[International health regulations--evaluation and trends].

The current International Health Regulations (IHR) were adopted by the Twenty-second World Health Assembly in 1969 and amended in 1973 and 1981. They are a revised and consolidated version of the International Sanitary Regulations which were adopted by the Fourth World Health Assembly in 1951, themselves based on the previous International Sanitary Conventions. The purpose of the IHR is to ensure maximum security against the international spread of diseases with a minimum interference to world traffic. Over the years the IHR included cholera, yellow fever, plague, smallpox, typhus and relapsing fever, and then dropped the last three as a result of the global eradication of smallpox and the decline of typhus and relapsing fever as international threats. The IHR have played and still play an important part with respect to the diseases for which they were drawn up. The international spread of yellow fever has been contained by the application of a highly effective vaccine to travellers, and of plague by the inspection of ships and aircrafts for rats, and improvements in the design of air and sea cargo carriers to make them increasingly uninhabitable for rats. The role of the IHR was questioned as far as smallpox and cholera are concerned by arguing that smallpox was eradicated by rigorous national local vaccination programmes and cholera must be defeated by improved environmental sanitation. However, one must not lose sight of the fact that an important element of the IHR is the obligation to notify cases of the diseases listed, together with as much epidemiological information as possible, in order to permit other countries to take appropriate action.(ABSTRACT TRUNCATED AT 250 WORDS)