Conference organized by:

Center for Biosecurity of UPMC

World Health Organization Communicable Disease Surveillance and Response Office

Conference sponsored by:

The Nuclear Threat Initiative

The New International Health Regulations
Presenter: David Byrne

As Special Envoy to the WHO, David Byrne was charged by the Director General with building political consensus for the revised International Health Regulations (IHR). The revision process was born of a need to establish a "rules based system" for dealing with disease outbreaks not covered by the current IHR. From his observations as Special Envoy, Mr. Byrne is confident that the revised IHR will be adopted at the World Health Assembly in May 2005.

Although they are not yet finalized, the revised IHR essentially differ from the current regulations in that they emphasize disease outbreaks of global public health significance instead of relying on a list of diseases that member countries must report. They also accord greater flexibility in response to disease outbreaks by allowing the WHO to consult nonofficial reports of disease outbreaks and make requests to collaborate in the response to a verified outbreak. In turn, member countries must provide a timely response to a request from the WHO for disease outbreak verification. If a member country does not respond, the new IHR allow the WHO to disclose that information publicly.

Mr. Byrne reflected on key observations he has made during his experience as Special Envoy to the WHO:

• Questions of national sovereignty are difficult to solve; some member states do not regard the WHO Secretariat as a partner for negotiation.
• WHO is considerably under funded.
• The world is simply not ready to respond to some public health threats, such as a potential influenza pandemic.
• Even in developed countries, public health does not get funding commensurate with its importance.

To these observations, he offered the following recommendations:

• Member states should strongly consider the benefits of pooling sovereignty with respect to responding to public health threats.
• The status and influence of the WHO must be upgraded in order to encourage the improvement of public health capacity in all member countries.
• Developing countries will have to pitch in to help build the public health capacity that the new IHR will require.
• It is in every member country's best interest to accord greater emphasis on public health, as citizens of all countries may ultimately penalize governments for failing to protect them from public health threats.

Finally, Mr. Byrne commended the work that the scientific and health community has done in the area of international public health and encouraged the community to continue to speak up on these issues.

- Summary by Jennifer Nuzzo, M.S.

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