International Health

Regulation
MK. Kebijakan Kesehatan Global
Fakultas Kesehatan Masyarakat
2019
 Learning Objectives

1 Define the concept, scope and objectives of International Health Regulation

2 Discuss the changing paradigm of IHR 1969 to 2005

3 Describe Public Health Emergency of International Concern (PHEIC)

4 Define the criteria used to establish PHEIC

6 Define the Goals and Scope of Asia Pacific Strategy for Emerging Diseases (APSED)

7 Define the risk assessment and discuss management risk in Public Health
 Vignettes
1. Uchenna lived in Nigeria and she suspected had malaria. Her family took
her in local health clinic and the clinic was not open at 11.00 in the
morning. Her family knew that the clinic rarely operated as it was supposed
to and took her instead to the district hospital. She waited for 6 hours to
examined by a doctor and given medicine for malaria.
2. Melissa live in State of Virginia, she had been unemployed, had little
money, and had no health insurance. She had cancer, had debt to doctors
and hospitals for the tests and treatment she had received so far. However,
she needed more treatment, drug, and additional surgery. Several
physicians who would not take her as patient because she had no health
insurance, she was found physicians who would do surgery with low cost.
She died few months later from the cancer.
MK: Kesehatan Global Fakultas Kesehatan Masyarakat Universitas Indonesia
 OUTLINE

1 International Health Regulation (Definition, Scope and Objectives)

2 IHR 1969 to 2005

3 Public Health Emergency of International Concern (PHEIC)

4 Goals and Scope of Asia Pacific Strategy for Emerging Diseases (APSED)
1. International health regulation
(Definition, Scope and Objectives)
 1. International Health Regulation

“…an international legal

instrument that is binding on
196 countries across the
globe, including all the
Member States of WHO”
 1. International Health Regulation

• The purpose and scope of these Regulations are :

a. 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
b. Avoid unnecessary interference with
international traffic and trade.
“Each State Party shall develop, strengthen and maintain, as soon as, possible
but no later than five years, from the entry into force of these, Regulations (…),
the capacity to, detect, assess, notify and report, events in accordance with
these, Regulations… and ... the capacity to, respond promptly and effectively…"
2. The paradigm changed of
IHR 1969 to 2005
2. The Paradigm Changed of IHR 1969 to 2005

The limitation of the IHR (1969) related to narrow scope

(three diseases are Cholera, Plague, and Yellow Fever)

Lack of a formal internationally coordinated mechanism

to contain international disease spread.

Dependence on official country notification

New challenges have arisen in the public health control

of emerging and re-emerging infectious diseases.
2. The Paradigm Changed of IHR 1969 to
2005
Meningkatkan
Menyeragamkan Mengintegrasi dan
kemampuan yang
hukum dalam berkolaborasi dalam
dibutuhkan dalam
pengendalian penyakit implementasi IHR
implementasi IHR

Melaksanakan
Memfasilitasi
pemerikasaan dan
implementasi IHR
pengukuran yang
secara menyeluruh
lengkap dan seragam.

Menjamin semua
negara
mengimplementasikan
IHR
3. Public Health Emergency of
International Concern
(PHEIC)
3. Public Health Emergency of International Concern (PHEIC)

….. in the International Health Regulations as “an extraordinary

event which is determined to constitute a public health risk to other
States through the international spread of disease and to
potentially require a coordinated international response”.

This definition implies a situation that is:

- Serious, sudden, unusual or unexpected;
- Carries implications for public health beyond the affected State’s
national border; and
- May require immediate international action.
 Impact / high risk to
public health.

outbreak or the nature of

the incident is unknown.

Potentially spread
internationally.

Risk to travel or trade.

Apakah kejadian tersebut
merupakan kejadian yang
tidak biasa atau tidak
diharapkan?
Apakah kejadian tersebut
merupakan kejadian yang tidak
biasa?

Apakah kejadian tersebut

merupakan kejadian yang tidak
diperkirakan dipandang dari
segi kesehatan masyarakat ?
Apakah ada risiko signifikan yang
berpotensi menyebabkan
penyebaran secara internasional?

Apakah secara Apakah ada faktor-faktor

epidemiologi terdapat yang memerlukan
bukti kejadian yang kewaspadaan terhadap
serupa di negara lain? potensi penyebaran
lintas negara, baik dari
penyebab, perantara,
maupun agen penular?

Adakah kesamaan kejadian ini
dengan penyebab terjadinya
hambatan pada perjalanan atau
perdagangan internasional yang
lalu?
Apakah sumber yang diduga
atau diketahui sebagai produk
makanan, air, atau barang yang
mungkin terkontaminasi, telah
diekspor/impor dari suatu
negara?

Apakah ada risiko signifikan yang

berpotensi menimbulkan
hambatan pada perjalanan dan
perdagangan internasional?

Apakah kejadian berhubungan

dengan pertemuan
internasional atau terjadi di
wilayah dengan kunjungan
wisatawan internasional yang
tinggi?
Apakah kejadian menimbulkan
permintaan informasi dari
kantor atau media asing?
Asia Pacific Strategy
for Emerging Diseases
Wilayah Asia Pasifik yang siap
untuk mitigasi risiko dan
dampak dari emerging diseases
dan kedaruratan kesehatan
masyarakat lainnya lewat
tanggung jawab kolektif untuk
keamanan kesehatan
masyarakat.
VISION
2010
GOALS
Untuk membangun kapasitas
nasional dan regional yang
berkelanjutan dan kerjasama untuk
memastikan keamanan kesehatan
masyarakat lewat perencanaan
kesiapsiagaan (preparedness
planning), pencegahan, deteksi dini
dan respon cepat atas emerging
diseases dan kedaruratan kesehatan
masyarakat lainnya.
6. Goals and Scope of Asia Pacific
Strategy for Emerging Diseases (APSED)
6. Goals and Scope of Asia Pacific Strategy
for Emerging Diseases (APSED)
6. Goals and Scope of Asia Pacific Strategy
for Emerging Diseases (APSED)
a. Surveillance,
risk assessment b. Laboratories c. Zoonosis
and response

d. Infection f. Public health

e. Risk
prevention and emergency
communications
control; preparedness

g. Regional
h. Monitoring and
preparedness,
evaluation.
alert and response
 Learning Objectives Accomplished

 Describe theterms
Define the main function
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health, and global health

 Review
Discusshow health
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examples arepublic
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Discussselected examples of
some examples health system
of global health activities

 Outline
Describekeysome
healthofsystem issues and
the guiding how they
principles ofmight
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work

 Describe
Describe how health
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health

Describe
Brieflysome examples
discuss theof global
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public and privatesmallpox
eradicate sector cooperation in health services delivery

Reference : Global Health 101 2nd Edition, Richard Skolnik, 2012

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