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

Once an event is reported, WHO reviews the situation declaring the event a PHEIC if it is thought to constitute a public health risk to other countries through the international spread of disease, and if it potentially requires a coordinated international response. To date, despite increasing numbers of potential events being reported, and hundreds of updates and announcements posted on the IHR event information site for National IHR Focal Points, WHO has declared just four PHEICs: influenza A (H1N1) pandemic (2009) InterseCtIons wItH HeAltH systems WHO supports assessments of countries' IHR (2005) 'core capacities'. To date, these have been self-reported and involve States Parties returning annually a completed questionnaire to WHO. Implementation and reporting has not been consistent across countries, 11 13 and the information does not necessarily indicate how the IHR (2005) capacity requirements are actually implemented in the country ii . To improve the quality of reporting, countries have been recommended to move from exclusive self-evaluation to approaches that combine self-evaluation, peer review and voluntary external evaluations involving a combination of domestic and independent experts. This has been addressed by the newly proposed IHR Monitoring and Evaluation Framework which includes, in addition to the self-evaluation, voluntary Joint External Evaluation (JEE), simulation exercises and after-action ii The Commission on Creating a Global Health Risk Framework for the Future (GHRF) noted in its report that only a third of countries had so far complied with the IHR (2005) requirements. reviews. The JEE and the other assessment instruments help assess gaps to develop a national action plan to strengthen country IHR capacity, including through multisectoral action iii .