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capacities notify and situations Assembly, demonstra implement highlighte but noted t
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ase, includin anel and in States on the leaves these ng the disea , in the cont us (MERS-C ut the Arabian n influenza v an influenza in humans currently ex .
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on the grou , Member S ated an ina
tation of th d the role of that a differe paper descri aps identified nt and monit ce with the IH
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h Assembly that States P n of the Reframework i nt of implem for IHR-rel ear hazards.
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embly discus w Committee plementation of the Ebola Assembly w tation of the t high risk, an mediate conc
discussion o dentified in
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ssed and en e on Second n (1), as wel a Interim Ass was the relia e national cap
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HA61.2), in General shou r this purposdicators and apacities, and infectious, z s is not inten
een countries
on of the e 2016 tar
report of the for Establis reports on t nel (2). Amon he self-assess rements for I the internatio curity in this Middle East
and current ill occurring o spread in b the world, a entation of ed countries
and maintain y, in order to make a tailo y Committe
to global h ed the need capacities.
chnical supp ddress the cu r monitoring n. It propose f the require
veillance a
n accordance uld report to se, a monitoself-assessm d the develop zoonotic, fo nded for use
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e Internation shing Nation the outbreak ng the conce sments cond IHR. The Pa onal commun
s context, th respiratory tly circulatin g in west Afr
birds, reassor and which i
recommenda s not export
n core publ o detect earl ored respons ee. During th
health secu d to accele
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ment questio pment of cap ood safety,
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nal Health nal Public k of Ebola rns raised ducted by anel noted
nity”.
he Health syndrome ng widely
ica at that rting with s causing ations for ting wild
lic health ly, assess, se to local he Health rity have erate the tates also ber States nges.
mentation proach for s for and
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graph 1 ofAssembly work was
onnaire. It pacities at chemical, o rank the s a tool to
assist indi address an Resu 7.
implement However, preparedne countries r previously In th 8.
national co The incid standard o perceived epidemics/
and simul mechanism absent, an surveillanc investigati investigati In the 9.
structure, r not in plac blood and manageme diagnosis;
laboratory pathogens strategy, in Ebola risk
With 10.
standard o points of detection, travel sect arrangeme were often limited. G people ade
Monitor
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that the co date to fac basis. Mem hour acces
ividual count ny gaps ident
lts obtained tation level during the ess and resp related to th y reported ha he majority oordination s dent comman operating pr
as an integ /emergencie ation exerci m for enhan nd event-bas
ce and ana ion and outb ion of diseas e majority o roles and res ce in most c d body flui ent system, i
protocols or y manageme
and glove b ncluding ris k communica regard to po operating pro
entry and w assessment tor, includin ents for tracin n not availab Ground cross
equately.
ing the co
World Health ontact details cilitate the co mber States a ssibility is notries to mon tified.
d from the of 72% (3) missions car ponse to a p he preparedn aving met the
of countries structure and nd and cont rocedures for
gral part of s and lacked ses to test th ced detectio sed surveill alysis of da break respon
e outbreaks w f countries, a sponsibilities countries: pro
d spills; a including sta r guidelines ent system;
boxes for ha k communic ation plan as oints of entry ocedures wer
with the nat of and respo ng airline co ng contacts.
ble, while ca sings were p
ompliance
h Assembly s of the centr ommunicatio are annually ot being mainnitor progres
2014 IHR , with many rried out to potential imp ess and resp e obligations , the main d also of an e trol chain w
r event man the nationa d a multisec
he existing E n and respo ance was n ata was in nse at the dif
was limited.
a national in s, plan of act ocedures for
national pr andard opera on safe colle
and a biosa andling and cation and s an integral p y, in most co re not in plac tional system onse to cases
ompanies, re Designated apacity to un poorly equip
with IHR
has previous re designated on between nconfirming ntained.
2 s towards m
R self-asses y countries countries o portation of ponse capaci under the IH gaps identif emergency o was either ab nagement an al public he ctoral approa Ebola plans onse to any not yet form nadequate. M fferent admi
nfection prev tion and bud r safe medica rogramme o
ating proced ection, transp afety level
inactivation ocial mobili part of a natio
ountries, pub ce, and coord m was lacki s were also n egarding pot spaces to iso ndertake ent pped and ha
sly urged Me d as the Nati national foca
the designat
meeting the c
sment ques having met f the Region Ebola, many ities. This fin HR by the fir fied were th operating cen
bsent or had nd alerts. Na ealth plan fo ach and stan
had not bee suspected ca malized. The Multidisciplin inistrative le
vention and c dget was not al waste man of occupatio dures for spe
portation and 3 facility fo of suspecte ization, was onal risk com blic health co dination betw ng. Standard not in place,
tential cases olate sick pas
try screening d limited ca
ember States ional IHR Fo l points and ion of IHR n
core capacity
stionnaires i many of th n in late 20 y critical ga nding includ rst or second e absence o ntre within th d major stru ational plans or preparedn dard operati en conducted ase was eith e human re nary rapid vels were no
control progr in place. Th nagement an nal safety;
ecimen hand d shipment of
or handling d samples. E very weak mmunication
ontingency p ween the diff d operating
while comm was weak ssengers and g measures, apacities to
s (resolution ocal Point ar WHO contac national foca
y requiremen
indicated a he IHR requ 014 to assess aps were ide ded countries d deadline.
