take into account factors that include the risk to human health and international spread as well as advice from an international committee of experts, the IHR Emergency Committee (EC), one of whom should be an expert nominated by the State within whose region the event arises. Rather than being a standing committee, the EC is created on an ad hoc basis. Until 2011, the names of IHR EC members were not publicly disclosed; in the wake of reforms, now they are. These members are selected according to the disease in question and the nature of the event. Names are taken from the IHR Experts Roster. The director-general takes the advice of the EC, following their technical assessment of the crisis using legal criteria and a predetermined algorithm after a review of all available data on the event. Upon declaration, the EC then makes recommendations on what actions the director-general and member states should take to address the crisis. The recommendations are temporary and require review every three months while in place. Declarations Summary of PHEIC declarations Swine flu (2009) In the spring of 2009, a novel influenza A (H1N1) virus emerged. It was detected first in Mexico, North America. It spread quickly across the United States and the world. On 26 April 2009, more than one month after its first emergence, the initial PHEIC was declared when the H1N1 (or swine flu) pandemic was still in phase three. Within three hours on the same day, the WHO web site received almost two million visits, necessitating a dedicated web site for the swine influenza pandemic. At the time that H1N1 had been declared a PHEIC, it had occurred in only three countries. Therefore, it was argued that the declaration of the H1N1 outbreak as a PHEIC, was fueling public fear. A 2013 study sponsored by the WHO estimated that, although similar in magnitude to seasonal influenza, it cost more life-years than seasonal flu, due to a shift toward mortality among persons less than 65 years of age. Polio (2014–present) The second PHEIC was the 2014 polio declaration, issued on 5 May 2014 with a rise in cases of wild polio and circulating vaccine-derived poliovirus. The status achieved, as global eradication, was deemed to be at risk by air travel and border crossing overland, with small numbers of cases in Afghanistan, Pakistan, and Nigeria. In October 2019, continuing cases of wild polio