Core Capacities for Public Health Emergencies of International Concern at Ground Crossings: A Case Study from North India

2019 ◽  
Vol 14 (2) ◽  
pp. 214-221
Author(s):  
Rahuldeep Singh ◽  
Kumar Sumit ◽  
Shaikh Shah Hossain

ABSTRACTObjective:International airports, ports, and ground crossings are required to have health units for undertaking public health measures during routine times and specific measures during the time of public health emergency of international concern (PHEIC). This study was conducted at a ground crossing of North India to assess the implementation status of International Health Regulations (IHR) (2005) at a ground crossing in the prevention and control of public health emergencies and to assess the risk of imported infections from a ground crossing.Methods:A qualitative study was conducted at the selected point of entry. The World Health Organization (WHO) core capacity assessment tool and in-depth interviews were used for data collection in the form of meetings and visits to isolation sites, and general observations were conducted regarding facilities on routine and other infrastructure and equipment that can be used during emergencies. Respondents were recruited using purposive methods.Results:The findings reveal that there is lack of awareness among the travelers, which increases the risks of spreading diseases. The overall implementation status at the ground crossing according to the assessment conducted using WHO Tool was 76%. It showed the need for further strengthening of the implementation at the site. Gaps were identified regarding the local capacity for handling chemical, radiological and nuclear hazards, and shortage of regular staff through stakeholders.Conclusion:The findings from this study, as well as the suggestions and recommendations given by stakeholders, should help revise the current strategies of action. Hence, the gaps identified should be fulfilled to better respond to PHEIC at the ground crossings.

Author(s):  
Roojin Habibi ◽  
Steven J. Hoffman ◽  
Gian Luca Burci ◽  
Thana Cristina de Campos ◽  
Danwood Chirwa ◽  
...  

Abstract The International Health Regulations (ihr), of which the World Health Organization is custodian, govern how countries collectively promote global health security, including prevention, detection, and response to global health emergencies such as the ongoing covid-19 pandemic. Countries are permitted to exercise their sovereignty in taking additional health measures to respond to such emergencies if these measures adhere to Article 43 of this legally binding instrument. Overbroad measures taken during recent public health emergencies of international concern, however, reveal that the provision remains inadequately understood. A shared understanding of the measures legally permitted by Article 43 is a necessary step in ensuring the fulfillment of obligations, and fostering global solidarity and resilience in the face of future pandemics. In this consensus statement, public international law scholars specializing in global health consider the legal meaning of Article 43 using the interpretive framework of the Vienna Convention on the Law of Treaties.


2015 ◽  
Vol 9 (5) ◽  
pp. 568-580 ◽  
Author(s):  
Frederick M. Burkle

AbstractIf the Ebola tragedy of West Africa has taught us anything, it should be that the 2005 International Health Regulations (IHR) Treaty, which gave unprecedented authority to the World Health Organization (WHO) to provide global public health security during public health emergencies of international concern, has fallen severely short of its original goal. After encouraging successes with the 2003 severe acute respiratory syndrome (SARS) pandemic, the intent of the legally binding Treaty to improve the capacity of all countries to detect, assess, notify, and respond to public health threats has shamefully lapsed. Despite the granting of 2-year extensions in 2012 to countries to meet core surveillance and response requirements, less than 20% of countries have complied. Today it is not realistic to expect that these gaps will be solved or narrowed in the foreseeable future by the IHR or the WHO alone under current provisions. The unfortunate failures that culminated in an inadequate response to the Ebola epidemic in West Africa are multifactorial, including funding, staffing, and poor leadership decisions, but all are reversible. A rush by the Global Health Security Agenda partners to fill critical gaps in administrative and operational areas has been crucial in the short term, but questions remain as to the real priorities of the G20 as time elapses and critical gaps in public health protections and infrastructure take precedence over the economic and security needs of the developed world. The response from the Global Outbreak Alert and Response Network and foreign medical teams to Ebola proved indispensable to global health security, but both deserve stronger strategic capacity support and institutional status under the WHO leadership granted by the IHR Treaty. Treaties are the most successful means the world has in preventing, preparing for, and controlling epidemics in an increasingly globalized world. Other options are not sustainable. Given the gravity of ongoing failed treaty management, the slow and incomplete process of reform, the magnitude and complexity of infectious disease outbreaks, and the rising severity of public health emergencies, a recommitment must be made to complete and restore the original mandates as a collaborative and coordinated global network responsibility, not one left to the actions of individual countries. The bottom line is that the global community can no longer tolerate an ineffectual and passive international response system. As such, this Treaty has the potential to become one of the most effective treaties for crisis response and risk reduction worldwide. Practitioners and health decision-makers worldwide must break their silence and advocate for a stronger Treaty and a return of WHO authority. (Disaster Med Public Health Preparedness. 2015;9:568–580)


2020 ◽  
Vol 35 (4) ◽  
pp. 353-357 ◽  
Author(s):  
Frederick M. Burkle ◽  
Asha V. Devereaux

