Who is the WHO?

By CHHS Extern Meghan Howie

Amid the COVID-19 pandemic, public entities which the public had previously rarely heard became commonplace. One of these is the World Health Organization. The WHO’s role in public health emergencies is commonly discussed- pulling together a global network of experts and governments to provide guidance and resources to address the situation at hand. Given its central position in the COVID-19 pandemic response, it is important to understand not only its many functions in other efforts but also key pieces of context for its efforts.

This international body connects nations, partners, and people to promote health, keep the world safe, and serve the vulnerable. They were established under the 1948 Constitution. Through a UN body called the International Health Conference in 1946. Some of the 61 initial signatories include China, the US, the UK, Venezuela, Ukraine, Switzerland, Turkey, South Africa, etc. Notably, the WHO was not meant to be housed under the UN. The body exists as its own international organization, and 10 of its original signatories were not UN members.

The WHO has grown since its inception. The principal organs are the World Health Assembly, the Executive Board, and the secretariat. Their governing body, the WHA, is a gathering of delegates from all 194 current member states. This assembly determines policy, budgeting, and administrative actions. The Executive Board is made up of individuals “technically qualified in the field of health” from 32 elected member countries. The WHO constitution authorizes the board “to take emergency measures within the functions and financial resources of the Organization to deal with events requiring immediate action. In particular, it may authorize the director-general to take the necessary steps to combat epidemics and to participate in the organization of health relief to victims of a calamity.” The secretariat, headed by the director-general, is responsible for technical and administrative personnel of the WHO. It also coordinates the efforts of localized branches. Much of the on-the-ground work done by the WHO is decentralized aside from coordination coming from the secretariat.

In addition to participating in the assembly and other leadership positions, member states are responsible for funding the organization. Funding is calculated by taking a percentage of GDP from each member state. Voluntary funds may be contributed above that value by nations. Outside partners may also donate voluntarily. According to 2021 funding spreadsheets published by the WHO, the United States has contributed 22% of the annual budget in 2019-2021. Other significant contributors include the United Kingdom (4.56%), Japan (8.56%), Italy (3.3%), Germany (6.09%), and France (4.43%). The total budgetary contributions of member states totaled 977.9 million USD for 2020-2021.

As for the mission areas of the organization, the WHO is involved in emergency management as well as promotion of access to healthcare for all. This takes on many forms. In times of peace, WHO leads efforts to expand universal healthcare and promote healthier lives. They focus on globalized efforts to address social determinants of health outcomes and expansion of healthcare resources in developing nations. (INCLUDE PROGRAMS AND NATIONS) They are continuously monitoring high-impact communicable diseases which do not constantly make the headlines. The ultimate goal is eradication of such diseases. Through broad data collection, the WHO is a resource for understanding the big picture of the world’s health.

In emergencies, the WHO provides a centralized voice of experts around the world outside of state governments. By uniting scientists in a formalized community, nations are provided with learned guidance on the situation and scientific advances are disseminated more quickly. All of this increases efficiency in emergency responses and improves scientific backing in public health policies as related to a constantly evolving global pandemic. Developing nations are also able to find support in creating healthcare policies to respond to unique circumstances. The organization’s role is unifying global efforts in public health and providing resources to nations that request assistance.

One unfortunate reality of entities which rely on funding from certain more centralized sources, like the WHO, is the risk of politicization of their efforts. The risk was laid bare in the Trump administration’s decision to cut US funding to the WHO in April of 2020. No matter the factual background of this decision, the impact of cutting over 20% of the organization’s budget in the beginning stages of a global pandemic left a mark on the policies. Through these circumstances the WHO can be buffeted by the storms of international political discourse.

So, as the world becomes aware of an international organization which provides so much information to the COVID-19 response, it is important to maintain a balanced perspective in interpreting the information coming from the WHO. No organization can completely rid itself of outside influence and bias. The centralization of expert discourse and collaboration among nations is an amazing feat of international cooperation which should not be discounted. However, the influence of powerful nations, as in any international body, must not be underestimated. No matter the source of scientific information, it is important to be informed of the outside biases implicated in publications and press conferences.

