Thread by @disaster_lawyer

1. So - what happens now?
WHO set to decide if #monkeypox represents health emergency reuters.com/business/healt…

2. Under the International Health Regulations - the most widely subscribed international treaty to date - WHO's Director General @DrTedros has sole authority to declare a "public health emergency of international concern," what we call a "PHEIC." who.int/publications/i…

3. He'll take advice from an Emergency Committee, which is scheduled to meet next Thursday [more on that in a sec]. It's important to note that the EC isn't a standing committee. It's convened on occasions when the DG already suspects we've got an emergency on our hands.

4. But ECs don't automatically affirm the DG. Of 9 ECs previously convened, 6 recommended a PHEIC declaration; 3 recommended against. For more details, see this v informative piece by @Ep1Chrissy @LawrenceGostin @JenniferNuzzo & others: gh.bmj.com/content/5/6/e0…

5. Here's how international regulations define a PHEIC:

6. @DrTedros ticked most of those boxes, saying "unusual" developments warranted a "coordinated" international response to contain the virus.
abcnews.go.com/Health/wireSto…

7. It's hard to predict what the EC will do, though public health experts think a PHEIC declaration makes sense:

8. I tend to agree, but do want to note one peculiarity. The DG announced his decision to convene the EC this past Tuesday, scheduling them to meet *next* Thursday - almost a week and a half delay.

9. But for #coronavirus, the EC met just 2 days after the DG announced his decision to convene. (sidebar: a covid PHEIC wasnt declared until its next meeting a week later). More than a week for the EC to meet for #monkeypox feels ... less than urgent.

10. I can't say with confidence whether this is significant, but I do wonder if it relates to reforms (so far failed), to modify the PHEIC process. Right now the EC has two choices - declare a PHEIC or not. A conundrum referred to the "binary nature of PHEIC declarations"

11. But the DG and others have called for an intermediate alert level that encourages States to coordinate a response, but won't set off an adverse chain of events like travel restrictions that, though sometimes helpful, can devastate certain economies.
reliefweb.int/report/world/h…

12. Maybe the #monkeypox EC schedule is meant to do just that: establish a middle-ground to alert the global community of a serious threat & encourage a more dedicated and coordinated response, w/o triggering panic or instigating public resistance.