IHR Coordination ProgrammeGuénaël Rodier, WHO, Geneva

A new international framework,

an opportunity for strengthening health systems

WHO / World Bank videoconference 19 September 2008

IHR Coordination Programme

30 years of international public health threats

HIV/AIDS

CHERNOBYL

PLAGUE

EBOLA / MARBURG

NvCJD

NIPAH

YELLOW FEVER

...

ANTHRAX

SARS

MENINGITIS

CHOLERA

CHEMICAL

AVIAN INFLUENZA

XDR-TB

...

IHR Coordination Programme

Economic impact (HIV/AIDS, meningitis, BSE/NvCJ, SARS, Avian

influenza, BT …)

Global concern (international spread)

World unprepared: IHR(1969) obsolete

limited list of diseases (cholera, plague, yellow fever – revised 1983)

focus on borders (ports, airports)

pre-set rather than tailored measures

do not address international coordination

May 1995, WHA Resolution on the Revision of the IHR

Overall drive and rationale

IHR Coordination Programme

“ 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" (Article 2)

International Health Regulations

1969, 2005: IHR purpose remains the same

IHR Coordination Programme

IHR (2005): Three Paradigm Shifts

From control of borders to [also] containment at source

From diseases list to all public health threats

From preset measures to adapted responses

Entered into force on 15 June 2007

IHR Coordination Programme

Four Technical areas

Seven strategic actions to guide IHR(2005) implementation

A legal and monitoring framework

Awareness

World Health Report 2007

IHR Coordination Programme

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

IHR Coordination Programme

• Health system

• Epidemiology• Laboratory• Preparedness• Case management• Infection control• Social mobilisation• Communication• …

• Health system

• Epidemiology• Laboratory• Preparedness• Case management• Infection control• Social mobilisation• Communication• …

At community, intermediate,

and national level.

IHR Annex 1A

IHR Coordination Programme

Investing in

– Human resources (training, distance learning, twinning programmes …)

– Infrastructure (buildings, equipments, logistics …)

– Standard Operating Procedures (investigation, response, biosafety …)

In the areas of

– Laboratory quality system (EQA programmes, biosafety, specimen collection, lab regional network, twinning programmes …)

– Surveillance and response systems (epidemic intelligence, field investigation, data analysis, risk assessment, reporting, points of entry …)

– Communication (social mobilization, media, web, on-line training …)

(Annex 1A): “capacity to detect, assess, notify and report events in accordance

with this Regulations …”

IHR Coordination Programme

• Ports

• Airports

• Ground crossingsIntersectoral collaboration

• Aviation sector (ICAO, ACI, IATA)

• Shipping (IMO, ISF, CLIA)

• Railways (UIC)

IHR Annex 1B, (also 3, 4, 5, 8, and 9)

IHR Coordination Programme

The LYO mission is to

coordinate and support WHO's

effort in the Regions to

strengthen laboratory

diagnostic capacity, national

surveillance and response

systems, and facilities at

designated points of entry

(e.g. airports, ports) in order that

all countries can meet the core

capacity required under the IHR.

IHR Coordination Programme

• Timeline

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 …"

Possible extensions

Core capacity requirements for surveillance and response (Annex 1A):

“capacity to detect, assess, notify and report events in accordance with this Regulations …”

IHR Coordination Programme

• Intelligence

• Verification

• Risk assessment

• Response (GOARN)

• Logistics

• …

"Event-based"

surveillance and response

at global level

IHR Annex 2 (notification instrument)

IHR Coordination Programme

Global Outbreak Alert & Response Network (GOARN)

Institutions and Partner Network

IHR Coordination Programme

WHO IHR Contact Point

National IHR Focal Point

(One per State Party) (One per WHO Region)

“National IHR Focal Point” means the national centre, designated by each State Party, which shall be accessible at all times for communications with

WHO IHR Contact Points under these Regulations;

Responsible authorities (Article 4)

► Notification

► Reports

►Consultation

► Verification

IHR Coordination Programme

• Influenza• Polio• SARS• Smallpox• Cholera• Meningitis• Yellow fever• Food safety• Chemical safety• Radionuclear safety• …

INFOSAN

Driving forces at

country level … but

vertical and not

integrated

• Tuberculosis• Malaria• HIV/AIDS• EPI

IAEA

GAVIUNAIDS

GFATM

ICG

IHR Coordination Programme

w w w . w h o . i n t / i h r

IHR News

The WHO quarterly bulletin on IHR implementation

Thank you