WHO updates rules to prevent spread of disease

May 24, 2005 (CIDRAP News) – Member countries of the World Health Organization (WHO) yesterday approved the first major revision of the WHO's rules to prevent the international spread of diseases in decades.

The new version of the International Health Regulations reflects lessons learned over the past 30 years and especially the world's experience with SARS (severe acute respiratory syndrome) in 2003 and avian influenza in the past 2 years, the WHO said yesterday.

"The new regulations bring disease control into the twenty-first century," Dr Anarfi Asamoa-Baah, WHO assistant director-general in charge of communicable diseases, stated in a WHO news release. "With this framework, we can now support the work of countries in controlling outbreaks more effectively. The regulations provide WHO with new, clearly defined roles and responsibilities as we help countries to respond to disease outbreaks."

The new regulations, which take effect 2 years from now, were approved by the World Health Assembly yesterday in Geneva. The rules require member countries to have or develop specific capabilities to identify and respond to public health emergencies of international concern and to take routine preventive measures at ports, airports, and border stations.

"Every country already has some of these capacities but almost no country has a perfect system," said Dr Max Hardiman of WHO, who coordinated the revision of the regulations. "The new regulations set clear standards and will help countries to identify where their disease surveillance and response must improve."

The WHO originally adopted what were then called the International Sanitary Regulations in 1951; they were renamed in 1969 and modified in 1973 and 1981. The rules were originally designed to help monitor and control six serious infectious diseases: cholera, plague, yellow fever, smallpox, relapsing fever, and typhus.

"The new rules will govern a broader range of public health emergencies of international concern, including emerging diseases," the WHO said.

The rules include a list of diseases that must be reported to the WHO, such as smallpox, polio, and SARS, along with guidelines to help countries decide whether other outbreaks or threats are of international concern. Under the existing regulations, only cholera, plague, and yellow fever must be reported to the WHO.

The regulations also address the "natural occurrence, accidental release or deliberate use of biological and chemical agents or radionuclear material," according to an Agence France-Presse (AFP) report published yesterday.

WHO officials have said the revised rules largely reflect existing informal procedures that have been developed in recent years, the AFP report said.

Dr Guenael Rodier, WHO director of communicable disease surveillance and response, commented in the news release, "The existing regulations were written for a very different world from the one we live in today. Air travel was a luxury and the movement of goods and people around the world was relatively slow. Today, travel and trade have expanded far beyond what was envisaged under the original regulations. The new rules respond to a globalized, 24-hour world in which a disease outbreak in one country can rapidly move around the world."

The revision of the regulations has taken several years and "an enormous amount of work" by all 192 member countries of the WHO, the agency said. The project was capped by several long sessions of a working group chaired by Ambassador Mary Whelan of Ireland.

See also:

May 23 WHO news release
http://www.who.int/mediacentre/news/releases/2005/pr_wha03/en/index.html

WHO International Health Regulations page
http://www.who.int/csr/ihr/en/

Full text of regulations (60 pages)
https://apps.who.int/gb/ebwha/pdf_files/WHA58/A58_55-en.pdf

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