WHO declares the COVID-19 global emergency over

After more than three years, the World Health Organization finally declared an end to COVID-19 as a global health emergency. But the agency cautioned COVID-19 remains a global health threat, with thousands of people continuing to die from the disease and millions infected weekly. WHO Director-General Tedros Adhanom Ghebreyesus made the announcement on Friday, in line with the recommendations by the COVID-19 emergency committee that met on Thursday to deliberate on whether COVID-19 remains a public health emergency of international concern or PHEIC. Tedros warned countries should not let down their guard, saying the COVID-19 virus “is here to stay.” “It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths,” he said. Nearly 2.8 million new COVID-19 cases and over 17,000 deaths were reported between April 3 and April 30, according to WHO’s latest epidemiological update on COVID-19 published this week. That puts total deaths at almost 7 million, although the real death toll is likely significantly higher, at least 20 million, according to WHO. “Lives were lost that should not have been. We must promise ourselves and our children and grandchildren that we will never make those mistakes again.” --— Tedros Adhanom Ghebreyesus, director-general, WHO Tedros said on the committee’s advice, he’s using a provision in the International Health Regulation — a legally binding global instrument that outlines responsibilities for WHO and countries during a public health emergency — to establish a review committee to develop “long-term, standing recommendations for countries on how to manage COVID-19 on an ongoing basis.” The end of COVID-19 as a global health emergency has long been anticipated. Tedros has, on several occasions last year, commented on how close the world is to ending its emergency phase. Many countries have already moved on, easing restrictions on masking and movement. Prof. Didier Houssin, chair of the emergency committee that has been advising Tedros on COVID-19 since 2020, said there were several risks they had to contend with in making the recommendation, including the emergence of more pathogenic mutations of the virus, the public lowering their guard thinking COVID-19 is no longer a threat, and the impact this will have on access to vaccines, because of changes in the regulatory environment. But he said they came to the conclusion that “it was important to be realistic considering the situation.” In addition, there are other measures, such as the issuance of a standing recommendation, that WHO can use to manage the risks posed by COVID-19. Tedros also said that if needed, he won’t hesitate to convene the emergency committee again. Dr. Kate O’Brien, director of WHO’s Department of Immunization, Vaccines and Biologicals, said there’s work that needs to be done now to move vaccine use authorizations to a “more regular form of authorization.” Many vaccines were issued under emergency use during PHEIC, but the emergency committee said the termination of COVID-19 as a PHEIC “should not affect access to vaccines and diagnostics that have already received an [emergency use listing]” and countries will still be able to access both, as long as manufacturers continue their production. O’Brien added that declaring the end of COVID-19 as a global health emergency does not end vaccination efforts. COVID-19 vaccine coverage for individuals at high risk of COVID-19 remains “far too low” in many countries, such as in the African continent. “There's a full commitment to continue to support countries in their ambition to broaden out the coverage of vaccination, especially for those groups who most need vaccines,” she said, adding that COVAX remains in operation for the rest of the year and that decisions will be made about the platform continuing to provide countries with vaccine supply. Dr. Maria Van Kerkhove, WHO’s technical lead on COVID-19, said they’re now working with countries to “calibrate” their response. “We don't want to see systems shut down. We don't want to see people laid off. We don't want to see labs closed,” Kerkhove said. However, she said there’s a need to “calibrate” to make sure that countries aren’t just focusing on COVID-19, but also dealing with it in the context of other health and non-health emergencies. Ahead of the announcement, WHO published on Wednesday an updated COVID-19 Global Strategic Preparedness, Readiness and Response Plan to guide countries on how to manage COVID-19 over the next two years. Kerkhove said the plan’s aims include reducing and controlling the incidence of COVID-19 variants, and preventing, diagnosing and treating COVID-19 to reduce morbidity, mortality and COVID-19’s long-term effects, including post-COVID conditions. “There's a substantial number of people out there who are suffering from post-COVID-19 condition, and they need proper recognition, they need proper care,” she said. Reflecting on the past three years, Tedros said one of the “greatest tragedies of COVID-19” is that there were tools and technologies available, but due to a lack of coordination, equity and solidarity, “those tools were not used as effectively as they could have been.” “Lives were lost that should not have been. We must promise ourselves and our children and grandchildren that we will never make those mistakes again,” he said.