WHO Declares COVID-19 No Longer a Public Health Emergency of International Concern

Geneva, Switzerland · 5 May 2023 — World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus announced that COVID-19 is now an established and ongoing health issue which no longer constitutes a Public Health Emergency of International Concern (PHEIC). The declaration, made following the fifteenth meeting of the IHR Emergency Committee on 4 May 2023, ended the highest level of global alert under the International Health Regulations — a status that had been in place since 30 January 2020, a span of three years and four months.

The Emergency Committee highlighted the decreasing trend in COVID-19 deaths, the decline in hospitalisations and intensive care unit admissions, and high levels of population immunity to SARS-CoV-2. While acknowledging remaining uncertainties from potential viral evolution, the committee advised that it was time to transition to long-term management of the pandemic.

The Basis for the Decision

The committee considered the three criteria of a PHEIC: whether COVID-19 continues to constitute an extraordinary event, a public health risk to other States through international spread, and whether it potentially requires a coordinated international response.

The committee acknowledged that although SARS-CoV-2 has been and will continue circulating widely and evolving, it is no longer an unusual or unexpected event. The global risk assessment remained high, but evidence showed reducing risks to human health driven by:

• High population-level immunity from infection, vaccination, or both
• Consistent virulence of currently circulating SARS-CoV-2 Omicron sub-lineages compared to previously circulating ones
• Improved clinical case management
• A significant global decline in weekly deaths, hospitalisations, and ICU admissions

While SARS-CoV-2 continues to evolve, the currently circulating variants did not appear to be associated with increased severity.

A Three-Year Emergency

The COVID-19 PHEIC was declared on 30 January 2020, when fewer than 100 cases had been reported outside China and no deaths had yet been confirmed internationally. Over the following three years, the Emergency Committee convened fifteen times to reassess the situation, issuing temporary recommendations to guide the global response.

The pandemic prompted countries to enhance functional capacities in emergency coordination, collaborative surveillance, clinical care, and risk communications. The committee noted that reaching the point where COVID-19 could be considered as no longer constituting a PHEIC should be seen as an accolade to international coordination and commitment to global health.

Temporary Recommendations for the Transition

The Director-General issued seven temporary recommendations to guide countries through the transition:

1. Sustain national capacity gains and prepare for future events — update respiratory pathogen pandemic preparedness plans and restore health programmes adversely affected by the pandemic.
2. Integrate COVID-19 vaccination into life-course vaccination programmes — maintain efforts to increase coverage for high-priority groups.
3. Bring together diverse respiratory pathogen surveillance data — maintain reporting of mortality, morbidity, and variant surveillance to WHO.
4. Prepare for medical countermeasures to be authorised within national regulatory frameworks — strengthen regulatory authorities for long-term authorisation of vaccines, diagnostics, and therapeutics.
5. Continue risk communications and community engagement — adapt strategies to local contexts and manage infodemics.
6. Continue lifting COVID-19 international travel-related health measures — do not require proof of vaccination as a prerequisite for international travel.
7. Continue to support research — improve vaccines that reduce transmission, understand post-COVID-19 condition, and track viral evolution in immunocompromised populations.

Regulatory Continuity

A key concern during the transition was the regulatory status of vaccines and diagnostics that had received Emergency Use Listing (EUL). The WHO Secretariat confirmed that the Director-General would continue to authorise the EUL procedure, meaning that termination of the PHEIC should not affect access to vaccines and diagnostics already listed. COVAX committed to continuing funded doses and delivery support throughout 2023.

The Road Ahead

The Director-General announced he would convene an IHR Review Committee to advise on Standing Recommendations for the long-term management of SARS-CoV-2, taking into account the 2023–2025 COVID-19 Strategic Preparedness and Response Plan. This plan outlines actions across five areas: collaborative surveillance, community protection, safe and scalable care, access to countermeasures, and emergency coordination.

Simultaneously, Member States were negotiating the Pandemic Prevention, Preparedness, and Response Accord, discussing amendments to the IHR, and considering proposals to strengthen the Global Architecture for Health Emergency Preparedness, Response, and Resilience (HEPR).

The committee advocated that WHO, partners, and States Parties dedicate sustained attention and resources to preparedness and resilience for emerging threats — a call that reflected the hard lessons of a pandemic that claimed millions of lives and reshaped global society.

Sources

• WHO statement, Fifteenth meeting of the IHR Emergency Committee regarding the COVID-19 pandemic, 5 May 2023 — who.int
• WHO 2023–2025 COVID-19 Strategic Preparedness and Response Plan — who.int
• WHO COVID-19 policy briefs — who.int