International Health Regulations (2005)
Update on implementation
WHO/EPR
World Health assembly resolution
Early IHR implementation
May 2006
 Early implementation of IHR on a voluntary basis in the context of
pandemic influenza preparedness and response
 Differentiate between IHR start in June 2007 and voluntary compliance
now
Highlights
 90 days to designate National Focal Points (NFP) and for WHO to
designate IHR Contact Points
 Notification to WHO of human influenza cause by new virus subtype
 Surveillance, information sharing, consultation, verification and public
health response
 Measures for travellers
 WHO to establish a roster of experts
 Influenza pandemic task force
Elements for a WHO strategy
• 3 domains
• 7 areas of work
• Build on existing
• WHO alert & response operations
• WHO (relevant) control programmes
(e.g. GIP, ADE, ERI, IVB, POL, FOS, PHE …)
• Regional strategies for surveillance & response
(e.g. joint WPRO/SEARO, PAHO, IDSR in AFRO &
EMRO)
•…
Alert & Response Ops
Coordination
• IHR Contact Point
• Monitoring
• Reporting
• Resource mobilisation
• Administration
IHR Bodies &
Procedures
• Intelligence
• Verification
• Risk assessment
•Risk communication
• IHR Focal Points
• Notification
• Roster of experts
• Emergency Committee
• Review Committee
• National legislation
Project
Management
WHO Alert,
Preparedness,
and Response
Operations
National Core
Capacity
Points of Entry
• Ports
• Airports
• Ground crossings
• influenza
• polio
• smallpox
•Chemical/Radionuclear
• information
• advocacy
Specific threats
• SARS
IHR Communication
• education
• Response
• others
Country Alert & Response
• IHR NFP Operations
•National ARO
• Laboratory training / support
• Epidemiology training / support
• National system assessment
•Response preparedness
-Social mobilization
-Case management
Coordination:
Many players to bring on board
Potential
Donors
Country
relevant
professionals
WHO Senior
Management
Country IHR
Focal Points
International
Organisations
(FAO, OIE, WTO,
…)
WHO Country
Offices
Media / The
public
WHO Governing
Bodies
Regional
Organizations
(ASEAN, EU, …)
IHR Bodies & Procedures
National Focal Points (NFPs)
“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;
As of mid September 2006
60 NFPs have been officially designated
IHR Roster of Experts

Experts in all relevant fields of expertise—primary source of members of
Emergency Committees and Review Committees

DG appoints Roster members under WHO Regs for Expert Advisory Panels
& Committees (except as specified in IHR)

Additionally, DG appoints 1 Roster member at request of each State-Party,
and, as appropriate, experts proposed by relevant IGOs/REIOs

States must notify DG of qualifications / expertise of each expert

To date, 45 States have proposed experts for membership – 2 additional
States are under final negotiations – 2 experts of EU will be integrated

Database - IHR Expert Roster: http://intranet.who.int/ihre/default.asp
Emergency Committee:
Who is on it?

Members selected by DG from IHR Expert Roster (&
other expert advisory panels when appropriate)

Selected on basis of:
– expertise / experience for particular session/event
– due regard for equitable geographical representation

At least one member should be nominated by SP where
event arises

Meetings: Urgent, expedited, potentially electronic
Emergency Committee:
What does it do?

Only involved in context of probable or declared PHEIC

Emergency Committee advises DG on the key
determinations involving PHEICs:
– Whether an event constitutes a PHEIC
(only if SP does not agree with DG preliminary determination)
– Termination of a PHEIC
– Temporary Recommendations: Proposed issuance,
modification, extension or termination

DG always makes the final determination
Review Committee:
What does it do?

Review Committee provides technical advice to DG on:
– Standing Recommendations, and modifications/termination
(concerning specific ongoing public health risks on appropriate
health measures for routine or periodic application)
– Potential amendments to IHR
– Any other matter referred by DG concerning functioning of IHR
– Some reservations
– Potential additional two-year extension to core capacitybuilding deadlines in exceptional circumstances
Alert & Response Ops
Coordination
• IHR Contact Point
• Monitoring
• Reporting
• Resource mobilisation
• Administration
IHR Bodies &
Procedures
• Intelligence
• Verification
• Risk assessment
•Risk communication
• IHR Focal Points
• Notification
• Roster of experts
• Emergency Committee
• Review Committee
• National legislation
Project
Management
WHO Alert,
Preparedness,
and Response
Operations
National Core
Capacity
Points of Entry
• Ports
• Airports
• Ground crossings
• influenza
• polio
• smallpox
•Chemical/Radionuclear
• information
• advocacy
Specific threats
• SARS
IHR Communication
• education
• Response
• others
Country Alert & Response
• IHR NFP Operations
•National ARO
• Laboratory training / support
• Epidemiology training / support
• National system assessment
•Response preparedness
-Social mobilization
-Case management
Event notification and determination
under IHR (2005)
Determine whether an
event constitutes a PHEIC
and recommend measures
External
advice
Emergency
Committee
WHO DG
Coordinate
Receive, assess and
respond to events
notified
Consult events or notify
WHO of any events that
may constitute a PHEIC
Detect and report any
urgent or unexpected
events
WHO IHR
Contact Points
Other competent
Organizations
(IAEA etc.)
Communicate
National IHR
Focal Points
Various disease and event surveillance
systems within a country
Ministries/
Sectors
Concerned
Report
WHO IHR contact points - Status
• WHO Regional level
•1 (dedicated) telephone number + 1 (dedicated) fax number + 1
(dedicated) e-mail for each Region.
• Roster of duty Officers in each Region and HQ – 24/7 coverage
• SOPs to all Regions
• WHO Country Offices
• to be part of the Alert and Response system through
• contact with IHR NFP
• link to the Regional Contact Point
• IHR briefing / Operational Guide
Specific threats
Influenza Pandemic Task Force

