Intended for healthcare professionals

Rapid response to:


Proposed new International Health Regulations

BMJ 2005; 330 doi: (Published 10 February 2005) Cite this as: BMJ 2005;330:321

Rapid Response:

A good-and-for-all revision of the International Health Regulations

Angus Nicoll and colleagues are right in addressing the important decision and commitment of the World Health Organization and global community to the long-waited revision of the IHR in coming weeks.

They are right to call that "equally neither can any country be confident that it will not be the source of a threat to the global community". This has been demonstrated in the previous global epidemics, like polio, HIV, and SARS. Again, it is also true for the global health community to recognize the mutual benefits of efficient and immediate reporting and surveillance, proactive assistances in verification of emerging diseases, and technical support at all time by all scientists of the globe. Unfortunately, SARS could have been better handled if the revision had been completed and sufficiently implemented before 2003. There had been significant delay in reporting SARS from its origins at the beginning, mixed with non-scientific or over-optimistic statements from the States of concern. These retarded WHO in gathering sufficient evidences and made best professional decisions before dispatching her staffs to areas in great needs.

On the other hand, some State Members are reluctant to consider in any way that WHO and global health community would "interfere" with States' health affairs. Today, there are many competent and responsible health authorities and organizations independently fulfill the requirements for effective health measures for their residents and the communities of concern. These health authorities and international organizations have been partners with WHO as well as global health communities in one way or another, and they will be indispensable partners of the WHO beyond the revision of the IHR. Without comprehensive participation of these partners, it will be even more difficult to see full implementation of the revised IHR by many developing countries.

Revision of the IHR will not guarantee successful public health measures against newly emerging health threats. Without establishment of systems to implement these regulations, the world and nations will be as vulnerable as periods during SARS epidemics. On the other hand, capacity building and enhanced cooperation between global partners will prevent failure of this long-thought IHR revision.

Competing interests: None declared

Competing interests: No competing interests

14 February 2005
Geneva, Switzerland