The International Health Regulations (IHR) are a legally binding agreement between WHO member states aimed at preventing, protecting against, and controlling the spread of disease internationally. The IHR require countries to report certain public health events and diseases to the WHO and develop minimum core public health capacities for surveillance, risk assessment, and response. Major revisions in 2005 expanded the scope of the IHR beyond specific diseases to all public health emergencies of international concern. The IHR establish procedures for WHO to verify country reports and determine whether events constitute a public health emergency of international concern.
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
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.
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.
🔥HOT TOPIC🔥
Sharing my PowerPoint slides on 🐵 MONKEYPOX🐵
(a potential/sure shot question for MD exam)
This can be used for a 2 hour session of PG seminar since all the aspects of the disease are covered.
It includes a compilation of;
1. Infectious history (in detail)
2. Epidemiology (Global, local)
3. Case definitions
4. Clinical features
5. Differential diagnosis (including comparison with common DDs)
6. Complications
7. Investigations
8. Management
9. Vaccines
10. Other specific preventive measures
Share among Community Medicine residents for maximum reach and benefits...😊
Globalization, Global Health and Public Health.
Changing Concepts of Public Health.
Causes, Aspects and Types of Globalization.
Social Changes due to Globalization.
How Globalization affects Public Health.
Globalization of Public Health.
Threats to Global Health.
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
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.
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.
🔥HOT TOPIC🔥
Sharing my PowerPoint slides on 🐵 MONKEYPOX🐵
(a potential/sure shot question for MD exam)
This can be used for a 2 hour session of PG seminar since all the aspects of the disease are covered.
It includes a compilation of;
1. Infectious history (in detail)
2. Epidemiology (Global, local)
3. Case definitions
4. Clinical features
5. Differential diagnosis (including comparison with common DDs)
6. Complications
7. Investigations
8. Management
9. Vaccines
10. Other specific preventive measures
Share among Community Medicine residents for maximum reach and benefits...😊
Globalization, Global Health and Public Health.
Changing Concepts of Public Health.
Causes, Aspects and Types of Globalization.
Social Changes due to Globalization.
How Globalization affects Public Health.
Globalization of Public Health.
Threats to Global Health.
The Applicability of the IHR;
With the signing of the revised International Health Regulations (IHR) in 2005, the international community agreed to improve the detection and reporting of potential public health emergencies worldwide. IHR (2005) better addresses today’s global health security concerns and are a critical part of protecting global health. The regulations require that all countries have the ability to detect, assess, report and respond to public health events.
In response to the exponential increase in international travel and trade, and emergence and reemergence of international disease threats and other health risks, 196 countries across the globe agreed to implement the International Health Regulations (2005) (IHR). This binding instrument of international law entered into force on 15 June 2007.
The stated purpose and scope of the IHR are; "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." Because the IHR are not limited to specific diseases, but are applicable to health risks, irrespective of their origin or source, they will follow the evolution of diseases and the factors affecting their emergence and transmission. The IHR also require States to strengthen core surveillance and response capacities at the primary, intermediate and national level, as well as at designated international ports, airports and ground crossings.
The International Health Regulations (IHR), a legally binding agreement between 196 States Parties, whose aim is to prevent, protect against, control, and provide a public health response to the international spread of disease, deserve critical examination with regard to their applicability. The emergence and spread of the new mysterious hemorrhagic fever may constitute a public health emergency of international concern (PHEIC) and is therefore notifiable to the World Health Organization under the IHR notification requirement.
IHR (2005) is coordinated by the World Health Organization (WHO) and aims to keep the world informed about public health risks and events. As an international treaty, the IHR (2005) is legally binding; all countries must report events of international public health importance. Countries reference IHR (2005) to determine how to prevent and control global health threats while keeping international travel and trade as open as possible.
IHR (2005) requires that all countries have the ability to do the following:
· Detect: Make sure surveillance systems and laboratories can detect potential threats
· Assess: Work together with other countries to make decisions in public health emergencies
· Report: Report specific diseases, plus any potential international public health emergencies, through participation in a network of National Focal Points
· Respond: Respond to public healt.
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
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
COVID-19: A guide for Medical Officers in Primary Health Centres. All Details...Shivam Parmar
Disclaimer -
The Content belongs to rajswasthya.nic.in (Govt. of Rajasthan) Sharing here is just to spread awareness about Covid-19.
http://www.rajswasthya.nic.in/PDF/PPT%20for%20MOs%20at%20PHCs%20for%20COVID19%20management%2009052020%20(1).pdf
Risk assessment of potential health threats – Enhancing disease surveillance ...Global Risk Forum GRFDavos
GRF One Health Summit 2012, Davos: Presentation by Nicole ROSENKÖTTER,
Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI School of Public Health, Netherlands, Kingdom of the
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. What are International Health Regulations(IHR)?
What are the purpose of IHR?
What are the functions of IHR?
What are Public Health Emergencies of
International Concern?
What are the notifiable diseases?
What are the core capacities in each level?
What are the important vaccinations to be given
for travelers?
Learning Objectives
2
3. INTRODUCTION:
➢ The IHR are legally binding set of regulations adopted by WHO
which helps countries to save lives caused by diseases spread
internationally and other health risks.
