Technical, financial, and political barriers challenge implementation of new IHR

According to an editorial in last week’s edition of The Lancet, “Poorer countries could struggle to implement the new International Health Regulations (IHR) about to be brought into force.”

“Countries are obliged to nominate a national focal point to communicate detailed public-health information to WHO, including case definitions, laboratory results, number of cases and deaths, and conditions affecting the spread of disease. WHO would then be responsible for validating whether the threat was of international concern—declaring emergencies, recommending containment measures, and coordinating an international response. Chernobyl, Ebola virus, variant Creutzfeldt-Jakob disease, severe acute respiratory syndrome, and more recently avian influenza, have all highlighted the inadequacy of the old regulations (IHR 1969), which only required countries to raise the alarm in emergencies involving three diseases—yellow fever, plague, and cholera.”

The new IHR may pose additional challenges for resource poor nations that do not have the level of capacity or infrastructure necessary for meeting IHR surveillance, diagnostic, and containment demands. While the revised IHR requires WHO and Member States to mobilize financial resources, there is no mention of any concrete funding mechanisms. CARE's role in developing capacity and strengthening community-based surveillance may, therefore, become increasingly important as Member States work to adhere to these new regulations.

Political resistance will also pose a challenge for IHR implementation. “For the IHR to work, no territory—whether Taiwan or the Occupied Palestinian Territory—can be excluded from the global surveillance system, especially in light of the threat posed by avian influenza.”

Additionally, health inequities sure to arise in the event of a pandemic influenza might prevent compliance with the new regulations, as 96% of the projected 62 million deaths are expected to occur in the developing world.

http://www.thelancet.com/journals/lancet/article/PIIS0140673607607880/fulltext

http://www.medicalnewstoday.com/medicalnews.php?newsid=72097