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

l HIV/AIDS l ANTHRAX

l CHERNOBYL l SARS

l PLAGUE l MENINGITIS

l EBOLA / MARBURG l CHOLERA

l NvCJD l CHEMICAL

l NIPAH l AVIAN INFLUENZA

l YELLOW FEVER l XDR-TB

l ... l ...

4| International Health Regulations

 2003: SARS changes the world
Screening of exit passengers WHO travel recommendations WHO travel recommendations removed
27 March 2 April 25 May 23 June

120000
SARS: an unknown coronavirus
102 165
100000
• 8098 cases
• 774 deaths
• 26 countries affected
80000
• trends in airline passenger
Number of passenger

movement drop
60000 • economic loss: US$ 60 billion

40000
36 116

20000

14 670
13 May
0

6/2
6/5
6/8

6/14
6/17
5/21
5/24
5/27
5/30
5/3
5/6
5/9

5/15
5/18

6/11
4/3
4/6
4/9
3/16
3/19
3/22
3/25
3/28
3/31

4/12
4/15
4/18
4/21
4/24
4/27
4/30

5/12

5| International Health Regulations

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?

l From three diseases to all public health threats

l From preset measures to adapted response
l From control of borders to, also, containment at source

9| International Health Regulations

 All public health threats

l The revised IHR recognize that international

disease threats have increased

l Scope has been expanded from cholera,

plague and yellow fever to all public health
emergencies of international concern

l 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:

l the most effective way to secure
maximum protection against
international spread of diseases
l key to limiting unnecessary
health-based restrictions on
trade and travel

12 | International Health Regulations

 What do the IHR call for?

l Strengthened national capacity for

surveillance and control, including in
travel and transport
l Prevention, alert and response to
international public health emergencies
l Global partnership and international
collaboration
l 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:
l WHO assistance in building core capacities
l WHO’s guidance during outbreak investigation,
risk assessment, and response
l WHO’s advice and logistical support
l information gathered by WHO about public
health risks worldwide
l assistance to mobilize funding support

14 | International Health Regulations

 The IHR foster global partnership

l Other intergovernmental organizations:

– UN system (e.g. FAO, IAEA, ICAO, IMO)
– others: regional (e.g. EU, ASEAN), technical (e.g. OIE)
l Development agencies:
– governments, banks
l WHO Collaborating centres
l Academics & professional associations
l Industry associations
l 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:
l detect
l verify
l assess
l inform
l assist

16 | International Health Regulations

 WHO to help countries managing events

l New WHO global Event Management System

l WHO Regional Alert and Response teams
l Train countries’ NFPs and WHO contact points for event management
l Expand GOARN and other specialized
and regional support networks
l Develop new tools and standard
operating procedures
l 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:
l infectious diseases l radiological-related diseases
l chemical-related diseases l 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 2012 2014 2016

Planning Implementation

18 | International Health Regulations

Countries’ challenges for IHR implementation

l Mobilize resources and develop national action plans

l Strengthen national capacities in alert and response
l Strengthen capacity at ports, airports, and ground crossings
l Maintaining strong threat-specific readiness for known diseases/risks
l Rapidly notify WHO of acute public health risks
l Sustain international and intersectoral collaboration
l Monitor progress of IHR implementation

19 | International Health Regulations

 What will WHO do under the IHR?

l Designate WHO IHR contact points

l Support States Parties in assessing their public health risks, through

the notification, consultation, and verification processes

l Inform State Parties of relevant international public health risks

l Recommend adapted public health measures

l 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

l Lives saved

l Good international image

l No unilateral travel and trade restrictions

l Public trust

l 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