In 1951, the World Health Organisation (WHO) first established an international treaty or framework agreement on how best to respond to a major disease outbreak or other public health crisis.
The framework set out a series of measures that governments are supposed to follow to respond to a public health emergency and were significantly revised in 2005 in response to an outbreak of severe acute respiratory syndrome also known as SARS.
The SARS epidemic affected 26 countries and resulted in more than 8000 cases in 2003 causing around 800 deaths.
Under the revised 2005 framework, the WHO instituted a new alert level known as a public health emergency of international concern (PHEIC) in response to SARS.
Associate Professor in Global Health Security at the University of Sydney, Adam Kamradt-Scott explained how the WHO declared a PHEIC.
"Once an event starts to occur the director of WHO is then is able to convene what is described as an emergency committee, and the members of the emergency committee are usually public health experts and disease virologists and others," he said.
“They look at the information and then make a recommendation to the director-general about whether or not this meets the criteria for a public health emergency.”
Criteria for assessing a Public Health Emergency of International Concern
Associate Professor Kamradt-Scott said that once a disease or virus crosses international borders things start to get serious.
“Usually what we see or expect to see in that instance is an event that is already starting to spread or has spread across international borders and requires a coordinated international response," he said.
Since the new WHO framework was introduced, the first PHEIC to be declared was the 2009 H1N1 Influenza pandemic which started in Mexico and spread around the world.
After early outbreaks in North America in April 2009, it was officially declared a pandemic in June 2009 after a total of 74 countries had confirmed infections.
What kind of global health emergencies have we seen in recent years?
Other public health emergencies include the 2014 Ebola outbreak in West Africa, the Zika emergency of 2015-2016 and another Ebola outbreak in 2019 - along with Polio which, while being close to eradication, remains in a few countries.
Associate Professor Kamradt-Scott said a deceleration raises the political profile of an event which means international governments are more likely to offer support.
"Governments are more inclined to let their people go, for instance, epidemiologists, public health experts and so forth," he said.
"And if it's occurring somewhere overseas, they are more likely to release them from their standard workday jobs and allow them to assist.
"And, in addition, sometimes these declarations can assist in helping to raise funds because of that additional political attention to help co-coordinate the response to a public health emergency."
Even if a PHEIC is declared, WHO is unable to deploy people without a government's permission, but a government can then request assistance at which point the WHO will mobilise people to help.
There are more than 40,000 confirmed cases of coronavirus globally, the vast majority in China. Source: AAP
Professor Raina MacIntyre is a Professor of Global Biosecurity at the University of New South Wales.
She said the PHEIC classification allows for a more coordinated response by the international community.
"They then enable the WHO to use international health regulations to control the epidemic," she said.
"The WHO would be working with the countries to improve the surveillance and detection of cases and also in the analysis of the data and the epidemiological analysis of the outbreak to try and get better control of the disease and assist with other pressing public health issues."
Concerns about tourism and trade
Professor MacIntyre said the WHO also seriously considers the implications of a declaration on trade and tourism, which remains an important concern for member states.
“The SARS epidemic had a huge impact on particularly travel and tourism industries. It's had an impact on Australia now," she said.
"The tourism industry has been hard hit first by the bushfires and now by this epidemic.
"We have seen the financial markets show drops because of this epidemic. So yes there has already been impacts."
Unlike SARS, which also originated in China, it is believed the new coronavirus can spread during the incubation period of one to 14 days, possibly before an infected person is showing symptoms.
But Associate Professor Kamradt-Scott said, so far, the new virus does not appear to be as deadly as SARS despite more cases overall.
"Obviously China has been the worst affected country to date, they have over 6000 confirmed cases but almost 80 per cent of those cases are of people who have experienced mild to moderate illness, and that's quite different from what we saw during the SARS virus as well," he said.
"So it's a good sign that the coronavirus may actually be able to be controlled and we are not seeing the large number of deaths that we did like in SARS that we saw back in 2003."
China responding well to the crisis
Dr Michael Ryan the Executive Director of the WHO Health Emergencies Program said the Chinese government deserves huge credit for its response and for the transparency in which it has dealt with the outbreak.
Dr Ryan said China is taking extraordinary measures in the face of what is an extraordinary challenge.
"China is not only helping to manage the cases in its own country, but it is actively reaching out on an individual basis, not only to WHO but to other partners in the world, to help them respond in a more effective way," he said.
