International public health emergencies: 21st century pandemics and future preparedness
- Page updated onMay 17, 2026

In 2009, an outbreak of influenza A (H1N1) put the entire planet on alert. There had been other pandemics before, of course. However, this was the first to occur since the new International Health Regulations had been agreed in 2007. Moreover, the declaration of this outbreak as a Public Health Emergency of International Concern would not be the last. Since the influenza A (H1N1) pandemic, there have been eight further declarations for poliomyelitis, Ebola, Zika virus, COVID-19 and mpox (monkeypox).
Some of these international public health emergencies have had major consequences for populations affected by humanitarian crises. In these contexts there are weak health systems and specific challenges for epidemic response. This, combined with the resurgence of these types of infections and the slow progress in advancing global public health commitments, gives cause for reflection. What will the next major epidemic be? How will it affect the most vulnerable populations? Will we be prepared?
Table of contents:
The International Health Regulations: a legal framework for global emergencies
There is a legal duty to respond to international public health emergencies
The current International Health Regulations (IHR) were adopted in 2005. It was largely motivated by the outbreak of severe acute respiratory syndrome that in 2002-04 affected more than 8,000 people in 29 countries. Since then, it has been the main global instrument for preventing and responding to the international spread of diseases and public health emergencies. Its measures also seek to respect the dignity, freedom and rights of people, without unnecessary interference with international transport and trade.
The Regulations are a legally binding framework for all member states of the World Health Organization. They have their origins in international agreements from the nineteenth and twentieth centuries for the control of certain infectious diseases. After entering into force in 2007, they were updated in 2014 and again in 2022 and 2024 (WHO, 2024)World Health Organization. (2024). International Health Regulations (2005), as amended in 2014, 2022 and 2024. World Health Organization. https://apps.who.int/gb/bd/pdf_files/IHR_2014-2022-2024-en.pdf.
The regulation provides a framework for the public health functions of the states
On the one hand, the International Health Regulations provide a framework for the routine public health functions of a state. Moreover, it mandates that all countries assess, strengthen and maintain their capacity for epidemiological surveillance, risk assessment, reporting and response. This, however, may require for many countries large investments and international technical support. For this reason, several years were given for all countries to make it operational.
This framework also requires states to establish a national centre or public health department. It must be responsible for verifying events detected through epidemiological surveillance. It is likewise tasked with notifying the World Health Organization of the most significant ones: those that may constitute a Public Health Emergency of International Concern (PHEIC). These emergencies are defined as extraordinary events that constitute a risk to the public health of other states through the international spread of disease. They may therefore require a coordinated international response (WHO, 2024)World Health Organization. (2024). International Health Regulations (2005), as amended in 2014, 2022 and 2024. World Health Organization. https://apps.who.int/gb/bd/pdf_files/IHR_2014-2022-2024-en.pdf.
The IHR also provides a framework for international coordination in public health
Furthermore, the International Health Regulations also provide a framework for coordinating actors in the international response to the most urgent threats. These may affect multiple countries or even the entire planet. Under this framework, only the Director-General of the World Health Organization may declare a Public Health Emergency of International Concern. To do so, they must mandatorily consult an Emergency Committee (WHO, 2024)World Health Organization. (2024). International Health Regulations (2005), as amended in 2014, 2022 and 2024. World Health Organization. https://apps.who.int/gb/bd/pdf_files/IHR_2014-2022-2024-en.pdf.
Despite the IHR, the overall preparedness and response capacity can be greatly improved
Having a legally binding framework is no guarantee of success. Successive public health emergencies of international concern have demonstrated this (Wilder-Smith & Osman, 2020)Wilder-Smith, A., & Osman, S. (2020). Public health emergencies of international concern: A historic overview. Journal of Travel Medicine, 27(8), taaa227. https://doi.org/10.1093/jtm/taaa227. Each major pandemic and epidemic has revealed weaknesses and shortcomings in global preparedness and response capacity. As Harvey V. Fineberg, chair of the review committee on the functioning of the International Health Regulations during the influenza A (H1N1) pandemic, put it: "Pandemics are fearsome teachers" (WHO, 2011)World Health Organization. (2011). Strengthening response to pandemics and other public-health emergencies: Report of the Review Committee on the Functioning of the International Health Regulations (2005) and on Pandemic Influenza (H1N1) 2009. World Health Organization. https://www.who.int/publications/i/item/strengthening-response-to-pandemics-and-other-public-health-emergencies.
