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Statement on the fifth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic

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The fifth meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the coronavirus disease (COVID-19) took place on Thursday, 29 October 2020 from 12:30 to 16:05 Geneva time (CEST).

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by videoconference.

The Director-General welcomed the Committee, highlighted global advances and challenges in addressing the COVID-19 pandemic, and expressed his appreciation to the Committee for their continued support and advice.

Representatives of the legal department and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the Members and Advisers with an overview of the WHO Declaration of Interest process. The Members and Advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the committee. Each member who was present was surveyed and no conflicts of interest were identified.

The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin also welcomed the Committee and reviewed the objectives and agenda of the meeting.

The WHO Assistant Directors-General for Emergency Response and for Emergency Preparedness and International Health Regulations provided an overview of the current context and an update on the implementation of the 1 August 2020 Temporary Recommendation. WHO continues to assess the global risk level of the COVID-19 pandemic as very high.

The Committee expressed strong appreciation for WHO’s leadership and activities throughout the global response. In particular, the Committee appreciated WHO’s critical role in developing evidence-based guidance and recommendations; providing countries with technical assistance and operational support; communicating clear information and addressing misinformation; and convening the Solidarity Trials and the Access to COVID-19 Tools (ACT) Accelerator. The Committee commended WHO’s sustained efforts to strengthen national, regional, and global responses to the COVID-19 pandemic.

After ensuing discussion, the Committee unanimously agreed that the pandemic still constitutes an extraordinary event, a public health risk to other States through international spread, and continues to require a coordinated international response. As such, the Committee considered the COVID-19 pandemic to remain a public health emergency of international concern and offered advice to the Director-General.

The Director-General determined that the COVID-19 pandemic continues to constitute a PHEIC. He accepted the advice of the Committee to WHO and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR (2005).

The Emergency Committee will be reconvened within three months, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Advice to the WHO Secretariat

**Leadership and Coordination **

1. Continue to coordinate global and regional multilateral organizations, partners, and networks and share best practices for responding to the pandemic.

2. Provide States Parties with a mechanism including templates and processes to report on national progress in implementing the temporary recommendations; collect, analyze, and provide regular updates to the Committee on this progress.

Evidence-Based Response Strategies

3. Continue to provide evidence-based guidance for COVID-19 readiness and response. This guidance should include sustainable long-term response strategies, mitigation approaches for different levels of transmission, refined indicators for risk management and pandemic response, a meta-analysis of the effectiveness of public health and social measures for COVID-19 response, and lessons learned including from intra-action reviews.

**Research **

4. Continue to convene multi-disciplinary experts to agree on consistent language for and to further explain: all potential modes of transmission and virulence of SARS-CoV-2; severity risk factors and epidemiology of COVID-19; and the striking diversity of the pandemic dynamics globally.

5. Continue intersectoral collaborations to understand the origin of SARS-CoV-2, the role/impact of animals, and provide regular updates on international research findings.

6. Continue to work with partners to refine mathematical models that can inform policy decisions on how best to mitigate the effects of the pandemic.

**Surveillance and Contact Tracing **

7. Continue to work with partners and networks to provide guidance, tools, and trainings to support countries in strengthening their robust public health surveillance, comprehensive contact tracing, and cluster investigation.

8. Encourage and support countries to understand and report on their epidemiological situation and relevant indicators including through leveraging existing influenza sentinel surveillance systems for COVID-19.

Risk communications and community engagement

9. Continue to work with partners to counter the ongoing infodemic and provide guidance on community mobilization to support effective public health and social measures.

Diagnostics, therapeutics, and vaccines

10. Continue to support development of and equitable access to diagnostics, safe and effective therapeutics and vaccines, through the Access to COVID-19 Tools (ACT) Accelerator; continue to work with all ACT Accelerator partners to provide countries with additional clarity on the processes to enable equitable and timely access to diagnostics, therapeutics, and vaccines, including in humanitarian settings.

11. Accelerate support to enhance countries’ readiness for COVID-19 vaccine introduction by providing guidance, tools, and technical assistance for critical areas such as vaccination strategies, vaccine acceptance and demand, training, supply and logistics with a focus on cold chain, and monitoring uptake and vaccine safety.

Health Measures in Relation to International Traffic

12. Continue to work with partners to update and review evidence-based guidance for international travel consistent with IHR (2005) provisions. This guidance should focus on effective, risk-based, and coherent approaches (including targeted use of diagnostics and quarantine) that consider transmission levels, response capacities in origin and destination countries, and relevant travel-specific considerations.

Essential Health Services

13. Work with partners to support countries in strengthening their essential health services, with a particular focus on mental health, public health prevention and control systems, and other societal impacts, as well as preparing for and responding to concurrent outbreaks, such as seasonal influenza. Special attention should continue to be provided to vulnerable settings.

Temporary Recommendations to State Parties

**Leadership and coordination **

1. Continue to share with WHO best practices, including from intra-action reviews, and apply lessons learned for mitigating resurgence of COVID-19; invest in implementing National Action Plans for sustainable preparedness and response capacities in compliance with the IHR requirements.

2. Report to WHO on progress in implementing the Temporary Recommendations, particularly major achievements, milestones, and obstacles. This information will empower countries, WHO, partners, and the Committee to continue to make informed decisions as the pandemic evolves.

Evidence-Based Response Strategies

3. Avoid politicization or complacency with regards to the pandemic response which negatively impact local, national, regional, and global response efforts. National strategies and localized readiness and response activities should be driven by science, data, and experience and should engage and enable all sectors using a whole-of-society approach.

4. Implement a dynamic risk management approach using appropriate indicators to inform time-limited, evidence-based public health and social measures.

**Research **

5. Conduct research and share information on transmission, including role of aerosols; presence and potential impact of SARS-CoV-2 in animal populations; and potential sources of contamination (such as frozen products) to mitigate potential risks through preventative measures and international cooperation.

**Surveillance and Contact Tracing **

6. Sustain efforts to strengthen public health surveillance systems and investments in a trained workforce for active case finding, comprehensive contact tracing, and cluster investigations.

7. Continue timely and consistent reporting to WHO, including through platforms such as GISRS, on all recommended indicators for COVID-19 epidemiology and severity, response measures, and concurrent outbreaks, to enhance global understanding of the pandemic’s evolution.

Risk Communications and Community Engagement

8. Engage and empower individuals and communities to strengthen confidence in the COVID-19 response and promote sustained adherence to public health and social measures underpinned by the principles of solidarity and human rights; monitor and address rumours and misinformation.

Diagnostics, Therapeutics, and Vaccines

9. Establish a national multi-disciplinary taskforce, assess progress using the COVID-19 Vaccine Introduction Readiness Assessment Tool (VIRAT), and prepare the National Deployment and Vaccination Plan, which can serve as the holistic operational plan for COVID-19 vaccine introduction. A strong emphasis should be placed on communication with communities to prepare for COVID-19 vaccination.

Health Measures in Relation to International Traffic

10. Regularly re-consider measures applied to international travel in compliance with Article 43 of the IHR (2005) and continue to provide information and rationales to WHO on measures that significantly interfere with international traffic. Ensure that measures affecting international traffic (including targeted use of diagnostics and quarantine) are risk-based, evidence-based, coherent, proportionate and time limited.

11. Continue to strengthen capacity at points of entry to manage potential risks of cross-border transmission and to facilitate international contact tracing.

Essential Health Services

12. Maintain essential health services with sufficient funding, supplies, and human resources; strengthen health systems to cope with mental health impacts of the pandemic, concurrent disease outbreaks, and other emergencies.