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1International Health Regulations (2005)

Guidance for national policy-makers and partners

International

Health Regulations

2005 Guidancefor nationalpolicy-makersand partners

2International Health Regulations (2005)Guidance for national policy-makers and partners

OBLIGATIONS

OPPORTUNITIES

• If your country is a WHO Member State, it may become aparty to the new International Health Regulations, namelyIHR (2005), in June 2007.

• You will have new obligations to prevent and control thespread of disease inside and outside your borders. In doingso, your country is expected to improve its public healthcapabilities.

• WHO will be mandated to assist all its Member States infulfilling the new obligations.

• The new Regulations also offer you new opportunitiesto strengthen the public health capacities andcollaborate with each other and with WHO.

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Background

• The International Health Regulations (1969), the legallybinding international agreement to prevent the spread ofdisease, were revised in May 2005. The new Regulations willenter into force in June 2007.

• The current Regulations,adopted in 1969, applied to onlythree infectious diseases – cholera,plague and yellow fever. However,the world is a much different placenow. We all are living in a global“village”. International travel iscommonplace. Diseases can travelat the speed of jetliners. Severeacute respiratory syndrome (SARS)

WHO


was the first disease of the 21st century to expose ourvulnerabilities. It will not be the last.

• To meet these challenges, the new Regulations have a greatlyexpanded scope. They apply to diseases (including thosewith new and unknown causes), irrespective of origin orsource, that present significant harm to humans. Theyaddress weaknesses learnt in past decades in detecting andresponding to disease outbreaks. IHR (2005) aim atprotecting global health security with the least interferenceto global travel and trade.

• By adopting IHR (2005) the global community has agreedthat it will work together to meet these challenges. In areassuch as planning for a possible influenza pandemic, IHR(2005) provide a framework for mobilizing support fromgovernments and donors and for responding to an influenzapandemic.



Which countries must

comply

• Adopted at the Fifty-eight World Health Assembly in Genevain May 2005, the IHR (2005) become legally binding in anyWHO Member State that does not reject or reserve againstthem by December 2006. Countries’ reservations must notbe incompatible with the object and purpose of the newRegulations. Achieving the goal of IHR (2005) largely lieswith all countries.

WHO assistance

• Meeting new requirements will be challenging for manycountries. WHO has been mandated to provide its MemberStates with technical assistance in strengthening theirpublic health capacities and in facilitating theimplementation of IHR (2005). WHO will also mobilizeresources necessary for this purpose.

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What your country is

expected to do

••••• Your country must designate or establish a National IHRFocal Point (NFP), which should be a national centre, NOTan individual person.

National IHR Focal Point will

• be accessible at all times;

• communicate with WHO concerning IHRimplementation, including:

- consultation, notification, verification andassessment

- public health response; and

• coordinate with other ministries/sectors withinthe country.

• Your country is expected to respond to WHO’s requests forverification of information (including unofficial reports)regarding public health risk.

• Your country should notify WHO of all events that mayconstitute a public health emergency of internationalconcern, within 24 hours of assessment, by using a decisioninstrument – a flow chart that goes through the criteria forassessment and notification. The box below lists thesecriteria. Such a notification does not necessarily mean a realpublic health emergency of international concern. It is a startof consultation and collaboration process between thecountry and WHO.



Four criteria for assessment and notification

Is the public health impact of the event serious?

Is the event unusual or unexpected?

Is there a significant risk of international spread?

Is there a significant risk of restrictions oninternational travel or trade?

Answering “yes” to any two of the criteria requires acountry to notify WHO.

Examples attached to the Decision Instrument will helpyou work through these steps.


••••• Your country should start assessing the existing publichealth system, and improving its capacity for the detection,reporting and assessment of and response to public healthevents to meet the minimum core capacity requirementsunder IHR (2005).

It might be best for countries to consider parallel developmentof their national influenza pandemic preparedness plan andtheir plans to meet the increased demands of IHR (2005).Partners (including donors) concerned about the threat of aninfluenza pandemic will understand the need and prioritiesfor improving national disease surveillance and responsecapacities.



Actions to meet these

expectations

• It is time for Member States to make political commitmentsand mobilize necessary resources that will guarantee theeffective implementation of the new Regulations. Thisincludes ensuring that your national legislation iscompatible with IHR (2005).

• Together with WHO and other partners, Member Statesshould start assessing and strengthening their public healthcapacities to meet the core capacity requirements under IHR(2005).

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in briefin briefin briefin briefin briefMember States’ key

obligations

1. Designate or establish a National IHR Focal Point.

2. Strengthen and maintain the capacity to detect, report andrespond rapidly to public health events.

3. Respond to requests for verification of information regardingpublic health risk.



4. Assess public health events by using the decision instrumentand notify WHO, within 24 hours, of all events that mayconstitute a public health emergency of internationalconcern.

5. Provide routine inspection and control activities atdesignated international airports, ports and groundcrossings to prevent the international spread of disease.

6. Make every effort to implement WHO-recommendedmeasures.

7. Collaborate with each other and with WHO concerning IHR(2005) implementation.


Member States’ benefits

While your country is fulfilling the obligations, it willenjoy the benefits of a respected partner in theinternational effort to maintain global health security.

••••• Your country will receive WHO guidance in building thecore capacities necessary to quickly detect, report, assessand respond to public health emergencies, includingthose of national and international concern.vvvvvvvvvvvvv

••••• Your country will be given technical assistance and possiblefunding support to meet these new responsibilities.



••••• Your country will receive WHO guidance during the outbreakverification process.vvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvvv

••••• Your country will have access to privileged informationgathered by WHO about public health threats in othercountries that might affect you.

••••• WHO will give you advice and logistical support, whenrequested, to respond to disease outbreaks and other publichealth events.

••••• Your country will have accessto WHO’s Global OutbreakAlert and Response Network(GOARN), a “one-stop shop” ofglobal resources to helpmanage a public healthemergency, including those ofinternational concern.


WHO’s responsibilities

WHO also has increased responsibilities under IHR(2005). WHO will strengthen its ability to fulfil thosebroadened obligations.

WHO’s major tasks include:

• designating WHO IHR (2005) contact points;

• conducting global surveillance and intelligence gatheringto detect significant public health risks;

• supporting Member States’ efforts to assess their existingnational public health structures and resources;

• supporting Member States’ efforts to build and strengthenthe core capacities for surveillance and response, and atdesignated points of entry;

• assessing relevant events (including on-site assessment,when necessary) and determining whether or not a particularevent constitutes a public health emergency of internationalconcern, with the advice of a committee of external experts;



More information about IHR (2005) can be found athttp://www.wpro.who.int/health_topics/ihr/generalinfo.htm and http://www.who.int/csr/ihr/

You may also wish to obtain more information [email protected]

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• developing and recommending measures for use by MemberStates during a public health emergency of internationalconcern (with advice from a committee of external experts);

••••• providing technical assistance to Member States in theirresponse to public health emergencies of internationalconcern; and

• updating IHR (2005), its annexes and guidelines to maintainits scientific and regulatory validity.vvvvvvvvvvvvv

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