Further to the case studies in the previous chapter, we also sought to understand whether the same inconsistencies were present in outbreaks that were not declared a PHEIC. Within this chapter we consider events for which the DG convened an EC, but which did not result in a PHEIC declaration and second, we also consider events the DG did not convene an EC for, despite the criteria appearing to be met. Considering these events enables us to have a clearer understanding of the use of executive discretion by the DG in regard to the PHEIC, particularly in respect of when an EC is convened, and the relationship between the DG and the EC. We find that multiple DGs failed to convene ECs to consider an event a potential PHEIC, despite the criteria to do so appearing to be met. We further show that the DG is unwilling to go against the advice provided by the EC, even when, as was the case with MERS-CoV, it was apparent that the criteria to declare a PHEIC had been met. This is unusual, given the advice of an EC is one of multiple considerations the DG needs to consider when determining whether a PHEIC declaration is warranted, and goes some way towards demonstrating the extent to which certain aspects of the DG role have been fettered away to the EC.

MERS-CoV

Middle East respiratory syndrome coronavirus (MERS-CoV) is a zoonotic virus, which is transferred to humans from camels. It was first reported to the WHO in 2012, and since then has been detected in 27 countries, and has led to at least 858 deaths and 2,494 reported cases, with an estimated 35% mortality rate. The majority of these have occurred in Saudi Arabia, although there was a notable outbreak in South Korea.

A considerable issue with the initial global response to MERS was the lack of clear and transparent information. For example, a case was detected in the UK in a passenger recently arriving from Saudi Arabia, after the initial analysis by Public Health England MERS was confirmed, the UK was obligated to report this case to the WHO under Article 6 of the IHR.