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Practice Guideline
. 2023 Jul;8(7):e012615.
doi: 10.1136/bmjgh-2023-012615.

An analysis of WHO's Temporary Recommendations on international travel and trade measures during Public Health Emergencies of International Concern

Catherine Z Worsnop  1 , Samuel Nass  2 , Karen Ann Grépin  3 , Kelley Lee  4
Affiliations
Practice Guideline

An analysis of WHO's Temporary Recommendations on international travel and trade measures during Public Health Emergencies of International Concern

Catherine Z Worsnop et al. BMJ Glob Health. 2023 Jul.

Abstract

During Public Health Emergencies of International Concern (PHEICs), The International Health Regulations (IHR) require the WHO to issue Temporary Recommendations on the use of international travel and trade measures. During the COVID-19 pandemic, WHO's initial recommendation against 'any travel or trade restriction' has been questioned, and virtually all countries subsequently used international travel measures. WHO's Recommendations to States Parties also changed over the course of the pandemic. There is a need to understand how WHO's treatment of this issue compared with other PHEICs and why States Parties' actions diverged from WHO's initial Recommendations. This first analysis of WHO's Temporary Recommendations on international travel and trade measures during all seven PHEICs compares the guidance for clarity and consistency in several areas of substance and process. We find that lack of clarity and inconsistency in WHO guidance makes it difficult to interpret and relate back to IHR obligations. Based on this analysis, we offer recommendations to increase consistency and clarity of WHO's guidance on this issue during global health emergencies.

Keywords: COVID-19; Control strategies; Health policy.

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Conflict of interest statement

Competing interests: CZW was a member of a WHO guideline development group and technical consultation in 2019. KL was a member of two donor-funded reviews of WHO in 1995 and 1997. She was previously a codirector of the WHO Collaborating Centre on Global Change and Health, and has received WHO funding for research on globalisation and infectious diseases, global health governance, tobacco control and COVID-19. She is currently a member of an expert group and editorial board supporting the WHO Programme of Work on the Economic and Commercial Determinants of Health.

Figures

Figure 1
Figure 1
The timing of guidance on international travel and trade measures during PHEICs. (A) Days between first Disease Outbreak News (DON) report and first guidance of any type, the PHEIC declaration, and the first Temporary Recommendation. (B) Frequency of EC meetings (bottom transparent circle is minimum number of days between meetings, middle solid circle is the average number, and top transparent circle is the maximum number). EC, emergency committee; PHEICs, Public Health Emergencies of International Concern.
Figure 2
Figure 2
Timing of guidance on international travel and trade measures during COVID-19. PHEIC, Public Health Emergencies of International Concern.
See this image and copyright information in PMC

References

    1. World Health Organization . Statement on the second meeting of the international health regulations (2005) emergency committee regarding the outbreak of novel Coronavirus (2019-nCoV). 2020. Available: https://www.who.int/news/item/30-01-2020-statement-on-the-second-meeting... [Accessed 28 Jan 2023].
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    1. Worsnop CZ. Domestic politics and the WHO’s international health regulations: explaining the use of trade and travel barriers during disease outbreaks. Rev Int Organ 2017;12:365–95. 10.1007/s11558-016-9260-1 - DOI - PMC - PubMed

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