Background

In 1995, the Member States of the World Health Organization (WHO) decided that they needed better disease surveillance and response tools on a global scale. Ten years later, the World Health Assembly accepted the revised International Health Regulations [IHR (2005)], which now consitutes the latest in the history of international communicable disease law.

The purpose and scope of IHR 2005 are to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade. (Art. 2, IHR 2005

The revised International Health Regulations (2005), a legally binding international agreement (formal status: international law), provide the framework for improved international public health security. It represents a set of rules with defined procedures and responsibilities for WHO and States Parties. The International Health Regulations (2005) call on countries to assess and strengthen their national public health structures and, in time of a public health event which may constitute a public health emergency of international concern, to actively and collectively interact with WHO for information sharing, risk assessment, recommendation and implementation of public health measures.

It is critical that all countries have the capacity to detect, assess and respond to public health events of international concern. Enhanced international health security depends on all countries’ commitment to invest and ensure that this Public Health Capacity is in place. In this context 'Public Health Capacity' means a competent workforce (human resources) in combination with an adequate public health system (plans, procedures, legal framework, funding mechanism and infrastructure). Since such public health capacity is the basis of all defense against communicable diseases, it makes sense that the European Centre for Disease Prevention and Control (ECDC) has to fulfill article 9 of the ECDC Founding regulations: "The Centre shall, as appropriate, support and coordinate training programmes in order to assist Member States and the Commission to have sufficient numbers of trained specialists, in particular in epidemiological surveillance and field investigations, and to have a capability to define health measures to control disease outbreaks."

Topics covered by IHR are:

• International surveillance system
• International rules on response to international threats
• International rules on routine measures against international disease spread
• Procedural rules (WHO and states)

IHR define requirements for core capacities at various levels:

• Event detection
  • Local, regional, national level
• Event assessment and notification
  • National level
• Public health response to events 24/7
  • Support, including on-site assistance
  • Communication links
  • Public health emergency plan

In addition, specific core capacities for designated airports,ports and ground crossings are defined.

How is global public health security ensured ? What are the IHR and why have they been revised? What are the obligations for the WHO member states? What are the implications for surveillance in Member States? How to identify a Public Health Emergency of International Concern?