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Guénaël Rodier, WHO, Geneva

A new international framework, an opportunity for strengthening health systems. WHO / World Bank videoconference 19 September 2008. Guénaël Rodier, WHO, Geneva. HIV/AIDS CHERNOBYL PLAGUE EBOLA / MARBURG NvCJD NIPAH YELLOW FEVER. ANTHRAX SARS

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Guénaël Rodier, WHO, Geneva

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  1. A new international framework, an opportunity for strengthening health systems WHO / World Bank videoconference 19 September 2008 Guénaël Rodier, WHO, Geneva

  2. HIV/AIDS CHERNOBYL PLAGUE EBOLA / MARBURG NvCJD NIPAH YELLOW FEVER ... ANTHRAX SARS MENINGITIS CHOLERA CHEMICAL AVIAN INFLUENZA XDR-TB ... 30 years of international public health threats

  3. May 1995, WHA Resolution on the Revision of the IHR Overall drive and rationale • Economic impact (HIV/AIDS, meningitis, BSE/NvCJ, SARS, Avian influenza, BT …) • Global concern(international spread) • World unprepared:IHR(1969) obsolete • limited list of diseases (cholera, plague, yellow fever – revised 1983) • focus on borders (ports, airports) • pre-set rather than tailored measures • do not address international coordination

  4. “ to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade" (Article 2) International Health Regulations 1969, 2005: IHR purpose remains the same

  5. IHR (2005): Three Paradigm Shifts • From control of borders to [also] containment at source • From diseases list toall public health threats • From preset measures toadapted responses Entered into force on 15 June 2007

  6. Four Technical areas A legal and monitoring framework Awareness Seven strategic actions to guide IHR(2005) implementation World Health Report 2007

  7. Other intergovernmental organizations: UN system (e.g. FAO, IAEA, ICAO, IMO) others: regional (e.g. EU, ASEAN), technical (e.g. OIE) Development agencies: governments, banks WHO Collaborating centres Academics & professional associations Industry associations NGOs and Foundations The IHR foster global partnership

  8. Health system • Epidemiology • Laboratory • Preparedness • Case management • Infection control • Social mobilisation • Communication • … IHR Annex 1A At community, intermediate, and national level.

  9. Investing in Human resources (training, distance learning, twinning programmes …) Infrastructure (buildings, equipments, logistics …) Standard Operating Procedures (investigation, response, biosafety …) (Annex 1A): “capacity to detect, assess, notify and report events in accordance with this Regulations …” • In the areas of • Laboratory quality system (EQA programmes, biosafety, specimen collection, lab regional network, twinning programmes …) • Surveillance and response systems (epidemic intelligence, field investigation, data analysis, risk assessment, reporting, points of entry …) • Communication (social mobilization, media, web, on-line training …)

  10. Ports • Airports • Ground crossings IHR Annex 1B, (also 3, 4, 5, 8, and 9) • Intersectoral collaboration • Aviation sector (ICAO, ACI, IATA) • Shipping (IMO, ISF, CLIA) • Railways (UIC)

  11. The LYO mission is to coordinate and support WHO's effort in the Regions to strengthen laboratory diagnostic capacity, national surveillance and response systems, and facilities at designated points of entry (e.g. airports, ports) in order that all countries can meet the core capacity required under the IHR.

  12. Timeline 2 years + 3 + (2) + (up to 2) 2007 2009 2012 2014 2016 Planning Implementation Possible extensions "As soon as possible but no later than five years from entry into force …" Core capacity requirements for surveillance and response (Annex 1A): “capacity to detect, assess, notify and report events in accordance with this Regulations …”

  13. Intelligence • Verification • Risk assessment • Response (GOARN) • Logistics • … IHR Annex 2 (notification instrument) "Event-based" surveillance and response at global level

  14. Global Outbreak Alert & Response Network (GOARN)Institutions and Partner Network

  15. Responsible authorities (Article 4) “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; • Notification • Reports • Consultation • Verification WHO IHR Contact Point National IHR Focal Point (One per State Party) (One per WHO Region)

  16. Influenza • Polio • SARS • Smallpox • Cholera • Meningitis • Yellow fever • Food safety • Chemical safety • Radionuclear safety • … • Tuberculosis • Malaria • HIV/AIDS • EPI Driving forces at country level … but vertical and not integrated GFATM UNAIDS GAVI ICG INFOSAN IAEA

  17. Thank you w w w . w h o . i n t / i h r IHR News The WHO quarterly bulletin on IHR implementation

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