of a fully op he Ministry o uctural gaps,
s for Ebola ness and res ing procedur
d. An early her not funct esources cap response te ot available
ramme with he following nd the manag
a laborator dling, inactiv f specimens;
emerging d Ebola comm and a comp n plan was lac
plans with fu ferent stakeh procedures munication w with a lack d to interview if required, control mov
n WHA61.2) re complete ct points on al points. How
nts and to
regional uirements.
s national entified in s that had
perational of Health.
, with no were not sponse to res. Drills y warning tioning or pacity for
eams for and field
a defined were also gement of ry quality vation and
; a biorisk dangerous munication prehensive
cking.
unctioning olders for for early ith the air k of clear w contacts was very vement of
to ensure and up to a 24 hour wever, 24
The S 12.
most coun widely dis Mem 13.
constitutin provided i detailed pu and compr risk assess or through could be im such event
Coun 14.
occurring such event identified PHEIC an early inve avoid the c trigger the
Mem 15.
response t resources support is
In re 16.
implement Recomme concern an These add Ebola.
New app
The 17.required u IHR Revie General o strengthen The I 18.
“develop t approache combinatio 68th World The E 19.
but priorit the Interna and other current sit
Secretariat h ntries the fun sseminated am mber States ar
ng internatio in Annex 2 ublic health rehensive re sment of suc h coordinatin mpeded by a ts.
ntries have in their terri ts may have
the need fo nd is intended
stigation and conditions fo e alert phase.
mber States a to events by for the imp not currently esponse to
ted public ndations (4) nd which w ditional meas
proach for
decision to under the IHRew Committ n: 1) reques n and assess I IHR Review through regi es that comb on of domes d Health Ass Ebola Interim tized and cos
ational Healt stakeholders tuation in eac
has provided nctions have mong the rel re required t onal concern
of the IHR information eporting of s ch events and ng mobilizati absence of or
often shown itory that ma
political and or an “alert”
d to encoura d rapid respo or declaring
are required y providing plementation y being prov the perceiv health mea made by the were not cons sures had ne
r the asse
grant a furt R is made by tee. The Com sts from StatIHR core cap w Committee,
ional consult bine self-eva stic and inde sembly appro m Assessmen sted plan to d th Regulatio s for funding ch country. T
guidance on not been pu levant stakeh
o notify WH n within 24 R. The notifi
on the even uch events i d to respond ion of the re r delay in no
n reluctance ay constitute
d socioecono phase unde ge Member onse to such a PHEIC. Th
to collabora the necessar
of the IHR vided in the c ved threat p asures, such e WHO Dire sistent with egative impli
ssment an
ther extensio y the Directo mmittee con tes Parties fo pacities in th , in its report tative mecha aluation, peeependent exp oved implem nt Panel, in it develop the c ns (2005). T g. To propose This requires
3 n proposed fu ut in place. W
holders to fac HO of all pub hours of a ication must nt. Generally
is not well m d to them wit
quired suppo otification an
e to share i a public hea omic implica er the IHR. T
States to not events that w he Secretaria
ate with eac ry technical R in accorda context of an posed in the
h as a tra ector-Genera the conditio ications for
nd monito
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t (1) (recomm anisms optio er review an perts”. The E mentation of t
ts report (2), core public h This plan sho
e this plan W s some form
unctions for n Where availab cilitate imple blic health ev ssessment b t be followe in the Regio maintained. W thin the fram ort. However d sharing of
information alth event of ations. The This phase w tify WHO ea would result at is currently
ch other in cooperation ance with A agreed syste e context o avel ban, w al in public h ons laid out travel and tr
oring of IH
blishing the taking into a 3–14 Novemxtensions (2 long term.
mendation 7 ons to move nd voluntary
Executive B the recomme , stated that “ health capac ould be put t WHO will ne
of peer revie
national foca ble, they are ementation o
vents that are by using the
d by ongoin on, the early WHO is man mework of th
r, implement comprehens
related to internationa World Healt would preced arly and to sh from an aler y developing
the detection n, logistical s Article 44. Th
em or mainta of Ebola, m which excee ealth emerge in Article 4 rade for the
HR
national pub ccount the te mber 2014 to
014–2016);
), recommen from exclus external ev Board at its 1
endation.