Influenza A (H1N1) 2009-2010 and public communication issues
The influenza A (H1N1) pandemic of 2009-2010 was the first public health emergency of international concern, d according to the International Health Regulations. The response to this pandemic was marked by an emphasis on prevention. There was also great fear of the unpredictable nature of influenza, with variants that were either highly contagious, highly lethal, or both. In this case, it was a highly contagious but not very lethal variant.
The pandemic exposed important limitations in public health capabilities at all levels. Some were related to the available scientific knowledge and to making difficult decisions under great uncertainty. It also revealed weaknesses in global health cooperation and the problems of the lack of sanctions for countries that did not adopt the recommendations.
There were also major problems with communication between authorities, specialists and the general public. In many places, the population was exposed to headlines and public statements containing confusing and alarming terminology. Terms that were still relatively unfamiliar, such as "pandemic", foreshadowed an influenza A (H1N1) epidemic far more severe than what ultimately materialised. After all, the evidence available at the time indicated an alarming case fatality rate, up to five times higher than what was experienced in the months that followed. This generated distrust towards global and public health authorities in many countries. In fact, in many cases they were accused of being influenced by the commercial interests of vaccine and antiviral manufacturers. However, no conclusive evidence of large-scale corruption was found. In any case, it sparked a wide-ranging debate about the enormous influence of the pharmaceutical industry on public health decision-making (WHO, 2011)World Health Organization. (2011). Strengthening response to pandemics and other public-health emergencies: Report of the Review Committee on the Functioning of the International Health Regulations (2005) and on Pandemic Influenza (H1N1) 2009. World Health Organization. https://www.who.int/publications/i/item/strengthening-response-to-pandemics-and-other-public-health-emergencies.
The West African Ebola epidemic of 2013-16
The 2013-16 West African Ebola epidemic in 2013-16 threatened countries with very few resources
Many of the weaknesses in the response to the influenza A (H1N1) pandemic manifested themselves again as of December 2013. It was at that time that the largest Ebola epidemic on record to date began. The outbreak hit the population of three countries in West Africa: Guinea, Liberia and Sierra Leone very hard. None of them had experience with this disease. It also affected other countries, with imported or linked cases, but with little local spread. It caused a total of 11,000 deaths and a huge level of panic globally.
The epidemic exposed the weakness and limited public health capacity of lower-resource countries affected by complex humanitarian crises. It also revealed the enormous importance of strengthening their health systems, for the benefit of their populations and of global health security. International Health Regulations that were not being implemented were of no use whatsoever during this epidemic (WHO, 2016)World Health Organization. (2016). Implementation of the International Health Regulations (2005): Report of the Review Committee on the Role of the International Health Regulations (2005) in the Ebola Outbreak and Response (A69/21). World Health Organization. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_21-en.pdf.
It took several months from the beginning of the outbreak before the first cases were confirmed and reported. As a result, the response to the outbreak started too late. In addition, the population lacked information and a total lack of trust in the local and national authorities. As a result, many of their attempts to control the epidemic caused violence, stigma and fear towards the disease, health personnel and the government.
The Ebola epidemic also revealed to the world the slowness and tardiness of the international response
The crisis highlighted the lack of global leadership in public health. It also exposed the fragile vision of a global health system that was far from equitable and completely neglected the most vulnerable populations. In fact, the slow international response was not fully activated until the danger increased for countries such as Spain and, mainly, the United States.
Cases began in Guinea in December 2013 and reached other neighboring countries in March 2014. In June, moreover, MSF began warning of the need for a massive international deployment for the response to a completely out-of-control outbreak. However, the World Health Organization did not declare the epidemic a Public Health Emergency of International Concern until August 2014. It was this declaration that multiplied international humanitarian aid efforts, months after the outbreak began.
Humanitarian action contributed to the availability of health services with adequate infection control practices. However, the turning point in transmission only occurred when communities mobilized to adopt public health measures. Among these, one of the most important was the modification of traditional funeral practices. This greatly reduced transmission of the virus. However, by the time this occurred, the numbers of Ebola infections and deaths were already enormous. The epidemic also disintegrated many essential maternal and child health services and decimated the fragile economies of the affected countries.
