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 and Canada, were created following poorly managed threats such as Ebola and SARS, in recognition that a coordinated system with a specialized institution is needed to effectively respond to disease threats. NPHIs usually lead national efforts for disease surveillance and outbreak investigation (to monitor population health trends and detect and resolve outbreaks), laboratory services (to identify and confirm disease threats), health programs (including recommendations for immunizations and maternal and child health initiatives), and public health workforce development and research (including new treatments and technologies). NPHIs are designed to give governments the ability to assess and address major acute and long-term