The world faces an increasing number of emergencies with health consequences from all hazards, including infectious disease outbreaks, conflicts, natural disasters, chemical or radio-nuclear spills and food contamination.

Many emergencies can be complex, with more than one cause, and can have significant public health, social, economic and political impacts. WHO has specific responsibilities and accountabilities for emergency operations under the International Health Regulations (IHR) (2005) and within the global humanitarian system as the Interagency Standing Committee (IASC) Global Health Cluster Lead Agency.

These responsibilities begin with early detection and risk assessment or situation analysis of a public health event or emergency. Events or emergencies requiring an operational response by WHO are referred for grading.

This page describes the grading process, definitions of various grades, and the criteria for grading. WHO uses three levels of emergency grades; emergencies that continue for more than six months may be defined as protracted crises, which also have three grades.

The grading assigned to an acute emergency indicates the level of operational response required by WHO for that emergency. WHO’s immediate operational response to acute events and emergencies is not dependent on grading. If the risk assessment or situation analysis indicates the need for an operational response, WHO immediately repurposes the country office(s), initiates response activities and then proceeds to grading within a maximum of 24 hours of the analysis. Protracted emergencies (that persist for longer than 6 months) are assigned protracted grades to indicate the level of operational response to be sustained by WHO over a prolonged, often indefinite period.

Grading is an internal WHO process that is conducted to:

• Activate WHO’s Incident Management System and Emergency SOPs
• Inform the Organization of the level of WHO’s operational response to an emergency and the need for mobilization of internal and external resources
• Determine the need for a surge of additional human and material resources
• Permit the use of resources from the CFE above US$ 50,000
• Convey to partners, donors and other stakeholders WHO’s assessment of the scale of unmet needs within the health sector and, by extension, the requirement for additional international resources.

• Any public health event with a risk assessed as high or very high;
• Any public health event with a risk assessed as moderate or low, but that requires an operational response by WHO;
• Any emergency situation for which the initial situation analysis indicates a health impact likely to require an operational response by WHO;
• Any request for emergency assistance from a Member State.

For acute events and emergencies, the grading exercise is conducted within 24 hours of:

• A risk assessment that characterizes an acute event as high or very high risk.
• A situation analysis that indicates the likely need for an operational response by WHO to a sudden onset emergency, e.g. earthquake, tropical storm.
  

For moderate risks or slower onset events, e.g. due to conflict or drought, grading may only happen several days after initial assessment.