Trade, foreign policy, diplomacy and health

8. International Health Regulations and Epidemic Control

Johan Giesecke

1. New operational directions

  • Use of other information sources
  • Informal, confidential notification
  • A wider remit
  • Guaranteed assistance
  • A rapid, transparent decision mechanism

There are 5 changes that need to be made to the way the Regulations operate:

  • Use of other information sources. Although WHO cannot act on rumours, the present obligation to report cases of certain diseases should be extended to an obligation to rapidly respond to requests from WHO for more information based on unofficial reports. This extension is not without political problems, since it shifts the initiative from the country to the WHO.
  • Informal, confidential notification. Reporting could be made more acceptable by adding a proviso to the IHR that Member States could consult the WHO about an outbreak that could possibly spread to other countries without this information being made public.When news about the outbreak breaks, the country could gain credibility through co-operating with WHO.
  • A wider remit. There seems little value in having a list of notifiable diseases in the IHR. Instead, countries should notify 'urgent international public health events', with a number of criteria to define this concept given in the IHR.
  • Guaranteed assistance. The obligation of the WHO to rapidly assist countries in controlling outbreaks should be clearly spelt out in the IHR. This would be one of the most important factors to increase countries' propensity to report outbreaks.
  • A rapid, transparent decision mechanism. With the widened scope of the IHR from a short list of diseases to 'urgent international events' it follows that adequate international control measures cannot be listed beforehand. They need to be tailored to the actual epidemiological situation, and may change as this evolves. WHO must establish a mechanism to rapidly collect the best available data, and to turn this into a recommendation or a directive.