Ebola placed the WHO under intense scrutiny, as it proved unable to fulfil the responsibilities conferred upon it by the International Health Regulations (Gostin & Friedman, 2015)Gostin, L. O., & Friedman, E. A. (2015). A retrospective and prospective analysis of the west African Ebola virus disease epidemic: Robust national health systems at the foundation and an empowered WHO at the apex. The Lancet, 385(9980), 1902–1909. https://doi.org/10.1016/S0140-6736(15)60644-4. The organisation was funded primarily through voluntary contributions from member states and donors. As recently as 2011, it had undergone significant budget cuts. This clearly undermined its technical, operational, normative and global health leadership capacity.
From 2014 to 2018: Polio, Zika and Ebola (in DRC)
A polio emergency was declared in 2014 and is still ongoing
In May 2014, the Director-General of the World Health Organization declared a new public health emergency of international concern. It was polio due to its recent spread to three new countries: Afghanistan, Iraq and Equatorial Guinea. This was only two years after the international spread had, in theory, been halted.
The International Health Regulations Emergency Committee has decided to continue renewing this declaration in 2024 (WHO, 2024b)World Health Organization. (2024, August 13). Statement of the thirty-ninth meeting of the Polio IHR Emergency Committee. https://www.who.int/news/item/13-08-2024-statement-of-the-thirty-ninth-meeting-of-the-polio-ihr-emergency-committee. This comes at a time when efforts to achieve the eradication of wild poliovirus type 1 by 2026 are being intensified. Current global targets also include the elimination of circulating vaccine-derived poliovirus type 2 by 2028.
In 2016, an emergency was declared due to an outbreak of the Zika virus in several American countries
The new emergency was declared in February 2016 despite the apparently mild nature of the disease. In fact, Zika, a virus transmitted through the bite of the Aedes mosquito, typically causes infections that are generally asymptomatic. Only in around 20% of cases does it produce mild symptoms. However, there was considerable concern about the apparent relationship between infection in pregnant women and effects on newborns. Zika could cause defects in the neurological development of newborns, and a microcephaly epidemic. There was also concern about the possible sexual transmission of the infection (Heymann et al., 2016)Heymann, D. L., Hodgson, A., Sall, A. A., Freedman, D. O., Staples, J. E, Althabe, F., Baruah, K., Mahmud, G., Kandun, N., Vasconcelos, P. F. C., Bino, S., & Menon, K. U. (2016). Zika virus and microcephaly: Why is this situation a PHEIC? The Lancet, 387(10020), 719–721. https://doi.org/10.1016/S0140-6736(16)00320-2.
In the absence of a vaccine and despite efforts to control the vector, Zika incidence reached very high levels. This contributed to generating herd immunity, slowing transmission. As a result, in November of that same year, the WHO declared the end of the emergency (Wilder-Smith & Osman, 2020)Wilder-Smith, A., & Osman, S. (2020). Public health emergencies of international concern: A historic overview. Journal of Travel Medicine, 27(8), taaa227. https://doi.org/10.1093/jtm/taaa227.
Ebola shook the world again in 2018, this time from the Democratic Republic of the Congo
In this new public health emergency of international concern, the response overcame many of the weaknesses seen during the 2013–16 outbreak. On this occasion, detection by national authorities, who were familiar with the virus, and the international response were swift, despite the complexity of the context (Ilunga Kalenga et al., 2019)Ilunga Kalenga, O., Moeti, M., Sparrow, A., Nguyen, V.-K., Lucey, D., & Ghebreyesus, T. A. (2019). The ongoing Ebola epidemic in the Democratic Republic of Congo, 2018–2019. New England Journal of Medicine, 381(4), 373–383. https://doi.org/10.1056/NEJMsr1904253. Furthermore, for the first time, a new highly effective Ebola vaccine was available. It had been researched and trialled during the final months of the previous outbreak.
However, the response was severely hampered by insecurity and violence linked to the ongoing conflict. In areas where the conflict was most intense, peaks in violence coincided with peaks in disease incidence. Several analyses show that, had there been no ongoing conflict, vaccination would have had a considerably stronger effect. This epidemic went on to become the largest Ebola outbreak in the history of the African country (Wells et al., 2019)Wells, C. R., Pandey, A., Ndeffo Mbah, M. L., Gaüzère, B.-A., Malvy, D., Singer, B. H., & Galvani, A. P. (2019). The exacerbation of Ebola outbreaks by conflict in the Democratic Republic of the Congo. Proceedings of the National Academy of Sciences, 116(48), 24366–24372. https://doi.org/10.1073/pnas.1913980116.
