international health regulation
RULES AND GUIDELINES OF INTERNATIONAL HEALTH REGULATIONS:
International health regulations evolution:
The IHR originated with ISR adapted at the international sanitary conference in Paris in 1851
Cholera epidemic 🡪 Europe 🡪1830 & 1847
Need international cooperation
22nd World Health Assembly (1969) adopted, revised and consolidated the international sanitary regulations, renames as IHR in 1969
26th World Health Assembly 1973🡪amendment in IHR
Thirty-fourth World Health Assembly amended the IHR (1969) to exclude smallpox in the list of notifiable diseases.
During the Forty-Eighth World Health Assembly in 1995, WHO and Member States agreed on the need to revise the IHR (1969) most notably:
narrow scope of notifiable diseases (cholera, plague, yellow fever),
The past few decades have seen the emergence and re-emergence of infectious diseases.
The emergence of “new” infectious agents Ebola, Hemorrhagic Fever and the re-emergence of cholera and plague in South America and India, respectively;
dependence on official country notification; and
lack of a formal internationally coordinated mechanism to prevent the international spread of disease.
These challenges were placed against the backdrop of the increased travel and trade characteristic of the 20th century.
The IHR (2005) entered into force, generally, on 15 June 2007, and are currently binding on 194 countries (States Parties) across the globe, including all 193 Member States of WHO.
summary:
The International Health Regulations (IHR) are an international legal instrument that covers measures for preventing the transnational spread of infectious diseases.
IHR is an instrument of international law that is legally binding on countries.
IHR is a set of regulations that is legally binding upon 196 state parties.
This legal binding is adopted by 196 countries, including all (194) WHO member states.
IHR is a benchmark to state the rights and obligations of countries to report public health actions.
The objective of IHR is to work together to protect global health security.
IHR are the international agreements with the objective of preventing the spread of public health threats without unnecessary impairment of international travel and trade.
The IHR was adopted by the 58th World Health Assembly in 2005 through Resolution WHA 58.3.
International Health was in action since 15 June 2007
The International Health Regulations (IHR 2005) are a set of regulations legally binding on 196 States Parties, including all WHO Member States. They contribute to global public health security by providing a new framework for the coordination of the management of events that may constitute a public health emergency of international concern, and improve the capacity of all countries to detect, assess, notify and respond to public health threats.
The IHR were adopted at the Fifty-eighth World Health Assembly on 23 May 2005 and entered into force on 15 June 2007.
India being a developing country with growing population has been traditionally vulnerable to natural and man made disasters.
Development cannot be sustainable unless disaster mitigation is built into developmental process.
Disaster could be a nature calamity, outbreak of disease, bioterrorism, etc.
New Delhi, Feb 23. The health ministry has proposed a bill that seeks to empower state and local authorities to take appropriate actions to tackle public health emergencies like epidemics and bio-terrorism.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Overview of International Health Regulaiton - IHR 2005, AfghanistanIslam Saeed
International Health Regulation and its implementation in Afghanistan was prepared by Dr. islam Saeed, Director for Surveillance/DEWS in MoPH Afghanistan
This presentation contains in brief about various Non-communicable diseases (NCDs) and International interventions to combat NCDs. It also contains recent updates on current problem statement of common NCDs and updates on National Programme for Prevention and Control of non-Communicable Diseases (NP-NCDs).
This exhaustive and vibrant PowerPoint has around 90 slides and explains in detail all the must know concepts of Management in Healthcare. These slides have enough information to use it for 3 hour seminar (2 sessions) on Modern Management Techniques and its application in Healthcare. The session can be further extended if the concepts are explained with appropriate examples.
