Bulletin of the World Health Organization

Should this event be notified to the World Health Organization? Reliability of the International Health Regulations notification assessment process

Thomas Haustein, Helge Hollmeyer, Max Hardiman, Stephan Harbarth & Didier Pittet

Volume 89, Number 4, April 2011, 296-303

Table 1. Decisions made by an expert panel and 141 National International Health Regulations’ Focal Points when using Annex 2 of the International Health Regulations (2005) to assess whether the public health events described in 10 survey scenarios should be reported to the World Health Organization

Scenario Responses Survey item
1
2
3
4
5
6
Personal opiniona Criterion 1 of IHR Annex 2b Criterion 2 of IHR Annex 2c Criterion 3 of IHR Annex 2d Criterion 4 of IHR Annex 2e Notification decisionf
1 Expert panel’s NA Yes Yes No No Yes
NFPs “yes”, %g 87.2 95.7 92.9 38.3 19.1 90.8
NFPs “no”, % 8.5 3.5 5.7 24.8 52.5 7.8
NFPs “don’t know”, % 4.3 0.7 1.4 36.9 28.4 1.4
2 Expert panel’s NA Yes Yes Undecided No Yes
NFPs “yes”, %g 76.6 97.2 80.1 45.4 14.2 78.0
NFPs “no”, % 22.0 2.1 17.0 51.8 82.3 18.4
NFPs “don’t know”, % 1.4 0.7 2.8 2.8 3.5 3.5
3 Expert panel’s NA Yes Yes Undecided Undecided Yes
NFPs “yes”, %g 78.0 80.9 77.3 48.2 21.3 75.9
NFPs “no”, % 19.9 16.3 19.1 47.5 75.9 21.3
NFPs “don’t know”, % 2.1 2.8 3.5 4.3 2.8 2.8
4 Expert panel’s NA Yes Undecided No No No
NFPs “yes”, %g 55.3 90.1 56.0 19.1 3.5 55.3
NFPs “no”, % 39.7 9.2 43.3 70.2 92.9 41.8
NFPs “don’t know”, % 5.0 0.7 0.7 10.6 3.5 2.8
5 Expert panel’s NA No No No No No
NFPs “yes”, %g 32.6 50.4 8.5 41.1 17.7 38.3
NFPs “no”, % 66.0 49.6 90.8 55.3 78.7 60.3
NFPs “don’t know”, % 1.4 0.0 0.7 3.5 3.5 1.4
6 Expert panel’s NA Yes No No No No
NFPs “yes”, %g 48.9 74.5 63.8 16.3 17.0 53.9
NFPs “no”, % 50.4 24.1 31.9 81.6 80.1 46.1
NFPs “don’t know”, % 0.7 1.4 4.3 2.1 2.8 0.0
7 Expert panel’s NA NA NA NA NA Yes
NFPs “yes”, %g 87.9 77.3 82.3 61.0 12.8 88.7
NFPs “no”, % 11.3 21.3 17.7 36.2 82.3 10.6
NFPs “don’t know”, % 0.7 1.4 0.0 2.8 5.0 0.7
8 Expert panel’s NA Yes No No No No
NFPs “yes”, %g 36.2 69.5 77.3 7.1 2.1 41.8
NFPs “no”, % 61.7 26.2 19.1 90.8 96.5 55.3
NFPs “don’t know”, % 2.1 4.3 3.5 2.1 1.4 2.8
9 Expert panel’s NA Undecided No Undecided Yes Yes
NFPs “yes”, %g 78.7 77.3 81.6 52.5 58.9 82.3
NFPs “no”, % 19.1 17.7 14.2 39.0 34.0 14.9
NFPs “don’t know”, % 2.1 5.0 4.3 8.5 7.1 2.8
10 Expert panel’s NA Undecided Undecided Undecided Yes Undecided
NFPs “yes”, %g 63.8 39.7 74.5 83.0 85.8 78.0
NFPs “no”, % 33.3 57.4 22.7 11.3 12.8 20.6
NFPs “don’t know”, % 2.8 2.8 2.8 5.7 1.4 1.4

IHR, International Health Regulations; NA, not applicable; NFP, National IHR Focal Point.

a The personal opinions of the individuals who responded on behalf of the NFPs were obtained by asking the question: Before using the decision instrument or any relevant guidance, please tell us whether you personally consider that the event should be reported to the World Health Organization.

b For criterion 1, the question was: Is the public health impact of the event serious?

c For criterion 2, the question was: Is the event unusual or unexpected?

d For criterion 3, the question was: Is there a significant risk of international spread?

e For criterion 4, the question was: Is there a significant risk of international travel or trade restrictions?

f For the notification decision, the question was: Does this event need to be notified to the World Health Organization under Article 6 of the IHR?

g Percentages indicate the proportions of NFPs who chose a given answer. The totals for each scenario may not equal 100% due to rounding.