Since 2007, the International Health Regulations have been adopted by World Health Organization (WHO) member States, including Jamaica, to prevent, protect against, control and provide a public health response to the spread of diseases.
According to the WHO, this is done in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.
In an interview with JIS News, Director for the Emergency, Disaster Management and Special Services (EDMSS) Branch in the Ministry of Health and Wellness, Dr. Nicole Dawkins-Wright, explains how the regulations came about and the steps that Jamaica has taken to effectively implement them and abide by their requirements.
“International Health Regulations were implemented in 2005 when the world was concerned with major diseases related to travel and trade that affected the human population,” she says.
The Director explains that in response to an exponential increase in movement of persons across the globe and the emergence and re-emergence of international disease threats and other health risks, numerous countries decided to take action.
An agreement was reached by 196 member states of the UN Health body to implement the International Health Regulations (IHR) (2005). It is a binding instrument of international law, which was entered into force on June 15, 2007.
“It is one of the few international laws that are in place to protect the population because of the spread of diseases,” she says.
“The best way to contain any outbreak is to make sure that our containment measures within the country are as robust as possible, so countries that signed on to the International Health Regulations committed to making sure that we build capacity in the country to be able to detect, prevent and contain diseases,” she adds.
The Director points out that being a State party to the IHR requires multi-stakeholder participation and building on the system to make it effective within the country’s own context.
“The IHR require States to strengthen core surveillance and response capacities at the primary, intermediate and national levels, as well as at designated international ports, airports and ground crossings,” she informs.
According to Dr. Dawkins-Wright, the WHO puts out an annual self-assessment tool that allows countries to measure the extent to which they are achieving the 13 core capacities.
These are Legislation and Financing, IHR Coordination and National IHR Focal Point Functions, Zoonotic Events and the Human–animal Interface, Food Safety, Laboratory, Surveillance, Human Resources, National Health Emergency Framework, Health Service Provision, Risk Communication, Points of Entry, Chemical Events, and Radiation Emergencies.
The Director indicates that work has been done in this regard and that the country has made some positive strides.
“So, Jamaica has been evaluating itself over the last three or four years and we have made significant improvements in attaining those capacities. Jamaica is one of the countries that rank very highly in terms of the capacity that has been attained, and one of the reasons for this is because we have had the stakeholder advisory group that meets very regularly and we are always trying to enhance our systems,” she says.
“The meetings are held once per quarter and this is in an attempt to strengthen our collaboration, because under the IHR, although the Ministry is the lead, the implementation of the core capacities is a country initiative, so when all stakeholders come together, persons are aware of their responsibilities within each agency,” Dr. Dawkins-Wright explains.
She says that with these systems in place, in the event of a response, persons are coordinated “like a well-oiled machine”, citing the current situation where stakeholders are represented at different levels in the Emergency Operations Centre, which is currently operating on a 24-hour basis with briefings held twice daily, as an example.
The Director also explains the ways in which the IHR have guided the country’s COVID-19 response.
She points out that IHR is a surveillance system that involves watching what is happening locally, regionally and globally and applying the information to the situation in a particular country.
“On a daily basis, we ensure that we are monitoring our borders. Once a notification comes in regarding any illness that is of concern to us here in Jamaica, it is logged and followed up on,” the Director says, adding that there is close collaboration with other departments within the Health Ministry, such as Environmental Health, Port Health, Food Safety and Zoonosis (illnesses that humans can acquire through animals).
Dr. Dawkins-Wright informs that most of the illnesses that have the ability to cause pandemics are zoonotic diseases.
She points out that IHR is more than the monitoring of infectious diseases, but rather anything that can cause harm to a population, such as chemical and radiological events, and inadequate food safety.
“We also work closely with the International Food Safety Authorities Network (INFOSAN), which is an international agency that deals with the surveillance and safety of food in real time, because food safety is very important. Food can cause many persons to get ill very quickly,” the Director further explains.
She highlights a fairly recent incident with canned meat, where alerts were made and the particular items were immediately pulled from the shelves until there was confirmation that safety was achieved.
“It is done in real time, so all countries of the world get it at the same time, so this is really good to help persons to remain safe,” she says.
The Health Ministry also works closely with the Jamaica Fire Brigade, Jamaica Defence Force, Jamaica Constabulary Force, the Office of Disaster Preparedness and Emergency Management and other agencies to ensure that in the event that there is a need to respond to a radiation or chemical emergency, this can be done in a timely, responsive and all-inclusive manner.
Border control agencies, such as the Passport Immigration and Citizenship Agency (PICA) and Jamaica Customs Agency (JCA) also form a part of the IHR Stakeholder working group, and these entities are responsible to ensure that all persons entering the island are properly screened.
Dr. Dawkins-Wright adds that one very important mandate under IHR is to not interfere unnecessarily with international travel and trade, while maintaining border security and eliminating cross-country spread.
“We have to have containment at source, so we also have to prevent the introduction of new diseases and also prevent a disease that is occurring within the country from spreading to other countries,” she says.
“That is why we have to ensure that there is close collaboration with the Marine Police, the Coast Guard, and PICA. For this outbreak (COVID-19), we have closed our borders, and that is somewhat unprecedented, but the global situation dictates it,” the Director notes.
She says that under the IHR, it is imperative for State parties to have a system that is sensitive and robust enough to quickly detect and eliminate threats from anything that crosses their borders.