International health

• International Health Regulations (IHR) are legally binding rules that apply to the WHO
• Aim for international collaboration to prevent, protect against, control, and provide a public health response to the international spread of disease
• Avoid unnecessary interference with international traffic and trade
• The IHR grew out of the response to deadly epidemics in Europe
• Create rights and obligations for countries, including the requirement to report public health events
• Outline criteria to determine if an event constitutes a "public health emergency of international concern" (PHEIC)
• The International Health Regulations (IHR) were first adopted by the World Health Assembly in 1969 and last revised in 2005
• The 2005 IHR came into force in June 2007 with 196 binding countries
• Recognize certain public health incidents as Public Health Emergencies of International Concern (PHEIC)
• First fully applied in response to the swine flu pandemic of 2009
• Important notable dates in the history of IHR:
• 1948: World Health Organization Constitution was founded
• 1951: WHO issued its first infectious disease prevention regulations, the International Sanitary Regulations (ISR 1951)
• 1969: ISR revised and renamed the International Health Regulations
• 1973: Amendments made to IHR (1969) in relation to provisions on cholera
• 1981: Smallpox excluded from the list of notifiable diseases under IHR (1969)
• 1995: Agreement to revise IHR (1969) due to limitations in the scope of notifiable diseases
• The IHR provide an overarching legal framework for countries' rights and obligations in handling public health events and emergencies
• Each country must designate a National IHR Focal Point for communication with WHO
• Establish and maintain core capacities for surveillance and response, including at designated points of entry
• Address areas of international travel and transport, safeguarding rights of travellers
• WHO plays a coordinating role in implementing IHR and helps member countries build capacities
• Countries must have the ability to:
• Detect acute public health events in a timely manner
• Assess and report public health events to WHO through their National IHR Focal Point
• Respond to public health risks and emergencies to limit spread to neighboring countries
• The latest IHR is the IHR (2005) with seven areas of work for implementation:
• Foster global partnerships
• Strengthen national disease prevention, surveillance, control, and response systems
• Strengthen public health security in travel and transport
• Strengthen WHO global alert and response systems
• Strengthen the management of specific risks
• Sustain rights, obligations, and procedures
• Conduct studies and monitor progress
• A Public Health Emergency of International Concern (PHEIC) is an extraordinary event that constitutes a public health risk to other states through the international spread of disease
• May require immediate international action
• Diseases declared as PHEIC include H1N1 swine flu pandemic, Ebola virus epidemic, Zika virus outbreak, COVID-19 pandemic, and others
• The IHR 2005 has practical experiences and a broader scope than the 1969 edition
• Covers existing, new, and re-emerging diseases, including emergencies caused by non-infectious disease agents
• International Health involves health activities across two or more countries