REGIONAL COMMITTEE
Provisional Agenda item 4.3
Sixty-sixth Session SEARO, New Delhi, India 10–13 September 2013
SEA/RC66/8 Rev.1 12 August 2013
Implementation of the International Health Regulations (2005) The International Health Regulations (IHR 2005) came into force in 2007 and required States Parties to establish core capacities to detect, assess and report potential health threats by 15 June 2012. This deadline has now passed and all 11 Member States of the South-East Asia Region have requested an extension and developed a national IHR implementation extension plan, based on a new deadline of 15 June 2014. The IHR self-monitoring data are available from 10 Member States of the Region for 2012. The data showed that the overall (average) level of IHR implementation for these 10 countries was 67%, whereas levels of IHR implementation varied from 42–86%. Implementation was also uneven across capacities, with the lowest (average regional) implementation rates being seen for preparedness (59%) and for chemical (29%) and radiation hazards (44%). Implementation of IHR (2005) core capacities also continues to present a challenge in other areas, including legislation, points of entry, surveillance and laboratory. For many of these technical areas, capacity strengthening requires constructive engagement with stakeholders in health and non-health sectors, as well as support from partners. The IHR also allows an additional extension until June 2016, to be granted by the Director-General in exceptional circumstances. Any such request must be submitted four months in advance of the 15 June 2014 deadline, and be accompanied by a new implementation plan containing: a clear description of capacity gaps; progress made up until that date; proposed actions and a time frame towards establishment of capacities; technical and financial resources required for implementation, including any external assistance required.
Ministries of health and WHO should continue to strengthen advocacy for, and collaborate with non-health sector, technical and donor partners to identify gaps, including for institutional, human and financial resources.
WHO and Member States should also continue to work collectively to bridge identified gaps in IHR core capacities in the most efficient and effective way, for example through the use of existing strategic approaches and by harnessing the resources of States Parties, WHO, technical partners, donors and networks according to their different comparative advantages. The High-Level Preparatory (HLP) Meeting held in the Regional Office in New Delhi, India, from 1 to 3 July 2013 reviewed the attached document and made the following recommendations: Actions by Member States (1) (2) To recommend that the proposed criteria for an extension of IHR core capacity strengthening be discussed in the Sixty-sixth Session of the Regional Committee. For countries anticipating a request for an additional two-year extension from June 2014 until 2016: to undertake a careful assessment of core capacities and develop a strong and feasible implementation plan based on identified gaps and priorities, considering the use of existing strategic frameworks. To further strengthen multisectoral response and links between human health and authorities responsible for managing and securing risks related to livestock, wildlife, environmental health, food safety, chemical safety and radiological safety. To participate actively in efforts to strengthen intercountry collaboration to address identified national and regional capacity gaps, including exchange of information, joint assessments at points of entry (including land crossings), facilitation of study tours and strengthening regional technical networks. To work with partners to mobilize technical and financial resources for national IHR implementation plans, including with those responsible for managing and securing risks related to livestock, wildlife, environmental health, food safety, chemical safety and radiological safety.
(3)
(4)
(5)
Actions by WHO-SEARO (1) To facilitate the assessment of national IHR core capacities and the development of implementation plans that would be required to accompany a request for an extension until 2016. To facilitate intercountry collaboration, including strengthening networks, to address identified national and regional capacity gaps, with a focus on identified priorities, including points of entry and chemical/radiation safety. To advocate for and work with partners including those responsible for managing and securing risks related to livestock, wildlife, environmental health, food safety, chemical safety and radiological safety to mobilize/provide technical and financial support for national IHR implementation plans.
(2)
(3)
The working paper and the HLP recommendations are submitted to the Sixty-sixth Session of the Regional Committee for its consideration.
SEA/RC66/8 Rev.1
Introduction 1. The International Health Regulations (IHR 2005) came into force in 2007 and require States Parties to establish core capacities to detect, assess and report potential health threats by 15 June 2012. The scope of IHR (2005) is broad and includes the following:
Status of implementation of eight core capacities – – – – – – – –
national legislation, policy and financing coordination and national focal point (NFP) communications surveillance response preparedness risk communication human resources laboratory
Development of capacities at points of entry Development of all these capacities across four IHR-relevant hazards (zoonotic, food safety, chemical, radiological and nuclear).
2. The 15 June 2012 deadline has now passed and all 11 Member States of the Region have requested an extension, and developed a national IHR implementation extension plan based on a new deadline of 15 June 2014.
Situation analysis 3. In order to support IHR implementation, a monitoring framework has been made available by WHO to allow States Parties to monitor the status of their national capacities. The reports that result from this process help countries to determine progress, identify areas that can be strengthened, and also serve to highlight areas for WHO and partner support. 4. IHR self-monitoring data are available from 10 Member States of the South-East Asia Region for 2012. The data showed that the overall (average) level of IHR implementation for these 10 countries was 67%, whereas levels of IHR implementation varied among countries from 42–86% 5. Implementation also continues to be uneven across capacities, with the lowest (average regional) implementation rates being seen for preparedness (59%) and for chemical (29%) and radiation hazards (44%). 6. Implementation of IHR (2005) core capacities also continues to present a challenge in other areas, including legislation, points of entry, surveillance and laboratory. For many of these technical areas, capacity strengthening requires constructive engagement with stakeholders in health and non-health sectors, as well as support from partners.
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7. The IHR also allows an additional extension until June 2016, to be granted in exceptional circumstances. The process for reviewing any request for a second extension will be different from the process followed in 2012, with each submission being considered by the DirectorGeneral in conjunction with the IHR Review Committee. It is currently anticipated that such extensions will be sought by a significant number of States Parties. 8. Accordingly, resolution WHA65.23 requested the Director-General, inter alia, "to develop and publish the criteria to be used in 2014 by the Director-General (…) when making decisions about the granting of any further extensions". Although draft criteria have been developed, the Executive Board at its 132nd Session also recommended they would benefit from the opportunity of further consideration by Member States through the mechanism of the regional committee meetings to be held in 2013. Therefore, these draft criteria are presented below.
Draft criteria for an additional IHR extension proposed by the Secretariat 9. Any formal request for an extension must be made in writing to the Director-General at least four months in advance the 15 June 2014 deadline. This request must include a statement explaining the exceptional circumstances that have prevented the development and maintenance of the national IHR (2005) capacities. 10. Any such request must also be accompanied by a new implementation plan that includes the following elements:
a clear description of capacity gaps; progress made in establishing capacities up until that date; proposed actions and a time frame towards establishment of capacities; technical and financial resources required for implementation, including the proportion of these resources that will be invested from national budgets; and the extent of any external support required.
Conclusions
Effective intersectoral collaboration is essential for effective IHR implementation, but can present challenges. Strengthening IHR core capacities for public health legislation, points of entry and chemical and radiation safety remains a priority due to relatively slow progress in the Region. Strong intercountry collaboration and timely information exchange are essential components of IHR implementation at points of entry, including formal and informal ground crossings. Strengthening IHR core capacities may be accelerated through strong intercountry collaboration and through harnessing the use of technical networks, as well as by engaging partner and donor support.