The epidemic was declared locally and notified to the WHO on 1 August 2018 by the authorities of the Democratic Republic of the Congo. The declaration of a public health emergency of international concern was only made almost a year later, on 17 July 2019, after the Emergency Committee, following four meetings, expressed its concern about a possible spread of the epidemic (WHO, 2019)World Health Organization. (2019, July 17). Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 17 July 2019 -Statement-. https://www.who.int/news/item/17-07-2019-statement-on-the-meeting-of-the-international-healthregulations-(2005)-emergency-committee-for-ebolavirus-disease-in-the-democratic-republic-of-the-congo-on-17-july-2019.
From 2020 onwards: COVID-19, mpox and Ebola (Bundibugyo)
From 2020 to 2023, the COVID-19 pandemic again highlighted global inequity
The new COVID-19 emergency caused more than 700 million cases, 7 million confirmed deaths and an estimated excess mortality of 27 million deaths across more than 200 countries (Dattani, 2023)Dattani, S. (2023, December 7). What were the death tolls from pandemics in history? Our World in Data. https://ourworldindata.org/historical-pandemics. This pandemic triggered a global economic crisis and reduced the availability of and access to health services worldwide. It also had an enormous influence on the resurgence of many infections. The pandemic once again exposed the poor compliance with the International Health Regulations (WHO, 2021)World Health Organization. (2021). Report of the Review Committee on the Functioning of the International Health Regulations (2005) during the COVID-19 response (A74/9). World Health Organization. https://www.who.int/publications/m/item/a74-9-who-s-work-in-health-emergencies. It also highlighted the need for the WHO to be able to investigate public health threats rapidly. Furthermore, the pandemic exposed the inequity in access to vaccines, diagnostic tests, protective equipment and oxygen (Independent Panel for Pandemic Preparedness and Response, 2021)IPPPR. (2021). COVID-19: Make it the last pandemic. https://theindependentpanel.org/wp-content/uploads/2021/05/COVID-19-Make-it-the-Last-Pandemic_final.pdf.
In less than a year, a vaccine was successfully developed. Yet another year after it became available, coverage was deeply unequal and reflected profound injustices. The population with a completed initial vaccination schedule stood at 73% in high-income countries and just 6% in low-income countries. People living in poverty only gained access to the vaccine after wealthier populations had done so. First, the wealthiest countries met all their own needs and hoarded all existing and future production. The WHO Director-General described this inequity as placing the world [on the verge of] "a catastrophic moral failure." The United Nations Secretary-General also spoke in terms of "a moral indictment of the state of our world" and of "obscenity" (MSF Access, 2021)MSF Access. (2021, December 21). COVAX: A broken promise to the world – Issue brief. Médecins Sans Frontières. https://msfaccess.org/covax-broken-promise-world.
Initiatives emerged to address this inequity. One of them was the Access to COVID-19 Tools Accelerator (ACT-A) and its vaccine pillar: COVAX. However, this proposal excluded civil society and the governments of poorer countries from its governance and design. These mechanisms proved insufficient. They remained subject to the political will of donor countries and the voluntary action of the pharmaceutical industry (MSF Access, 2021)MSF Access. (2021, December 21). COVAX: A broken promise to the world – Issue brief. Médecins Sans Frontières. https://msfaccess.org/covax-broken-promise-world.
Two new emergencies were declared in 2022 and 2024, due to an epidemic of monkeypox
Before the COVID-19 emergency had ended, the WHO declared a new public health emergency of international concern in 2022. This was an outbreak of monkeypox (or mpox) that spread extensively, for the first time, outside Africa (Nakoune et al., 2023)Nakoune, E., Moussa Yagata, F. E., Nimbona, A., Darnycka Belizaire, M.-R., & Boum, Y. (2023). Mpox: Interdependence and inequity. The Lancet Infectious Diseases, 23(10), 1128–1129. https://doi.org/10.1016/S1473-3099(23)00487-5.
