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International Health Regulations (IHR 2005) Laboratory and Zoonosis update. Workshop on Laboratory Diagnosis for Zoonotic Pathogens 30 July – 01 August, Chonburi, Thailand. Dr Richard Brown, WHO Thailand. Priorities and context in the Asia Pacific Region?.
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International Health Regulations (IHR 2005)Laboratory and Zoonosis update Workshop on Laboratory Diagnosis for Zoonotic Pathogens 30 July – 01 August, Chonburi, Thailand Dr Richard Brown, WHO Thailand
Priorities and context in the Asia Pacific Region? • Priority Hazards to Public Health in the Asia Pacific Region..? • Emerging and re-emerging communicable diseases, including zoonoses • Anti-microbial resistance • Increasing incidence / recognition of chemical / toxic events • Increasing incidence of some natural disasters (typhoons & floods) • A changing context… • Rapid economic development and industrialization • Increasing travel • Effects of climate change
What are the revised International Health Regulations (2005)? • An internationally agreed instrument for global public health security • Represents the joint commitment of countries for shared responsibilities and collective defence against the spread of disease • Legally binding for WHO Member States since June 2007
Revision means a new approach • From control at borders, to containment at source • From a‘list of diseases’ to a broad range of threats • From preset measures to risk-based assessment / response • National IHR Focal points • WHO IHR Contact Points in Regional Offices • IHR Department in WHO Headquarters • Annual reporting to the World Health Assembly • Internet-based ‘Event Information Site’ • An IHR ‘Emergency Committee’ and an IHR ‘review process’
What does IHR implementation actually mean…? • Two very important aspects… • An immediate and ongoing requirement for countries to report some types of event when they occur, and for WHO to provide assistance • Joint risk assessment • Joint response • A requirement, linked to a timeframe for countries to establish ‘core capacities’ to detect and respond to public health events (initially, by June 2012)
What needs to be reported to WHO? • Any potential ‘Public Heath Event of International Concern’ (PHEIC) • To help any decision about what to report, some criteria have been established to describe a potential PHEIC • Is the public health impact of the event serious? • Is the event unusual or unexpected? • Is there a significant risk of international spread? • Is there a significant risk of international travel or trade restrictions? • A decision on whether to report an event to WHO will normally be made by the national IHR focal point
IHR Core Capacities • Eight “core capacities” • National legislation, policy and financing • Coordination and National Focal Point (NFP) Communications • Surveillance • Response • Preparedness • Risk communication • Human resources • Laboratory (need to safely diagnose / exclude all important endemic or imported pathogens and support diagnosis of chemical / toxic ‘events’) • Points of Entry • Capacities for IHR-relevant hazards (infectious diseases, zoonoses, food safety, chemical, radio-nuclear)
Current situation…. • Many countries that did not achieve IHR core capacities by June 15th 2014 have already applied for a second 2-year extension, until June 15th 2016 • When countries apply for an extension, they have to submit a detailed implementation plan • In the South-East Asia Region, only Thailand and Indonesia have not requested an extension • There is interest from US Government partners to fund capacity building, including support for leadership by Thailand
Thailand can play an important role in supporting other countries • It is not feasible for all countries to develop high-level capacity for laboratory diagnosis of all infectious diseases • Small countries only need to have access to laboratory • International laboratory networks are more efficient for some purposes • Requires ‘arrangements’ for safe inter-country shipping of specimens • Support can also be provided through • Assessing laboratory services in other countries • Delivery of training • Reviewing / developing guidelines • Supporting outbreak response ‘in the field’