Yellow fever epidemic: New global health emergency?

In their JAMA Viewpoint published online May 9, Daniel Lucey, MD, MPH, and Lawrence O. Gostin, JD, of the O'Neill Institute for National and Global Health Law at Georgetown, explain that the ongoing spread, and potential future spread, of yellow fever coupled with a limited vaccine supply should compel the WHO to "urgently convene an emergency committee to mobilize funds, coordinate an international response, and spearhead a surge in vaccine production."

An epidemic of yellow fever, first reported in January, has been spreading rapidly in Angola. As of last month, the country had 2,023 suspected yellow fever cases and 258 deaths. The Pan American Health Organization (PAHO) declared an epidemiological alert on April 22 for yellow fever in Latin America, where the Aedes aegypti mosquito vector is also actively transmitting Zika and dengue viruses.

Vaccine "supply shortages could spark a health security crisis," say the professors, pointing out that spread of yellow fever has already taken place in Kenya and the Democratic Republic of Congo, where efforts to vaccinate two million people are planned.

"Acting proactively to address the evolving yellow fever epidemic is imperative," they say.

Gostin and Lucey point out that an emergency committee meeting would allow its members to advise the Director-General on the epidemic and trigger discussions about a surge in vaccine production even if a public health emergency of international concern (PHEIC) is not declared.

Finally, the professors say time has come to consider a more efficient way to manage potential public health emergencies.

"The complexities and apparent increased frequency of emerging infectious disease threats, and the catastrophic consequences of delays in the international response, make it no longer tenable to place sole responsibility and authority with the Director-General to convene currently ad hoc emergency committees," Lucey and Gostin write.

Instead, they support establishing a "standing emergency committee" that would meet regularly to advise the Director-General.