Presentation on theme: "World Health Organization"— Presentation transcript:
1World Health Organization 7 April, 2017International Health RegulationsBuilding international public health security
2Why revised International Health Regulations? World Health OrganizationWhy revised International Health Regulations?7 April, 2017In 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 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
3Our world is changing as never before World Health Organization7 April, 2017Populations grow, age, and moveDiseases travel fastMicrobes adaptChemical, radiation, food risks increaseHealth security is at stakeThe unique conditions of the 21st century have amplified the invasive and disruptive power of epidemics and other public health emergencies.The dynamics of disease spread in the world have changed greatly in the last decades. We all are living in a global “village” where diseases can travel at the speed of jetliners on the wings of international travel and trade, and can jump from one continent to another in a matter of hours.This has made all nations vulnerable – not just to invasion of their territories by pathogens, but also to the economic, political and social shocks of public health events elsewhere. They have the power to disrupt the entire global system in ways that cannot be controlled by one nation acting alone. SARS was the first disease of the 21st century to expose the world’s vulnerabilities. It will not be the last.Shared vulnerabilities imply shared responsibilities and create a need for strong collective action to protect lives and livelihoods from disease spread. To address these public health risks, the world's countries, through WHO, initiated an intensive process to revise the IHR, eventually adopted by the World Health Assembly in May 2005.
430 years of international health in security World Health Organization30 years of international health in security7 April, 2017HIV/AIDSCHERNOBYLPLAGUEEBOLA / MARBURGNvCJDNIPAHYELLOW FEVER...ANTHRAXSARSMENINGITISCHOLERACHEMICALAVIAN INFLUENZAXDR-TB...The AIDS pandemic, December 200639.5 Mo HIV infected2.9 Mo deaths in 2006Drug-ResistanceNo vaccineA new virus recognized in the early 1980sEbola, Kikwit, Zaïre, April 1995315 cases250 deaths (CFR 80%)Global concernWHO Coordinated responseBovine spongiform encephalopathyA new prion diseaseCrossed the species barrierSpread through the food-chainMarch 2003: a new and severe acute atypical pneumonia emerges in China, Hanoi, Hong-Kong, Singapore and Toronto.8098 cases774 deaths26 countries affectedA new coronavirusPoliomyelitis: threat to global eradication effort …global spread has never been so easyH5N1 Avian Influenza, Human cases, Pandemic ThreatAccidental or deliberate release of infectious agentsSmaller, more powerful, more affordable, biotechnologiesIncreased risk for accidental release of infectious agents (e.g. SARS 2004)The deliberate release of infectious agents is no longer a remote threatChernobyl, Ukraine, 19861000 people with highest radiations600,000 people contaminated> 5 million people exposed> 4000 thyroid cancer cases (by 2002)
52003: SARS changes the world World Health Organization7 April, 2017Screening of exit passengersWHO travel recommendationsWHO travel recommendations removed27 March2 April25 May23 June120000SARS: an unknown coronavirus8098 cases774 deaths26 countries affectedtrends in airline passenger movement dropeconomic loss: US$ 60 billion10000080000Number of passenger60000SARS taught us how quickly a new disease can spread along the routes of international air travel.This universal vulnerability creates a need for collective defences and for shared responsibility in making these defences work.SARS finally spurred the energy of world’s States, coordinated by WHO, to strongly take action and strengthen global defences to health threats without boundaries4000036 1162000014 67013 May3/163/193/223/253/283/314/34/64/94/124/154/184/214/244/274/305/35/65/95/125/155/185/215/245/275/306/26/56/86/116/146/17
6H5N1: Avian influenza, a pandemic threat World Health Organization7 April, 2017The greatest threat to international health security would be an influenza pandemic. It has not receded, but early warnings allow the world a chance to prepare. Implementation of the IHR is the chance to prepare
7World Health Organization The 58th World Health Assembly adopts the revised International Health Regulations, “IHR”World Health Organization7 April, 2017
8International public health security is the goal World Health OrganizationInternational public health security is the goal7 April, 2017Come into force on 15 June 2007*Ensuring maximum public health securitywhile minimizing interference with international transport and tradeThe IHR represent a major step forward in international public health security.They provide an agreed framework for the collective international management of epidemics and other public health emergencies while minimising disruption to travel, trade and economies.India Reservation (related to yellow fever)USA Reservation (related to federalism)3 understandings (related to sources of incidents, to reporting concerning risks outside its territory, to the question of judicially enforceable private rights)Turkey Statement (related to a convention and regulations regarding the straits).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
9World Health Organization What’s new?World Health Organization7 April, 2017From three diseases to all public health threatsFrom preset measures to adapted responseFrom control of borders to, also, containment at sourceThe IHR are innovative becausethey move from purely a list of diseases to a dynamic process of risk identification, assessment and managementthey move from a concept of static defence at borders, airports and ports to the concept of early detection, reporting and containment at sourcethey built on the concept that international health security is based on strong national public health infrastructure connected a global alert and response system.
