May 15, 2021 Volume 397 Number 10287 p1781-1858, e12-e14
Problems with traffic light approaches to public health emergencies of international concern
Clare Wenham, et al.
The PHEIC mechanism is a potentially powerful and unique normative tool within the international system to spur collective action. However, PHEICs and the IHR are not perfect. The problems with PHEIC declarations are not about insufficient gradients of a health emergency. Instead, the tension within this global health security mechanism results from states’ refusal to engage in collective action in response to expert advice from an international organisation, particularly when seeing action as against short-term interests: a classic problem in international relations.
Although a non-binary PHEIC might appeal, to some governments and WHO, analysing similar efforts suggests that traffic light systems might only be useful at slowing traffic. A tiered or regional system will introduce bigger problems into global health diplomacy.