World Health Organization Perspective on Implementation of International Health Regulations

Maxwell Charles Hardiman

and World Health Organization Department of Global Capacities, Alert and Response

Author affiliation: World Health Organization, Geneva, Switzerland

Abstract

In 2005, the International Health Regulations were adopted at the 58th World Health Assembly; in June 2007, they were entered into force for most countries. In 2012, the world is approaching a major 5-year milestone in the global commitment to ensure national capacities to identify, investigate, assess, and respond to public health events. In the past 5 years, existing programs have been boosted and some new activities relating to International Health Regulations provisions have been successfully established. The lessons and experience of the past 5 years need to be drawn upon to provide improved direction for the future.

Throughout the >60 years that the World Health Organization (WHO) has been in existence, member states have made use of the constitutional provision that permits the Health Assembly to adopt regulations concerning sanitary and quarantine requirements and other procedures designed to prevent the international spread of disease (1). In 1951, the first such regulations, the International Sanitary Regulations, were adopted and focused on 6 communicable diseases requiring coordinated international measures to control their transmission between countries (2). By the 1990s, they had been amended and renamed the International Health Regulations (IHR); their application was reduced to only 3 diseases, and they were considered inadequate for addressing the increasingly globalized nature of health risks. In 1995, the Health Assembly called on the WHO secretariat to develop revised regulations that were more relevant to worldwide public health challenges (3–5). A process of intensive and wide technical consultation was followed by a series of intergovernmental negotiations in which WHO member states took control of the draft and negotiated additions and amendments to every aspect before agreeing to a final version in time for it to be adopted at the 58th Session of the Health Assembly (6).
Since entering into force in 2007, the IHR have provided a legally binding global framework to support national and international programs and activities aimed at preventing, protecting against, controlling, and providing a public health response to the international spread of disease (7). Although the IHR contain articles directed toward several facets of public health security, they can be broadly summarized into 2 main areas: urgent actions to be taken with respect to acutely arising risks to public health and strengthening of national systems and infrastructure (referred to as core capacities). This article provides an overview of selected contributions to these areas made during the past 5 years. It is written from the perspective of the WHO department charged with coordinating implementation of the IHR at WHO global headquarters in Geneva and seeks to identify major achievements and continuing challenges.