Countries Call for Early Compliance with Health Regulations

The assembly called for compliance with new provisions that require countries to notify WHO within 24 hours of any case of avian influenza in humans. To facilitate notification, every member country is urged to appoint, within 90 days, a national IHR Focal Point, while WHO is expected to name counterpart IHR Contact Points at headquarters and in its regional offices.

The new provisions allow WHO to gather information from unofficial sources, and they spell out when and how the organization may share information about human cases of avian or pandemic flu in Member States. The provisions allow WHO to make information about outbreaks in one country available to other member countries when:

• The director-general formally determines that the outbreak is a "public health emergency of international concern."
• There is evidence that the disease has already spread internationally.
• Control measures do not appear likely to succeed.
• The affected country is not capable of preventing further spread of the disease.
• The threat of the disease spreading through the international movement of people and goods is so great that international control measures are needed immediately.

According to the IHR, WHO may inform the general public about such an event if information about it has already become public and "there is a need for the dissemination of authoritative and independent information."

In addition, the accelerated provisions detail procedures that WHO's director-general should follow in making recommendations for controlling the spread of avian or pandemic flu through international travel and trade. After consulting with member governments and an expert Emergency Committee, he or she may recommend measures such as exit screening, refused entry for suspected cases, isolation and treatment of affected travelers, required vaccination or prophylaxis, and required medical exams. Other recommendations could include decontamination of baggage, cargo, and conveyances (planes, ships, vehicles) or seizure of contaminated goods or containers.

In addition to urging accelerated compliance with the IHR, the assembly urged countries to strengthen their capacities in the areas of surveillance and reporting, vaccine production, and pandemic planning. To support these efforts, WHO has established a Pandemic Influenza Task Force and is mobilizing additional resources to help it increase technical cooperation in these areas.

The original IHR, adopted in 1951, were issued to monitor and control six serious infectious diseases: cholera, plague, yellow fever, smallpox, relapsing fever, and typhus. After revisions in 1969, only cholera, plague, and yellow fever were notifiable.

The emergence in the early 1990s of new infectious diseases such as Ebola hemorrhagic fever prompted the 1995 World Health Assembly to call for revisions in the IHR. After a number of drafts, a new set of regulations was finally approved by the 2005 assembly and was set to go into effect in June 2007. However, growing concern over avian influenza and the threat of a human pandemic persuaded WHO member countries that immediate compliance with some of the new regulations could help avert or respond to these threats.