关于2019新型冠状病毒疫情的《国际卫生条例(2005)》突发事件委员会第二次会议的声明

关于2019新型冠状病毒疫情的《国际卫生条例(2005)》突发事件委员会第二次会议的声明
2020年1月30日 世卫组织的声明 瑞士日内瓦

世卫组织总干事根据《国际卫生条例(2005)》召集的突发事件委员会于2020年1月30日(星期四)日内瓦时间(欧洲中部时间)13:30至18:35 举行会议,讨论中华人民共和国发生的2019新型冠状病毒疫情以及其他国家出现的输入病例情况。委员会的作用是向总干事提供咨询意见,由总干事就确定是否构成国际关注的突发公共卫生事件作出最后决定。委员会还提供公共卫生咨询意见或酌情提出正式的临时建议。

会议简况

以电话会议方式召集突发事件委员会委员和顾问开会。

总干事对委员会表示欢迎,并感谢委员们的支持。他随即将会议交由会议主席Didier Houssin教授主持。

Houssin教授也对委员会表示欢迎,并请秘书处发言。

世卫组织合规、风险管理和道德操守司的一名代表向委员会委员们介绍了他们的作用和责任。

提请委员会委员注意其保密义务和有责任披露可能被视为构成利益冲突的个人、财务或专业关系。与会的每一委员都接受了审核,据认定没有与会议相关的任何利益冲突。自上次会议以来在此方面并无变化。

主席随后解释了会议议程,并介绍了发言者。

中华人民共和国国家卫生健康委员会的代表报告了现况和所采取的公共卫生措施。全国目前共有7711例确诊病例和12167例疑似病例。在确诊病例中,1370例为重症病例,170人死亡。124人已痊愈出院。

世卫组织秘书处概述了其他国家情况。目前在18个国家中出现了83例病例。其中,只有7例无中国旅行史。在中国境外,有3个国家出现了人际传播。其中一例为重症病例,没有人死亡。

在第一次会议上,委员们就这一事件是否构成国际关注的突发公共卫生事件表达了不同意见。当时的建议是,此疫情不构成国际关注的突发公共卫生事件,但委员们认为情况紧迫,并建议委员会第二天继续开会。第二天会议得出同样结论。

鉴于病例数大幅增加以及有更多国家报告了确诊病例,委员会今天举行了第二次会议。

结论和建议

对中国政府最高领导人的领导作用、政治承诺和在透明度方面的决心,以及为调查和控制当前疫情所做的努力,委员会表示欢迎。

中国迅速识别了这一病毒,并分享了病毒的基因序列,导致迅速开发了诊断工具,使其他国家能够迅速作出诊断和采取防护措施。

中国采取了十分有力的措施,例如与世卫组织保持每日联络,并在众多领域采取综合措施防止进一步传播。中国还在其他城市和省份采取了公共卫生措施;正在对病毒的严重性和传播力进行研究;并分享了数据和生物材料。中国还同意与需要其支持的其他国家合作。中国采取的措施不仅对中国有利,对世界其他地区也有益。

委员会确认世卫组织及其合作伙伴的领导作用。

委员会也承认,仍有许多未知因素。世卫组织已有五个区域在一个月内报告了病例,并且在武汉以外和中国境外发生了人际传播。

委员会认为,只要各国采取强有力的措施,及早发现、隔离和治疗病例,追踪接触者,并提倡针对风险程度采取相应的减少社交接触的措施,仍然有可能阻断病毒传播。应当指出的是,随着疫情的不断变化,预防和减少感染传播的战略目标和措施也将作出相应调整。委员会同意,本次疫情现已符合国际关注的突发公共卫生事件标准,并建议发布以下临时建议。

委员会强调,这次宣布国际关注的突发公共卫生事件,应本着支持和赞赏中国、中国人民以及在此次疫情的最前线中国所采取的各项行动的精神来看待,并希望中国的透明行动取得成功。委员会认为,全球需要团结一致,协调努力,加强世界其他地区的防范工作,并向可能需要更多支持的地区提供协助。

