Department of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program (1053 Carling Avenue), University of Ottawa, Ottawa (K1Y 4E9), Canada.
Global Health. 2012 Jan 10;8:1. doi: 10.1186/1744-8603-8-1.
The International Health Regulations (IHRs) (2005) was developed with the aim of governing international responses to public health risks and emergencies. The document requires all 194 World Health Organization (WHO) Member States to detect, assess, notify and report any potential public health emergency of international concern (PHEIC) under specific timelines. Annex 2 of the IHR outlines decision-making criteria for State-appointed National Focal Points (NFP) to report potential PHEICs to the WHO, and is a critical component to the effective functioning of the IHRs.
The aim of the study was to review and evaluate the functioning of Annex 2 across WHO-reporting States Parties. Specific objectives were to ascertain NFP awareness and knowledge of Annex 2, practical use of the tool, activities taken to implement it, its perceived usefulness and user-friendliness. Qualitative telephone interviews, followed by a quantitative online survey, were administered to NFPs between October, 2009 and February, 2010.
A total of 29 and 133 NFPs participated in the qualitative and quantitative studies, respectively. Qualitative interviews found most NFPs had a strong working knowledge of Annex 2; perceived the tool to be relevant and useful for guiding decisions; and had institutionalized management, legislation and communication systems to support it. NFPs also perceived Annex 2 as human and disease-centric, and emphasized its reduced applicability to potential PHEICs involving bioterrorist attacks, infectious diseases among animals, radio-nuclear and chemical spills, and water- or food-borne contamination. Among quantitative survey respondents, 88% reported having excellent/good knowledge of Annex 2; 77% reported always/usually using Annex 2 for assessing potential PHEICs; 76% indicated their country had some legal, regulatory or administrative provisions for using Annex 2; 95% indicated Annex 2 was always/usually useful for facilitating decisions regarding notifiability of potential PHEICs.
This evaluation, including a large sample of WHO-reporting States Parties, found that the IHR's Annex 2 is perceived as useful for guiding decisions about notifiability of potential PHEICs. There is scope for the WHO to expand training and guidance on application of the IHR's Annex 2 to specific contexts. Continued monitoring and evaluation of the functioning of the IHR is imperative to promoting global health security.
《国际卫生条例（2005）》旨在规范国际社会应对公共卫生风险和突发事件的反应。该文件要求所有 194 个世界卫生组织（世卫组织）成员国按照具体时间表，发现、评估、通报和报告任何潜在的国际关注的突发公共卫生事件（PHEIC）。《国际卫生条例》附件 2 概述了国家指定的国家归口单位（NFP）向世卫组织报告潜在 PHEIC 的决策标准，是《国际卫生条例》有效运作的关键组成部分。
本研究旨在审查和评估世卫组织报告缔约国附件 2 的运作情况。具体目标是确定 NFP 对附件 2 的认识和了解、该工具的实际使用情况、为执行该附件而采取的活动、其被认为的有用性和易用性。2009 年 10 月至 2010 年 2 月，对 NFP 进行了定性电话访谈和定量在线调查。
共有 29 名和 133 名 NFP 分别参加了定性和定量研究。定性访谈发现，大多数 NFP 对附件 2 有很强的工作知识；认为该工具对指导决策相关且有用；并已建立管理、立法和沟通系统以支持该工具。NFP 还认为附件 2 以人及疾病为中心，并强调其对涉及生物恐怖袭击、动物传染病、核放射和化学泄漏以及水或食物传播污染的潜在 PHEIC 的适用性降低。在定量调查答卷中，88%的答卷人报告对附件 2 有极好/良好的了解；77%的答卷人报告总是/通常使用附件 2 评估潜在的 PHEIC；76%的答卷人表示其国家有一些使用附件 2 的法律、监管或行政规定；95%的答卷人表示附件 2 总是/通常有助于促进关于潜在 PHEIC 通报的决策。
这项评估包括世卫组织报告缔约国的大样本，发现《国际卫生条例》附件 2 被认为有助于指导关于潜在 PHEIC 通报的决策。世卫组织有机会扩大对特定情况下应用《国际卫生条例》附件 2 的培训和指导。继续监测和评估《国际卫生条例》的运作对于促进全球卫生安全至关重要。