4. THE INTERNATIONAL HEALTH REGULATIONS
EVOLUTION
• 1948: WHO Constitution
• 1951: Adopted ISR
• 1969: Revised to IHR
1969 IHR( Cholera, plague, YF, small pox, relapsing fever and typhus)
In early 1990s, emergence of Ebola hemorrhagic fever
• 1995: 48th World Health Assembly ; Call for revision
•2001: Links to Global health Security strategy
• 2005: Adopted IHR 2005
•2007: IHR(2005) comes into effect
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
6. IHR (2005)
61. 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
7. PURPOSE AND SCOPE OF IHR:
“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.”
8. May 2005: World Health Assembly approved revised IHR and
June 15, 2007: Initial start date for revised IHR
June 2009:Member Countries complete assessment of the
ability of their national structures and resources to meet
minimum core capacities
2012: Member Countries should achieve the required
minimum level of core capacities, unless WHO grants an
extension
8THE ORIGINAL TIMELINE FOR IHR
IMPLEMENTATION
9. 2014: End of 2-year extensions on achieving core capacity,
unless an exceptional circumstance exists and a further
extension is granted by WHO
After a 2 year extension, in 2014, 64 countries reported
fully achieving the IHR core capacities.
Only about 1/3 of the countries in the world currently
have the ability to assess, detect and respond to public
health emergencies
10. The Stakeholders for IHR Implementation
Airports,
Ports &
Ground
Crossings
States, UTs
&
District
Authorities
National Focal Point
NICD, Delhi
Other
Ministries
, Dtes., &
Deptts.
MOHFW
DGHS
Other ministries
and deppts.
states, UTs and
District
authorities
11. INNOVATIONS:
(a) Not limited to any specific disease
(b) State Party obligations to develop certain minimum core public health
capacities;
(c) obligations on States Parties to notify WHO of events that may
constitute a public health emergency
(d) provisions authorizing WHO to obtain verification from States Parties
concerning such events;
(e )Determination and recommendation by the Director-General of PHEIC
(f) protection of the human rights of persons and travellers
(g) National IHR Focal Points and WHO IHR Contact Points for urgent
communications between States Parties and WHO.
12. MAJOR OBLIGATIONS FOR
MEMBER STATES: 196 WHO members
.
Major
Obligations
Designation
of a National
Focal PointCore
capacities to
detect, report
and respond
Comply with
routine
provisions
Legal &
administrative
framework
Assess events
& notify
Potential
PHEIC
13.
14. 14
The IHR require that all countries have the ability to do the
following:
Detect: Make sure surveillance systems and laboratories can
detect potential threats
Assess: Work together with other countries to make decisions
in public health emergencies
Report: Report specific diseases, plus any potential
international public health emergencies, through participation
in a network of National Focal Points
Respond: Respond to public health events
15. PUBLIC HEALTH EMERGENCY OF
INTERNATIONAL CONCERN: (PHEIC)
Defined 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”.
These events of potential international concern, which require States
Parties to notify WHO, can extend beyond communicable diseases and
arise from any origin or source.
17. Under IHR, a PHEIC is declared by the World Health
Organization if the situation meets 2 of 4 criteria:
❑Is the public health impact of the event serious?
❑Is the event unusual or unexpected?
❑Is there a significant risk of international spread?
❑Is there a significant risk of international travel or trade
restrictions?
18. 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?
2. Has the event the potential to have a high public health impact?
Concomitant factors that may hinder or delay the public health response (natural
catastrophes)
Spread of toxic, infectious or hazardous materials that has the potential to
contaminate a large geographical area.
3. Is external assistance needed to detect, investigate, respond and control the
current event, or prevent new cases?
Inadequate human, financial or technical material
19. Is the event unusual or unexpected?
Is the event unusual?
Occurrence of the event itself unusual for the area, season or
population.
5. Is the event unexpected from a public health perspective?
Event caused by a disease/agent that had already been eliminated
or eradicated from the State Party or not previously reported.
20. Is there a significant risk of
international spread?
6. Is there evidence of an epidemiological link to similar events
in other States?
7. Is there any factor that should alert us to the potential for
cross border movement of the agent, vehicle or host?
Where there is evidence of local spread, an index case (or other
linked cases) with a history within the previous month of travel
Event caused by an environmental contamination that has the
potential to spread across international borders.
21. Is there a significant risk of international
travel or trade restrictions?
8. Have similar events in the past resulted in international
restriction on trade and/or travel?
9. Is the source suspected or known to be a food product or any
other goods that might be contaminated that has been
exported/imported to/from other States?
10. Has the event occurred in association with an international
gathering or in an area of intense international tourism?
11. Has the event caused requests for more information by
foreign officials or international media?
22. Main Challenges
Building core capacities for surveillance and
response at all levels – national, intermediary,
local (technical challenge)
Mobilization of resources to meet core
capacities requirements (financial challenge)
National Commitment to rapid sharing of
information, materials and inter-country
collaboration (political challenge)
23. Once a WHO member country identifies an event of
concern, the country must assess the public health risks of
the event within 48 hours.
