Influenza A viruses
Protein combinations: H1-H18+N1-N11
*1918 Spanish flu
500 million cases
50-100 million deaths
Zoonotic virus endemic in West Africa
fruit bats? Monkeys?
50% death rate
Requirements of member states
Establish surveillance system
42 in compliance, 2012
64 in compliance, 2014
Remainder given extensions
Report outbreaks
Smallpox, polio, SARS, new influenzas, and other new diseases with serious health and spread risks.
WHO Director-General’s requirements
Convene advisory Emergency Committee
*Public Health Emergency of International Concern (PHEIC)
Special Session of WHA, Nov. 29-Dec.1 2021
Agreement to negotiate a new treaty on pandemic response by May 2024!!
Compare the performance of the WHO and member states under the 2005 IHR in surveilling for new infectious diseases, declaring a PHEIC, and collaborating to prevent a local outbreak from growing into a pandemic. Consider these outbreaks:
H1N1 influenza in the U.S. and Mexico in 2009
Ebola in Guinea, Liberia and Sierra Leone, 2014
COVID-19 (Refer to “25 Days that Shook the World” & Gostin, "Global Health Institutions Reached Their Limits")
What are the goals of the pandemic treaty now being negotiated among member states of the World Health Assembly? Why has it proved to be difficult to negotiate an effective treaty so far?
How would you advise WHA members states involved in treaty negotiations to improve pandemic surveillance?
H1N1 influenza in the U.S. and Mexico in 2009
Time from notification to PHEIC: 26 days
Ebola in Guinea, Liberia and Sierra Leone, 2014
Time from notification to PHEIC: 8 months
Médicins Sans Frontières/Doctors Without Borders
COVID-19 in Wuhan China, 2019
Time from notification to PHEIC: 1 month
| Nation-State | Amount in $ U.S. |
|---|---|
| Guinea | $33.72 |
| Liberia | $56.60 |
| Sierra Leone | $66.40 |
| China | $440.83 |
| Mexico | $494.68 |
| United States | $10,246.14 |
| World | $1,061.15 |
| European Union | $3,261.43 |
*COVAX Joint-venture