The document summarizes the International Health Regulations (IHR), which were revised in 2005 and entered into force in 2007. The IHR aim to help countries work together to detect and respond to public health threats, and minimize interference with international trade and travel. Key points of the revised IHR include expanding their scope to cover all public health emergencies instead of just three diseases, promoting rapid response at the source of outbreaks, and strengthening national and global surveillance and response capabilities. The IHR also establish procedures for international collaboration and information sharing during public health events.

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International
Health Regulations
Building international public health security

2. International Health Regulations
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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

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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

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30 years of international health in security
 HIV/AIDS
 CHERNOBYL
 PLAGUE
 EBOLA / MARBURG
 NvCJD
 NIPAH
 YELLOW FEVER
 ...
 ANTHRAX
 SARS
 MENINGITIS
 CHOLERA
 CHEMICAL
 AVIAN INFLUENZA
 XDR-TB
 ...

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0
20000
40000
60000
80000
100000
120000
3/16
3/19
3/22
3/25
3/28
3/31
4/3
4/6
4/9
4/12
4/15
4/18
4/21
4/24
4/27
4/30
5/3
5/6
5/9
5/12
5/15
5/18
5/21
5/24
5/27
5/30
6/2
6/5
6/8
6/11
6/14
6/17
Number
of
passenger
WHO travel recommendations removed
36 116
WHO travel recommendations
2 April
14 670
13 May
102 165
25 May
27 March 23 June
Screening of exit passengers
SARS: an unknown coronavirus
• 8098 cases
• 774 deaths
• 26 countries affected
• trends in airline passenger
movement drop
• economic loss: US$ 60 billion
2003: SARS changes the world

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H5N1: Avian influenza, a pandemic threat

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The 58th World Health Assembly adopts
the revised International Health Regulations, “IHR”

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International public health security is the goal
Ensuring maximum public health security
while minimizing interference with international
transport and trade
Come into force on 15 June 2007*
* A later date applies to States that have submitted reservations
Legally binding for WHO and the world’s countries that have agreed
to play by the same rules to secure international health.

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What’s new?
 From three diseases to all public health threats
 From preset measures to adapted response
 From control of borders to, also, containment at source

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All public health threats
 The revised IHR recognize that international
disease threats have increased
 Scope has been expanded from cholera,
plague and yellow fever to all public health
emergencies of international concern
 They include those caused by infectious
diseases, chemical agents, radioactive
materials and contaminated food

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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.

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Containment at source
Rapid response at the source is:
 the most effective way to secure
maximum protection against
international spread of diseases
 key to limiting unnecessary
health-based restrictions on
trade and travel

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What do the IHR call for?
 Strengthened national capacity for
surveillance and control, including in
travel and transport
 Prevention, alert and response to
international public health emergencies
 Global partnership and international
collaboration
 Rights, obligations and procedures,
and progress monitoring

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Why should countries implement the IHR?
Countries will receive:
 WHO assistance in building core capacities
 WHO’s guidance during outbreak investigation,
risk assessment, and response
 WHO’s advice and logistical support
 information gathered by WHO about public
health risks worldwide
 assistance to mobilize funding support
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.

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The IHR foster global partnership
 Other intergovernmental organizations:
– UN system (e.g. FAO, IAEA, ICAO, IMO)
– others: regional (e.g. EU, ASEAN), technical (e.g. OIE)
 Development agencies:
– governments, banks
 WHO Collaborating centres
 Academics & professional associations
 Industry associations
 NGOs and Foundations

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Acute public health threats
are collectively managed
The key functions of this global system, for States and WHO, are to:
 detect
 verify
 assess
 inform
 assist
The IHR define a risk management process where States Parties work together,
coordinated by WHO, to collectively manage acute public health risks.

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WHO to help countries managing events
 New WHO global Event Management System
 WHO Regional Alert and Response teams
 Train countries’ NFPs and WHO contact points for event management
 Expand GOARN and other specialized
and regional support networks
 Develop new tools and standard
operating procedures
 Carry out IHR exercises

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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:
 infectious diseases  radiological-related diseases
 chemical-related diseases  food-related diseases
Timeline
15 June 2007 2009 2012 2014 2016
Planning Implementation
2 years + 3 + (2) + (up to 2)
"As soon as possible but no later than five years from entry into force"

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

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What will WHO do under the IHR?
 Designate WHO IHR contact points
 Support States Parties in assessing their public health risks, through
the notification, consultation, and verification processes
 Inform State Parties of relevant international public health risks
 Recommend adapted public health measures
 Assist States Parties in their efforts to investigate outbreaks and
meet the IHR national requirements for surveillance and response

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 Lives saved
 Good international image
 No unilateral travel and trade restrictions
 Public trust
 No political and social turmoil
Benefit from IHR implementation

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International
Health Regulations
Building international public health security
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