If the event is determined to be notifiable under the IHR,
the country must report the information to WHO within 24
hours.
Some diseases always require reporting under the IHR, no
matter when or where they occur, while others become
notifiable when they represent an unusual risk or situation.
23
STEPS
24. Notifiable:
Smallpox
Poliomyelitis due to wild-type poliovirus
Human influenza caused by a new subtype
Severe acute respiratory syndrome (SARS)
Since the revised IHR were put into place, three PHEICs
have been declared by WHO
HINI (2009)
Polio (2014)
Ebola (2014)
25. ❑Epidemic prone diseases
Cholera, yellow fever, meningococcal disease, SARS, avian
influenza, Ebola, Marburg haemorrhagic fever, drug resistant
diarrhoeal diseases, West Nile Fever hospital acquired infections,
malaria, meningitis, respiratory tract infections and sexually
transmitted infections and HIV infections.
❑ Food borne diseases
Microbial contamination chemicals and toxins. The emergence of
new food borne diseases i.e. new variant of Creutzfeldt Jakob disease
associated with bovine spongiform encephalopathy (BSE).
❑ Accidental and deliberate outbreaks
Breaches in bio-safety measures are often responsible for
outbreaks associated with the accidental release of infectious agents
for example anthrax in USA in 2001.
26. ❑Toxic chemical accidents
Dumping of 500 tons of petrochemical waste in at least 15
sites led to the deaths of 8 people, and 90000 were seeking
medical help in West Africa in the year 2006.
❑Radio nuclear Accidents
Chernobyl disaster in 1986 resulted in the evacuation and
resettlement of over 3,36,000 people.
❑ Environmental disasters
❑Heat wave in Europe 2003, the lives of 35,000 persons
were linked to extremes in weather.
❑Bhopal gas tragedy in December 1984
27. IHR: capacities required at each
level
Local level
National level
Intermediate level
Regional & International
level
- Detection of event
- Reporting
- Controlling
-Confirmation
Response
Assessment
--Assessment
-Notification
-P.H. response
- Event alert
- Verification
- Assessment
- Intl. response
28. • At all times
• Access to medical services
• Transport of ill travellers
• Inspection of conveyances
• Control of vectors
• For responding to events
• Emergency contingency
• Arrangement for isolation
of ill patients
• Apply specific
control/quarantine measures
Minimum Core Capacities at
Designated Points of Entry
29. Core Capacity
requirements for
Designated
Airports, Ports and
Ground Crossings
Contingency
plan Care or affected
travellers
Space: interview
suspect
Assessment,
quarantine of suspect
travellers
Deratting,
disinfection ,
disinsection
Entry/exit
controls for
travellers
Transfer of
travellers carrying
infection
30. All travelers
Routine Vaccination:
These vaccines include measles-mumps-rubella
(MMR) vaccine, diphtheria-tetanus-pertussis
vaccine, varicella (chickenpox) vaccine, polio
vaccine, and yearly Rotavirus shot.
30
Vaccination
34. Article 1
“Isolation”- separation of ill persons from healthy people
“quarantine”- the restriction of activities and/or separation
from others of suspect persons who are not ill or of suspect
baggage, containers, conveyances or goods in such a manner
as to prevent the possible spread of infection or contamination
“temporary recommendation” means non-binding advice
issued by WHO for application on a time-limited, risk-specific
basis, in response to a public health emergency of international
concern, so as to prevent or reduce the international spread of
disease and minimize interference with international traffic
34
Articles Under IHR 2005
35. 35
ARTICLE 4
Relates to responsible authorities
PUBLIC HEALTH RESPONSE (ARTICLE 5-14)
ARTICLE 5
surveillance
ARTICLE 6
notification
ARTICLE 7
Information-sharing during unexpected or unusual public health
events
ARTICLE 8
consultation
36. ARTICLE 9
Other reports
ARTICLE 10
Verification
ARTICLE 11
Provision of information by WHO
ARTICLE 12
Determination of a public health emergency of
international concern
ARTICLE 13
Public health response
ARTICLE 14
Cooperation of WHO with intergovernmental
organizations and international bodies
37. Coordinating implementation of the IHR.
They are working to:
Foster global partnerships
Strengthen national disease prevention, surveillance, control
and response systems
Strengthen public health security in travel and transport
37
WHO Responsibilities
38. Strengthen WHO global alert and response
systems
Strengthen the management of specific risks
Sustain rights, obligations and procedures
Conduct studies and monitor progress
38
39.
40. Focus is on detection, prevention, and control.
One major role for CDC is to support existing health
monitoring systems that identify and report diseases.
Collaborate with local, state, and federal public health
authorities to improve the ability of national health
monitoring systems to report possible PHEICs under
IHR provisions.
40
CDC Responsibilities
41. In 2014, the United States and its partner countries
came together to commit to the Agenda
The GHS Agenda provides a road map to help reach
the initial goals set out by the IHR in 2005
The GHS Agenda lays out a framework to:
Prevent avoidable epidemics
Detect threats early
Respond rapidly and effectively
Creates clear goals and activities that support the
regulations
41
Global Health Security Agenda (GHS)