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2008/SOM1/HWG/016

Agenda Item: VI

The International Health Regulations and APEC: APEC Cooperation to Protect, Prevent, Control, and Respond to Public Health Emergencies of International Consequence – Ports and Airports

Purpose: Consideration

Submitted by: USA

/ First Health Working Group Meeting Lima, Peru
21 - 22 February 2008

The International Health Regulations and APEC

APEC Cooperation to Protect, Prevent, Control, and Respond to Public Health Emergencies of International Consequence – Ports and Airports

OBJECTIVE: In order to encourage regional approaches to implementing the World Health Organization (WHO) International Health Regulations (IHRs), the U.S. is submitting this proposal to APEC to assess the core public health capacities of the region's airports and maritime ports. The proposal is consistent with APEC's economic focus, important U.S. biodefense goals, and aims to complement WHO's efforts to assist economies in implementing the IHRs.

PROPOSAL: In June of 2007, APEC Health Ministers agreed to support the implementation of the International Health Regulations (IHRs), noting that the IHRs are a critical part of the global response to reduce the impact of health threats on economic growth and social functioning. Additionally, Leaders’ statements since 2005 have resolved to enhance APEC cooperation on challenges to human security in a manner that is attuned to the needs of business – specifically mentioning the threats posed by infectious diseases such as pandemic influenza.

This year, the United States proposes that APEC economies advance these commitments and support the WHO in its efforts to assess national and regional capacities for implementing the IHRs – specifically those associated with the core capacity requirements for airports and maritime ports (Annex 1, section B).

Through the establishment of an APEC IHR Peer Review Group as well as one or more regional workshops, APEC members would develop an assessment of the region's abilities to implement the public health measures described in the IHRs that pertain to international travelers, goods, cargo, and conveyances at maritime ports and airports. These efforts would draw from ongoing or completed member-level assessments of their own capacities – and identify regional approaches to addressing areas for improvement. Assessment activities would commence immediately and continue through 2009 – consistent with the IHR assessment phase. Depending on the success of this work, coordination with WHO, and the nature of the improvements identified by the IHR Peer Review Group, APEC members may develop future proposals aimed at implementing those improvements.

APEC economies should endorse to set the following targets:

  • By September of 2008, APEC members should identify and appoint experts from both the public health and relevant transportation sectors to an APEC IHR Peer Review Group. Their three-fold task will be to summarize member assessments, develop a regional capacity assessment, and identify potential regional approaches to address areas for improvement.
  • Members, on their own or in cooperation with the WHO, shall conduct their own assessments of relevant capacities and identify areas for improvement. Members will provide these assessments to the APEC IHR Peer Review Group, by January of 2009.
  • By June 2009, the group would submit a report to the APEC Health Working Group that summarizes regional capacities for implementing the relevant sections of the IHRs, and identifies potential regional approaches towards addressing areas for improvement.

BACKGROUND: In the summer of 2007, the International Health Regulations (IHRs) entered into force. They represent a comprehensive, all-hazards approach towards controlling, preventing, and responding to public health emergencies – and they have been adopted by all of the WHO's Members. This international consensus makes the IHRs an important mechanism for improving global public health and addressing the threats posed by a range of infectious diseases; including SARS and pandemic influenza. Under the IHRs, parties are obliged, inter alia, to strengthen and maintain their existing capacity for disease surveillance and to implement control measures at designated international airports and ports to prevent the international spread of disease.

The 2007 entry into force of the IHRs does not mean that all WHO Member States are obliged to implement immediately all the core capacity requirements described in the IHRs. The Regulations establish a timeline for addressing such requirements, which can be summarized as follows:

  • Summer 2007– Summer 2009: two years for the assessment of existing structures and resources, which must lead to the development of plans of action.
  • Summer 2009–Summer 2012: three years for the implementation of these plans of action to ensure that core capacities are present and functioning, unless an extension is sought or granted in accordance with relevant provisions of the IHRs.

According to this schedule, the assessment phase is already underway. This proposal is designed to optimize those efforts for the Asia-Pacific region. The work envisioned by this proposal will also prepare the region for the implementation phase of the IHRs. Not envisioned in this proposal is the formation of permanent body in APEC that will monitor IHR compliance and implementation. Additionally, the work envisioned should be consistent with and supportive of the WHO's efforts – while avoiding unproductive duplication.

The large volume of international travel and trade amongst the APEC economies is essential to the economic growth of the region; and the airports and maritime ports through which that trade moves are essential to the region's economy. However, the international movement of people and cargo also provides mechanisms and opportunities for disease spread that must be considered and addressed – if only to avoid the threat of more serious and prolonged economic disruptions. To that end, the IHRs have been written to minimize unnecessary restrictions, while at the same time recognizing that during a public health emergency of international concern, the application of time-limited measures affecting international travel and trade may be necessary.

The IHRs describe two general types of core capacities that must be in place at designated airports and maritime ports. At all times, designated maritime ports and airports must ensure a safe environment for travelers and provide access to appropriate medical care to assess and care for ill travelers. Additionally, designated maritime ports and airports must be able to respond to public health emergencies by applying exit or entry controls – including the ability to quarantine suspect travelers if required. Fully implementing these core capacities at all maritime ports and airports is an unrealistic goal, and the IHRs recognize this by requiring implementation only at designated maritime ports and airports – which, in the event of a public health crisis, will play important funneling roles in facilitating the continued flow of people and cargo across international boundaries.

BENEFITS:

  • APEC members will be implementing guidance from Leaders to enhance Human Security – along with specific guidance from APEC Health Ministers to support the full implementation of the International Health Regulations.
  • The work envisioned in the proposal will draw from ongoing assessments that APEC members are already obligated to conduct under the IHRs.
  • An APEC-led assessment will facilitate a regional approach to responding to all events that constitute public health hazards by identifying and recommending needed improvements in the health, travel, tourism, and trade infrastructures essential to the region.
  • The work envisioned in this proposal will lower the technological barriers, and ease the resource constraints that many APEC members are facing in the implementation of an international treaty that all members agreed to.
  • At the same time, this work will simultaneously engage the health and transportation sectors of APEC in a cooperative effort to strengthen the travel, transport, and tourism infrastructures that are essential to the prosperity and economic security of all APEC member economies.

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