International Health Regulations (2005)
The World Health Assembly – the decision-making body of the World Health Organization – adopted the International Health Regulations (IHR) on May 23, 2005, in its 58th meeting in Geneva, Switzerland. The purpose of the Regulations, Article 2 of the IHR notes, is “…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.” The IHR (2005) entered into force on June 15, 2007.
are 196 States Parties to the IHR (2005), including India.
IHR contain 66 Articles in 10 parts. Articles 1 to 4 (Part I) cover the
definitions, purpose and principles of the IHR, and specify the authorities
responsible for implementation. Articles 5-14 (Part II) cover such themes as communicating
information during unexpected public health events, and the WHO’s role in
determining the existence of a public health emergency of international concern
and providing information about it. Articles 15-18 (Part III) outline the WHO’s
recommendations on appropriate health measures for States Parties. Articles
19-22 (Part IV) discuss such measures pertaining to ports and airports in each
23-34 (Part V) discuss general and special measures for international travel,
and conveyance operators, ships, trains, civilian lorries, and aircrafts in
transit. Articles 35-39 (Part VI) pertain to health documents. Articles 40-41
(Part VII) discuss the charges for health measures to be implemented. Articles
42-46 (Part VIII) cover additional health measures and the treatment of
personal data for public health purposes. Articles 47-53 (Part IX) propose the
establishment of an IHR Roster of Experts, an Emergency Committee and a Review
Committee to recommend amendments to the IHR. Articles 54-66 (Part X) cover
amendments to the IHR, the IHR’s relationship with other international
agreements, and the settlement of disputes among States Parties.
What do the IHR (2005) say about States Parties’ response to public health emergencies of international concern?
The Regulations mandate that States Parties develop, strengthen and maintain their capacity to detect, assess, notify and report events that constitute public health emergencies of international concern.
If a State Party has evidence of an unexpected or unusual public health event within its territory that constitute a public health emergency of international concern, it shall notify WHO within 24 hours of such an assessment and provide them with all relevant public health information. The State Party shall inform WHO whether the disease can be spread internationally through the import or export of human cases, vectors (insects and other animals which transport infectious agents that constitute a public health risk), and contaminated goods.
What is a ‘public health emergency of international concern’?
The IHR define a ‘public health emergency of international concern’ as an extraordinary event which constitutes a ‘public health risk’ to other States through the international spread of diseases, which potentially requires a coordinated international response. A public health risk refers to the likelihood of an event that may adversely affect the health of human populations, especially events that may spread internationally or present a serious and direct danger.
The director-general of WHO shall determine whether an event constitutes a public health emergency of international concern on the basis of the information received – in particular from the State Party within whose territory such an event is occurring.
What is the role of WHO under the IHR (2005)?
Upon request, WHO shall assist States Parties to develop, strengthen and maintain the capacity to detect, assess, notify and report events that constitute public health emergencies of international concern. It shall collect information through its ‘surveillance’ activities and assess their potential to spread the disease internationally. ‘Surveillance’ refers to the systematic and ongoing collection, collation and analysis of data for public health purposes, and the timely dissemination of information for assessment and public health response.
At the request of a State Party, WHO shall provide technical guidance and assistance for that State’s response to a public health emergency of international concern – it shall assess the effectiveness of control measures already in place, and mobilise international teams of experts for on-site assistance, if necessary.
WHO shall coordinate its activities with other intergovernmental organisations or bodies, and cooperate with them to implement the IHR.
What regulations do the IHR (2005) prescribe for international travellers?
The IHR say that a State Party may require information on an international traveller’s destination and their health documents. The State may ask for the itinerary to ascertain if the person/s travelled in, or near, an area affected by disease, or whether they had other possible contacts with infection.
If the State Party believes that a traveller may pose an imminent public health risk, it may compel them to undergo a “…non-invasive medical examination [to] achieve the public health objective”, vaccination, or additional established health measures that prevent or control the spread of disease, including isolation, quarantine or placing the traveller under observation.
The IHR mandate that States Parties shall treat all travellers with courtesy and respect; take into consideration their gender, sociocultural, ethnic or religious concerns; and arrange adequate food, water, accommodation and other appropriate assistance for travellers who are quarantined, isolated or subject to medical examinations or other procedures for public health purposes.
Focus and Factoids by Pratik Dixit.
PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.
World Health Organization
World Health Organization
23 May, 2005