3 4 December, Bangkok. Overview of IHR (2005)

Transcription

1 3 4 December, Bangkok Overview of IHR (2005)

2 Overview of IHR IHR Implementation at PoE

3 What do the IHR call for? Strengthened national capacity for surveillance and control, including in travel and transport Prevention, alert and response to international public health emergencies Global partnership and international collaboration Rights, obligations and procedures, and progress monitoring

4 44 years of international health in security HIV/AIDS ANTHRAX CHERNOBYL SARS PLAGUE MENINGITIS EBOLA / CHOLERA MARBURG CHEMICAL NvCJD AVIAN INFLUENZA NIPAH XDR TB YELLOW FEVER MERS CoV

5 Purpose of IHR (2005) SARS Cases 19 February to 5 July 2003 Total: 8,439 cases, 812 deaths, 30 co untries i n 7-8 mo nths To prevent, protect against, control and provide a public health response to the international spreadof disease In ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade (Article 2) Canada (243) USA (72) Colom bia (1) Brazil (3) Europe: 10 countries (38) South Afr ica (1) Russian Fed. (1) Mongolia (9) China (5326) Kuwait (1) Hong Kong (1755) India (3) Viet Na m (63) Singa pore (206) Source: Korea Rep. (3) Macao (1) Taiwan (698) Malaysia (5) Indones ia (2) Philip pines (14) Thailan d (9) Australia (5) New Zealand (1)

6 Why IHR (2005) Populations grow, age,andand move Diseases travel fast Microbes adapt Health security is at risk Chemical, radiation, foodrisks increase

7 Global threats: why are we concerned? Epidemics not new, but took days, weeks/months to reach far territories Emergence/re emergence of infectious diseasesand and increased pace of spread Threat of deliberate use of biological and chemical agents Impact on health, economy, security

8 Global threats : International Health Security

9 Screening of exit passengers 2003: SARS changes theworld WHO travel recommendations WHO travel recommendations removed 27 March 2 April 25 May 23 June Number of passe enger SARS: an unknown coronavirus 8098 cases 774 deaths 26 countries affected trends in airline passenger movement drop economic loss: US$ 60 billion May 3/16 3/19 3/22 3/25 3/28 3/31 4/3 4/6 4/9 4/12 4/15 4/18 4/21 4/24 4/27 4/30 5/3 5/6 5/9 5/12 5/15 5/18 5/21 5/24 5/27 5/30 6/2 6/5 6/8 6/11 6/14 6/17

10 MERS CoV new concern!

11 IHR(2005): a paradigm shift From control of borders to containment at source From diseases list to all threats From preset measures to adapted and real time response

12 Highlights g of IHR (2005) Much broader scope National IHR Focal Point & competent authorities Consultation, notification, verification & assessment Recommended measures from WHO in public health emergencies of international concern National core capacity requirements

13 Acute public health threats are collectively managed The IHR define a risk management process where States Parties work together, coordinated by WHO, to collectively manage acute public health risks. The key functions of this global system, for States and WHO, are to: detect verify assess inform assist

14 National IHR Focal Point The national centre for communications with WHO On a 24/7 basis NOT an individual person Legally required functions Sending urgent communications to WHO Disseminating information to and consolidating inputs from relevant governmental sectors/institutes/agencies Potential additional tasks as determined by State: Risk assessment, coordinated response etc.

15 Importance of nationalcapacity Thebest way to prevent ent international spread of diseases is to detect public health threats early and implement effective measures when the problem is at local level

16 National lihr Focal lpoints Communications and Information management Receiving from WHO Providing to WHO: Information Notification, continuing information Requests Verification Determinations Consultation Recommendations Reporting National Disseminating information, recommendations and requests from WHO Receiving information from national sectors Interacting with senior health and other government officials

17 IHR National lfocal lpoints Co ordination and assessment National capacity assessment, planning and reporting Linking to national emergency response systems Risk assessment International responses

18 Surveillance and response capacity At national level Assessment At local level Notification (to WHO) Detection of events Public health response Reporting Control measures Support t(tfflb) (staff, lab) Control measures On site assistance At intermediate levels Operational Confirmation links/liaison Public health Assessment emergency response Reporting plan On 24 hour basis

19 Verification of events Value of unofficial sources of information for early alert (to beassessedandverification and requested) WHO mandated to seek verification (from State Party in which event arising) of events which may be emergencies of international concern States Parties must give initial reply within 24 hours and provide of information Offer On siteassessment, whennecessary necessary

20 IHR Event notification and determination i Determine whether an event constitutes t a PHEIC and recommend measures WHO DG External advice Emergency Committee Review Committee WHO s Expert Roster Receive, assess and respond to events notified WHO IHR Contact Points Coordinate Other competent Organizations (IAEA etc.) Consult events or notify WHO of any events that may constitute a PHEIC National IHR Focal Points Communicate Ministries/ Sectors Concerned Detect and report any urgent or unexpected events Various disease and event surveillance systems within a country Report

