Legislative Frameworks for IHR Implementation
Dr Kubra S. Nasser
Head of Communicable Diseases group
Dr. Muna Al Musawi
National IHR Focal Officer
Bahrain
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A. Identification
of national stakeholders for implementation of
IHR
In Bahrain National stakeholders for implementation of IHR were indentified.
Primary stakeholders:
o Minister of Health
o Undersecretary of Ministry of health
o Assistant Undersecretary of Primary Care and Public Health.(AUP)
o
Assistant Undersecretary of secondary care.
o Director of Public health
o Ministers and Undersecretaries of Ministries of the concerned parties.
The main function of these stakeholders is to authorize the work done by secondary
stakeholders and resources allocation.
Secondary stakeholders:
Secondary stakeholders:
Function
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1-Representative from public health directorate in 
Ministry of Health (National IHR Focal Officer)
Management of IHR Center -NFP(all functions)

Prepare the plans for IHR implementation

Proposed the mission that will be requested from
WHO.

Monitoring of IHR implementation in different sectors.

Preparing the monitoring report which will be
submitted to WHO.

Respond to Minister’s request on issues related to IHR
Representative from the General Organization of 
Act as focal point in their sector to implement IHR
Seaport

Facilitate the communication of their sector with NFP
Representative from Civil Aviation Affairs

Prepare
Representative from animal welfare section in
Ministry of Municipalities Affaires and Planning,
Animal Wealth Directorate
emergency
plans
for
their
sector
in
collaboration with NFP

Event notification to NFP

Participate in monitoring of IHR implementation

Prepare their part of WHO IHR monitoring tool and
Representative from private sector.
submit it to NFP
Representative from Ministry of Interior(Customs)
Representative from Ministry of Industry and
Commerce
Representative from Legal affairs office in
Ministry of Health.
Representative from the General Directorate of
Environment and Welfare Protection.
Representative from Ministry of Foreign affairs
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Representative from public health directorate in
Ministry of Health , communicable Diseases Unit
Representative from the Ministry of Information Facilitate the communication with public through TV
(public TV )
Communicable Diseases Unit

Act as focal point in their sector to implement IHR

Facilitate the communication of their sector with NFP

Prepare
emergency
plans
for
their
sector
in
collaboration with NFP

Event notification to NFP

Participate in monitoring of IHR implementation
Prepare their part of WHO IHR monitoring tool and
submit it to NFP
Radiation Protection in the Ministry of Health

Act as focal point in their sector to implement IHR

Facilitate the communication of their sector with NFP

Prepare
emergency
plans
for
their
sector
in
collaboration with NFP

Event notification to NFP

Participate in monitoring of IHR implementation
Prepare their part of WHO IHR monitoring tool and
submit it to NFP
Ministry Of Interior, Civil Defense

Act as focal point in their sector to implement IHR

Facilitate the communication of their sector with NFP

Prepare
emergency
plans
for
their
sector
in
collaboration with NFP

Event notification to NFP

Participate in monitoring of IHR implementation
Prepare their part of WHO IHR monitoring tool and
submit it to NFP
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Gulf Air Clinic

Act as focal point in their sector to implement IHR

Facilitate the communication of their sector with NFP

Prepare
emergency
plans
for
their
sector
in
collaboration with NFP

Event notification to NFP

Participate in monitoring of IHR implementation
Prepare their part of WHO IHR monitoring tool and
submit it to NFP

Nomination of Secondary stakeholders:
It done through sending official letters signed by director of public health to the authorities in
all above mentioned sectors.
A list of secondary stakeholders is prepared with their contact details (names, working place
telephone numbers and e-mail addresses).
With more review of IHR core capacities requirements, we realized the importance of the
presence of
representative from civil defense (command center for disaster committee) and
the Consultant of radiation from Ministry of Health among the secondary stakeholders group.