对世卫组织的建议

委员会欢迎世卫组织即将向中国派遣一个多学科技术专家组,其中包括国家和地方专家。该专家组应当审查和支持为调查疫情的动物源、疾病在临床上的整体表现及其严重性、社区和医疗机构中的人际传播程度而开展的工作以及为控制疫情所做的努力。这个专家组将向国际社会提供信息,以帮助了解局势及其影响,并促进分享经验和成功措施。

委员会希望再次强调研究病毒可能来源的重要性,以排除隐性传播并供实施风险管理措施参考。

委员会还强调需要加强湖北以外地区的监测,包括病原体的基因组测序,以了解当地是否存在循环传播。

世卫组织应继续通过其技术专家网络评估如何能在全球范围最有效地控制这一疫情。

世卫组织应加强对防范和应对的支持,特别是在脆弱国家和区域。

应当制定措施,确保低收入和中等收入国家能快速开发和获得潜在的疫苗、诊断工具、抗病毒药物和其他治疗手段。

世卫组织应继续提供一切必要的技术和业务支持,以应对这一疫情,包括与其广泛的伙伴和协作机构网络合作,实施全面的风险沟通战略,并针对这一新型冠状病毒推进相关的研究和科学发展。

世卫组织应继续探索在无需就《国际卫生条例(2005)》文本重启谈判的情况下,是否可在国际关注的突发公共卫生事件或非国际关注的突发公共卫生事件这两种可能性之间建立一个中间警报级别。

世卫组织应及时地以透明方式审议相关形势并更新其基于证据的建议。

根据现有信息,委员会不建议采取任何旅行或贸易限制措施。

总干事宣布2019-nCoV疫情构成国际关注的突发公共卫生事件,并接受了委员会的建议,将其作为《国际卫生条例(2005)》下的临时建议发布。

对中华人民共和国的建议

请继续:

  • 实施全面的风险沟通战略,定期向民众通报疫情变化情况、针对人群的预防和保护措施以及为控制疫情所采取的应对措施。
  • 加强公共卫生措施,控制当前疫情。
  • 确保卫生系统具有抵御能力,并保护医务人员。
  • 加强中国各地的监测和积极发现病例工作。
  • 与世卫组织和相关伙伴合作开展调查,以了解此次疫情的流行病学和演变情况以及疫情控制措施。
  • 共享人类病例相关数据。
  • 继续确定疫情的人畜共患病源,尤其要确定其传播潜力,并尽快与世卫组织共享有关信息。
  • 在尽量减少对国际交通造成干扰的同时,在国际机场和港口进行出境筛查,目的是及早发现有症状的旅客,以便作出进一步评估和治疗。

对所有国家的建议

预计任何国家都可能出现进一步的国际输入病例。因此,所有国家都应作好控制疫情的准备,包括主动监测、早期发现、隔离和病例管理、接触者追踪和防止2019-nCoV感染的进一步传播,并与世卫组织共享全部数据。技术建议可从世卫组织网站获取。

请各国注意,根据《国际卫生条例》,它们必须与世卫组织共享信息。

任何在动物中检出2019-nCoV病毒的情况(包括有关病毒种类、诊断检测结果和相关流行病学信息)均应作为新发疾病向世界动物卫生组织报告。

各国应特别重视减少人类感染,防止继发性传播和国际传播,以及通过多部门交流与合作、积极参与增加关于该病毒和该疾病的知识和推进研究工作,为国际对策作出贡献。

根据现有信息,委员会不建议实施任何旅行或贸易限制。

各国必须按照《国际卫生条例》的要求向世卫组织通报所采取的任何旅行措施。根据《国际卫生条例》第三条中的原则,请各国不要采取可能助长侮辱或歧视的行动。

鉴于这一局势在迅速演变,委员会请总干事就这些事项提供进一步建议,必要时应逐项提出新的建议。

 

对国际社会的建议

由于这是一种新型冠状病毒,而且以往的经验表明,针对类似的冠状病毒,需要为促进定期共享信息和开展研究作出巨大努力,因此,国际社会应遵循《国际卫生条例(2005)》第四十四条规定,继续团结合作,相互支持,以确定这一新型病毒的起源及其在人际传播中的全部潜力,防范可能输入的病例并开展研究以开发必要的治疗方法。

