The International Health Regulations (2005): A Global Platform for Collaboration and Capacity Building to Identify, Prevent, Prepare for and Respond to Chemical Risks

摘要

In 2005, the World Health Organization (WHO) Member States adopted the revised International Health Regulations (IHR) (2005). The Regulations provide a unique public health framework in the form of obligations and recommendations that enable countries to better prevent, prepare for and respond to public health events and emergencies of potential international concern, including chemical events. The Regulations obligate States Parties to develop certain minimum core public health capacities (especially for early event detection and response) and to notify WHO of events that may constitute a public health emergency of international concern according to defined criteria. While the core capacities to control selected communicable diseases were already understood, international collaboration among the Regulations' 196 States Parties to detect diseases due to other hazards was new. In real life, disease outbreaks occur for which the cause is not immediately known, so many disciplines must work together. WHO has specified a set of core capacities for chemical events and developed a system of national focal points and an on-line event information site for sharing information. Achievement of the core capacities is regularly assessed. As of 31 March 2015, 160 countries had reported on the implementation of the Regulations during 2014. Relatively low capacities for handling chemical events were reported. The global capacity score for chemical events was 56%, with large variations between WHO regions ranging from 28% in the African Region to 79% in the European Region. The scores for the other regions were Americas 54%, South-East Asia 50%, Eastern Mediterranean 53%, and Western Pacific 62%. Globally, the capacity indicator that most (76%) of countries had was a designated focal point for coordination during a chemical event. Only 40% of countries had an updated chemical event response plan, 56% had adequate laboratory capacity to confirm a chemical event and 63% had surveillance systems for chemical exposures. WHO is working with countries to strengthen chemicals capacities. The establishment of surveillance systems for early event detection is a critical capacity. As well as acute outbreaks with known chemicals, surveillance can identify new threats, known threats with a changing pattern of occurrence, and emerging risks of a less acute onset. Sometimes the chemical cause of an outbreak is identified quickly, for example, methanol poisoning, but sometimes not. Examples will be presented.