Poorer countries could struggle to implement the new International Health Regulations (IHR) about to be brought into force, says an Editorial in this weeks edition of The Lancet.

The aim of IHR, which goes live on June 15, is to prevent national public health emergencies from spreading internationally.

Countries are obliged to nominate a national focal point to communicate detailed public-health information to the World Health Organisation, including case definitions, number of cases and deaths and conditions affecting the spread of the disease. WHO would then decide if the threat was of international concern, and declare an emergency if necessary, as well as recommending containment measures and co-ordinating an international response.

The Editorial expresses concern that many developing countries do not have the core capacity to meet the demands of IHR, whilst others face political challenges citing Taiwan as an example.

It says: "China fears that granting Taiwan WHO membership will be a step towards recognition of Taiwan as an independent state. But the greater fear should be the possibility that a public health emergency in Taiwan could rapidly spread throughout Asia and the around the world. For the IHR to work, no territory, whether Taiwan or the Occupied Palestinian Territory can be excluded from the global surveillance system, especially in light of the threat posed by avian influenza."

The Editorial adds that to ensure global health security, countries not only have to protect the wellbeing of their own populations but also those of fellow nations. The international community has agreed a deadline of 2016 by which all WHO member states should be able to full implement the regulations.

It concludes: "Whether the technical, financial, and political barriers to this goal can be overcome by then remains to be seen. And whether global health threats, such as an avian influenza pandemic, will be n
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Lancet
24-May-2007