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International Health Regulations Building international public health security 1| International Health Regulations Why revised International Health Regulations? In today’s world, diseases travel fast and no single country can protect itself on its own. Acknowledging this, the 193 WHO Member States unanimously adopted a new version of the International Health Regulations (IHR). The revised IHR enter into force in June 2007. It will now be up to the world to translate the new code of the Regulations into the reality of greater international public health security. Dr Margaret Chan, WHO Director-General 2| International Health Regulations Our world is changing as never before Populations grow, age, and move Diseases travel fast Microbes adapt Chemical, radiation, food risks increase Health security is at stake 3| International Health Regulations 30 years of international health in security HIV/AIDS ANTHRAX CHERNOBYL SARS PLAGUE MENINGITIS EBOLA / MARBURG CHOLERA NvCJD CHEMICAL NIPAH AVIAN INFLUENZA YELLOW FEVER XDR-TB ... ... 4| International Health Regulations 2003: SARS changes the world Screening of exit passengers 27 March WHO travel recommendations WHO travel recommendations removed 2 April 25 May 120000 SARS: an unknown coronavirus 102 165 • • • • 8098 cases 774 deaths 26 countries affected trends in airline passenger movement drop • economic loss: US$ 60 billion 100000 Number of passenger 23 June 80000 60000 40000 36 116 20000 5| International Health Regulations 6/17 6/14 6/11 6/8 6/5 6/2 5/30 5/27 5/24 5/21 5/18 5/15 5/12 5/9 5/6 5/3 4/30 4/27 4/24 4/21 4/18 4/15 4/12 4/9 4/6 4/3 3/31 3/28 3/25 3/22 3/19 0 3/16 14 670 13 May H5N1: Avian influenza, a pandemic threat 6| International Health Regulations The 58th World Health Assembly adopts the revised International Health Regulations, “IHR” 7| International Health Regulations International public health security is the goal Come into force on 15 June 2007* Ensuring maximum public health security while minimizing interference with international transport and trade Legally binding for WHO and the world’s countries that have agreed to play by the same rules to secure international health. * A later date applies to States that have submitted reservations 8| International Health Regulations What’s new? From three diseases to all public health threats From preset measures to adapted response From control of borders to, also, containment at source 9| International Health Regulations All public health threats The revised IHR recognize that international disease threats have increased Scope has been expanded from cholera, plague and yellow fever to all public health emergencies of international concern They include those caused by infectious diseases, chemical agents, radioactive materials and contaminated food 10 | International Health Regulations Adapted response International public health security is based on strong national public health infrastructure connected to a global alert and response system. This is at the core of the IHR. 11 | International Health Regulations Containment at source Rapid response at the source is: the most effective way to secure maximum protection against international spread of diseases key to limiting unnecessary health-based restrictions on trade and travel 12 | International Health Regulations What do the IHR call for? Strengthened national capacity for surveillance and control, including in travel and transport Prevention, alert and response to international public health emergencies Global partnership and international collaboration Rights, obligations and procedures, and progress monitoring 13 | International Health Regulations Why should countries implement the IHR? To detect and contain public health threats faster, to contribute to international public health security, and to enjoy the benefits of being a respected partner. Countries will receive: WHO assistance in building core capacities WHO’s guidance during outbreak investigation, risk assessment, and response WHO’s advice and logistical support information gathered by WHO about public health risks worldwide assistance to mobilize funding support 14 | International Health Regulations The IHR foster global partnership Other intergovernmental organizations: – UN system (e.g. FAO, IAEA, ICAO, IMO) – others: regional (e.g. EU, ASEAN), technical (e.g. OIE) Development agencies: – governments, banks WHO Collaborating centres Academics & professional associations Industry associations NGOs and Foundations 15 | International Health Regulations Acute public health threats are collectively managed The IHR define a risk management process where States Parties work together, coordinated by WHO, to collectively manage acute public health risks. The key functions of this global system, for States and WHO, are to: detect verify assess inform assist 16 | International Health Regulations WHO to help countries managing events New WHO global Event Management System WHO Regional Alert and Response teams Train countries’ NFPs and WHO contact points for event management Expand GOARN and other specialized and regional support networks Develop new tools and standard operating procedures Carry out IHR exercises 17 | International Health Regulations As each country builds its capacity, the entire world wins The greatest assurance of public health security will come when all countries have in place the capacities for effective surveillance and response, for: infectious diseases radiological-related diseases chemical-related diseases food-related diseases Timeline "As soon as possible but no later than five years from entry into force" 2 years + 3 + (2) + (up to 2) 15 June 2007 2009 Planning 18 | International Health Regulations 2012 Implementation 2014 2016 Countries’ challenges for IHR implementation Mobilize resources and develop national action plans Strengthen national capacities in alert and response Strengthen capacity at ports, airports, and ground crossings Maintaining strong threat-specific readiness for known diseases/risks Rapidly notify WHO of acute public health risks Sustain international and intersectoral collaboration Monitor progress of IHR implementation 19 | International Health Regulations What will WHO do under the IHR? Designate WHO IHR contact points Support States Parties in assessing their public health risks, through the notification, consultation, and verification processes Inform State Parties of relevant international public health risks Recommend adapted public health measures Assist States Parties in their efforts to investigate outbreaks and meet the IHR national requirements for surveillance and response 20 | International Health Regulations Benefit from IHR implementation Lives saved Good international image No unilateral travel and trade restrictions Public trust No political and social turmoil 21 | International Health Regulations www.who.int/ihr International Health Regulations Building international public health security 22 | International Health Regulations