International Health Regulations

The International Health Regulations (IHR) are an international legal instrument that covers measures for preventing the transnational spread of infectious diseases.

The IHR were adopted by the 58th World Health Assembly in 2005 through Resolution WHA58.3. They constitute the legal framework that, inter alia, defines national core capacities, including at points of entry, for the management of acute public health events of potential or actual national and international concern, as well as related administrative procedures.

The IHR (2005) has as purpose and scope "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".

Key facts

The IHR is legally binding on 196 countries, including the 194 WHO Member States.
The IHR require countries to designate a National IHR Focal Point for communications with WHO, to establish and maintain core capacities for surveillance and response, including at designated points of entry.
IHR introduce important safeguards to protect the rights of travelers and other persons in relation to the treatment of personal data, informed consent and non-discrimination in the application of health measures.
100% of States Parties - All 196 States Parties have reported on IHR indicators at least once in recent years.
More than 440 experts at the WHO - Rosters of experts established by the WHO Director-General under IHR include more than 440 experts.
83% high-risk countries - 83% of high-risk countries in the Index of Risk Management have interagency preparedness plans.

Overview

This third edition contains the first amendment to the IHR (2005): a revision to Annex 7 adopted by the Sixty-seventh World Health Assembly in 2014. The amendment provides that the period of protection from vaccination with an approved vaccine against infection with Yellow Fever, and the validity of the related certificate, will be for the life of the person vaccinated rather than a period of ten years as previously required. In accordance with the WHO Constitution and the IHR (2005), this amendment entered into force for all States Parties on 11 July 2016. There were no reservations or rejections concerning the amendment submitted by any State Party within the period required by the IHR (2005). This edition also updates Appendix 1 containing the list of IHR (2005) States Parties (to include Liechtenstein and South Sudan). As of the Sixth-ninth World Health Assembly in 2016, three Review Committees have been convened under the IHR (2005) and reported through the Director-General to the Health Assembly with conclusions and recommendations on key aspects of the functioning and implementation of the Regulations.

IHR Implementation

Meeting the requirements in the IHR is a challenge that requires time, commitment and the willingness to change. The IHR require that all countries have the ability to do the following:

Detect: Make sure surveillance systems can detect acute public health events in a timely matter
Assess and report: Use the decision instrument in Annex 2 of the IHR to assess public health events and report to WHO through their National IHR Focal Point those that may constitute a public health emergency of international concern
Respond: Respond to public health risks and emergencies

The goal of country implementation is to limit the spread of health risks to neighboring countries and to prevent unwarranted travel and trade restrictions.

A paper developed to guide WHO Member States and other countries that are parties to the Regulations in the implementation of the obligations contained in them sets out seven areas of work to assist countries with the challenges inherent in meeting the new obligations.

Each area of work has a specific goal that contributes to the overarching goal of international public health security, and each area of work will be the subject of one or more detailed implementation plans.

The seven areas of work for IHR (2005) implementation:

Foster global partnerships
Strengthen national disease prevention, surveillance, control and response systems
Strengthen public health security in travel and transport
Strengthen WHO global alert and response systems
Strengthen the management of specific risks
Sustain rights, obligations and procedures
Conduct studies and monitor progress

Seven Strategic actions to guide IHR (2005) Implementation

Partnerships

In a closely interdependent world, global partnerships are essential to the successful implementation of the IHR. Partnership is required between all countries to share technical skills and resources, to support capacity strengthening at all levels, to support each other in times of crisis and promote transparency.

Partnership between different sectors (e.g. health, agriculture, travel, trade, education, defense) is also essential to build coherent alert and response systems that cover all public health threats, and, at the time of events, are able to rapidly mobilize the required resources in a flexible and responsive way.