Legal frame for the work of the secondary stakeholders
Ministerial order were prepared by IHR focal point including the term of references under the
name of “National IHR committee” and submitted to the legal adviser for review, finally it is
signed by Minister of Health. Moreover this committee is headed by National IHR person
within the IHR focal point.
Formulation of subcommittee in Ministry of Health:
Includes the followings:
o
Representative from food control section
o Representative from communicable disease surveillance group.
o Representative from Environmental Control Section(vector control)
o Representative from Primary Health Care
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o Representative from Health Promotion Directorate
o Representative from Drug Control Section
o Representative of Public Relation Section in MOH(a liaison with all media in Bahrain)
o Legal Adviser
N.B: These members was originally were within the National IHR committee ,but according to
the remarks of the legal adviser that to many members were in the main committee ,so we
thought of formulation subcommittee for MOH which headed by IHR focal person.
This committee is regulated by ministerial order signed by Mistier of Health
Dynamic of work of secondary stakeholders:
i. Arranged regular meeting is held for IHR committee members and
subcommittees.
ii. Each nominee headed a subcommittee in his /her sector as a technical
members and contact point in their sectors
iii. The contact number of IHR committee members and their subcommittees
is available in IHR focal point.
Other stakeholders in the kingdom of Bahrain
o Private Hospitals and Clinics (These participate in event detection, notification to public
health authority and event management (they may support the governmental health system
during emergency e.g. Intensive care facilities)
o Ministry of Education: incorporating public health measures in their curriculums, event
detection through absenteeism surveillance, reporting of event to public health authority and
help in implementing public health measures.
o Ministry of Defense: participate in event detection, notification to public health authority and
event management through their hospital.
o Red Crescent, charity fund sand municipalities
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IHR Advocacy, social mobilization or funds allocation for activities related to IHR Advocacy
and implementation.
Regional stakeholders in Gulf Cooperation Council (GCC):
The chief of the Executive Board of the Health Ministers’ Council for Cooperation Council
States is our regional stakeholders.
B. Identification of national legislation in Bahrain relevant to
IHR (2005) implementation
The analysis of this subject will be done according to the key areas for implementation
IHR (2005) as the following:
C. National IHR Focal Points (NFP): designation and operation
Designation: The Minister of Health designated the Public Health Directorate as the
National IHR focal point and sends a written official communication to WHO containing
its designation with all contact details and the responsible persons with in it .
Operation:
The proposed NFP function with authority to communicate nationally and internationally
sent officially to the higher officials at the Ministry of Health
Urgent action needed: to give authority to NFP by revision of the proposed draft of NFP
function and to release ministerial order in this regards urgently.
D. Detection, reporting, verification, and control of
events:
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Detection:
The National list of notifiable disease in Bahrain include almost all IHR (2005) listed
disease in Annex (2) such as Poliomyelitis, Influenza caused by new sub-type, SARS,
Cholera, plague, Yellow fever, Viral hemorrhagic fevers meningococcal disease and food
poisoning .Small Pox not included but it is counted under the unusual events. Mandatory
reporting for these diseases is according to the Amiri decree 1977 for “the health
percussion to prevent communicable diseases” by all health facilities in Bahrain. The
Minister of Health can make amendment (according to decree) in the disease list by
adding or removing any disease of the list, so the updated form
Other strength in the event notification in Bahrain is that “unusual event” is added to the
list of notifiable diseases. Moreover the responsibility of notification to public health
authority according to the same decree is in the following order, treating physician,
patient himself or his guardians or adult relatives in same house, anyone living with the
patient in the same house even if he or she not relatives and hotel owner or school
principle in which the patient is present.
Animal disease notification are legally bind to OIE notifiable disease list in which the
director of animal welfare when receive electronic reporting from the peripheral site will
notify OIE accordingly. A reporting system of animal diseases to public health was
established in 2012 as well as chemical or radio-nuclear events to public health (NFP)
Reporting of the event to WHO: included in the NFP proposed function
Verification of the events: included in the NFP proposed function
Control of events: According to the Admire decree 1977, Public health authority is
responsible for implementation of all health measures to control of the events of public
health nature.
Urgent action needed:

Updating the legislations of notification of communicable diseases to include all
the events rather than communicable disease only during revision of Public
Health Law (which is under revision now).

To create mechanism for mandatory reporting of all events including chemical,
radio-nuclear that may have impact on public health to NFP
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E. Communications, domestically and internationally
Domestic Communication Network:
Ministerial order signed by Minster of Health was issued in 2010 for formulation of
IHR committee which is headed by IHR National Focal Officer; other members
represent relevant sectors to IHR implementation as mentioned above.
International Communication:
Ministry of Health communicates regularly with WHO through the officially
assigned focal point for each health program.
F. Human rights
Kingdom of Bahrain is a party to the following major human rights Conventions
such as Conventions on the Rights of the Child (CRC), Conventions on the
Elimination of All Forms of Racial Discrimination, Slavery Convention, 1926,
and others.
Kingdom of Bahrain is committed to the United Nations General Assembly
resolution 60/251, which established the Human Rights Council Having been
elected to membership of the Council, will assist in creating a conducive
international atmosphere and commitment for cooperation in human rights.
In addition, Bahrain is actively studying becoming a party to the International
Covenant on Economic, Social and Cultural Rights, and the International
Covenant on Civil and Political Rights, both of which the Government has
referred to Parliament.
G. Implementation of IHR (2005) documents:
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 Ship Sanitation Certificate
As Bahrain decided to issue” Ship Sanitation Control Exemption Certificate”
only, modification to model given in “Annex 3 done accordingly.
 International Certificate of Vaccination and Prophylaxis
Yellow fever center is available and provide the services free of charge for
resident and with cost charge for international travelers and documentation of
vaccination done on National certificate.
 Maritime Declaration of Health and Health Part of Aircraft General Declaration :
The models of these forms were prepared according to (IHR 2005)
Urgent action needed for the above documents: issuing a circular from Undersecretary of
Ministry of Health in this regards to all concerned parties on the use of these documents with a
guideline for the procedure to issue them.
H. Designation of Points of Entry (ports, airports and ground
crossings)
for
development
of
core
public
health
capacities:
Done in July 2011 and send officially to WHO.
I. Identification (and informing WHO) of ports authorized
to issue Ship Sanitation Certificates and provide related
services
Minister of Health sent official letter to WHO with list of ports authorized to issue “Ship
Sanitation Control Exemption Certificates” in January 2008
J. Preparatory actions which were taken for legislative
assessment in Bahrain :
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 Establishment of an intersectoral committee (National IHR committee) through
which all the members were requested to submit all legislative documents related
to their sector.
 The documents to be revised by the legal adviser in Ministry of Health (member)
as all health related issues in the country will be referred to Ministry of Health.
 Review of “International Health Regulations (2005) Toolkit for implementation
in national legislation 2009” by NFP members and legal adviser.
K. Review of the currently used Public health law and the submitted
one to insure the availability of IHR requirements in them
L. Conclusion :
Bahrain started the legislative assessment and identified the areas to work on to fully implement
the IHR (2005), but a follow is needed to implement the proposed legislations.
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