10All public health threats World Health OrganizationAll public health threats7 April, 2017The revised IHR recognize that international disease threats have increasedScope has been expanded from cholera, plague and yellow fever to all public health emergencies of international concernThey include those caused by infectious diseases, chemical agents, radioactive materials and contaminated food
11World Health Organization Adapted responseWorld Health Organization7 April, 2017International 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.SARS taught us how quickly a new disease can spread along the routes of international air travel. This universal vulnerability creates a need for collective defences and for shared responsibility in making these defences work.The containment of SARS was due to unprecedented cooperation between countries which prevented a new disease gaining a foothold in the human population.The IHR build on this and many other efforts to respond to and contain disease threats and will help to ensure that outbreaks and other public health emergencies are detected and investigated more rapidly and that collective international action is taken to support affected a states to contain the disease and apply life saving interventions.GOARNA “strike force” of specialized staff is rapidly deployed for on-the-spot emergency investigations through the Global Outbreak Alert and Response Network (GOARN). It interlinks in real time 120 networks and institutes.For chemical, radiological and food-related incidents GOARN is complemented by WHOChemical Incidents and Emergencies Network (ChemiNet)Radiation Emergency Medical Preparedness and Assistance Network (REMPAN)International Food Safety Authorities Network (INFOSAN)
12World Health Organization Containment at sourceWorld Health Organization7 April, 2017Rapid response at the source is:the most effective way to secure maximum protection against international spread of diseaseskey to limiting unnecessary health-based restrictions on trade and travelThe extent of international travels is an extraordinary opportunity for disease transmission.
13World Health Organization What do the IHR call for?7 April, 2017Strengthened national capacity for surveillance and control, including in travel and transportPrevention, alert and response to international public health emergenciesGlobal partnership and international collaborationRights, obligations and procedures, and progress monitoring
14Why should countries implement the IHR? World Health OrganizationWhy should countries implement the IHR?7 April, 2017To 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:WHO assistance in building core capacitiesWHO’s guidance during outbreak investigation, risk assessment, and responseWHO’s advice and logistical supportinformation gathered by WHO about public health risks worldwideassistance to mobilize funding support
15The IHR foster global partnership World Health Organization7 April, 2017Other intergovernmental organizations:UN system (e.g. FAO, IAEA, ICAO, IMO)others: regional (e.g. EU, ASEAN), technical (e.g. OIE)Development agencies:governments, banksWHO Collaborating centresAcademics & professional associationsIndustry associationsNGOs and FoundationsThe IHR provide for cooperation between WHO and other competent intergovernmental organizations or international bodies in the implementation of the Regulations.WHO will therefore continue to foster its longstanding working relationships with a number of organizations such as the International Atomic Energy Agency, the International Air Transport Association, the International Civil Aviation Organization, the International Maritime Organization, the World Tourism Organization, Food and Agriculture Organization of the United Nations, the Office International d'Epizooties (World Organisation for Animal Health) and the World Trade Organization.In addition to these specialized organizations, WHO will work with regional economic integration organizations such as the European Union and the Mercado Común del Sur (MERCOSUR) in implementing the Regulations in the countries of their respective regions.
