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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
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
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
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
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
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)