 Poster: Assessment & Notification of Public Health Events (PDF, 1.5 Mb)
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IHR Brochure: Basic information for national policy-makers and partners (PDF)
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 Special Coverage of the Entry into Force of the Revised IHR, 15 June 2007
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Key WHO Documents
- National IHR Focal Points: The Designation or Establishment of National IHR Focal Points
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- IHR (2005) Voluntary Applications: Application of the International Health Regulations (2005)
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- IHR (2005): Revision of the International Health Regulations
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Main WHO Resources
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Dr. Marlo Libel, Regional Advisor on Communicable Diseases
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Input from Regional Consultation Meetings, Americas
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Background: The International Health Regulations (IHR) represents the earliest multilateral initiative to develop an effective framework to prevent the international spread of disease. The IHR was first adopted in 1969 to monitor, report, and control six communicable diseases: cholera, plague, yellow fever, smallpox, relapsing fever, and typhus. In 1973, the IHR was amended to include additional provisions for cholera; and in 1981, it was subsequently revised to exclude smallpox, eradicated by an unprecedented international effort. By that time the diseases reportable to WHO were only cholera, plague, and yellow fever (IHR [1969]).
Revision Process: After an extensive revision process, the World Health Assembly (WHA) adopted on 23 May 2005 the revised International Health Regulations or IHR (2005).
The Revised Regulations:
IHR (2005)
The purpose of the revised IHR (2005) is to "prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade."
For the purposes of these Regulations, the term "public health emergency of international concern" (PHEIC) was introduced to define "an extraordinary event which is determined to:
- constitute a public health risk to other States through the international spread of disease and
- potentially require a coordinated international response".
A decision instrument and the criteria for assessment and notification of events that may constitute a PHEIC were adopted and are found in Annex 2. Regarding its implementation, IHR (2005) stipulates that countries shall develop, strengthen and maintain core capacities to detect, assess and intervene so as to control public health events of international concern (Annex 1). It also specifies the obligations that WHO's headquarters, regional and country offices are to meet.
On 26 May 2006, the WHA adopted Resolution WHA59.2 regarding the application of the IHR (2005), taking into consideration the serious risk to human health, arising from ongoing outbreaks in poultry and humans of highly pathogenic avian influenza, caused by the H5N1 strain of Influenza virus A. This resolution calls upon WHO Member States to comply immediately, on a voluntary basis, with provisions of the International Health Regulations (2005) considered relevant to the risk posed by avian influenza and pandemic influenza. It is also recognized in this resolution that strengthening the "capacity to respond to human cases of avian influenza and the corresponding pandemic threat will strengthen the capacity to respond to many other emerging and epidemic-prone infectious diseases, and thus increase global public health security against the threat of infectious diseases."
Actions Taken by PAHO and its Member Countries
The Pan American Health Organization (PAHO) has been actively involved since the beginning of the IHR revision process. PAHO worked with Member States to obtain their comments on the proposed revisions and to keep them informed on the progress made. An IHR Task Force was created and then expanded its terms of reference to become a PAHO Epidemic and Alert and Response Task Force, which is currently in charge of developing the regional response plan for influenza pandemic preparedness. This Task Force includes all Areas of the Organization involved in providing technical cooperation to countries including the Communicable Diseases Unit as lead to its implementation, Legal Affairs, Veterinary Public Health, Disaster Preparedness and Emergency Relief, Vaccines and Immunization, Technology and Health Services Delivery (Essential Medicines and Laboratories), Sustainable Development and Environmental Health, Health Policies and Systems, and Public Information.
The upcoming entry into force of the International Health Regulations (2005) represents a major step forward for the international action and cooperation in the fight against the spread of epidemics. As we are approaching 15 June 2007—the date of entry into force of the IHR (2005), taking into consideration that countries unanimously agreed to their early application—PAHO has to accelerate the implementation preparations both at the regional and national level.
Compliance with these modern regulations will ensure that the world is not taken by surprise when outbreaks occur and that disruption to travel, commerce, and business activities are minimized. |
Until the entry into force of the IHR (2005) on 15 June 2007, Member States and the Secretariat are focusing their attention on the
- Designation or establishment of National Focal Points according to the National IHR Focal Point Guide.
- Increasing awareness on the IHR (2005) provisions among the decision-makers, health professionals and other sectors involved in the IHR implementation, through subregional meetings by June 2007.
- Identification of technical cooperation needs for IHR (2005) implementation after the national assessments of capacities for surveillance of and response to PHEIC and point of entries by 2009.
- Evaluation of progress made in IHR (2005) implementation, annually after 2007.
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