Covid-19 Pandemic, where are we now? Latest update on Covid-19 Second Wave 20...Shivam Parmar
Disclaimer -
The Content belongs to WHO (World Health Organisation). Sharing here is just to spread awareness about Covid-19.
https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update51_pandemic_overview_where_are_we_now.pdf?sfvrsn=709278aa_5
international health regulation
RULES AND GUIDELINES OF INTERNATIONAL HEALTH REGULATIONS:
International health regulations evolution:
The IHR originated with ISR adapted at the international sanitary conference in Paris in 1851
Cholera epidemic 🡪 Europe 🡪1830 & 1847
Need international cooperation
22nd World Health Assembly (1969) adopted, revised and consolidated the international sanitary regulations, renames as IHR in 1969
26th World Health Assembly 1973🡪amendment in IHR
Thirty-fourth World Health Assembly amended the IHR (1969) to exclude smallpox in the list of notifiable diseases.
During the Forty-Eighth World Health Assembly in 1995, WHO and Member States agreed on the need to revise the IHR (1969) most notably:
narrow scope of notifiable diseases (cholera, plague, yellow fever),
The past few decades have seen the emergence and re-emergence of infectious diseases.
The emergence of “new” infectious agents Ebola, Hemorrhagic Fever and the re-emergence of cholera and plague in South America and India, respectively;
dependence on official country notification; and
lack of a formal internationally coordinated mechanism to prevent the international spread of disease.
These challenges were placed against the backdrop of the increased travel and trade characteristic of the 20th century.
The IHR (2005) entered into force, generally, on 15 June 2007, and are currently binding on 194 countries (States Parties) across the globe, including all 193 Member States of WHO.
summary:
The International Health Regulations (IHR) are an international legal instrument that covers measures for preventing the transnational spread of infectious diseases.
IHR is an instrument of international law that is legally binding on countries.
IHR is a set of regulations that is legally binding upon 196 state parties.
This legal binding is adopted by 196 countries, including all (194) WHO member states.
IHR is a benchmark to state the rights and obligations of countries to report public health actions.
The objective of IHR is to work together to protect global health security.
IHR are the international agreements with the objective of preventing the spread of public health threats without unnecessary impairment of international travel and trade.
The IHR was adopted by the 58th World Health Assembly in 2005 through Resolution WHA 58.3.
International Health was in action since 15 June 2007
The International Health Regulations (IHR 2005) are a set of regulations legally binding on 196 States Parties, including all WHO Member States. They contribute to global public health security by providing a new framework for the coordination of the management of events that may constitute a public health emergency of international concern, and improve the capacity of all countries to detect, assess, notify and respond to public health threats.
The IHR were adopted at the Fifty-eighth World Health Assembly on 23 May 2005 and entered into force on 15 June 2007.
India being a developing country with growing population has been traditionally vulnerable to natural and man made disasters.
Development cannot be sustainable unless disaster mitigation is built into developmental process.
Disaster could be a nature calamity, outbreak of disease, bioterrorism, etc.
New Delhi, Feb 23. The health ministry has proposed a bill that seeks to empower state and local authorities to take appropriate actions to tackle public health emergencies like epidemics and bio-terrorism.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Overview of International Health Regulaiton - IHR 2005, AfghanistanIslam Saeed
International Health Regulation and its implementation in Afghanistan was prepared by Dr. islam Saeed, Director for Surveillance/DEWS in MoPH Afghanistan
This presentation contains in brief about various Non-communicable diseases (NCDs) and International interventions to combat NCDs. It also contains recent updates on current problem statement of common NCDs and updates on National Programme for Prevention and Control of non-Communicable Diseases (NP-NCDs).
This exhaustive and vibrant PowerPoint has around 90 slides and explains in detail all the must know concepts of Management in Healthcare. These slides have enough information to use it for 3 hour seminar (2 sessions) on Modern Management Techniques and its application in Healthcare. The session can be further extended if the concepts are explained with appropriate examples.
Covid-19 Pandemic, where are we now? Latest update on Covid-19 Second Wave 20...Shivam Parmar
Disclaimer -
The Content belongs to WHO (World Health Organisation). Sharing here is just to spread awareness about Covid-19.
https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update51_pandemic_overview_where_are_we_now.pdf?sfvrsn=709278aa_5
Everything you need to know about Corona Virus.Tanveer Padder
• This is one of the most comprehensive & fact based resources for Corona virus
• This Presentation covers everything Including the symptoms, diagnosis, testing ,treatment options and prevention of Corona virus.
