International health regulations short note psm
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International Health Regulations IHR 2005 PSM community medicine short note
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IHR 2005 key provisions PHEIC core capacities notifiable diseases PSM park textbook
I now have comprehensive information from Park's Textbook of PSM and authoritative WHO/CDC sources. Here is the complete short note:
International Health Regulations (IHR) - Short Note (PSM)
Definition & Purpose
The International Health Regulations (IHR) are a legally binding international legal framework adopted by the World Health Assembly under Articles 21 and 22 of the WHO Constitution. The stated purpose is:
"To prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade."
Historical Evolution
| Version | Year | Notes |
|---|---|---|
| International Sanitary Regulations | 1951 | Original WHO framework |
| IHR (1969) | 1969 | Covered cholera, plague, yellow fever |
| IHR (2005) | 2005 (force: June 2007) | Major revision post-SARS 2002-04 |
| Amendments | 2014, 2022, 2024 | Ongoing updates |
The IHR 2005 is binding on 196 countries (194 WHO member states + 2 non-member states).
Diseases Under IHR
Under IHR 1969 (3rd Annotated Edition, 1983) - 3 diseases notifiable to WHO:
- Cholera
- Plague
- Yellow Fever
Under WHO International Surveillance (additional):
- Louse-borne typhus fever
- Relapsing fever
- Paralytic poliomyelitis
- Malaria
- Viral Influenza-A
- SARS
- Smallpox
(Park's Textbook of PSM)
Always Notifiable Under IHR 2005 (regardless of time/place)
- Smallpox
- Poliomyelitis due to wild-type poliovirus
- Human influenza caused by a new subtype
- SARS (Severe Acute Respiratory Syndrome)
Other potentially notifiable events:
- Cholera, Pneumonic plague, Yellow fever
- Viral haemorrhagic fevers (Ebola, Lassa, Marburg)
- West Nile fever
- Any biological, radiological, or chemical event meeting criteria
Public Health Emergency of International Concern (PHEIC)
A PHEIC is defined as: "an extraordinary event which constitutes a public health risk to other states through international spread of disease and potentially requires a coordinated international response."
A PHEIC is declared when 2 of the following 4 criteria are met:
- Is the public health impact serious?
- Is the event unusual or unexpected?
- Is there a significant risk of international spread?
- Is there a significant risk of international travel or trade restrictions?
The declaration is made by the WHO Director-General on advice of an Emergency Committee.
PHEICs declared since 2007:
- Swine flu H1N1 (2009)
- Polio re-emergence (2014)
- Ebola, West Africa (2014)
- Zika virus (2016)
- Ebola, DR Congo (2019)
- COVID-19 (Jan 30, 2020)
- Monkeypox/Mpox (2022, 2024)
Key Obligations of State Parties
1. Designate a National IHR Focal Point
- The national authority for communication with WHO
- Must be accessible at all times (24/7)
2. Core Capacity Requirements (Annex 1)
National Level:
- Assess all urgent event reports within 48 hours
- Notify WHO through the National IHR Focal Point within 24 hours of a notifiable event
- Determine control measures to prevent domestic and international spread
- Provide laboratory analysis, logistical support, and on-site assistance
Points of Entry (airports, seaports, ground crossings):
- Maintain sanitary measures
- Keep international airports and seaports free from vectors
- Under IHR, international airports/seaports must be kept free from mosquitoes for 400 metres around perimeter
3. Notification Requirements
- Health administrations notify WHO Geneva for any communicable disease under international surveillance
- Notifications made via the Weekly Epidemiological Record (WER) and Automated Telex Reply Service (ATRS)
WHO's Powers Under IHR 2005
- Issue Temporary Recommendations in response to a PHEIC
- Issue Standing Recommendations for routine measures
- Take into account unofficial/informal sources (media reports, NGOs) to verify events - a major change from IHR 1969
- Active surveillance vs. passive notification: WHO can now proactively alert the world
Innovations of IHR 2005 (vs. IHR 1969)
| Feature | IHR 1969 | IHR 2005 |
|---|---|---|
| Scope | 3 specific diseases | All hazards (biological, chemical, radiological) |
| Basis | Disease-specific | Risk-based |
| Reporting sources | Official only | Official + unofficial |
| WHO role | Passive | Active - PHEIC, Temporary Recommendations |
| Core capacities | Not required | Mandated (Annex 1) |
Key Annexes
- Annex 1: Core capacity requirements for surveillance and response
- Annex 2: Decision instrument for assessment and notification of events
- Annex 3: Ship Sanitation Control/Exemption Certificate
- Annex 4: Technical requirements for conveyances/operators
- Annex 5: Vector-borne diseases
- Annex 6: Vaccination, prophylaxis, and related certificates
India's Responsibilities
- India is a signatory to IHR 2005
- The Bureau of Immigration, Ministry of Home Affairs oversees Health Regulation at points of entry
- National IHR Focal Point coordinates with WHO
- All notifiable diseases must be reported to WHO Geneva
Mnemonic for IHR 1969 Diseases (Original 3)
"CPY" - Cholera, Plague, Yellow fever
Source: Park's Textbook of Preventive and Social Medicine; WHO - International Health Regulations; CDC - IHR
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