Public Health Emergency of International Concern second PHEIC was issued in May 2014 with the resurgence of polio after its near-eradication, deemed "an extraordinary event." On Friday, August 8, 2014, the World Health Organization declared its third Public Health Emergency of International Concern in response to the outbreak of Ebola in Western Africa. On Monday, February 1, 2016, the World Health Organization declared its fourth PHEIC in response to clusters of microcephaly and Guillain–Barré syndrome in the Americas, which at the time were suspected to be associated with the ongoing outbreak of Zika virus. Later research and evidence bore out these concerns; in April, the WHO
International Association of National Public Health Institutes a comprehensive NPHI focusing on collecting data to inform public health decisions. That will require significant organizational, human resource, and infrastructure changes. Without a central reference lab or adequate human resources, NIH cannot quickly identify major disease threats or outbreaks nor contain them. IANPHI is partnering with Brazil's FIOCRUZ, and architects HDR CUH2A's Design 4 Others to help Mozambique strengthen disease monitoring and outbreak investigation, create a formal system to collect and analyze health data to promote evidence-based decision making, and build a coordinated system of public health laboratories, linked to a new NPHI facility. The U.S. CDC in Maputo