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The International Health Regulations (IHR) are a binding agreement that all Member States of the World Health Organization (WHO) have accepted. The IHR are designed to enable rapid identification and a harmonized response to public health emergencies of international concern (PHEIC). To achieve these objectives, the IHR require countries to meet core capacities for surveillance and response at designated points of entry. The IHR also provide a risk assessment algorithm a with time line for reporting of potential PHEICs to WHO.
METHODS:
Since the IHR came into force in 2007, countries should annually report the status of IHR implementation to the World Health Assembly. In 2012, countries had the possibility to request a 2-year extension from WHO to achieve the core capacities according to an action plan addressing gaps. This report describes the U.S. implementation of core capacities.
RESULTS:
The U.S. determined that the IHR core capacities were fully in place. This is exemplified by the fact that the U.S. reported 53 potential PHEICs to WHO, including the 2009 H1N1 pandemic, the only event, to date, determined by the WHO Director General to be a PHEIC. In the U.S., the Assistant Secretary of Preparedness and Response oversees the overall implementation of the IHR; the Centers for Disease Control and Prevention has formed an IHR working group and developed standard operating procedures for assessment and reporting of potential PHEICs; CSTE has developed position statements; and states have participated in assessment and reporting of public health events.
In the U.S. the federal government has the responsibility to assess an event and notify WHO of potential PHEICs. To fulfill this obligation, public health practitioners at all levels including astute clinicians need to report unusual public health events early, often and with an awareness of our global connectedness and responsibility. The federal government also has the responsibility to maintain the core capacities at designated points of entry, but can only do so within a well-functioning public health and medical system including e.g., ambulatory services, contact tracing, food inspection services.
CONCLUSIONS:
To fully benefits from the implementation of the IHR, there is a need to maintain good collaboration between global, federal, state and local partners, and across sectors. Therefore, sustained awareness and ongoing education at all levels are required to maintain the desired level of capacities needed to detect, assess, and report public health events with implications beyond the U.S. borders.