Supreme Court Blocks Vaccine Mandate: An Issue of Institutional Competence

By CHHS Extern Jenna Newman

On September 9th, 2021, President Biden first announced the creation of a plan that would require a large number of Americans to receive the COVID-19 vaccination. The Occupational Safety and Health Administration (OSHA) then published the aforementioned vaccine mandate on November 5. The OSHA mandate required workers employed by businesses with at least 100 employees to receive the COVID-19 vaccine, with an exception only allowed for workers who were tested weekly at their own expense and wore a mask each day. The mandate also pre-empted contrary state laws. On January 13, the U.S. Supreme Court stayed OSHA’s COVID-19 vaccine mandate.

The majority on the Court explained that because this order required 84 million Americans to either receive the COVID-19 vaccine or take weekly tests at their own expense, it was not an “everyday exercise of federal power.” The Court further noted that OSHA is tasked with ensuring occupational safety, which includes “safe and healthy working conditions.” The justices speaking for the majority found that this mandate did not set workplace safety standards, rather enacting broad public health measures that went against the original text of the act. They reasoned that “permitting OSHA to regulate the hazards of daily life – simply because most Americans have jobs and face those same risks while on the clock – would significantly expand OSHA’s regulatory authority without clear congressional authorization.” The Court drew a distinction between occupational hazards and risks that occur in the workplace, explaining that COVID-19 is not an occupational hazard that OSHA has the power to regulate. For example, COVID-19 is a universal risk that is present everywhere that people choose to gather, not just in the work-place setting. That is the difference between occupational risks and risks in general.

By contrast, the justices writing for the dissent argued that the OSHA mandate was within the agency’s mission to “protect employees from grave danger that comes from new hazards.” The dissenting justices noted that COVID-19 is a new hazard that poses a grave danger to millions of people, making the OSHA mandate “necessary” to address the dangerous situation. As a result, the dissent found that the majority ruling was at odds with the statutory scheme.

The biggest issue that the case raises surrounds the institutional competence to address the health care crisis. The dissent stated that the underlying dispute “is a single, simple question: Who decides how much protection, and of what kind, American workers need from COVID-19?” The options are either an agency or the Court. While competing arguments exist on both sides, the reality is that the decision is now left up to each individual company. Companies must now weigh the pros and cons of instituting regulations or potentially losing staff. For example, United Airlines and Tyson foods have instituted their own mandates, but others have chosen to not take any action, such as Walmart, Amazon, and JPMorgan Chase.

The institutional competence issue is further shown in the majority opinion in Biden v. Missouri, which was a small win for the Biden administration because it allowed a limited mandate that required health care workers to receive the COVID-19 vaccine if they worked at a facility that received federal funding. Differing significantly from the majority opinion concerning the OSHA mandate, the majority in Biden v. Missouri found that the secretary of health and human services mandate “fell within the authorities that Congress conferred upon him.” The statute that gives authority to the mandate states that the Secretary can make Medicaid and Medicare funds contingent on conditions that “the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services.” Here, the majority found that this limited mandate was within congressional authorization because it ensures that providers are taking to steps to stop the spread of a dangerous virus.

These cases certainly illustrate the challenges that the pandemic has created in interpreting the authority conferred upon agencies by Congress, and what types of regulations go beyond these authorities. In light of the contrasting majority opinions, the institutional competence issue will continue until a consensus is reached on the proper authority of agencies to make vaccine regulations in the workplace.

CHHS Releases Winter 2022 Newsletter

CHHS is proud to release its Winter 2022 newsletter. In this edition, CHHS Founder and Director Michael Greenberger highlights our project work in pandemic response, cybersecurity, economic recovery and more.

CHHS Winter 2022 Newsletter

Be sure to check out our newsletter page for earlier editions: https://www.mdchhs.com/media/newsletters/

 

 

CHHS, University of Maryland Carey School of Law, Enter Historic Partnership with CYBERCOM Academic Network

CHHS, along with the University of Maryland Francis King Carey School of Law, is proud to partner with U.S. Cyber Command (CYBERCOM)i n a nationwide effort to meet cyberspace educational and workforce needs. Maryland Carey Law is the first law school to take part in CYBERCOM’s Academic Engagement Network (AEN), a program designed to create a robust and accessible pool of qualified cyber professionals.