AbstractThere have been multiple inconsistencies in the manner the COVID-19 pandemic has been investigated and managed by countries. Population-based management (PBM) has been inconsistent, yet serves as a necessary first step in managing public health crises. Unfortunately, these have dominated the landscape within the United States and continue as of this writing. Political and economic influences have greatly influenced major public health management and control decisions. Responsibility for global public health crises and modeling for management are the responsibility of the World Health Organization (WHO) and the International Health Regulations Treaty (IHR). This review calls upon both to reassess their roles and responsibilities that must be markedly improved and better replicated world-wide in order to optimize the global public health protections and its PBM.“Ask a big enough question, and you need more than one discipline to answer it.”Liz Lerman, MacArthur “Genius” Fellow, Choreographer, Modern Dance legend, and 2011 Artist-in Residence, Harvard Music Department


2002 ◽  
Vol 6 (20) ◽  
Author(s):  
N Gill

The latest progress report from the World Health Organization (WHO) states that broadening the requirement to notify WHO, from the present three diseases listed in the regulations (cholera, plague and yellow fever), is central to the revision of the International Health Regulations (IHR) that is under way (1).


2006 ◽  
Vol 11 (12) ◽  
pp. 1-2 ◽  
Author(s):  
J C Desenclos

In May 2005 the World Health Assembly approved an innovative and ambitious revision of the International Health Regulations, known as IHR(2005), in order to detect and control, in a timely manner, all public health events that may have a serious international impact. It represents a dramatic move from administrative notification by Member States (MS) to the World Health Organization (WHO) of cases of a limited list of diseases to a systematic analysis of health events of international concern, infectious or not [1]. The analysis of the public health events will take into account severity, unexpectedness, potential for international spread, and interference with international movement of people and goods. National focal points are to be identified in each MS to interact with WHO. The philosophy behind the new IHR is to promote early dialogue between MS and WHO, leading to early mutual risk assessment of events which may not necessarily have to be notified, depending on the results of the assessment and measures taken. WHO can also use informal sources to detect earlier events of international concern and then, together with the national focal point, conduct verification, risk assessment and implement appropriate measures.


Author(s):  
Iris Hunger

This chapter looks at the part of international order relating to surveillance and response to public health emergencies of international concern, which in turn forms part of the broader partial international order on global health. The main actor on international health emergencies control is the World Health Organization (WHO), with the International Health Regulations (IHR) being the applicable legally binding document. Based on much older sanitary agreements, the IHR came into being in 1969. Looking in detail at the response to the major international health emergencies following the complete overhaul of the IHR in 2005—pandemic influenza declared in 2009, polio 2014, Ebola 2014, and Zika 2016—this chapter argues that the WHO has become considerably more effective over the last two decades in countering international health emergencies, and that the international order on health emergencies response is remarkably robust, having so far not shown signs of disintegration or decline.


2014 ◽  
Vol 9 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Frederick M Burkle ◽  
Christopher M Burkle

AbstractLiberia, Sierra Leone, and Guinea lack the public health infrastructure, economic stability, and overall governance to stem the spread of Ebola. Even with robust outside assistance, the epidemiological data have not improved. Vital resource management is haphazard and left to the discretion of individual Ebola treatment units. Only recently has the International Health Regulations (IHR) and World Health Organization (WHO) declared Ebola a Public Health Emergency of International Concern, making this crisis their fifth ongoing level 3 emergency. In particular, the WHO has been severely compromised by post-2003 severe acute respiratory syndrome (SARS) staffing, budget cuts, a weakened IHR treaty, and no unambiguous legal mandate. Population-based triage management under a central authority is indicated to control the transmission and ensure fair and decisive resource allocation across all triage categories. The shared responsibilities critical to global health solutions must be realized and the rightful attention, sustained resources, and properly placed legal authority be assured within the WHO, the IHR, and the vulnerable nations. (Disaster Med Public Health Preparedness. 2014;0:1-6)


2015 ◽  
Vol 43 (S2) ◽  
pp. 49-56
Author(s):  
Polly J. Price

These teaching materials explore the specific powers of governments to implement control measures in response to communicable disease, in two different contexts:The first context concerns global pandemic diseases. Relevant legal authority includes international law, World Health Organization governance and the International Health Regulations, and regulatory authority of nations.The second context is centered on U.S. law and concerns control measures for drug-resistant disease, using tuberculosis as an example. In both contexts, international and domestic, the point is to understand legal authority to address public health emergencies.


Author(s):  
Frank Mahoney ◽  
James W. Le Duc

Multinational collaborations on international outbreak investigations and response have a long history. Development of the World Health Organization (WHO) in 1948 was closely linked to efforts by the global community to prevent, detect, and respond to outbreaks of international concern. Through the International Health Regulations (IHR) of 2005, a legally binding instrument requiring countries to report certain outbreaks and public health events, WHO outlined a strategy for disease threat response. Efforts by global partners to strengthen cooperation have evolved over the years, including roles and responsibilities of WHO, its Member States, and other partners. Among the challenges faced by Member State and WHO in implementing the IHRs are limited funding to support staffing and operational support as well as sometimes conflicting multijurisdictional decision-making. The response to recent outbreaks provides evidence that much work remains to be done to strengthen IHR mechanisms.


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