition from EUL to prequalification of vaccines and diagnostics. As the massive majority of therapeutics used to deal with COVID-19 are repurposed medicines already licensed for different indications, the termination of a PHEIC shouldn’t have an effect on their regulatory standing.

Deliberative Session on the Status of the PHEIC

The Committee thought-about the three standards of a PHEIC: whether or not COVID-19 continues to represent 1) a rare occasion, 2) a public well being threat to different States by means of the worldwide unfold, and three) doubtlessly requires a coordinated worldwide response. They mentioned the present standing of the COVID-19 pandemic. They acknowledged that, though SARS-CoV-2 has been and can proceed circulating extensively and evolving, it’s not an uncommon or sudden occasion. The Committee acknowledged that the Director-General might resolve to convene an IHR Emergency Committee on COVID-19 sooner or later if the state of affairs requires.

The COVID-19 PHEIC has prompted international locations to boost their useful capacities, notably associated to emergency coordination, collaborative surveillance, scientific care, and threat communications and communication engagement. The world has made vital and spectacular world progress because the declaration of the PHEIC in January 2020. Reaching the purpose the place COVID-19 may be thought-about as not constituting a PHEIC must be seen as accolade to worldwide coordination and dedication to world well being.

As it has throughout previous conferences, the Committee deliberated the potential advantages and points posed by sustaining the PHEIC. While the PHEIC has been a precious instrument to help the worldwide response to COVID-19, the Committee agreed that the time is true to maneuver in direction of the long-term administration of SARS-CoV-2 as an ongoing well being situation.

Moving ahead, the Committee prompt that the Director-General contemplate convening an IHR Review Committee to advise on Standing Recommendations to for long-term dangers posed by SARS-CoV-2 making an allowance for the 2023-2025 COVID-19 Strategic Preparedness and Response Plan. At the identical time, the Committee acknowledged that Member States are presently negotiating the Pandemic Prevention, Preparedness, and Response Accord, discussing amendments to the IHR, and contemplating the ten proposals to build a safer world collectively by strengthening the Global Architecture for Health Emergency Preparedness, Response, and Resilience (HEPR).

They thanked the WHO Secretariat and States Parties for his or her sustained dedication and technical experience, and emphasised that this isn’t the time to cease work or dismantle programs. The Committee confused that it will likely be crucial to handle the gaps recognised throughout the pandemic. They highlighted the necessity to strengthen well being programs, proceed lively threat communications and neighborhood engagement, implement a One Health method to preparedness and response, and combine COVID-19 surveillance and response actions into routine well being programmes. The Committee advocated that WHO, companions, and States Parties dedicate sustained consideration and assets to preparedness and resilience for rising threats.

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Temporary Recommendations issued by the WHO Director-General to all States Parties

1. Sustain the nationwide capability positive aspects and put together for future occasions to keep away from the prevalence of a cycle of panic and neglect. States Parties ought to contemplate how one can enhance nation readiness for future outbreaks. In alignment with WHO steerage, States Parties ought to update respiratory pathogen pandemic preparedness plans incorporating learnings from nationwide and sub-national After Action Reviews. States Parties ought to proceed to revive well being programmes adversely affected by the COVID-19 pandemic. 

2. Integrate COVID-19 vaccination into life course vaccination programmes. States Parties ought to keep efforts to extend COVID-19 vaccination protection for all folks within the high-priority teams (as outlined by the SAGE Roadmap of April 2023) with WHO really useful vaccines and proceed to actively tackle vaccine acceptance and demand points with communities. 

3. Bring collectively data from various respiratory pathogen surveillance information sources to permit for a complete situational consciousness. States Parties ought to keep reporting of mortality and morbidity information in addition to variant surveillance data to WHO. Surveillance ought to incorporate data from an applicable mixture of consultant sentinel populations, event-based surveillance, human wastewater surveillance, sero-surveillance, and surveillance of chosen animal populations recognized to be prone to SARS-COV-2. States Parties ought to leverage the Global Influenza Surveillance and Response System (GISRS) and help the institution of the WHO Global Coronavirus Laboratory Network (CoViNet). 

4. Prepare for medical countermeasures to be licensed inside nationwide regulatory frameworks to make sure long-term availability and provide. States Parties ought to strengthen their regulatory authorities to help long-term authorization and use of vaccines, diagnostics, and therapeutics. 

5. Continue to work with communities and their leaders to attain sturdy, resilient, and inclusive threat communications and neighborhood engagement (RCCE) and infodemic administration programmes. State Parties ought to adapt RCCE and infodemic administration methods and interventions to native contexts.