The law school was chosen in large part because of the its well-established cyber law program, developed and lead by CHHS Founder and Director Michael Greenberger, and CHHS Cybersecurity Program Director Markus Rauschecker.

For more information on the partnership, click here. 

Analysis of Court Order Enforcing Title 42 Restrictions on Migrants

By CHHS Extern Cailey Duffy

On September 30th, the U.S. Court of Appeals for the District of Columbia allowed a stay of the September 16th ruling in Huisha-Huisha v. Mayorkas. Circuit judges Rogers, Millett, and Katsas allowed the Biden administration to continue enforcing the Title 42 order while their appeal is in progress. Title 42 was issued under former president Trump in March 2020. It allows the government to prevent certain individuals from entering the U.S. during public health emergencies. Former President Trump cited the coronavirus pandemic as a reason to expel migrants attempting to enter the United States. President Biden has continued this order, deporting over 900,000 migrants, and rationalizing it as a preventative measure to keep detention centers from overflowing during the pandemic. To combat the order, the ACLU filed a preliminary injunction in U.S. District Court, arguing that individuals at the border should be allowed to seek asylum under U.S. law. On September 16th, the injunction was granted.

In his opinion in Huisha-Huisha, Judge Sullivan ruled that Congress is not authorized to expel migrants under Title 42 – it is only allowed to limit who enters. He held the plaintiffs had shown they were likely to suffer irreparable harm as a result of deportation, as many would have to return to violent and unsafe home countries. Furthermore, he argued that the migration would not likely affect coronavirus rates, due to the wide availability of testing and vaccines. The injunction did not prevent the expulsion of single adults, so many individuals were still left with no choice but to be returned to their previous country of residence. The Biden administration appealed, and the appeal was granted. The administration cites the need for the Title 42 order as preventing a surge of migrant families that the nation is unable to handle given the current pandemic. They worry that an influx of migrants would lead to higher rates of COVID-19. However, the administration has not provided evidence that this would actually be the case.

Biden is under pressure from the Republican Party to crack down on migration due to the increasing number of arrests at the border. His critics believe that reversal of former president Trump’s immigration policies has led to an uptick in migration. However, it is more likely this increase in migration is due to political turmoil and food insecurity in nations like El Salvador, Guatemala, and Haiti. While Biden’s administration has exempted unaccompanied children from the Title 42 deportations and is trying to be more lenient with families at the border, many are concerned that the continuance of Title 42 in any capacity contradicts Biden’s campaign promises of a more humane approach to immigration. Biden is surely in a difficult spot, caught between Democratic critics of the Title 42 order and republican critics of his immigration reform. However, categorizing migration as a public health threat is not only speculative, but creates serious humanitarian concerns.

Critical Incident Stress Management and the Emergency Manager

Emergency Managers’ role during an incident requires that decision-making is done under various levels of stress. Emergency Managers experience stress like that of traditional first responders. However, they must operate under additional pressures in complex coordination, fluid response efforts, varying levels of professionals, and political influence. Additionally, decision-making is often required to be made with little or incomplete information. The concern and stress related to unintentional negative outcomes further muddle the decision-making process. The potential effects of stress-causing health issues are quite real. Fortunately, there are actions to offset and mitigate negative effects.

Before the COVID-19 pandemic, and subsequent ongoing response, research showed that Emergency Managers and staff experienced a host of mental and physical health issues, including PTSD, anxiety, depression, heart disease, stroke, and hypertension, to name a few. It is logical to assume that in post-COVID-19 response research and surveys that an increase of these issues will be reported.

For decades, Critical Incident Stress Management (CISM) has been in place to provide military combat veterans, and ultimately civilian first responders (police, fire, ambulance, emergency workers, and disaster rescuers), with a crisis intervention protocol for those who experienced trauma. CISM utilizes techniques by trained professionals (usually in the same field as those needing assistance) to include inner dialogue, coping, debriefing, defusing, and pre-crisis education.

