Guénaël Rodier, WHO, Geneva
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Transcript of Guénaël Rodier, WHO, Geneva
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
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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