Strengthening global health security by embedding the International Health Regulations requirements into national health systems

Kluge, Hans; Martín-Moreno, Jose Maria; Emiroglu, Nedret; Rodier, Guenael; Kelley, Edward; Vujnovic, Melitta; Permanand, Govin

some of the implementation gaps and failings already identified. For instance, the USA employs a public health legal preparedness (PHLP) framework, which represents a legal imperative for multisectoral action in emergencies. 18 While the US framework was borne of the need to serve a federal structure, there is a need for something similar in countries in order to formally mandate obligatory multisectoral responses in support of health system emergency preparedness and the IHR (2005). And while this cannot necessarily eliminate the potential for domestic political factors to impede IHR (2005) compliance-as was the case with both the H1N1 pandemic and Ebola outbreak-such a meso-level bottom-up approach can help to ensure an adequate response and make the case for greater compliance. This is in line with calls from civil society for a 'socialisation' of the IHR (2005), 19 the need for strong intervention at and with community level 20 and the need to confer national ownership to countries. A stronger implementation of the IHR (2005), both in terms of its embedding into the fabric of health systems and into national law, potentially supported via an external funding source, 21 could facilitate improved and timely detection and response to health threats, and governance more widely.