21 Answer combinations requiring notification Serious and risk ikfor international ti spread Unexpected and risk for international spread Serious and risk for international restrictions Unexpected and risk for international restrictions Risk for international spread and risk for international restrictions

22 Event notification Any event that may constitute a public health emergency of internationalconcern (PHEIC) To WHO within 24 hours of national assessment Continue to provide WHO withdetailed public health information including: case definition, cases/deaths, conditions affecting spread, measures Does NOT mean an actual PHEIC is necessarily occurring

23 Points of entry under the IHR (2005) Points of entry provisions in the International Health Regulations (2005) or (IHR (2005)) are designed to minimize public health risks caused by the spreadof diseases through international traffic.

24 The IHR (2005) define a point of entry as "a passagefor international entry or exit of travelers, baggage, cargo, containers, conveyances, goods and postal parcels, as well as agencies and areas providing services to them on entry or exit"

25 Points of entry There are three types of points of entry: international airports, ports and ground crossings.

26 Capacity Strengthening at Points of Entry Inspection for conveyances(for passenger,cargo vessels & aircrafts) Quarantine/isolation facilities at PoE/off PoE(for suspects, animals) Contingency plans for ports, airports, ground crossings Disinfections/decontamination methods & measures for conveyances, cargo, goods, persons, animals Qualifications for persons carrying out public health inspection/environmental audit/pest control Minimum requirements for designated hospital & clinic Reporting sickness on board and reporting on containers Recovering cost

27 Capacity at Points of entry at all times e a Medical service, staff & equipment b Equipment & personnel for transport c Trained staff and programme for vector control Trained personnel for inspection of conveyances d ensure safe environment, water, catering facilities, wash rooms, disposal services & inspection programmes

28 Capacity at Points of entry during P.H.E.I.C.D a Emergency resp. plan, coordinator, contact points for relevant PoE, PH & other agencies b Provide PH assessment & care for affected travellers, animals, goods by establishing arrangements with medical, veterinary facilities for isolation, treatment & other services c Provide space, separate from other travellers to interview suspect or affected persons g Provide access to required equipment, personnel with protection gear for transfer of travellers with infection/ contamination f To apply entry/exist control for departing & arriving passengers e d To apply recommended measures, disinsect, disinfect, decontaminate, baggage, cargo, containers, conveyances, goods, postal parcels etc Provide for assessment, quarantine of suspect or affected travellers

29 Roles for Competent Authorities i and Conveyance Operators States Parties to the IHR (2005) are required to identify the competent authorities to carry out : 1. development of core capacities at designated points of entry; 2. implementation at points of entry of appropriate levels of hygiene and sanitation as well as ensuring effective vector, rodent and environment control measures and procedures; and 3. application of health measures at points of entry in affected areas.

30 Designating points of entry and assessing core capacity requirements StatesParties shall designate airports and ports and may designated certain ground crossings to develop the capacities provided in Annex 1 of the IHR (2005). Thailand have 18 designed dpoe

31 Ship Sanitation Certificates 15 June 2007 is the date that the International Health Regulations (2005) (IHR (2005)) entered into force. Among the provisions that apply to conveyances is a new Ship Sanitation Control Exemption Certificate/Ship Sanitation Control Certificate SSCEC/SSCC, a model of which is shown in Annex 3. These certificates willreplace the Deratting Certificate/Deratting Exemption Certificate (DC/DEC) issued under IHR (1969).

32 Thecompetent authoritymay proceed to inspect the ship with one of three possible outcomes 1. No evidence of a public health risk is found on board. The competent authority may issue a SSCEC. 2. Evidence of a public health risk is found on board. The competent authority satisfactorily completes or supervises the completion of the necessary control measures and is required to issue a SSCC. The SSCC is valid for a maximum period of 6 months. The control measures must be completed before a further SSCC is issued. 3. The competent authority extends the SSCEC for a period of one month until the ship arrives at a port at which the Ship Sanitation Control lcertificate may be received

33 Guidance on IHR (2005) implementation at points of entry Management of public health risks at points of entry Provisionof of technical assistance in developing points of entry capacities Maintenance ofaccessible data for designated pointsof of entry, including capacity to issue Ship Sanitation Control Exemption and Ship Sanitation Control certificates Inspection and WHO certification criteria for airports and ports Recommended measures for affected travellers, conveyances, containers, cargo and goods Ship sanitation and hygiene and sanitation in aviation Application of health measures at ground crossings

34 Points of entry Challenges for States Review legislation or rules Designate points of entry Inform on Ports list Review practice Assess capacity and plan any strengthening in timetable Develop procedures for linking to National lihr FP Procure and train staff on new documents

35 THANK YOU