• This Presentation will definitely help you to prevent yourself from getting the corona virus.
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Here is the you tube Video of this presentation
https://www.youtube.com/watch?v=4ABj7xqMYS4
https://youtu.be/ZogtL23P3Pg
The international health regulations (IHR) is an agreement among 194 countries, including all WHO member countries ,to work together for healthy security of the world. Under the IHR, all countries need to report all events of international public health impact
National Leprosy Eradication Programme (NLEP) as on 08/12/2018Tapeshwar Kumar
Health Policy by Government of India under Ministry of Health & Family Welfare(Ministry of Health).
Better. Clarity on Google Drive Link:
https://drive.google.com/drive/folders/1L59zjagV1U4rzkEWe4eV7fW09Y6ZDA_M?usp=sharing
https://goo.gl/jAtCfv
You can remove footnote (TapeshwarAIIMS_3210/2015) by choosing the Header & Footnote option & deselecting it.
Should All Patients Having Planned Procedures or Surgeries Be Tested for COVI...JohnJulie1
The current pandemic of Corona Virus Disease-2019 (COVID-19) which is caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) has resulted in lockdown in many countries culminating in a major socio-economic crisis globally. COVID-19 can remain asymptomatic and so is crucial for early diagnosis to prevent further spread of this pandemic.
Should All Patients Having Planned Procedures or Surgeries Be Tested for COVI...suppubs1pubs1
The current pandemic of Corona Virus Disease-2019 (COVID-19) which is caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) has resulted in lockdown in many countries culminating in a major socio-economic crisis globally. COVID-19 can remain asymptomatic and so is crucial for early diagnosis to prevent further spread of this pandemic. Here we highlight the importance of screening asymptomatic patients prior to elective surgery, procedure or scheduled hospital admission. This analysis was done for the month of July 2020 during which 261 asymptomatic people were screened for COVID-19. Out of this, 6 patients (2.29%) were diagnosed to have COVID-19 on nasopharyngeal/ oropharyngeal swabs and subsequently had to delay their elective procedure or surgery. This clearly shows how important it is to screen this cohort of asymptomatic people who could potentially have spread the virus to other patients as well as healthcare professionals.
Resilience strategy in emergency medicine during the Covid-19 pandemic in ParisOceane MINKA
This study describe the organizational impact of the Covid-19 pandemic in Emergency Medicine. Published in JEUREA : https://doi.org/10.1016/j.jeurea.2021.04.001
Important maternal and child health parameters to evaluate quality care for the special group. Includes MMR, IMR, SBR, PMR, NMR, PNMR, U5MR. Practical class for UG 4th sem
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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2. CONTENTS
1. Background, Purpose and Scope
2. IHR 2005
3. Determination of a PHEIC
4. Case scenarios
5. GOARN
6. Responsible authorities
7. Public health measures
8. Core capacity requirements
16-07-2018 2Dr Tanveer Rehman PSM JIPMER
3. HISTORY
1. 1830 – 1847: Cholera epidemics in Europe - First International Sanitary
Conference Paris, 1851
2. 1951 - WHO Member States adopted the International Sanitary
Regulations - renamed the International Health Regulations (IHR) in 1969
3. Resurgence of epidemic diseases- The IHR (2005) entered into force on
15 June 2007
16-07-2018 3Dr Tanveer Rehman PSM JIPMER
4. PURPOSE AND SCOPE
“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”
