What is a Global Health Emergency and Who should decide? Africa CDC’s declaration of a “Public Health Emergency of Continental Security” in a Crisis-Ridden World

On August 14, 2024, the upsurge of mpox across more than a dozen African countries was declared a public health emergency of international concern (PHEIC). 1 As is often the case, the World Health Organization’s (WHO) director-general made this determination on the basis of advice tendered by an expert committee convened under the International Health Regulations (IHR)—the world’s only international agreement on public health emergency prevention, preparedness, and response. 2 The timing of this declaration, however, differed in one crucial respect from past PHEIC declarations: just one day earlier, the Africa Centres for Disease Control and Prevention (Africa CDC) had issued its own regional alert, designating the outbreak a “Public Health Emergency of Continental Security” (PHECS). 3