向低收入和中等收入国家提供支持,使其能够应对这一事件,并促进获得诊断工具、潜在的疫苗和疗法。

根据《国际卫生条例》第四十三条规定,采取明显干扰国际交通的额外卫生措施(指拒绝国际旅行者、行李、货物、集装箱、交通工具、物品等入境或出境或延误入境或出境24小时以上)的缔约国有义务在采取措施后48小时内向世卫组织报告相关公共卫生依据和理由。世卫组织将审查这些理由,并可能要求有关国家重新考虑其措施。世卫组织必须与其他缔约国分享关于所收到的措施和理由的信息。

总干事将酌情决定在三个月后(或者更早)再次召集突发事件委员会会议。

总干事感谢委员会的工作。

资料来源

 


Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)

30 January 2020 Statement Geneva, Switzerland

The second meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding the outbreak of novel coronavirus 2019 in the People’s Republic of China, with exportations to other countries, took place on Thursday, 30 January 2020, from 13:30 to 18:35 Geneva time (CEST). The Committee’s role is to give advice to the Director-General, who makes the final decision on the determination of a Public Health Emergency of International Concern (PHEIC). The Committee also provides public health advice or suggests formal Temporary Recommendations as appropriate.

Proceedings of the meeting

Members and advisors of the Emergency Committee were convened by teleconference

The Director-General welcomed the Committee and thanked them for their support. He turned the meeting over to the Chair, Professor Didier Houssin.

Professor Houssin also welcomed the Committee and gave the floor to the Secretariat.

A representative of the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.

Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting. There were no changes since the previous meeting.

The Chair then reviewed the agenda for the meeting and introduced the presenters.

Representatives of the Ministry of Health of the People’s Republic of China reported on the current situation and the public health measures being taken. There are now 7711 confirmed and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 are severe and 170 people have died. 124 people have recovered and been discharged from hospital.

The WHO Secretariat provided an overview of the situation in other countries. There are now 83 cases in 18 countries. Of these, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of these cases is severe and there have been no deaths.

At its first meeting, the Committee expressed divergent views on whether this event constitutes a PHEIC or not. At that time, the advice was that the event did not constitute a PHEIC, but theCommittee members agreed on the urgency of the situation and suggested that the Committee should continue its meeting on the next day, when it reached the same conclusion.

This second meeting takes place in view of significant increases in numbers of cases and additional countries reporting confirmed cases.

Conclusions and advice

The Committee welcomed the leadership and political commitment of the very highest levels of Chinese government, their commitment to transparency, and the efforts made to investigate and contain the current outbreak. China quickly identified the virus and shared its sequence, so that other countries could diagnose it quickly and protect themselves, which has resulted in the rapid development of diagnostic tools.

The very strong measures the country has taken include daily contact with WHO and comprehensive multi-sectoral approaches to prevent further spread. It has also taken public health measures in other cities and provinces; is conducting studies on the severity and transmissibility of the virus, and sharing data and biological material. The country has also agreed to work with other countries who need their support. The measures China has taken are good not only for that country but also for the rest of the world.

The Committee acknowledged the leading role of WHO and its partners.

The Committee also acknowledged that there are still many unknowns, cases have now been reported in five WHO regions in one month, and human-to-human transmission has occurred outside Wuhan and outside China.

The Committee believes that it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection. The Committee agreed that the outbreak now meets the criteria for a Public Health Emergency of International Concern and proposed the following advice to be issued as Temporary Recommendations.

The Committee emphasized that the declaration of a PHEIC should be seen in the spirit of support and appreciation for China, its people, and the actions China has taken on the frontlines of this outbreak, with transparency, and, it is to be hoped, with success. In line with the need for global solidarity, the Committee felt that a global coordinated effort is needed to enhance preparedness in other regions of the world that may need additional support for that.

Advice to WHO

The Committee welcomed a forthcoming WHO multidisciplinary technical mission to China, including national and local experts. The mission should review and support efforts to investigate the animal source of the outbreak, the clinical spectrum of the disease and its severity, the extent of human-to-human transmission in the community and in healthcare facilities, and efforts to control the outbreak. This mission will provide information to the international community to aid in understanding the situation and its impact and enable sharing of experience and successful measures.