16-07-2018 4Dr Tanveer Rehman PSM JIPMER
5. Why were the IHR revised?
1. Increase in cross-border travel, trade and communication technology
2. Focus on just three diseases (cholera, plague and yellow fever) - not
equipped to address the growing and varied public health risks
3. Reluctance to promptly report outbreaks of these diseases for fear of
unwarranted and damaging travel and trade restrictions
16-07-2018 5Dr Tanveer Rehman PSM JIPMER
6. IHR (2005)
1. From control of borders to containment at source
2. From diseases list to all threats
3. From pre-set measures to adapted and real time response
16-07-2018 6Dr Tanveer Rehman PSM JIPMER
7. Determination of a
Public Health Emergency of International Concern (PHEIC)
1. Director-General (DG) seeks view of “Emergency Committee” (EC)
2. EC formed by IHR Roster of Experts - experts in all relevant fields of expertise
(including from the concerned state party of Emergency) in accordance with the
WHO Regulations for Expert Advisory Panels and Committees
3. DG - invite the State Party in whose territory the event arises to present its
views to the EC
4. Final decision: By DG
16-07-2018 7Dr Tanveer Rehman PSM JIPMER
11. Case 1
1. Municipality with 180,000 inhabitants in the centre of Country A
2. Within last 3 days only: 220 new suspect cases of Cholera
3. Currently: 45 laboratory confirmed Vibrio cholerae cases being treated
4. 4 deaths recorded
5. Rural municipality - poor sanitation services
6. Recent rains setting in with human waste and other materials being washed into
existing water sources leading to widespread contamination
7. Cholera is a recurring problem during rainy season, resulting sometimes into
case fatality rates higher than 2%
16-07-2018 11Dr Tanveer Rehman PSM JIPMER
13. A. Is the Public Health Impact of the Event Serious?
1. Is the number of cases and/or number of deaths for this type of
event large for the given place, time or population?
OR
2. Has the event the potential to have a high public health impact?
OR
3. Is external assistance needed to detect, investigate, respond and
control the current event, or prevent new cases?
16-07-2018 13Dr Tanveer Rehman PSM JIPMER
14. HIGH PUBLIC HEALTH IMPACT
1. Pathogen with high potential to cause epidemic
2. Indication of treatment failure
3. Cases reported among health staff or vulnerable population
4. Factors delaying public health response (natural catastrophes, armed conflicts)
5. High population density
6. Spread of toxic, infectious or otherwise hazardous materials contaminating a
large geographical area
16-07-2018 14Dr Tanveer Rehman PSM JIPMER
15. B. Is the Event Unusual or Unexpected?
Unusual:
1. An unknown agent or the source, vehicle, route of transmission is
unusual or unknown
2. Evolution of cases more severe than expected or with unusual
symptoms
3. Occurrence of the event itself unusual for the area, season or
population.
Unexpected:
Disease/agent that had already been eliminated or eradicated
16-07-2018 15Dr Tanveer Rehman PSM JIPMER
16. C. Is there a significant risk of international spread?
A. Is there evidence of an epidemiological link to similar events in other States?
OR
B. Is there any factor that should alert us to the potential for cross border
movement of the agent, vehicle or host?
Eg. Index case (or other linked cases) with a history within the previous month:
1. International travel or gathering (pilgrimage, sports event, conference, etc.)
2. Close contact with an international traveller or a highly mobile population
3. Environmental contamination that has the potential to spread across international borders
16-07-2018 16Dr Tanveer Rehman PSM JIPMER
17. D. Is there a significant risk of
International travel or trade restrictions?
1. Similar events in the past resulted in international restriction on
trade and/or travel?
2. Source suspected or known to be a food product/water/other goods
that might be contaminated, that has been exported/imported to/from
other States?
3. In association with an international gathering or in an area of intense
international tourism?
4. Requests for more information by foreign officials or international
media?
