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Although many countries do not yet have all the capacities required by the International Health Regulations (IHR), there has been overall an improvement in country capacity for prevention, detection and response to health risks of potential international concern. In a technical session today, part of the 67th World Health Assembly, Margaret Chan, Director of the World Health Organization (WHO), analyzed both achievements and challenges remaining for full implementation of the IHR.

Geneva, 19 May 2104 (PAHO/WHO) - Although many countries do not yet have all the capacities required by the International Health Regulations (IHR), there has been overall an improvement in country capacity for prevention, detection and response to health risks of potential international concern. In a technical session today, part of the 67th World Health Assembly, Margaret Chan, Director of the World Health Organization (WHO), analyzed both achievements and challenges remaining for full implementation of the IHR.

The IHR, which went into effect in 2007, are a binding international legal instrument for WHO's 194 Member States that seeks to help the international community prevent and respond to serious public health risks that could have an impact across national borders.  

Chan said the countries' collective defenses have been strengthened through the IHR while noting  the emergence of new health threats including H7N9 Influenza and Middle East coronavirus (MERS/CoV) as well as the recent re-emergence of Ebola. She thanked WHO Member States involved in the response to Ebola and those that have been managing exported cases of MERS/CoV.

The technical session was chaired by the Minister of Health of South Africa, Precious Matoso, who explained that, despite countries' broad endorsement of the IHR, some 80-90 countries will request an extension until 2016 in order to achieve full implementation. "The recent outbreaks of Ebola and H7N9 remind us that we need to be well prepared," she said.

Experience in the Americas

Ambassador Victoria Velázquez of El Salvador described her country's experience in integrating different institutions and actors into the process of strengthening health security and response capacity. She indicated that the Government of El Salvador was fully committed to IHR implementation, and as of 2013, the country had achieved 90% implementation of the regulations' health protection measures. She noted that this achievement  was a very good example of what can be done, even when resources are scarce.

The U.S. Secretary of Health and Human Services (HHS), Kathleen Sebelius, said that IHR's importance is clear, especially given the recent outbreaks of H7N9 and MERS/CoV. "Outbreaks can be just a plane flight away," she said, while noting that the IHR provide countries with a framework for improving both prevention and response to health risks.

Sebelius reminded delegates that the United States and 28 other countries had joined WHO in February 2014 to launch a new Global Health Security initiative. In September, another high-level meeting will be convened to promote the initiative, this time at the White House.

Chan took the opportunity to bid farewell to Sebelius, who is resigning her post as Secretary of HHS. Chan called her "a champion of global health" and thanked her for her support of WHO and for her efforts to promote equitable access to health care in the United States.

The Minister of Health and Social Welfare of Liberia, Walter T. Gwenigale described his country's recent experience with the ebola virus. He acknowledged WHO's support for Liberia's response to the outbreak. "What we learned is that when you confront something like this, you cannot afford to lose any time. You must immediately let people know what is happening".

Oman's Health Minister, Ahmed bin Mohammed bin Obaid Al Sa'eedi, highlighted the importance of sharing information through the formal channels established in the IHR. Nafsiah Mboi, Minister of Health of Indonesia, called for "the full implementation of the IHR to benefit the entire global family."

Wang Quoquiang, vice-minister of China's National Health and Family Planning Commission, described his country's efforts to respond to the recent outbreak of H7N9 influenza. He said China had succeeded in improving communication between regions and agencies and strengthening detection, case management, and supply of medicines for the illness. He also noted that "information has been open and transparent."

Keiji Fukuda, WHO Assistant Director-General for Health Security, said one of the lessons learned from these outbreaks is that such emergencies produce anxiety, fear and confusion. He said it was important to involve other sectors in the response so it is understood that IHR is an instrument that helps countries rather than just an added burden.

Some of the salient points emerging from these discussions were:

  • That the successful implementation of the IHR requires an all- sector approach
  • That the IHR should be used to strengthen national health systems in order to combat other diseases
  • That physicians in training should be provided with an orientation to global health, the IHR and its implications

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