The timely sharing of information related to events that may cross borders and threaten international public health is a central feature of the International Health Regulations (IHR) (2005). Information sharing helps the international community to fulfil the IHR's principal purpose of preventing, protecting against, controlling and responding to an international spread of disease, while avoiding unnecessary interference with international traffic and trade.
The IHR's all-hazard approach to information sharing (encompassing events and hazards not limited to the health sector) helps to protect countries from risks that cannot be controlled at the national level or by the health sector alone. This ultimately strengthens global health security.
The IHR's operational mechanism for rapid, global information sharing consists of 2 principal components: a designated National IHR Focal Point (NFP) within each State Party that acts as the central, multisectoral communication hub at the national level; and regional IHR Contact Points within each of the 6 WHO regional offices. NFPs maintain communication with WHO IHR Contact Points at all times.
A key provision of the IHR is that countries report any event that may constitute a potential public health emergency of international concern (PHEIC). Countries are expected to assess each event occurring within their territories within 48 hours by applying a specific algorithm contained in Annex 2 of the IHR. Each event is assessed according to the following criteria:
- Is the public health impact of the event serious?
- Is the event unusual or unexpected?
- Is there a significant risk of international spread?
- Is there a significant risk of international travel or trade restrictions?
If the assessment of an event satisfies 2 or more of the 4 questions, a country must report this event to WHO within 24 hours. Some diseases always require reporting under the IHR (for example smallpox, poliomyelitis caused by a wild poliovirus type, human influenza caused by a new subtype, and severe acute respiratory syndrome), while others require reporting only if they represent a risk of cross-border spread (for example cholera, pneumonic plague, yellow fever, viral haemorrhagic fever and West Nile fever). Any other diseases or biological, radiological or chemical events with potential health consequences that meet the criteria established by the IHR must also be reported.
In case of doubt, States Parties are encouraged to informally consult with their WHO IHR Contact Point (based on Article 8 of the IHR). Following an analysis of the information received, WHO will determine whether the reported event constitutes a PHEIC.