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(1)

Provision

Asse

Introduc

The 1.

Regulation Health Ca virus disea by the Pa Member S that “This Amon 2.

Assembly, coronaviru throughou time; avian other avia infections countries poliovirus The 3.

capacities notify and situations Assembly, demonstra implement highlighte but noted t

This 4.

and the ga assessmen complianc

Monitor

The W 5.

Article 54 on the im developed The m 6.

involves th points of radiologic performan

al agenda it

essment a Hea ction

68th World ns (2005) (IH apacities and

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 .

IHR impose for surveill d report to W

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

ing of imp

World Healt

of the IHR, mplementatio

d.

monitoring he assessmen

entry and al and nucle nce of countr

tem 4(c)

and moni alth Regu

Health Asse HR) Review d on IHR Im

g the report the Health ir implemen e countries at ases of imm text of the d CoV), first i

n Peninsula;

virus A(H5N viruses tha in Egypt; a xporting wi

e obligation ance and re WHO events

und and with States ackno adequate lev he IHR and f WHO in co ent strategic a ibes the limi d in Member toring of th HR.

plementati

h Assembly that States P n of the Re

framework i nt of implem for IHR-rel ear hazards.

ries or to com

toring of lations (2

embly discus w Committee plementation of the Ebola Assembly w tation of the t high risk, an mediate conc

discussion o dentified in

the new cas N1) and A(H9 t are endem and polio, in ild polioviru

ns on Memb sponse, inclu covered by h the advice owledged th vel of prep

strengthen ontinuing to approach nee itations of th r States capa e developm

ion of IHR

decided (re Parties and th egulations an

includes a c mentation of e

lated hazard The monitor mpare perform

f the imple 2005): me

ssed and en e on Second n (1), as wel a Interim Ass was the relia e national cap

nd increases ern to globa on IHR, disc Saudi Arab ses of Ebola 9N2), which mic in variou n particular us and for

ber States t uding at poi

their provisi e of the IHR hat the curr

paredness, existing pu provide the eds to be con he current me acities for im ment and mai

R capacitie

esolution WH the Director-

nnually. For

checklist, ind eight core ca ds, notably ring process mance betwe

ementatio eeting the

dorsed the r d Extensions

ll as several essment Pan ability of th pacity requir the risk for t al health sec cussed the M bia in 2012

that were st h continues t us parts of t

the implem polio-affecte

o develop a ints of entry ions, and to R Emergenc rent threats

and stresse ublic health e required tec nsidered to a

echanism for mplementatio

intenance of

es for surv

HA61.2), in General shou r this purpos

dicators 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 monito

self-assessm d the develop zoonotic, fo nded for use

s. Rather, it i

Internati rget

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

Member St port to Memb

urrent challen g IHR implem

es a new app ed capacitie

and respo

e with parag o the Health A

oring framew

ment questio pment of cap ood safety,

as a tool to is intended a

ional

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

onse

graph 1 of

Assembly work was

onnaire. It pacities at chemical, o rank the s a tool to

(2)

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

The W 11.

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 no

tries 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 main

nitor 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 n

confirming 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

(3)

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 IHR

ew 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 Stat

IHR 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, pee

ependent 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

on for estab or-General, t nvened on 13

for second ex he short and l

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 Novem

xtensions (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

blic health echnical adv o advise the and 2) how

nded the Sec sive self-eva valuations inv

136th session

ld propose a countries in r encies, Memb

information external valid

owever, in ulated nor

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

(4)

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

The S 24.

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

ology of w ring

Secretariat w tation of the the Secretar ogress report ssessment vis mber States ar rred in their al capacity fo

IHRRAC w ember States

documentatio

ssment is use ommends th proposed to oversee the

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

work unde

will take the

e 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

ns of the IHR

r the new

lead in supp on the volu y out mission lementation o

d with the IH ed to evaluat

imulation ex nce and respo nce a year d nt the progr rovided by M

4 he countries’

o this be exp e IHR Regio ation of IHR

e Region and evel of Memb be addressed e on the prog

IHR Task F onized imple of the IHRRA sions of the I

ional and reg RAC on the w

nd engage wi

IHRRAC an e request of M

HRRAC and ed support fo

sment IHR m HR impleme RRAC to me

approach

porting Mem untary reques ns to Membe

of the IHR i HRRAC.

te and docum xercises shou

onse.