16Acute public health threats are collectively managed World Health OrganizationAcute public health threats are collectively managed7 April, 2017The 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:detectverifyassessinformassistTimely and enhanced epidemic intelligenceReal-time exchange of situational reports and other data for decision-makingEnhanced information management and risk communicationsJoint risk analysis and decision supportAction planning and coordination of response activitiesTechnical partnerships to support international health security.
17WHO to help countries managing events World Health OrganizationWHO to help countries managing events7 April, 2017New WHO global Event Management SystemWHO Regional Alert and Response teamsTrain countries’ NFPs and WHO contact points for event managementExpand GOARN and other specialized and regional support networksDevelop new tools and standard operating proceduresCarry out IHR exercisesWHO wide-exercise tests the global system for international health securityOn, 15 June 2007, the day of the IHR’s entry into force, WHO will hold the first exercise to test its preparedness to successfully manage and support States during public health emergencies of international concern. As part of WHO's increased responsibilities under the revised IHR, considerable effort has been made to establish procedures, technological and human resource infrastructures to ensure WHO is ready to receive, analyse and disseminate information and make recommendations for dealing with public health emergencies of international concern.The exercise on 15 June is the first of a series meant to test the mechanisms in place, their compliance with the IHR and opportunities for improvement. It consists of notifying a public health event involving multiple regions. This is an occasion to validate policy direction and coordination, information management and risk assessment capacity as well as the ability to utilize communications methods to report events from the country level through the Regional Offices to Headquarters.Participants will span many levels of WHO across the globe, including selected country office staff, WHO IHR contact points, Regional Directors, Regional Advisors, WHO Emergency and Preparedness and Response group at Headquarters, and the office of the Director-General.
18As each country builds its capacity, the entire world wins World Health Organization7 April, 2017The 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 diseaseschemical-related diseases food-related diseasesTimeline"As soon as possible but no later than five years from entry into force"2 years (2) + (up to 2)Each country has committed to develop and maintain core public health capacities for surveillance and response.These capacities encompass outbreaks of infectious diseases and diseases of chemical, radiological and food origin.Health services and facilities are also to be developed at important international ports, airports and ground crossings.15 June 20072009201220142016PlanningImplementation
19Countries’ challenges for IHR implementation World Health OrganizationCountries’ challenges for IHR implementation7 April, 2017Mobilize resources and develop national action plansStrengthen national capacities in alert and responseStrengthen capacity at ports, airports, and ground crossingsMaintaining strong threat-specific readiness for known diseases/risksRapidly notify WHO of acute public health risksSustain international and intersectoral collaborationMonitor progress of IHR implementation
20What will WHO do under the IHR? World Health OrganizationWhat will WHO do under the IHR?7 April, 2017Designate WHO IHR contact pointsSupport States Parties in assessing their public health risks, through the notification, consultation, and verification processesInform State Parties of relevant international public health risksRecommend adapted public health measuresAssist States Parties in their efforts to investigate outbreaks and meet the IHR national requirements for surveillance and response
21Benefit from IHR implementation World Health Organization7 April, 2017Lives savedGood international imageNo unilateral travel and trade restrictionsPublic trustNo political and social turmoilThe legally binding nature of IHR(2005) does not include an enforcement mechanism per se for the States which fail to comply with its provisions. Nevertheless, the potential consequences of non-compliance, especially in economic terms, are a powerful compliance tool.Being a binding international agreement, the IHR(2005) are associated to greater expectations of compliance by their State Parties through greater expectations of compliance by other parties and concerns about potential retributive measures by other countries in case of non-compliance.Working together with WHO to control a public health event and to communicate accurately any associated to other States or their populations helps to protect against unjustified measures being adopted unilaterally by other States.
22World Health Organization 7 April, 2017w w w . w h o . i n t / i h rInternational Health RegulationsBuilding international public health security