Abstract
ObjectiveTo respond to the World Health Assembly call for dissemination of lessons learnt from countries that have begun implementing the International Health Regulations, 2005 revision; IHR (2005).MethodsIn November 2015, we conducted a systematic search of the following online databases and sources: PubMed®, Embase®, Global Health, Scopus, World Health Organization (WHO) Global Index Medicus, WHO Bulletin on IHR Implementation and the International Society for Disease Surveillance. We included identified studies and reports summarizing national experience in implementing any of the IHR (2005) core capacities or their components. We excluded studies that were theoretical or referred to IHR (1969). Qualitative systematic review methodology, including meta-ethnography, was used for qualitative synthesis.FindingsWe analysed 51 articles from 77 countries representing all WHO Regions. The meta-syntheses identified a total of 44 lessons learnt across the eight core capacities of IHR (2005). Major themes included the need to mobilize and sustain political commitment; to adapt global requirements based on local sociocultural, epidemiological, health system and economic contexts; and to conduct baseline and follow-up assessments to monitor the status of IHR (2005) implementation.ConclusionAlthough experiences of IHR (2005) implementation covered a wide global range, more documentation from Africa and Eastern Europe is needed. We did not find specific areas of weakness in monitoring IHR (2005); sustained monitoring of all core capacities is required to ensure effective systems. These lessons learnt could be adapted by countries in the process of meeting IHR (2005) requirements.
Highlights
While bi- and multilateral communication and collaboration are the foundation for global control of infectious disease epidemics, they are strengthened by the International Health Regulations (IHR)
While country exchanges and regional meetings are one mechanism to achieve this, we systematically evaluated published literature and reports for lessons learnt from national experience in implementing IHR (2005)
A more detailed summary of the included articles and themes identified is available from the corresponding author
Summary
While bi- and multilateral communication and collaboration are the foundation for global control of infectious disease epidemics, they are strengthened by the International Health Regulations (IHR). First introduced in 1969, IHR is global legislation requiring countries to link and coordinate specific actions.[1] These regulations were originally designed to control cholera, plague, yellow fever, smallpox, relapsing fever and typhus. Given the need to expand the scope to include new epidemics and to improve global coordination, the regulations were revised in 2005, as IHR (2005).[2] One of the key changes was the requirement for countries to notify the World Health Organization (WHO) of all events that may constitute a public health emergency of international concern and to respond to requests for verification of information about these events.[2] Since IHR (2005) was adopted by WHO States’ Parties, several outbreaks, epidemics and pandemics have been declared public health emergencies of international concern: the H1N1 pandemic influenza in 2009, wild poliovirus in 2014, Ebola virus disease in 2014, and Zika virus and increases in neurological disorders and neonatal malformations in 2016.3–6
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