“WHO shoul ities for all c to donor age eed reliable i ew or other e
al points. Ho e neither regu of the IHR.
e assessed as e decision in ng communi y notification andated to su he IHR, eithe tation of this sive informat
public heal al concern (P th Assembly de the decla hare informa rt phase mig g criteria to d
n, assessmen support and The provision
ained.
many Memb eded the T encies of inte
3 of the Re countries af
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nded the Sec sive self-eva valuations inv
136th session
ld propose a countries in r encies, Memb
information external valid
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s possibly nstrument ication of n to WHO upport the er directly s mandate tion about
th events PHEIC) as
therefore aring of a ation. The ght help to define and
nt of and financial n of such
ber States Temporary
ernational gulations.
ffected by
capacities vice of the Director- w to better
retariat to luation to volving a n and the
a thorough respect of ber States about the dation. At
present on analysis; th
On th 20.
independe reference:
a) review assess b) identif c) identif Region d) report
It is a 21.
and other established a) gather b) suppor c) advise d) advoc
of glob WHO 22.
a) assess b) comm c) guide Mem 23.
a) contin b) report c) implem
Methodo monitor
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implement IHRRAC, A pro 25.
on each as Mem 26.
have occur the nationa The 27.
where Me available d
nly self-asses he Panel rec his basis it is ent body to
w implement ment tool;
fy strategic p fy major iss n to meet the
annually to also propose r partner age
d in line with r evidence re
rt the implem e the Regiona
ate for imple bal health se O will serve a
implementa municate relev
States Partie mber States w nue to comple
to the IHRR ment the reco
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Secretariat w tation of the the Secretar ogress report ssessment vis mber States ar rred in their al capacity fo
IHRRAC w ember States
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tation of the priority activ sues and cha
eir obligation the Regiona ed to establis encies to en h the recomm equired for st
mentation of al Director an ementation o ecurity.
as the Secret ation of the IH
vant informa es and provid will:
ete the annua RAC on the p ommendatio
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will take thee IHR. Up riat will carry t on the impl sit and share re encourage countries. Si for surveillan will meet on s shall prese on/reports pr
ed. It is in th at ways to do o establish the implementa
e IHR in the ities at the le allenges to b ns;
l Committee h a regional nsure harmo mendations o trategic decis the IHR nati nd the IHRR of the IHR an
tariat for the HR upon the ation to the IH de the require
al self-assess progress of IH
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nd engage wi
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te and docum xercises shou
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during the an ress in imple Member Stat
own interest plored”.
onal Assessm R in the Reg
d verify data ber States to d by WHO t
ress of IHR i Force (IHRTF
ementation AC with the f IHRRAC;
gional plans;
way forward;
ith partners w
nd will contin Member Stat d Member Sta
or implement
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mber States ist of Memb er States to a n each Mem
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ment Commis gion, with th
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uestionnaire;
heir territory;
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sponse to pub cted to furthe
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be carried
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The s 28.
short-term in line wit Assembly
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the Region The 31.
Committee obtained f country re Executive
Tools to
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throug In ad 33.
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The S 34.
to support Action by
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secretariat, w m and long-te
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plate to guide of key perfor ard operating mentation of Secretariat w
them in mee y the Regio Regional Co nt Commissi
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with the sup ual basis a p HR self-asse R-related issu World Health
the asses
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ment protoco cuments will ssment quest -assessments following too
e reporting o rmance indic g procedures f the IHR;
will continue eting their ob onal Comm ommittee is ion and Regi
en and furthe
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.
ad hoc basis
pport of the rogress repo ssment tool, ues. The feed h Assembly.
sment and
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6
References
1. Implementation of the International Health Regulations (2005): report of the Review Committee on Second Extensions for Establishing National Public Health Capacities and on IHR Implementation.
Geneva: World Health Organization; 2015 (A68/22 Add.1;
http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_22Add1-en.pdf, accessed 17 September 2015).
2. Ebola Interim Assessment Panel: first report of the Panel. Geneva: World Health Organization; 2015 (A68/25; http://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_25-en.pdf, accessed 17 September 2015).
3. Global Health Observatory (GHO) data IHR core capacities implementation status 2014, WHO Eastern Mediterranean Region.
(http://www.who.int/gho/ihr/monitoring/region_eastern_mediterranean/en/, accessed 17 September 2015).
4. IHR Emergency Committee regarding Ebola: WHO statements on Ebola. Geneva: World Health Organization; 2014-2015 (http://www.who.int/ihr/ihr_ec_ebola/en/, accessed 17 September 2015).