The Committee wished to re-emphasize the importance of studying the possible source, to rule out hidden transmission and to inform risk management measures

The Committee also emphasized the need for enhanced surveillance in regions outside Hubei, including pathogen genomic sequencing, to understand whether local cycles of transmission are occurring.

WHO should continue to use its networks of technical experts to assess how best this outbreak can be contained globally.

WHO should provide intensified support for preparation and response, especially in vulnerable countries and regions.

Measures to ensure rapid development and access to potential vaccines, diagnostics, antiviral medicines and other therapeutics for low- and middle-income countries should be developed.

WHO should continue to provide all necessary technical and operational support to respond to this outbreak, including with its extensive networks of partners and collaborating institutions, to implement a comprehensive risk communication strategy, and to allow for the advancement of research and scientific developments in relation to this novel coronavirus.

WHO should continue to explore the advisability of creating an intermediate level of alert between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the text of the IHR (2005).

WHO should timely review the situation with transparency and update its evidence-based recommendations.

The Committee does not recommend any travel or trade restriction based on the current information available.

The Director-General declared that the outbreak of 2019-nCoV constitutes a PHEIC and accepted the Committee’s advice and issued this advice as Temporary Recommendations under the IHR.

To the People’s Republic of China

Continue to:

• Implement a comprehensive risk communication strategy to regularly inform the population on the evolution of the outbreak, the prevention and protection measures for the population, and the response measures taken for its containment.

• Enhance public health measures for containment of the current outbreak.

• Ensure the resilience of the health system and protect the health workforce.

• Enhance surveillance and active case finding across China.

• Collaborate with WHO and partners to conduct investigations to understand the epidemiology and the evolution of this outbreak and measures to contain it.

• Share relevant data on human cases.

• Continue to identify the zoonotic source of the outbreak, and particularly the potential for circulation with WHO as soon as it becomes available.

• Conduct exit screening at international airports and ports, with the aim of early detection of symptomatic travelers for further evaluation and treatment, while minimizing interference with international traffic.

 

To all countries

It is expected that further international exportation of cases may appear in any country. Thus, all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoVinfection, and to share full data with WHO. Technical advice is available on the WHO website.

Countries are reminded that they are legally required to share information with WHO under the IHR.

Any detection of 2019-nCoV in an animal (including information about the species, diagnostic tests, and relevant epidemiological information) should be reported to the World Organization for Animal Health (OIE) as an emerging disease.

Countries should place particular emphasis on reducing human infection, prevention of secondary transmission and international spread, and contributing to the international response though multi-sectoral communication and collaboration and active participation in increasing knowledge on the virus and the disease, as well as advancing research.

The Committee does not recommend any travel or trade restriction based on the current information available.

Countries must inform WHO about travel measures taken, as required by the IHR. Countries are cautioned against actions that promote stigma or discrimination, in line with the principles of Article 3 of the IHR.

The Committee asked the Director-General to provide further advice on these matters and, if necessary, to make new case-by-case recommendations, in view of this rapidly evolving situation.

To the global community

As this is a new coronavirus, and it has been previously shown that similar coronaviruses required substantial efforts to enable regular information sharing and research, the global community should continue to demonstrate solidarity and cooperation, in compliance with Article 44 of the IHR (2005), in supporting each other on the identification of the source of this new virus, its full potential for human-to-human transmission, preparedness for potential importation of cases, and research for developing necessary treatment.

Provide support to low- and middle-income countries to enable their response to this event, as well as to facilitate access to diagnostics, potential vaccines and therapeutics.

Under Article 43 of the IHR, States Parties implementing additional health measures that significantly interfere with international traffic (refusal of entry or departure of international travellers, baggage, cargo, containers, conveyances, goods, and the like, or their delay, for more than 24 hours) are obliged to send to WHO the public health rationale and justification within 48 hours of their implementation. WHO will review the justification and may request countries to reconsider their measures. WHO is required to share with other States Parties the information about measures and the justification received.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General.

The Director-General thanked the Committee for its work.

Source

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