Somewhat similar functions to Emergency Committee
for AI/PI issues–but only until IHR (2005) enter into
force - 15-June-07

IPTF mandate – Provides technical advice to DG:
– Response to avian influenza
– Appropriate phase of pandemic alert and the corresponding
response measures
– Declaration of an influenza pandemic
– International response to a pandemic

IPTF operational – 21 members – meets end of Sept
Alert & Response Ops
Coordination
• IHR Contact Point
• Monitoring
• Reporting
• Resource mobilisation
• Administration
IHR Bodies &
Procedures
• Intelligence
• Verification
• Risk assessment
•Risk communication
• IHR Focal Points
• Notification
• Roster of experts
• Emergency Committee
• Review Committee
• National legislation
Project
Management
WHO Alert,
Preparedness,
and Response
Operations
National Core
Capacity
Points of Entry
• Ports
• Airports
• Ground crossings
• influenza
• polio
• smallpox
•Chemical/Radionuclear
• information
• advocacy
Specific threats
• SARS
IHR Communication
• education
• Response
• others
Country Alert & Response
• IHR NFP Operations
•National ARO
• Laboratory training / support
• Epidemiology training / support
• National system assessment
•Response preparedness
-Social mobilization
-Case management
International Consultation on Strengthening National Capacities for Epidemic
Preparedness and Response in Support to the National Implementation of the
International Health Regulations (IHR)
Lyon, France 2 - 5 May 2006
Strategic approaches to improving national capacities for
epidemic alert and response in the context of IHR
• Key Components and Essential Elements
• Strategies and Mechanisms
• WHO Strategies to Support Development of National Capacities
100 participants
National core capacities for IHR
• Advance draft on “Minimum and Desirable Core
Capacities”
Peripheral
Intermediate
National
•Link with requirement for AI pandemic preparedness
• Includes preparation to the response
IHR M & E :
Pillar 1
Policy
Planning Financing
5 Pillars System
Pillar 3
Pillar 2
IHR Infrastructures
& Institutions
IHR Human
Resources
knowledge & skills
Pillar 4
Pillar 5
IHR Technical
Resources
IHR Systems and
Services
15 Early Warning
System
1 Legal framework
for IHR
4 National IHR Focal
Point
8 IHR training and
continuous education
11 IHR Resources
Mapping
2 National Plan for
PHEIC
5 Focal Point for
communication
with Media
9 Roster of professionals
with IHR “qualification”
12 Telecommunication
Resources
10 Active Participation
in International IHR
related Networks
13 Infection Control SOPs
3 Budget allocation
for IHR
6 Points of Entry
7 National Emergency
Committee
14 Clinical Management
guidelines for PHEIC
16 Verification and risk
assessment system
17 Rapid Investigation &
Response Team
18 Equipments and
Stockpiles
19 Functioning
laboratory system
for PHEIC
WHO Resources
IDSR–APSED–EID–HMN
GOARN – EMS – E-Health- Global Atlas – Health Mapper – CSUN- GLADNet…
Points of Entry
Montreal meeting outcomes
3 working groups have produced SOPs on designation and
certification criteria for ports, airports and ground
crossings
These SOPS will be further refined and tested, and finalized in
Vancouver, Canada, in November for May 2007 product
delivery
2-5
Capacity
strengtening
at Points of LyonEntry
Capacity
Strengthening
at
April '06
Points ofStandard
Entry
operating procedures
1.
2.
3.
4.
5.
6.
7.
8.
Inspection for conveyances(for passenger,cargo vessels & aircrafts)
Quarantine/isolation facilities at PoE/off PoE(for suspects, animals)
Contingency plans for ports, airports, ground crossings
Disinsection/decontamination methods & measures for conveyances,
cargo, goods, persons, animals
Qualifications for persons carrying out public health
inspection/environmental audit/pest control
Minimum requirements for designated hospital & clinic
Reporting sickness on board and reporting on containers
Recovering cost
Epidemic and Pandemic Alert and Response (EPR)
15
Guides

Guide to ship sanitation – publication early
2007

Guide to hygiene and sanitation in aviation
– in progress (peer review June 2007)