Emerging Viral Diseases: The One Health Connection: Workshop Summary by Eileen R. Choffnes

Author:Eileen R. Choffnes
Language: eng
Format: epub
Publisher: The National Academies Press
Published: 2015-03-31T00:00:00+00:00

TABLE A5-1 World Health Organization (WHO) Pandemic-Phase Descriptions and Main Actions According to Phase

FIGURE A5-1 H1N1 influenza pandemic. Data are from the World Health Organization and http://fluNet.org.

2005 International Health Regulations

A number of provisions of the 2005 IHR proved helpful in dealing with the 2009 H1N1 pandemic. For example, the 2005 IHR established systematic approaches to surveillance, early-warning systems, and response in member states and promoted technical cooperation and sharing of logistic support. Communication among countries and the WHO was strengthened by the establishment in each member state of National Focal Points—national offices that would be responsible for rapid collection and dissemination of emerging data and guidance.

A static and potentially outdated list of notifiable diseases in previous regulations was replaced by a more flexible flow diagram and decision tool that identified conditions warranting public health action. The 2005 IHR required, for the first time, that member states implementing unilateral measures that interfere with international traffic and trade inform the WHO and that they also provide a public health rationale and scientific justification for those measures. Most important, the 2005 IHR formally assigned to the WHO the authority to declare a public health emergency of international concern and take a leading role in the global response.

Despite these positive features, many member states did not have in place the capacities called for in the IHR, nor were they on a path to meet their obligations by the 2012 deadline specified in the document. Of the 194 eligible states, 128 (66%) responded to a WHO questionnaire on their state of progress in 2011. Only 58% of the responding member states reported having developed national plans to meet their core capacity requirements, and only 10% claimed to have fully established the capacities called for in the IHR (WHO, 2011a).

The IHR fails to specify a basis for virus sharing and vaccine sharing. This has been partially ameliorated in a framework for pandemic-influenza preparedness, adopted in 2011, that calls on member states to encourage vaccine manufacturers to set aside a fraction of their pandemic-vaccine production for donation and for discounted pricing in developing countries (WHO, 2011b). A glaring gap in the IHR, which has not been remedied, is its lack of enforceable sanctions. For example, if a country fails to explain why it restricted trade or travel, no financial penalties or punitive trade sanctions are called for under the 2005 IHR.

World Health Organization

The WHO is an indispensable global resource for leading and coordinating the response to a pandemic. In the 2009 H1N1 pandemic, the WHO had many notable achievements. The organization provided guidance to inform national influenza-preparedness plans, which were in place in 74 countries at the time of the first outbreak in North America, and helped countries monitor their development of IHR core capacities. The WHO Global Influenza Surveillance Network detected, identified, and characterized the virus in a timely manner and monitored the course of the pandemic.

Within 48 hours after the activation of provisions in the 2005 IHR, the WHO convened the first meeting of the emergency committee of experts who would advise the WHO on the status of the pandemic.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.