The WHO declared the emergency again in 2024 due to another outbreak of a more lethal variant of mpox than the previous one. This time it was concentrated in the Democratic Republic of the Congo, but with several confirmed cases in several neighbouring countries and even outside the African continent.
Although a vaccine was available for this disease, once again the inequity in access to tools for combating epidemics became evident. At the time the new emergency was notified, the vaccine was only available in wealthy countries. Moreover, pledges of international donations fell short of the needs expressed by the Africa Centres for Disease Control and Prevention (Africa CDC) (Gostin et al., 2024)Gostin, L. O., Jha, A. K., & Finch, A. (2024). The mpox global health emergency: A time for solidarity and equity. New England Journal of Medicine, 391(14), 1265–1267. https://doi.org/10.1056/NEJMp2410395.
In May 2026, an Ebola epidemic caused by the Bundibugyo virus was declared in Uganda and the Democratic Republic of the Congo
On 17 May 2026, the WHO Director-General declared a new public health emergency of international concern due to Ebola, caused by the Bundibugyo virus. This is a different virus from those responsible for the 2013–16 emergency in West Africa and the 2018 emergency in the Democratic Republic of the Congo (WHO, 2026)World Health Organization. (2026, May 17). Epidemic of Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern -Statement-. https://www.who.int/news/item/17-05-2026-epidemic-of-ebola-disease-in-the-democratic-republic-of-the-congo-and-uganda-determined-a-public-health-emergency-of-international-concern.
The declaration came following the reporting of 246 suspected cases, 80 deaths and 8 laboratory-confirmed cases across three different areas of the Democratic Republic of the Congo, along with 2 further apparently unrelated confirmed cases and one death in Kampala, Uganda. It is worth highlighting the notable differences between the 2026 declaration and that of the 2018 epidemic. The 2018 outbreak was declared a public health emergency of international concern one year after it had begun, and following four meetings of the Emergency Committee. In 2026, the emergency was declared two days after the outbreak was declared by the Congolese authorities (MSPHPS de la RDC, 2026)Ministère de la Santé Publique, Hygiène et Prévoyance Sociale de la République Démocratique du Congo. (2026, May 15). Déclaration de la 17e épidémie de la maladie à virus Ebola dans les zones de santé de Rwampara, Mongwalu et Bunia, province de l'Ituri. https://logcluster.org/sites/default/files/public/2026-05/declaration-de-la-17e-epidemie-de-la-maladie-virus-ebola-dans-les-zones-de-sante-de-rwampara.pdf and without any prior meetings of the Emergency Committee.
For this variant, which is now striking a region affected by humanitarian crises, violence and displacement, there are no approved vaccines or treatments.
Will the world be prepared for the next pandemic?
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We do not know when there will be a new pandemic of "disease X", but there will be one
In 2017, following the West African Ebola epidemic of 2013–2016, the CEPI (Coalition for Epidemic Preparedness Innovations) was established (CEPI, 2021)Coalition for Epidemic Preparedness Innovations. (2021). CEPI 2.0: The 2022–2026 strategy. https://static.cepi.net/downloads/2023-12/CEPI-2022-2026-Strategy-v3-Jan21_0.pdf. This organisation, along with many others and the WHO, has spent years discussing "Disease X": a hypothetical infection that could in the future be caused by a new or as yet unidentified pathogen. It is believed it could trigger a significant epidemic or even pandemic, with global repercussions for both health and the world economy. COVID-19 has probably been our first "Disease X" since the term was coined. Yet today we can be certain that there will be many more significant international public health emergencies to come (CEPI, n.d.)Coalition for Epidemic Preparedness Innovations. (n.d.). The viral most wanted. https://cepi.net/viral-most-wanted.
Against COVID-19, it took the world 326 days to have a vaccine ready. This was a breakthrough unimaginable years ago. However, it is still far from what is considered ideal to address the threat of the next major international public health emergencies. The target is set at 100 days, desde reconocer la nueva amenaza, hasta desarrollar una vacuna segura y efectiva lista para su autorización y fabricación a gran escala (CEPI, 2026)Coalition for Epidemic Preparedness Innovations. (2026). CEPI 3.0 strategy (2027–2031). https://static.cepi.net/downloads/2026-02/CEPI%203.0%20Strategy%20Report%20DIG%20ENG%20FINAL.pdf.
