Central Asia Regional Health Security WorkshopCo-organized with the Command Surgeon, US Central Command and

the George C. Marshall European Center for Security Studies

17-19 April 2012, Garmisch-Partenkirchen, Germany

Legislations and Disease Surveillance

In IHR

(2005)

Dr Hashim Elzein ElmousaadPublic Health Specialist

17 April 2012

Learning objectives

On completion of the exercise, participants will be able to:

- Identify the hazards to be assessed and the core capacities needed for implementation of IHR.

- Identify what are the needs for developing a legislation policy compatible with IHR (2005) as well as strong event surveillance system.

Introduction

ALL member States have legal frameworks (may support many IHR 2005)

IHR (2005) may have many functions and provisions not considered in current legislation

Main Question:

What needs to be adjusted in the national legal framework to ensure that your country can implement all rights and obligations in the IHR ?

IHR (2005)

• Under the IHR (2005), each Member State is required to develop, strengthen and maintain, as soon as possible but no later than five years from the entry into force of these Regulations (i.e. by 2012). The capacity to detect, assess, notify, report and respond promptly and effectively to public health risks and public health emergencies of international concern.

You are the Director of International Health Department in country C. You were called by H.E. the Ministry of Health for a meeting 2 days later to discuss the preparation of your department with the Director of Epidemiology to assess the core capacities of the IHR (2005) in the country. H.E. the Minister has fair knowledge on IHR (2005) and its importance. He wants to know more about certain components of the planned assessment so as to help him facilitating the formation of health coordination committee when meeting representative of other line ministries.

H. E. the Minister put the following 3 Questions to be answered:

3 Questions

• What are the hazard areas and core capacities that will be assessed?

• What needs to be adjusted in the national legislation and policy frame work to ensure that the country can implement all rights and obligations in the IHR?

• What are the requirements needed in order for the national surveillance to comply with the IHR (2005)?

What are the hazard areas and core capacities that will be assessed?

Question 1

• The main hazards (Infectious diseases, zoonoses, Chemical, food safety and in some countries radio-nuclear)

• Core Capacities– National legislation and policy

– Coordination.

– Surveillance.

– Response.

– Preparedness.

– Risk communication.

– Laboratory.

– Human resource capacity.

Question 2

What needs to be adjusted in the national legislation and policy frame work to ensure that

the country can implement all rights and obligations in the IHR?

Assessment and Decision

Assess to identify gaps or other potential concern.

-Compares IHR provisions with existing national legal framework

Decide for each gap or concern

- country to decide what action is required to address it.

Further more: Updating

- Any additional legislation changes (e.g. general update to legislation)

Legally Binding……

IHR is legally binding upon each country as a whole, not only the Ministry of Health or other part of the government.

Areas and functions affected by IHR implementation

• Health

• Environment

• Ports, airports, ground crossings

• Customs

• Food safety

• Borders

• Immigration

• Security

• Agriculture (and animal health)

• Radiological / nuclear activities

• Chemical related activities

• International transport/trade/travel

• Human rights

• Industry / Commerce

• Defense

• Dissemination of health information

Prioritize

–What needs to be done most urgently?

–What are the most important elements for each country?

–Consider options to expedite the legislative process if urgently needed.

Strengthening the Role of NFP

Establish a clear, specific legal / governmental mandate for all NFP functions

Resources

IHR

Disease Surveillance

Question 3

What are the requirements needed in order for the national surveillance to comply with the

IHR (2005)?

Surveillance System Structure

• Legislation

• Surveillance Strategy

• Trained Human Resources

• Trained Stakeholders

• Networking - Partnership

Surveillance Core Functions

• Case Detection

• Case Registration

• Case Confirmation

• Case Definitions

• Reporting

• Data Analysis and interpretation

• Epidemic Preparedness

• Response and Control

• Feedback

Events

Surveillance Quality

• Completeness

• Timeliness

• Usefulness

• Simplicity

• Acceptability

• Flexibility

• Sensitivity and Specificity

• Positive predictive value

• Representativeness

Other Supporting Aspects

• Standards and guidelines

• Training

• Supervision

• Communication Equipment

• Resources (Material, Money, Manpower)

• Monitoring & Evaluation

• Coordination

Questions

Questions?

Dr. Hashim A. Elzein Elmousaad

Public Health Specialist

Cairo – Egypt

elmousaadh@gmail.com

Tel: 00201120400733