International Health Regulations (IHR)

Meeting of the Bi-regional Technical Advisory Group on the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III): Advancing Implementation of the International Health Regulations (2005)

New Delhi, India
19-21 June 2018


The Asia-Pacific Region continues to face acute threats to public health, including emerging infectious diseases (e.g. influenza, dengue, chikungunya, nipah virus), and other public health emergencies. The impact of these threats on individuals and communities has been the driving force for the establishment of a common framework to guide collective efforts to strengthen core capacities for risk reduction, preparedness, event detection and response.

The agreed legal mandate among Member States for preparing and responding to public health emergencies is the International Health Regulations (IHR) (2005). The IHR (2005) have been in force since 15 June 2007, and aim to ensure that national, regional and international capacities are in place to manage acute public health events and emergencies in a collective, coordinated and effective manner.

In the WHO South-East Asia and Western Pacific regions, the Asia Pacific Strategy for Emerging Diseases (APSED) was developed as a guiding strategic framework for implementing and strengthening IHR core capacities. The most recent version, the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III) is designed to address all hazard approach in line with IHR (2005) and global health security in the context of WHO emergency response to Ebola, MERS-CoV and Zika. APSED III aims to fit within a broader context of strategies and goals, including the 2030 Sustainable Development Goals (SDGs), Universal Health Coverage (UHC) and Global Health Security Agenda (GHSA).

Well-functioning health systems are necessary to respond to emerging health security threats of biological, chemical and radionuclear origin. While WHO manages risks and emergencies due to all hazards it has special responsibilities with respect to infectious hazards, especially in light of its role as custodian of the International Health Regulations (IHR). Early detection, risk assessment and response are vital to ensuring that infectious disease events do not escalate into large-scale outbreaks or pandemics. The Ebola crisis in West Africa and MERS-CoV in Middle-East countries clearly illustrates that existing annual self-assessments and annual reporting by States Parties on the implementation of eight core capacities and the development of capacities at points of entry and for hazards covered by the Regulations is not adequate to assess functional status of core capacities. The IHR Monitoring and Evaluation Framework (IHR M&EF) was developed to assess national core capacity for implementation and effective functioning of the IHR. There are four components of the IHR MEF, including annual report, after action reviews, exercises and joint external evaluation (JEE). JEE is an important element of monitoring and evaluation under APSED III. JEE, a key component of the IHR M&E Framework, provides an objective view of countries’ capacities. Seven countries in SEAR and 5 countries in WPR have completed JEE mission in 2017 and other countries are in the process. The recommendations from JEE are expected to inform development of the national action plan for health security/ APSED country work plan. Since JEE version 2.0 with costing tool will be launched at the beginning of 2018 and WHO is developing a five year strategic plan to further strengthen IHR core capacities, it will be important for WHO Secretariat and Member States to better understand and discuss how to streamline it with APSED (III) and best use new tools and strategic plan in this bi-regional platform.

The World Health Organization has drafted five year global strategic plan to improve preparedness and response Integrating core capacities required by the International Health Regulations (2005) and resilient health systems. On the other hand, WHO came up with new Global Programme of Work (GPW) which outlines priority actions to strengthen global health security. The TAG meeting is an important opportunity to brief Member States about new global strategic plan and GPW and how it affects WHO's work on outbreaks and emergencies in the region.

The Technical Advisory Group (TAG) on the APSED was established in 2006 to function as the key mechanism to provide technical advice on the priority actions to support implementation of this Strategy to the respective Regional Directors of the WHO regional offices for South-East Asia and the Western Pacific and Member States. In addition to the meeting of the TAG, a back-to-back meeting of national IHR focal Points/EID programme managers, technical and donor partners has also traditionally been held. For the initial five year term of the strategy (i.e. APSED 2005) a bi-regional TAG meeting was convened on an annual basis to review implementation of APSED and IHR (2005). However, at the first TAG meeting for the second term of the strategy (i.e. APSED 2010), a decision was taken to instead convene the bi-regional TAG meeting on a biennial basis and to rotate the meeting between the two Regions.

In accordance with mutual understanding of holding bi-regional meeting in alternate year by SEARO and WPRO, SEARO is hosting bi-regional IHR/APSED with TAG members, Member States, partners and WHE country office staff in New Delhi from 19-21 June 2018.

General objectives

An Emergency Medical Team is a group of health professionals (e.g., doctors, nurses, paramedics) providing direct clinical care to populations To strengthen capacity of the Asia-Pacific Region to combat emerging infectious diseases (EIDs) and public health emergencies through IHR implementation.

Specific objectives

  • to review emerging issues and progress made in implementing the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies (APSED III) in order to achieve and strengthen IHR core capacities;
  • to review experiences of JEE, and challenges and progress in initial development and implementation of National Action Plan on Health Security; and
  • to recommend common priority activities until the next bi-regional Technical Advisory Group (TAG) meeting in 2020, considering the findings and updates shared in the meeting.

Tentative agenda

  • Opening
  • Regional and global overview of progress in IHR/APSED implementation (and global overview of IHR implementation)
  • National progress in development and implementation of NAP on Health Security/APSED work plan
  • Implementation of IHR M&E Framework
  • Review the progress in implementing recommendation from previous APSED TAG meeting
  • Public health events/emergencies of regional importance in the past 10 years: Lessons to learn
  • Recommendations
  • Closing