Who Are the Members of the IHR Emergency Committee?

When a health crisis threatens to cross borders and become a global emergency, the World Health Organization relies on a specialized group of experts to guide critical decisions. The IHR Emergency Committee plays a vital role in determining whether an outbreak constitutes a Public Health Emergency of International Concern (PHEIC) and what actions should be taken. But who exactly makes up this influential committee, and how are these experts selected?

The IHR Expert Roster: A global pool of specialized knowledge 🔗

The foundation of the IHR Emergency Committee lies in the IHR Expert Roster, a carefully curated list of international experts established by the WHO Director-General under Article 47 of the International Health Regulations. This roster serves as a pool from which Emergency Committee members are drawn when a potential public health emergency arises.

The roster includes professionals with expertise in disease control, virology, vaccine development, and infectious disease epidemiology. Beyond these core medical fields, the WHO seeks experts in international health regulations, international law, health law and legislation, ethics, equity, human rights, surveillance, clinical management, infection prevention and control, microbiology, vector control, environmental science, and the human-animal interface. This diversity ensures that the committee can address the multifaceted challenges of global health emergencies.

How experts join the roster 🔗

Becoming part of the IHR Expert Roster involves a formal application process. The WHO issues calls for expressions of interest from scientists, technical experts, healthcare practitioners, healthcare regulators, and policy makers worldwide. Applicants submit their curriculum vitae, a cover letter explaining their motivation and qualifications, and a declaration of interest form. State Parties can also nominate experts, and the Director-General may appoint members from relevant intergovernmental and regional economic integration organizations.

Once on the roster, experts serve for an initial period of five years. The roster remains dynamic, with WHO continuously updating it to reflect current expertise and emerging health challenges.

Selection criteria: Balancing expertise with representation 🔗

When a potential public health emergency emerges, the WHO Director-General doesn’t simply choose any experts from the roster. The selection process follows specific criteria designed to ensure both technical excellence and fair representation.

Technical competence comes first 🔗

Selection is based primarily on technical ability and experience in the relevant fields of expertise. The nature of the health event determines which specific expertise is needed. For example, a committee convened for an Ebola outbreak would require different specialists than one addressing a novel respiratory virus or arboviral disease like Zika.

Members can be selected based on the expertise required for any particular session. This flexibility allows the WHO to assemble the most qualified team for each unique emergency situation.

Ensuring diverse perspectives 🔗

Technical expertise alone isn’t enough. The Director-General aims to ensure that Emergency Committee members have the broadest possible geographical representation and reflect diverse knowledge, practical experience, and approaches. Achieving gender balance is also a desirable goal in the selection process.

This commitment to diversity isn’t just about fairness. Different regions face unique health challenges, and experts from various parts of the world bring valuable insights shaped by their local contexts and experiences. A virologist from Asia may have different perspectives on outbreak management than one from Europe or Africa, and both viewpoints enrich the committee’s deliberations.

Including voices from affected countries 🔗

One crucial requirement stands out: at least one member of the Emergency Committee should be an expert nominated by a State Party within whose territory the event arises. These affected countries are also invited to present their views to the Emergency Committee, ensuring that the committee hears directly from those on the front lines of the outbreak.

This provision prevents decisions from being made in isolation from ground realities. The experts from affected countries can provide firsthand knowledge about local transmission patterns, healthcare system capacities, cultural factors affecting disease control, and practical challenges in implementing interventions.

Operating without financial incentives 🔗

It’s worth noting that members of WHO advisory panels and committees, including the IHR Emergency Committee, do not receive any remuneration from the organization. This voluntary service underscores the commitment of these experts to global health security rather than personal financial gain.

Non-member technical advisors: Expanding the knowledge base 🔗

Beyond the formal committee members, the IHR framework allows for additional expert input through technical advisors. The Director-General may appoint one or more technical experts to advise the committee, either on his or her own initiative or at the request of the committee itself.

Here’s the key distinction: persons who are neither members of the IHR Experts Roster nor other WHO Expert Advisory Panels could be appointed as technical experts to advise the Committee, but not as members of the Committee. This provision provides crucial flexibility.

Why technical advisors matter 🔗

Technical advisors serve several important functions. They may possess specialized knowledge about a particular pathogen, geographical region, or intervention strategy that isn’t represented among the formal committee members. For instance, during the COVID-19 pandemic, the Emergency Committee included advisors from organizations like the Food and Agriculture Organization and the International Maritime Organization, bringing perspectives on animal health and maritime safety that complemented the core public health expertise.

These advisors can offer fresh perspectives unencumbered by previous WHO committee experience. They may represent specific technical domains or stakeholder groups whose input is essential for comprehensive decision-making. During the monkeypox outbreak, for example, advisors helped ensure the committee considered diverse regional contexts and vulnerable populations.

The distinction between members and advisors 🔗

While both members and advisors contribute to the committee’s deliberations, only formal members participate in the final recommendation to the WHO Director-General about whether an event constitutes a PHEIC and what temporary recommendations should be issued. Advisors provide input and expertise but don’t vote on these determinations.

The role of both members and advisors includes understanding their responsibilities under the IHR, maintaining confidentiality about committee discussions, and disclosing any potential conflicts of interest. WHO has strengthened these transparency measures over time, now publishing the names, job titles, and potential conflicts of interest of both members and advisors on its website.

Accountability and transparency 🔗

The IHR Emergency Committee framework has evolved significantly since the International Health Regulations were revised in 2005. Initially, even the names of committee members were kept confidential. Following reforms in 2011, WHO now publishes detailed information about both members and advisors, recognizing that transparency is essential for maintaining public trust.

Before each meeting, the Office of Legal Counsel briefs members and advisors on their roles and responsibilities. The Ethics Officer reminds them of their duty of confidentiality and their obligation to disclose any interests that might create conflicts. These safeguards help ensure that recommendations are based solely on scientific evidence and public health considerations.

The committee typically includes 15 members and up to 9 advisors, though the exact composition varies depending on the health event. Throughout the emergency, the committee reconvenes at least every three months to reassess whether the situation continues to constitute a PHEIC and whether temporary recommendations need adjustment based on evolving circumstances.

What do you think? How might the inclusion of experts from affected countries influence the committee’s recommendations compared to a committee composed solely of outside experts? Should there be more public involvement in understanding how these critical global health decisions are made?

References

1. https://www.who.int/teams/ihr/ihr-expert-roster
2. https://www.who.int/news-room/questions-and-answers/item/emergencies-international-health-regulations-and-emergency-committees
3. https://www.who.int/news-room/articles-detail/call-for-expression-of-interest–international-health-regulations-(2005)-roster-of-experts
4. https://www.who.int/groups/covid-19-ihr-emergency-committee
5. https://www.paho.org/en/news/1-11-2022-third-meeting-international-health-regulations-2005-ihr-emergency-committee