Progress has been made on a new update of the international health regulations
Before the COVID-19 pandemic, we already had International Health Regulations developed in 2005 and updated on several occasions. These detailed the key actions needed to be prepared to face a major epidemic or pandemic. However, by 2020, these Regulations had still not been properly implemented and in many cases were even being ignored (IPPPR, 2022)Independent Panel for Pandemic Preparedness and Response. (2022). Transforming or tinkering? Inaction lays the groundwork for another pandemic. https://theindependentpanel.org/documents/transforming-or-tinkering_report_final__embargoed-distribution/.
For this reason, following the COVID-19 pandemic it was decided to update the International Health Regulations (2005) once again. The amendment was completed in June 2024 (WHO, 2024)World Health Organization. (2024). International Health Regulations (2005), as amended in 2014, 2022 and 2024. World Health Organization. https://apps.who.int/gb/bd/pdf_files/IHR_2014-2022-2024-en.pdf. The changes include, for example, new national authorities responsible for implementing the Regulations in their respective countries. A new financial control mechanism for equity in access to medical products has also been established.
This update also contemplates a new key term related to international public health emergencies: the "Pandemic Emergency". This term goes beyond the 2005 Public Health Emergency of International Concern. Thus, a pandemic emergency is a communicable disease that has had or may have wide geographic spread in multiple States. It also exceeds or may exceed the capacity of health systems to respond in those States. In addition, it causes or may cause substantial social and/or economic disruption, including disruption of international traffic and trade. It therefore requires rapid, equitable and enhanced international action, with coordinated whole-of-government and whole-of-society approaches.
The new WHO Pandemic Agreement shows promise but limited scope
After the COVID-19 pandemic, it was also decided to create another instrument: a Pandemic Agreement. This was to ensure international cooperation and global political commitment of the 194 WHO member countries for the response to the next pandemic. This agreement was slow to materialize and, at times, came to seem impossible. Nevertheless, the intergovernmental negotiating body created in 2021, after obtaining an extension of its mandate, finally succeeded.
The agreement was adopted at the World Health Assembly in May 2025 with 124 votes in favour from member states, 70 abstentions and one conspicuous absence: that of the United States, which had already announced its withdrawal from the WHO (WHO, 2025)World Health Organization. (2025). WHO Pandemic Agreement (WHA78/R1). World Health Organization. https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_R1-en.pdf. At last, the new Pandemic Agreement established rules on how countries should act and collaborate to prevent, prepare for and respond to pandemic threats, with a One Health approach. However, the very factors that delayed the adoption of the agreement have ultimately weakened its ambition and content (Clark & Johnson Sirleaf, 2025)Clark, H., & Johnson Sirleaf, E. (2025). The Pandemic Agreement is a milestone: Now it is time for action in national capitals. The Lancet, 405(10496), 2510–2511. https://doi.org/10.1016/S0140-6736(25)01178-X.
To bridge the gaps between countries' priorities and needs, flexibilities were introduced into the terms of the agreement. As a result, the level of obligations around global governance above individual countries' interests and responsibilities has been reduced. The requirements for fair and equitable resource sharing have also been weakened. In fact, only 20% of medical products are subject to public health needs and risks. The remaining 80% stays on the market, available to the highest bidder. Finally, there is still no agreement on obligations to share technology, biological samples and genomic sequencing data from pathogens with pandemic potential. This, which will be crucial in responding to future international public health emergencies, remains open to negotiation for a further year, until the signing and ratification of the agreement, scheduled for the next Assembly in May 2026, at a time of deep financial crisis for global health in general and for the World Health Organization in particular (Dupraz-Dobias, 2026)Dupraz-Dobias, P. (2026, February 15). Wide gaps on pandemic treaty annex cast doubt on May deadline, says health expert Suerie Moon. Geneva Solutions. https://genevasolutions.news/global-health/wide-gaps-on-pandemic-treaty-annex-cast-doubt-on-may-deadline-says-health-expert-suerie-moon.
