Transcript Multisectoral involv..

Multisectoral involvement in
IHR 2005
Prof. Dr. Be-Nazir Ahmed
Director, Disease Control
National IHR Focal Point
[email protected]
Communicable Disease Control Division DGHS MHFW GPR Bangladesh
IHR 2005: Background
 The International Health Regulations (IHR)
administered by WHO were in force since 1969 and
revised in 1981
 Member States were required to notify only cholera,
plague and yellow fever
 Again revised and adopted by member countries on
21 May 2005 is now referred to as “International
Health Regulations (2005)”
IHR 2005: Goal and responsibilities
 The goal is to prevent international spread of diseases
 Member states be able to timely detect, assess, notify
and report events and respond to public health risks and
Public Health Emergency of International Concern (PHEIC)
IHR Core Capacities
1. National legislation, policy and financing
2. Coordination and NFP Communication
3. Surveillance
4. Response
5. Preparedness
6. Risk communication
7. Human resources
8. Laboratory services
Disease Reporting
• Small Pox
• Poliomyelitis
• Influenza
• SARS
Any event
1. Serious public health
impact of the event
2. Unusual or
unexpected event
3. Significant risk for
international spread
4. Significant risk for
international Travel or
trade restrictions?
Diseases
• Cholera
• Pneumonic
• Plague
• Yellow Fever
• V. H. Fevers
• Dengue,
• Rift Valley Fever
• Meningococcal
diseases
EVENT SHAL BE NOTIFIED TO THE WHO UNDER IHR 2005
HEALTH RELATED
EVENTS
Country Level
DETECTION
Local Community Level or Primary
Public Health Response Level
REPORTING
Intermediate Public Health
Response Level
REPORTING
International
Level
National Level
National IHR Focal Point
Preliminary Control
Measures
Investigation and
additional Control
Measures
Formal assessment.
Containment and Control
Measures
NOTIFICATION OR REPORTING
WHO IHR Contact Point
Recommendations and other
Control Measures
Public health surveillance structures and processes specified in
International Health Regulations (IHR) 2005.
Animal
Health
Social
Food
Environment
Human
Health
Psychol
ogical
Radiation
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Good Example of Multisectoral
Involvement
 Rabies elimination: DBM, MDV, DPM
 MHFW, MLGD, MFL, WHO, OIE, FAO, WSPA, HIS
 Avian influenza prevention and control
 MFL, MHFW, MFE, FAO, OIE, WHO, USAID, UNICEF
 Anthrax management
 MFL, MHFW, FAO, OIE, WHO
 Nipah infection control
 MHFW, MFL, MFE, ICDDRB, CDC,USA, FAO, OIE, WHO,
USAID, UNICEF
 Filariasis elimination
 MHFW, MPME, WHO, USAID, UNICEF, CWW, J&J,
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Event notification and determination
under IHR (2005) at WHO
Collaboration for IHR at all levels
 UN and development agencies
 Stakeholders in government, private sectors and NGOs
 Bangladesh and neighboring countries
 Among laboratories
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IHR Committees and Institutes
National Coordination Committee
National Technical Committee
Core Committee at DGHS
National IHR Focal point
National IHR Technical Focal Institute
Designated Point of Entry (PoE)
Coordination Committee at Ports (Hazrat Shahjalal
International Airport, Dhaka, Chittagong Sea port,
Chittagong, Benapole Land Port, Jessore)
VIII.IHR Focal Hospitals: Infectious Disease hospital (IDH),
Kurmitola General Hospital
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II.
III.
IV.
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VI.
VII.
National IHR Coordination Committee
• President:
– Senior Secretary, Ministry of Health and Family Welfare
• Member Secretary:
– Director, Disease Control and Line Director, CDC. DGHS.
National Focal Point-IHR 2005, Bangladesh Members:
• Members : 27
• TOR
1.
2.
3.
4.
5.
Approval of Strategy, Action Plan and Policy for IHR 2005
Provides decision on proposals sent by IHR national
technical committee
Monitoring and evaluation IHR Implementation
Meet every once a year or before when necessary
Co-opt member (s) when necessary
National IHR Focal Point
• President: Director, Disease Control and Line Director, CDC,
• Member Secretary: DPM, Avian and Pandemic Influenza
• Members : 04
• TOR
1. Draft Strategy, Action Plan and Policy for IHR
2. Draft budget for IHR
3. Spokes person on behalf of DG on PHEIC
4. Manage and coordinate outbreak investigation
5. Contact with WHO IHR focal point and other relevant persons
6. Collect information on zoonotic, chemical, radio nuclear and
food related diseases and events
7. Arrange workshop, seminar and round table discussion
National IHR Technical Focal Institute
• National IHR Technical Focal Institute: IEDCR
• TOR
1. Conduct surveillance
2. Investigate outbreak
3. Send update to control room of DGHS
4. Do lab tests for Influenza, Nipah and ERD
5. Draft , implement and coordinate implementation of IHR
2005
6. Inform PHEIC to National IHR Focal Point
7. Organize training for improving capacity for surveillance
8. Conduct IHR related research
9. Conduct above activities in coordination with National IHR
Focal
Coordination Committees for PoEs
Hazrat Shahjalal International Airport, Dhaka :
 Coordinator: Airport health officer
 Member Secretary: Assistant Airport Health Officer
 Members: 13
Chittagong Port:
 Coordinator: Port Health Officer
 Member Secretary: Assistant Port Health Officer
 Members: 8
Benapoe Land Port:
 Coordinator: Upazila Health Family Officer, Sharsha , Jessore
 Member Secretary: In charge Port Medical Officer
 Members: 7
TOR for Coordination Committees of Ports
1. According to article 22 of IHR, they will act as
appropriate authority
2. Apply and implement IHR related health activities in
POE
3. Inform national IHR focal point on activities taken
4. According to article 57 take measures through
bilateral or multilateral agreement for prevention
and control of diseases
Referral Hospitals
 Infectious Disease hospital
 Kurmitola General hospital
TOR of Referral Hospitals
1. Isolation and quarantine
2. Inform national IHR focal point
Issues and challenges
 Administrative, Collaborative, and legal issues
 Development of specific National Plan for Multisectoral Public
Health Emergency Preparedness and Response
 Approval of draft law for implementation of IHR (2005)
 Some funds are allocated for some activities under different
heads but no separate head as such for IHR has been created.
 Laboratory capacities
 Lack of capacity of detecting AI/H5N1, A/H1N1 (2009), Nipah, Polio
or Anthrax at district level
 No laboratory networking between human and animal health or
inter-country agreement for laboratory networking
 Infection Control and Prevention
 Lack of National Infection Control Committee nor National Focal
Point for Infection Control.
Issues and challenges
 Core Capacities of Points of Entry (PoE)
 Building of minimum core capacity at designated PoEs as
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per IHR (2005) guideline within the timeframe of 2014
No agreement between Bangladesh and neighboring
countries concerning prevention and control of disease at
PoE
Very few trained personnel for the control of vectors and
reservoirs in and near points of entry:
Majority of the PoEs had no Entry/exit control tools.
Veterinary facilities for assessing potentially
contaminated/ infected animals are absent at all PoEs.
No practice for submission of Health part of Aircraft
General Declaration by the Captain/crew member to the
airport authority in case aircraft coming from an infected
area.
Thanks