16-07-2018 17Dr Tanveer Rehman PSM JIPMER
18. Case 2
1. 12 tourists: acute gastrointestinal symptoms - prior to departing Country B
2. Staying at the same popular tourist resort hotel
3. Vibrio cholerae in stool: six of them
4. Suspect: source of infection - seafood salad - boat trip
5. Previous years: sporadic cases of cholera
6. Country C reported WHO two likely imported cholera cases just returned
from Country B
16-07-2018 18Dr Tanveer Rehman PSM JIPMER
19. Case 3
1. An area where housing and sanitation conditions are poor
2. 68 clinically suspected and 12 presumptive cases of Bubonic Plague
3. Three patients, of which one died, indicate Septicemic Plague
4. Bacteriologically confirmed or presumptive human cases (300/year) of
bubonic plague occur annually in this enzootic area during the rainy tropical
summer season
5. Local health-care providers started antibiotic treatment with streptomycin
6. Public health education: avoid exposure to fleas
16-07-2018 19Dr Tanveer Rehman PSM JIPMER
20. Case 4
1. 15 days - 23 cases of febrile encephalitis associated with respiratory
illness – 17 deaths
2. Three cases: household members of index case
3. Other cases including one nurse: spread from index - same hospital
4. Specimens from 3 cases tested positive for Nipah virus
5. Over 2000 people in 2 districts were quarantined
6. Investigation: identify the source of human infection (suspected bats)
7. Travel advisory and disease awareness: Mass media
16-07-2018 20Dr Tanveer Rehman PSM JIPMER
22. Global Outbreak Alert and Response Network
1. Global technical partnership - World Health Organization (WHO) - to
engage the resources of technical agencies beyond the United Nations for
rapid identification, confirmation and response to PHEIC
2. 200 technical institutions and networks: United Nations organisations, the
Red Cross and Red Crescent Societies, international humanitarian non-
governmental organisations, and national public health institutions
3. Sequence: Formal request for support – Alert - Mission agreed
16-07-2018 22Dr Tanveer Rehman PSM JIPMER
28. RESPONSIBLE AUTHORITIES
National IHR Focal Point
Dr Ritu Singh Chauhan,
National Professional Officer,
IHR WHO Country Office for India,
RK Khanna Tennis Stadium,
Africa Avenue, New Delhi
IHR Contact Point
Country Health Emergency Preparedness & IHR,
WHO SEARO,
Indraprastha Estate,
Ring Road, New Delhi
16-07-2018 28Dr Tanveer Rehman PSM JIPMER
30. A. Arrival and
Departure
• Traveller’s itinerary
• Non-invasive medical
examination
• Inspection of baggage
• Vaccination
B. Conveyance
• Free of sources of
infection
• Comply with the health
measures
• Disinfect or isolation
C. Ships and aircraft
• Free pratique by radio or
other communication
means
• If affected: no traveller on
board shall leave
3016-07-2018 Dr Tanveer Rehman PSM JIPMER
31. SURVEILLANCE & NOTIFICATION
1. Develop, strengthen and maintain - capacity to detect, assess, notify
and report events
2. Notify National IHR Focal Point - within 24 hours - public health
emergency of international concern
3. Following a notification - continue to communicate to WHO timely,
accurate and sufficiently detailed information
16-07-2018 31Dr Tanveer Rehman PSM JIPMER
32. Core Capacity requirements for Surveillance & Response
A. Local community level
1. Detect events involving disease
above expected levels
2. Report all available essential
information immediately
3. Implement preliminary control
measures immediately
B. Intermediate level
1. Confirm the status of reported
events
2. Assess reported events
immediately
C. National level
1. Assess all reports of urgent
events within 48 hours
2. Notify WHO immediately
through the National IHR
Focal Point
16-07-2018 32Dr Tanveer Rehman PSM JIPMER
33. Core Capacity
requirements for
Designated Airports,
Ports and Ground
Crossings
Contingency
plan
Care for
affected
travellers
Space:
interview
suspect
Assessment,
quarantine of
suspect
travellers
Disinfect -
baggage
Entry/exit
controls for
travellers
Transfer of
travellers
carrying infection
16-07-2018 33Dr Tanveer Rehman PSM JIPMER
34. Response Global Outbreak Alert
and Response Network
SUMMARY
Event
Intelligence
Verification IHR
Official, State
sources
Risk Assessment
IHRWHO HQ, Regional & Country
Offices, Collaborators
and experts
3416-07-2018 Dr Tanveer Rehman PSM JIPMER