References
- Clark, H., & Johnson Sirleaf, E. (2025). The Pandemic Agreement is a milestone: Now it is time for action in national capitals. The Lancet, 405(10496), 2510–2511. https://doi.org/10.1016/S0140-6736(25)01178-X
- Coalition for Epidemic Preparedness Innovations. (2021). CEPI 2.0: The 2022–2026 strategy. https://static.cepi.net/downloads/2023-12/CEPI-2022-2026-Strategy-v3-Jan21_0.pdf
- Coalition for Epidemic Preparedness Innovations. (2026). CEPI 3.0 strategy (2027–2031). https://static.cepi.net/downloads/2026-02/CEPI%203.0%20Strategy%20Report%20DIG%20ENG%20FINAL.pdf
- Coalition for Epidemic Preparedness Innovations. (n.d.). The viral most wanted. https://cepi.net/viral-most-wanted
- Dattani, S. (2023, December 7). What were the death tolls from pandemics in history? Our World in Data. https://ourworldindata.org/historical-pandemics
- Dupraz-Dobias, P. (2026, February 15). Wide gaps on pandemic treaty annex cast doubt on May deadline, says health expert Suerie Moon. Geneva Solutions. https://genevasolutions.news/global-health/wide-gaps-on-pandemic-treaty-annex-cast-doubt-on-may-deadline-says-health-expert-suerie-moon
- Gostin, L. O., & Friedman, E. A. (2015). A retrospective and prospective analysis of the west African Ebola virus disease epidemic: Robust national health systems at the foundation and an empowered WHO at the apex. The Lancet, 385(9980), 1902–1909. https://doi.org/10.1016/S0140-6736(15)60644-4
- Gostin, L. O., Jha, A. K., & Finch, A. (2024). The mpox global health emergency: A time for solidarity and equity. New England Journal of Medicine, 391(14), 1265–1267. https://doi.org/10.1056/NEJMp2410395
- Heymann, D. L., Hodgson, A., Sall, A. A., Freedman, D. O., Staples, J. E., Althabe, F., Baruah, K., Mahmud, G., Kandun, N., Vasconcelos, P. F. C., Bino, S., & Menon, K. U. (2016). Zika virus and microcephaly: Why is this situation a PHEIC? The Lancet, 387(10020), 719–721. https://doi.org/10.1016/S0140-6736(16)00320-2
- Ilunga Kalenga, O., Moeti, M., Sparrow, A., Nguyen, V.-K., Lucey, D., & Ghebreyesus, T. A. (2019). The ongoing Ebola epidemic in the Democratic Republic of Congo, 2018–2019. New England Journal of Medicine, 381(4), 373–383. https://doi.org/10.1056/NEJMsr1904253
- Independent Panel for Pandemic Preparedness and Response. (2021). COVID-19: Make it the last pandemic. https://theindependentpanel.org/wp-content/uploads/2021/05/COVID-19-Make-it-the-Last-Pandemic_final.pdf
- Independent Panel for Pandemic Preparedness and Response. (2022). Transforming or tinkering? Inaction lays the groundwork for another pandemic. https://theindependentpanel.org/documents/transforming-or-tinkering_report_final__embargoed-distribution/
- MSF Access. (2021, December 21). COVAX: A broken promise to the world [Issue brief]. Médecins Sans Frontières. https://msfaccess.org/covax-broken-promise-world
- Ministère de la Santé Publique, Hygiène et Prévoyance Sociale de la République Démocratique du Congo. (2026, May 15). Déclaration de la 17e épidémie de la maladie à virus Ebola dans les zones de santé de Rwampara, Mongwalu et Bunia, province de l’Ituri. https://logcluster.org/sites/default/files/public/2026-05/declaration-de-la-17e-epidemie-de-la-maladie-virus-ebola-dans-les-zones-de-sante-de-rwampara.pdf
- Nakoune, E., Moussa Yagata, F. E., Nimbona, A., Darnycka Belizaire, M.-R., & Boum, Y. (2023). Mpox: Interdependence and inequity. The Lancet Infectious Diseases, 23(10), 1128–1129. https://doi.org/10.1016/S1473-3099(23)00487-5
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- The 21st Century and the resurgence of infections
- International public health emergencies
- Diarrheal diseases and cholera
- Tuberculosis and pneumonia: respiratory infections
- Malaria: progress and challenges toward elimination
- Vaccination in humanitarian emergencies
- Response to epidemics in humanitarian crises
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How to cite this page
Abarca, B. (May 17, 2026). International public health emergencies: 21st century pandemics and future preparedness. Salud Everywhere. https://saludeverywhere.com/en/health-in-humanitarian-crises/international-public-health-emergencies/
