In 2005 the World Health Organization adopted the IHR (International Health Regulations) which – among other things - requires countries to develop mandated surveillance and testing systems, and to report certain disease outbreaks and public health events to WHO.
Although the agreement went into force in 2007, member states had until mid- 2012 to meet core surveillance and response requirements. Many nations failed to meet that deadline, as explained below by the WHO:
A majority of States Parties, however, have requested and obtained a two-year extension to this deadline and, in exceptional circumstances, may be granted an additional extension, not exceeding two years.
The implementation of these standards is a big job, of course (see Ten things you need to do to implement the IHR), and requires a major commitment of money and resources by all member states. A job made even tougher during these times of economic slowdowns.
Today, with the summer 2014 revised deadline approaching, the WHO regional Office For Europe has posted a report indicating that in Europe alone, 21 nations have cited `exceptional circumstances’ and have requested an additional 2 year extension, meaning they may not be fully compliant with IHR until 2016.
Wide international travel and globalized trade offer extraordinary opportunities for the international spread of disease. Today, a health threat in any part of the world is a health threat to any population around the world.
Threats to health also move faster than ever before. They include sudden shocks to health and economies from emerging diseases, such as pandemic and avian influenza, humanitarian emergencies and even potential bioterrorism.
From IHR ratification to first deadline for implementation
In the WHO European Region, 21 countries have requested extensions to the deadline set for developing the core capacities for implementing the International Health Regulations (IHR): June 2014. They need more time to fully develop their capacities to detect, assess, inform about and respond to emergencies.
When the IHR entered into force in 2007, they established an early warning system not only for infectious diseases but for anything that can threaten human health and livelihoods, including radiation and chemical hazards. Since then, countries and WHO/Europe have focused on developing national capacities to make health security a global reality. This goal has not yet been reached. Until all countries are fully prepared to respond to disease outbreaks and emergencies, no country is safe.
Leveraging national capacities until the final deadline for implementation
Better prepared countries are stronger international partners during disease outbreaks and emergencies. WHO/Europe can help.
While countries have developed their capacities to implement the International Health Regulations (IHR) to a large extent, these can only have their full effects if different ministries and neighbour countries coordinate their efforts. Although countries face public health threats on a daily basis, they do not take full advantage of the IHR as a day-to-day tool.
At a meeting in Luxembourg in February 2013, the 55 States Parties to the IHR in the European Region (53 Member States, the Holy See and Liechtenstein) acknowledged that the health sector needs more support to empower national IHR focal points, to test developed capacities, to advocate outside the health sector and to gain the commitment of senior decision-makers. Countries have developed capacities to gather epidemiological data on public health threats, but these can only be useful if they are analysed and shared among sectors and with other countries and WHO.
WHO/Europe has strengthened its role in guiding States Parties to assess public health threats and to develop as fast as possible their IHR capacities in the following areas:
- ports, airports and ground-crossings
- cross-border collaboration among neighbouring regions and countries
- risk communication
- national legislation
- event-based surveillance and early warning systems
- national exercises to test and assess capacities and mechanisms
- topic- or sector-specific support.
The deadline for final implementation of the IHR is 2016. If all countries meet it, they will have a powerful tool to ensure global health security.
One of the big lessons of the 21st century is that oceans and borders are no protection against emerging infectious diseases.
SARS in 2003 spread from China, to Canada, and then on to more than a dozen more countries. In 2009, pandemic H1N1 spread globally in a matter of weeks, winging its way across oceans and time zones aboard commercial airlines. Last month Canada recorded their first imported H5N1 case, and just today, Malaysia and Hong Kong are reporting imported cases of H7N9.
The next global health threat – be it a novel flu, coronavirus, other pathogen – could appear at any time. Which is why the WHO is stressing the importance of all nations fully implementing the IHR.
As they state in their infographic:
Until all sectors are on board with the IHR, no country is ready.