Background to the International Health Regulations

The International Health Regulations 2005 are the authoritative World Health Organization (WHO) framework for preventing and controlling the spread of infectious disease and other hazards that may pose a global risk to public health.

At a day-to-day level, key components of the IHR have been incorporated into New Zealand’s domestic legislation and underpin the routine pest control measures associated with ports, airports, ships and aircraft, and the routine border health provisions governing quarantinable diseases.

The IHR also require disease reporting to WHO to help the world body with its global surveillance and advisory role.

The former IHR 1969 were narrowly focused on the management and reporting of three particular diseases (cholera, yellow fever and plague). In recent years there have been a number of disease outbreaks of international significance, including most notably several avian influenza incidents and of course SARS in 2003. WHO played an important role in monitoring and coordinating responses to these outbreaks, and the experience gained was used directly to inform further work on the revision process.

The revised IHR were adopted at the World Health Assembly in May 2005, and entered into force on 15 June 2007.

In addition to retaining many of the tried and true features (such as pratique, a focus on disease vectors as well as diseases, and the expectations around sanitary measures for ships, aircraft, ports and airports), the IHR 2005 also include some innovative new provisions.

These include:

  • a deliberate focus on a broader range of threats to public health, including unusual events or those of unknown origin, rather than just focusing on a short list of specified diseases
  • explicit expectations that countries will develop and maintain the capacities for local and national surveillance and to mount timely and coordinated responses to threats to public health
  • a requirement to rapidly assess and then notify WHO of events which might constitute a potential public health emergency of international concern, along with a flow-chart (decision instrument) to assist countries make such assessments
  • a mechanism for confidential consultations between member states and WHO in circumstances where a formal notification is not quite justified or may be a marginal call
  • recognition that WHO may take into account information from unofficial as well as from official sources in forming its views about an emerging issue, and that WHO may initiate investigations in conjunction with member states, (rather than waiting to be formally invited).
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