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

monitoring qu entation in th eet IHR oblig

h for IHR a

mber States i

st of Memb er States to a n each Mem

ment their res uld be conduc

nnual meetin ementing IH

es and identi

t to have a th

ment Commis gion, with th

a obtained th implement I to support M implementat F) comprisin of policies, following ter

; and who will enh

nue to:

tes and the IH ates; and ting the IHR

uestionnaire;

heir territory;

gations.

assessme

n the assessm ber States an

ssess IHR im mber State wi

sponse to pub cted to furthe

ng of IHR r HR. The IHR ify priority a

horough and

ssion (IHRRA he following

through the IHR; and Member Stat tion in the Re ng experts fro strategies a rms of refere

hance the ach

HRRAC;

R.

;

; and

nt and

ment, monit nd the reque mplementatio ill be develop

blic health e er review and

regional stak RRAC will r

activities to b

objective

AC) as an terms of

IHR self-

tes in the egion.

om WHO and plans ence:

hievement

oring and est of the on.

ped based

vents that d enhance

keholders, review all

be carried

(5)

out by eac the availab

The s 28.

short-term in line wit Assembly

The r 29.

engage the The I 30.

the Region The 31.

Committee obtained f country re Executive

Tools to

The 32.

implement a) A rost region chemi out IH b) The I WHO c) The IH

throug In ad 33.

IHR:

a) a temp b) a list o c) standa implem

The S 34.

to support Action by

The R 35.

Assessmen

ch State Party ble reports.

secretariat, w m and long-te

th the recomm to support IH regional plan em in its imp IHRRAC ma nal Director.

IHRRAC, w e on an annu from the IH eports on IHR

Board and W

o support t

following tation:

ter of IHR e ns in the diff ical safety, ra HR assessmen IHR assessm guiding doc HR self-asse gh these self- ddition, the f

plate to guide of key perfor ard operating mentation of Secretariat w

them in mee y the Regio Regional Co nt Commissi

y to strengthe

with the adv erm priority

mendations o HR impleme n of action w plementation ay meet on a

with the sup ual basis a p HR self-asse R-related issu World Health

the asses

existing too

experts will ferent specia adiation safe nts.

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

vice of the I activities, ba of the Region entation in th will be shared

.

ad hoc basis

pport of the rogress repo ssment tool, ues. The feed h Assembly.

sment and

ols will be

be formed f alties of legis ety and risk c ol will be us also be used tionnaire wil s will be veri ols will be de

of progress on cators to eval

and scenari

to carry out bligations.

mittee invited to co ional IHR Ta

5 er maintain t

IHRTF, will ased on avai

nal Committ he Region.

d with global

to discuss u

e Secretariat ort on IHR im

, country pr dback of the

d monitor

e used for

from the Ea slation, surv communicati sed for carry d as supportin ll continue to ified during t

eveloped to

n IHR imple luate implem ios to carry o

t strategic ac

onsider the ask Force, the

their national

develop a r lable progre tee, the Exec

l and regiona

urgent IHR-r

t, will devel mplementatio rogress repo e Regional C

ring of IHR

the assess

astern Medite eillance, lab ion. These ex ying out IH ng document o be used on the assessme support the

ementation;

mentation of t out simulatio

tivities that a

proposed es eir functions

l public healt

regional plan ss reports an cutive Board

al technical p

related issues

lop and sub on in the Reg orts on IHR ommittee wi

R impleme

sment and

erranean Reg oratory, poin xperts will s R assessmen ts.

n an annual b nt visits.

assessment a

the IHR;

on exercises

apply to all S

tablishment and method

lth capacities

n of action, nd document and the Wor

partners and

s, upon the r

bmit to the gion, based R implementa

ill be submit

entation

monitoring

gion and oth nts of entry, support WHO

nt in Memb basis. Results

and monitori

and drills to

States Partie

of the IHR dology of wo

s based on

including tation and rld Health

donors to

request of

Regional on results ation and tted to the

of IHR

her WHO food and O to carry er States.

s obtained

ing of the

o evaluate

s in order

Regional rk.

(6)

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).

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