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International Health Regulations (2005) Update on implementation

International Health Regulations (2005) Update on implementation. WHO/EPR. World Health assembly resolution Early IHR implementation May 2006. Early implementation of IHR on a voluntary basis in the context of pandemic influenza preparedness and response

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International Health Regulations (2005) Update on implementation

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

  2. World Health assembly resolutionEarly IHR implementation May 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

  3. 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) • …

  4. Alert & Response Ops • IHR Contact Point • Intelligence • Verification • Risk assessment • Risk communication • Notification • Response • Coordination • Monitoring • Reporting • Resource mobilisation • Administration • IHR Bodies & Procedures • IHR Focal Points • Roster of experts • Emergency Committee • Review Committee • National legislation WHO Alert, Preparedness, and Response Operations Project Management • Specific threats • influenza • polio • smallpox • SARS • Chemical/Radionuclear • others • IHR Communication • information • education • advocacy National Core Capacity • Country Alert & Response • IHR NFP Operations • National ARO • Laboratory training / support • Epidemiology training / support • National system assessment • Response preparedness • -Social mobilization • -Case management • Points of Entry • Ports • Airports • Ground crossings

  5. Country relevant professionals WHO Senior Management Country IHR Focal Points WHO Country Offices Regional Organizations (ASEAN, EU, …) Media / The public WHO Governing Bodies International Organisations (FAO, OIE, WTO, …) Potential Donors Coordination: Many players to bring on board

  6. IHR Bodies & ProceduresNational 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

  7. IHR 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

  8. Emergency Committee: 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

  9. Emergency Committee: 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

  10. Review Committee: 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

  11. Alert & Response Ops • IHR Contact Point • Intelligence • Verification • Risk assessment • Risk communication • Notification • Response • Coordination • Monitoring • Reporting • Resource mobilisation • Administration • IHR Bodies & Procedures • IHR Focal Points • Roster of experts • Emergency Committee • Review Committee • National legislation WHO Alert, Preparedness, and Response Operations Project Management • Specific threats • influenza • polio • smallpox • SARS • Chemical/Radionuclear • others • IHR Communication • information • education • advocacy National Core Capacity • Country Alert & Response • IHR NFP Operations • National ARO • Laboratory training / support • Epidemiology training / support • National system assessment • Response preparedness • -Social mobilization • -Case management • Points of Entry • Ports • Airports • Ground crossings

  12. Event notification and determination under IHR (2005) External advice Emergency Committee Determine whether an event constitutes a PHEIC and recommend measures WHO DG Other competent Organizations (IAEA etc.) WHO IHR Contact Points Coordinate Receive, assess and respond to events notified Consult events or notify WHO of any events that may constitute a PHEIC Communicate Ministries/ Sectors Concerned National IHR Focal Points Detect and report any urgent or unexpected events Various disease and event surveillance systems within a country Report

  13. WHO IHR contact points - Status • WHORegional 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

  14. Specific threatsInfluenza 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

  15. Alert & Response Ops • IHR Contact Point • Intelligence • Verification • Risk assessment • Risk communication • Notification • Response • Coordination • Monitoring • Reporting • Resource mobilisation • Administration • IHR Bodies & Procedures • IHR Focal Points • Roster of experts • Emergency Committee • Review Committee • National legislation WHO Alert, Preparedness, and Response Operations Project Management • Specific threats • influenza • polio • smallpox • SARS • Chemical/Radionuclear • others • IHR Communication • information • education • advocacy National Core Capacity • Country Alert & Response • IHR NFP Operations • National ARO • Laboratory training / support • Epidemiology training / support • National system assessment • Response preparedness • -Social mobilization • -Case management • Points of Entry • Ports • Airports • Ground crossings

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

  17. National core capacities for IHR • Advance draft on “Minimum and Desirable Core Capacities” • Peripheral • Intermediate • National • Link with requirement for AI pandemic preparedness • Includes preparation to the response

  18. IHR M & E : 5 Pillars System Pillar 1 Policy Planning Financing Pillar 2 IHR Infrastructures &Institutions Pillar 3 IHR Human Resourcesknowledge & skills Pillar 5 IHR Systems and Services Pillar 4 IHR Technical Resources 15Early Warning System 16 Verification and risk assessment system 17Rapid Investigation & Response Team 18Equipments and Stockpiles 19 Functioning laboratory system for PHEIC 11IHR Resources Mapping 12 Telecommunication Resources 13 Infection Control SOPs 14 Clinical Management guidelines for PHEIC • 8IHR training and • continuous education • Roster of professionals with IHR “qualification” • 10ActiveParticipation • in International IHR • related Networks • 4National IHR Focal • Point • 5 Focal Point for • communication • with Media • 6Points of Entry • 7 National Emergency • Committee 1 Legal framework for IHR 2 National Plan for PHEIC 3 Budget allocation for IHR 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…

  19. Points of EntryMontreal 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

  20. Inspection for conveyances(for passenger,cargo vessels & aircrafts) Quarantine/isolation facilities at PoE/off PoE(for suspects, animals) Contingency plans for ports, airports, ground crossings Disinsection/decontamination methods & measures for conveyances, cargo, goods, persons, animals Qualifications for persons carrying out public health inspection/environmental audit/pest control Minimum requirements for designated hospital & clinic Reporting sickness on board and reporting on containers Recovering cost Capacity strengtening at Points of EntryStandard operating procedures Lyon- 2-5 April '06 Capacity Strengthening at Points of Entry Epidemic and Pandemic Alert and Response (EPR) 15

  21. Guides • Guide to ship sanitation – publication early 2007 • Guide to hygiene and sanitation in aviation – in progress (peer review June 2007)

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