International Health Regulations (2005) Update on implementation WHO/EPR.

International Health Regulations (2005)International Health Regulations (2005)

Update on implementationUpdate on implementation

WHO/EPRWHO/EPR

World Health assembly resolutionWorld Health assembly resolutionEarly IHR implementation Early IHR implementation

May 2006May 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)

• …

Coordination• Monitoring• Reporting• Resource mobilisation• AdministrationIHR Bodies &

Procedures• IHR Focal Points

• Roster of experts

• Emergency Committee

• Review Committee

• National legislation

Alert & Response Ops• IHR Contact Point

• Intelligence

• Verification

• Risk assessment

•Risk communication

• Notification

• Response

Country Alert & Response• IHR NFP Operations

•National ARO• Laboratory training / support

• Epidemiology training / support

• National system assessment

•Response preparedness

-Social mobilization

-Case management

IHR Communication

• information

• education

• advocacy

Points of Entry

• Ports

• Airports

• Ground crossings

Specific threats• influenza

• polio

• smallpox

• SARS

•Chemical/Radionuclear

• others

Project Management

National Core Capacity

WHO Alert, Preparedness, and Response

Operations

Coordination:Many players to bring on board

WHO Senior Management

WHO Country Offices

Country relevant

professionals

Country IHR Focal Points

WHO Governing Bodies

Media / The public

International Organisations

(FAO, OIE, WTO, …)

Regional Organizations

(ASEAN, EU, …)

Potential Donors

IHR Bodies & ProceduresIHR Bodies & ProceduresNational Focal Points (NFPs)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 ExpertsIHR 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

http://intranet.who.int/ihre/default.asp



Emergency Committee: Emergency Committee: Who is on it?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: Emergency Committee: What does it do?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: Review Committee: What does it do?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 capacity-building deadlines in exceptional circumstances








• Intelligence

• Verification

• Risk assessment


• Notification

• Response







-Case management

IHR Communication

• information

• education

• advocacy

Points of Entry

• Ports

• Airports



• polio

• smallpox

• SARS


• others

Project Management



Operations

Event notification and determination Event notification and determination under IHR (2005)under IHR (2005)

WHO DG

Various disease and event surveillance systems within a country

National IHRFocal Points

National IHRFocal Points

WHO IHR Contact Points

WHO IHR Contact Points

EmergencyCommittee

Other competent Organizations

(IAEA etc.)

Detect and report any urgent or unexpected events

Consult events or notify WHO of any events that may constitute a PHEIC

Receive, assess and respond to events notified

Ministries/ Sectors

Concerned

Determine whether an event constitutes a PHEIC and recommend measures

Externaladvice

Coordinate

Communicate

Report

• 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

WHO IHR contact points - Status

Specific threatsSpecific threatsInfluenza Pandemic Task Force 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








• Intelligence

• Verification

• Risk assessment


• Notification

• Response







-Case management

IHR Communication

• information

• education

• advocacy

Points of Entry

• Ports

• Airports



• polio

• smallpox

• SARS


• others

Project Management



Operations

International Consultation on Strengthening National Capacities for Epidemic International Consultation on Strengthening National Capacities for Epidemic Preparedness and Response in Support to the National Implementation of the Preparedness and Response in Support to the National Implementation of the

International Health Regulations (IHR) 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

• Advance draft on “Minimum and Desirable Core Capacities”

PeripheralIntermediateNational

•Link with requirement for AI pandemic preparedness

• Includes preparation to the response

National core capacities for IHR

IHR M & E : 5 Pillars SystemIHR M & E : 5 Pillars System

W H O R e s o u r c e s

I D S R – A P S E D – E I D – H M N

GOARN – EMS – E-Health- Global Atlas – Health Mapper – CSUN- GLADNet…

Pillar 1 Policy

Planning Financing

Pillar 3 IHR Human Resources

knowledge & skills

Pillar 4 IHR Technical

Resources

Pillar 5 IHR Systems and

Services

15 Early Warning System

16 Verification and risk assessment system

17 Rapid Investigation & Response Team

18 Equipments and Stockpiles

19 Functioning laboratory system for PHEIC

Pillar 2

IHR Infrastructures & Institutions

4 National IHR Focal Point

5 Focal Point for communication with Media

6 Points of Entry

7 National Emergency Committee

1 Legal framework for IHR

2 National Plan for PHEIC

3 Budget allocation for IHR

8 IHR training and continuous education

9 Roster of professionals with IHR “qualification”

10 Active Participation in International IHR related Networks

11 IHR Resources Mapping

12 Telecommunication Resources

13 Infection Control SOPs

14 Clinical Management guidelines for PHEIC

Points of EntryPoints of Entry Montreal meeting outcomesMontreal 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

1. Inspection for conveyances(for passenger,cargo vessels & aircrafts)

2. Quarantine/isolation facilities at PoE/off PoE(for suspects, animals)

3. Contingency plans for ports, airports, ground crossings

4. Disinsection/decontamination methods & measures for conveyances, cargo, goods, persons, animals

5. Qualifications for persons carrying out public health inspection/environmental audit/pest control

6. Minimum requirements for designated hospital & clinic

7. Reporting sickness on board and reporting on containers

8. Recovering cost

Epidemic and Pandemic Alert and Response (EPR) 15

Capacity Strengthening at Points of Entry

Lyon- 2-5 April '06

Capacity strengtening at Points of EntryCapacity strengtening at Points of EntryStandard operating proceduresStandard operating procedures

GuidesGuides

Guide to ship sanitation – publication early 2007

Guide to hygiene and sanitation in aviation – in progress (peer review June 2007)

International Health Regulations (2005) Update on implementation WHO/EPR.

Documents

Transcript of International Health Regulations (2005) Update on implementation WHO/EPR.