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

In 2009, in the aftermath of the H1N1 influenza pandemic, WHO's Executive Board convened an independent review of the effectiveness of the IHR (2005). 12 The review highlighted a number of positives but concluded that more was required for the world to respond adequately to sustained public health emergencies, and delivered a series of recommendations including lessons for future PHEICs. what are the new findings? â–º That health system strengthening and health security efforts for prevention, alert and response need to be pursued in tandem, as part of the same mutually reinforcing approach to developing resilient health systems, is a new understanding. â–º There is now a demonstrated need to embed the IHR (2005) core capacities into health systems, across the six health system functions, where the leadership and governance function is probably the most important to improving IHR implementation and pursuing Universal Health Coverage (UHC). â–º UHC supports health security (eg, preventing outbreaks through high immunisation coverage, providing early alert by rapid access of all patients to healthcare, better response thanks to reliable infrastructure and healthcare workforce for case management, etc), while health security investment supports UHC by avoiding health crises that prevent patients accessing healthcare (eg, a health workforce diverted from regular care to focus on crisis response, or is itself victim of the crisis as seen during Severe Acute Respiratory Syndrome, influenza pandemics, Ebola, etc; or patients' fear of contamination sees them avoid regular care seeking). â–º Understanding this mutual reinforcement and the urgent need for joint work and synergy between health system strengthening and health security efforts is a new concept.