Summary
IHR(International health regulations) are an important set of global rules focusing on public health that aim to manage and address threats to population health around the world. Originally formulated in the year 1969 and revised in the year 2005 of the World Health Assembly, IHR assists countries in controlling the spread of disease across borders.
Origins and Evolution Of IHR
The development of the IHR can be dated back to the nineteenth century during conferences on international sanitary conventions concerned with the spread of cholera, plague and yellow fever across borders. Such conferences provide framework in the disease control collaborative effort.
In 1951, the WHO adopted the International Sanitary Regulations dealing with six quarantinable diseases. These regulations were later updated by 1969 and called the International Health Regulations in order to enforce the globalization of health risks.
Milestones in IHR History
1969: The IHR were codified and included the diseases of cholera, plague, and yellow fever.
1973 & 1981: Revision also occurred to the developments of the diseases; for instance, small pox were eradicated.
1995: The need to update IHR started with the level of globalization trading, traveling and new disease emergence such as Ebola and the re-emergence of diseases such as cholera.
2005: After the SARS outbreak (2002-2004), these IHR were overhauled radically, and their ambit was expanded to respond to any PHEIC.
Key Features of the 2005 Revisions
The updated IHR introduced several transformative elements:
- An approach that is centered on the recognition as well as management of all forms of risks to public health instead of individual diseases.
- Creating a new classification, PHEIC, which will help to organize a quicker and more effective reaction of the world.
- To enable the combined social body of the WHO to function as the paramount surveillance and coordination agency at the global level.
- The IHR's first full use was during the 2009 Swine Flu pandemic, which demonstrated how it could be used in navigating through global health disasters.
Challenges and Progress in the 21st Century
Although, the IHR has the advantage of the above principles, its implementation is likely to be faced with some challenges. The 2014 Ebola virus disease outbreak and the 2016 Zika virus epidemic illustrated that the field of health security and the resilience of nations requires improvements in the linkage between health security and health systems.
Subsequent evaluations focused more on increasing effectiveness, increasing conformity, and reducing asymmetry of resources amongst different countries.
Public Health Emergency of International Concern (PHEIC)
An epidemiological alert PHEIC according to the IHR 2005 is “an event…which poses an international public health risk through the potential spread abroad.”
Key criteria for declaring a PHEIC include:
- In certain serious, sudden, unusual or unexpected circumstances.
- Findings and conclusion: International perspective and cross border repercussion in the field of public health.
- Finding that there is an urgent need for international action.
Examples of PHEIC Declarations (since 2007):
| Year | Event Description |
| 2009 | H1N1 swine flu pandemic |
| 2014 | Challenges in global polio eradication efforts |
| 2013–2016 | West African Ebola outbreak |
| 2016 | Zika virus outbreak |
| 2018–2019 | Kivu Ebola epidemic |
| 2019–2023 | COVID-19 pandemic |
| 2022 | Monkeypox outbreak |
| 2024 | Mpox clade 1b outbreak |
Key Bodies and Processes:
IHR Experts Roster: A center of gravity of international specialists from different fields of knowledge.
Emergency Committee (EC): Temporary committee helping the Director-General of the World Health Organization in emergencies. Members are event specific and come up with temporary recommendation which are reviewed from time to time preferably after three months.
Review Committee: Examines IHR effectiveness and makes recommendations for improvement, by calling for better parity in implementation and stronger representation of diverse expertise from around the world.
Criticisms of the IHR
The poor reaction to the West Africa Ebola outbreak also highlighted the flaws in health care mechanisms of the world.
As we saw by 2015, most of the world’s countries could not provide the minimum necessary health care requirements to address such crises.
Key issues identified included:
Core Capacities: Lack of adequate monitoring measures and poor identification of epidemic procedures.
Trade and Travel Restrictions: Pre-Exacerbation Measures That Do Not Make Sense and Deter Reporting of Outbreaks.
Outbreak Reporting: That shows how delays affect its introduction because of fear of economic and political consequences.
Recommendations for Improvement:
- To build and enhance the core capacities through external and domestic investments.
- Reduce unnecessary trade and movement barriers with international benchmarks.
- Improve first and second generation reporting gain by providing adequate operational and financial backing.
Joint External Evaluations (JEE):
JEEs evaluate a country’s capacities to mitigate, identify and manage threats to the health of the community. They began in 2016, they said, also pointing out deficiencies in biosecurity systems and developing things like the Australia National Action Plan for Health Security 2019 – 2023.
PHEICs demonstrate the need to have international collaborative efforts, an early response, and sound public health infrastructure to prevent and control global health threats.
The Future of the IHR
It is significant to augment the IHR when there is tremendous connection between different countries in the world. They suggest that IHR should be incorporated into the national health care policies, the international cooperation should be enhanced, and the tendencies in the use of technology for disease surveillance identification should be taken into consideration. The following measures will guarantee the international health regulation to protect the world’s health, human rights, and national sovereignty.
The IHR's enduring relevance lies in its vision of collective action, uniting nations in their shared responsibility to combat health threats. As the world faces emerging challenges, the IHR remains a vital instrument in the pursuit of global health security.
Data of this article is taken from the official website of WHO(World health organization).
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