 

Moving forward, recommendations will be made that will include, at a minimum, passing legislation that classifies Emergency Managers as a “high-risk” occupation population. Also recommended is that a statewide team of trained Emergency Managers be assembled and ready for deployment throughout the jurisdictions as needed, either by request or as a courtesy check during, or following, an incident that impacts the state or any of the jurisdictions within the state.

In an upcoming issue of the newsletter, we will further explore the risks to mental and physical health to Emergency Managers, current issues that Emergency Managers are contending with during the COVID-19 response, potential negative impacts to the individuals and the profession as a whole, and recommendations to mitigate the challenges Emergency Managers are facing.

Friday, September 10th: CHHS Presents “Public Health Emergencies 20 Years after 9/11” and “Preventing a Cyber 9/11”

CHHS will be hosting two additional (virtual) panels this week as we approach the 20th anniversary of 9/11. The panels will focus specifically on public health and cybersecurity. We hope you will tune in live this Friday to hear from your colleagues working on these issues.

 

Friday September 10th 1:00pm

Public Health Emergencies 20 Years after 9/11

Join CHHS experts as we discuss the ways the U.S.’ perception and response to public health emergencies has evolved in the past 20 years. Moderated by Public Health Program Director Trudy Henson, panelists include Senior Law and Policy Analyst Christine Gentry, Law and Policy Analyst Jessica Pryor, Public Safety Technology Program Director Chris Webster.

 

Join Zoom Meeting:

https://umaryland.zoom.us/j/99773901036?pwd=QUsyZUUrODljMWhwWXNDc2RKOFJBQT09

Meeting ID: 997 7390 1036

Passcode: 878664

 

Friday September 10th 2:00pm

Preventing a Cyber 9/11

Over the past 20 years, cyber threats have risen to the forefront of challenges that government and the private sector face. Join CHHS’ virtual panel discussion on Friday, September 10 at 2:00pm to learn about what we are doing to help state and local jurisdictions become better prepared for cyber incidents. Additionally, hear about how businesses are addressing cybersecurity threats and navigating the complex landscape of data privacy law from Maryland Carey Law graduate and Cybersecurity and Crisis Management Law Certificate recipient, Rachel Cooper (’17).

 

Panelists: Ben Yelin, JD, CHHS Program Director for Public Policy and External Affairs; Netta Squires, JD, MSL, CEM, CHHS Senior Law and Policy Analyst; Rachel Cooper, JD, Maryland Carey Law Grad ’17, Cyber Security Counsel, McKesson

Moderator: Markus Rauschecker, JD, CHHS Cybersecurity Program Director

Join Zoom Meeting:
https://umaryland.zoom.us/j/97246048273

Meeting ID: 972 4604 8273

No passcode needed

CHHS To Participate In Maryland Carey Law School Anchor Event Commemorating 20th Anniversary of 9/11 Attacks

The program speakers will examine the laws and policies that were adopted in response to the 9/11 terrorist attacks and discuss how effectively these decisions have addressed the changing threats faced by the United States over the last twenty years; specifically, the shift from large, international organizations to decentralized and increasingly domestic actors. Emphasis will also be given to the vast expansion of the “surveillance state” and the ensuing public backlash. The panel will also consider how this approach as impacted the US’s ability to prepare for and respond to other types of emergencies and whether new federal legislation is needed.

The event will take place Monday, August 30th at 12pm ET at the University of Maryland Carey Law School, Room 107 (Overflow Room 108).

For those who are unable to attend in person, the Live Stream can be accessed here: https://www.youtube.com/watch?v=cZtF1QSJHYI

NY Times: The Supreme Court won’t block Indiana University’s vaccine mandate

NY Times: The Supreme Court won’t block Indiana University’s vaccine mandate

 

New: Summer 2021 CHHS Newsletter Released

CHHS has released its semiannual newsletter, which highlights some of the work we’ve done over the past several months. The newsletter includes a welcome message from CHHS Founder and Director Michael Greenberger.

Check it out here:

CHHS Summer 2021 Newsletter