CPHM forum on the International Health Regulations and its proposed amendments

On February 27, 2024, the College of Public Health Medicine (CPHM), Academy of Medicine Malaysia organised a pivotal forum at the WPR-TDR-RTC Implementation Science Learning Centre located in the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya. The forum centered on the scrutinisation of the International Health Regulation (IHR) 2005 alongside the contemplation of its proposed amendments.

The forum’s primary objective was to forge a cadre of future public health medicine specialists, imbuing them with the capacity to critically assess and engage with burgeoning public health dilemmas, both within the Malaysian context and on a global scale. To this end, the CPHM extended invitations to Doctor of Public Health (DrPH) candidates from a network of seven Malaysian universities offering this programme—Universiti Malaya (UM), Universiti Kebangsaan Malaysia (UKM), Universiti Sains Malaysia (USM), Universiti Putra Malaysia (UPM), Universiti Malaysia Sarawak (UniMAS), Universiti Malaysia Sabah (UMS), and Universiti Institute Technologi Mara (UiTM).

The participants included Dr. Nadhir Bin Adi Azahar from UM, Dr. Thinakaran Kandayah from UKM, Dr. Nelson Lean Boon Leong from UMS, Dr. Fatin Binti Ismail from UPM, Dr. Zulaikha Binti Abdul Razak from UniMAS, Dr. Mohammad Fazrul Bin Mohammad Basir from USM, and Dr. Rifhan Bin Rasuli from UiTM.

Dr. Bala Murali, a medical lecturer from the Department of Social and Preventive Medicine, adeptly emceed the event, while the doa recitation was reverently delivered by Dr. Mohd Fadzil Mohd Hussin, a fellow DrPH student at UM. The forum commenced with insightful opening remarks by Prof. Dr. Victor Hoe, Head of the Department of SPM, which smoothly transitioned to an inspiring address by Dr. Anita Sulaiman, President of CPHM, AMM.

Dato’ Indera Dr. Shaari Ngadiman, an expert with a storied history in the Ministry of Health Malaysia, moderated the forum sessions with sagacity, presenting each participant with questions reflecting earlier identified concerns. The discussions probed the implications of IHR amendments on national sovereignty, the beneficial aspects of these amendments for the country, the prospective efficacy of a pandemic treaty in future global health crises, and the expectations from such a treaty given the experiences of the COVID-19 pandemic.

The forum’s format included two sessions where Dr. Ngadiman not only posed specific questions to the participants but also imparted his valuable experiences in public health governance.

In an era of digital interconnectivity, the event reached an extensive audience, being broadcast via the Zoom platform to all seven participating universities. Additionally, the supporter of the participants were there physically to provide support and encouragement to their colleague. The CPHM council members were also there and contributed their insights and feedback.

The forum’s resounding success is attributed to the tireless efforts of the organizing committee from the Department of Social and Preventive Medicine. The dedication of individuals such as Suhaili Suboh, Muhammad Haizril Arif Md Mokhtar, Nur Hashimah Kaman Redzawan, Noorazlina Mohammad, Kamar Johari, and Abdul Rahman Awang Senik, was the linchpin in the seamless execution of this academic symposium. Their unwavering commitment to the cause of public health and the advancement of academic discourse is commendable and lays a strong foundation for future forums of this magnitude.

The International Health Regulations

The International Health Regulations (IHR) 2005 represent a legally binding framework agreed upon by 196 countries, including all the Member States of the World Health Organization (WHO). This instrument was formulated to ensure a collective and effective international response to the spread of diseases and health risks, while avoiding unnecessary interference with international traffic and trade.

Originally adopted in 1969 and revised in 2005 in the wake of the severe acute respiratory syndrome (SARS) outbreak, the IHR primarily focuses on the prevention, protection against, control, and response to the international spread of disease. The regulations emphasize the development of core capacities in surveillance and response; the reporting of specific diseases, public health events, and potential international public health emergencies; and the implementation of health measures for travelers.

Proposed amendments to the IHR 2005 have been prompted by the challenges and shortcomings experienced during the COVID-19 pandemic. These proposed changes seek to bolster the global health response architecture through a variety of means:

1. Improved Surveillance and Response: Enhancements to the early warning system for outbreaks and strengthened international cooperation and information sharing are central aims of the amendments.

2. Transparency and Compliance: Proposals include mechanisms to improve transparency in nations’ reporting and compliance with the regulations, potentially providing WHO with more authority to investigate outbreaks with or without the consent of the country in question.

3. Equitable Access to Resources: Emphasis on equitable access to medical resources and countermeasures during health emergencies is a cornerstone of the proposed changes, addressing the disparity observed during the COVID-19 vaccine rollout.

4. One Health Approach: The amendments consider a ‘One Health’ approach that acknowledges the interconnection between human, animal, and environmental health, reflecting the need for a multi-sectoral response to health threats.

5. Strengthened WHO Role: The proposed amendments aim to enhance the WHO’s capacity to coordinate and respond to public health emergencies, potentially endowing the organization with the power to declare emergencies and recommend health measures based on a range of scientific inputs.

6. Funding and Resources: Proposals suggest a need for sustainable funding for outbreak preparedness and response, and for the development of the core capacities required by the IHR within member states.

These proposed amendments are subject to rigorous international discussion and negotiation, and their adoption would require consensus or a majority vote by the World Health Assembly, the decision-making body of WHO. They represent an effort to address the lessons learned during the COVID-19 pandemic and to better prepare the global community for future health emergencies.