First Meeting of the Review Committee on the Functioning of the International Health Regulations (2005) in Relation to Pandemic (H1N1) 2009 (WHO, edit

[Giuseppe]

First Meeting of the Review Committee on the Functioning of the International Health Regulations (2005) in Relation to Pandemic (H1N1) 2009 (WHO, edited)

[Source: World Health Organization, Full PDF Document (LINK). Edited.]

FIRST MEETING OF THE REVIEW COMMITTEE ON THE FUNCTIONING OF THE INTERNATIONAL HEALTH REGULATIONS (2005) IN RELATION TO PANDEMIC (H1N1) 2009

14 April 2010

12?14 April 2010, Geneva, Switzerland

Report of the First Meeting of the Review Committee on the Functioning of the International Health Regulations (2005) in Relation to Pandemic (H1N1) 2009

• • BACKGROUND(1)

1. In 2008, the Sixty-first World Health Assembly decided in resolution WHA6(1.2) that the first review of the functioning of the International Health Regulations (2005) (an event that must take place no later than five years after their entry into force) should be made by the Sixty-third World Health Assembly in May 2010.
2. In view of the currently evolving pandemic (H1N1) 2009 and the Health Assembly decision concerning the review of the functioning of the Regulations, the Executive Board at its 126th session welcomed the Director-General?s proposal to convene the IHR Review Committee provided for in Chapter III of Part IX of the International Health Regulations (2005) and to request it to review the experience gained in the global response, in order to inform the review of the functioning of the Regulations; to help assess and, where appropriate, to modify the ongoing response; and to strengthen preparedness for future pandemics.
3. The review has three aims:
   • (i) to assess the functioning of the International Health Regulations (2005) in relation to the current pandemic (H1N1) 2009 and other public health events;
   • (ii) to review the scope, appropriateness, effectiveness, and responsiveness of global actions as well as the role of the WHO Secretariat in supporting pandemic preparedness, alert and response in relation to the pandemic;
   • (iii) based on the above, to identify and review the major lessons learnt from the global response to the current pandemic and to recommend actions to be taken by Member States and the Director-General to strengthen the preparedness and response to potential future influenza pandemics and other public health emergencies.
4. The scope of the review will encompass an assessment of international preparedness, alert and response in relation to the current and evolving pandemic of H1N1 influenza.
5. The review of the functioning of the Regulations will include aspects of the core capacities required for surveillance and response (Annex 1 of the Regulations), the functioning of the national focal points, provision of information, guidance and assistance, cooperation among international organizations, as well as the functioning of the Emergency Committee, and the effectiveness of temporary recommendations made in relation to the pandemic and the definition of pandemic phases.
6. The review of the Secretariat?s role in supporting the preparedness, alert and response to the pandemic will include preparedness and planning; disease surveillance and epidemiology; risk assessment; communications; technical support for outbreak response; pharmaceuticals development and access; resource mobilization; and coordination. It will also include the work of relevant expert committees, advisory groups and other scientific groups providing advice to WHO, and the appropriateness of recommendations made by WHO as a result of their work.
   • APPOINTMENT OF REVIEW COMMITTEE
7. The Director-General appointed 29 members of the Review Committee from the IHR Roster of Experts. In accordance with IHR article 50 and rules for Expert Committees as specified in WHO?s Basic Documents, members were appointed on the basis of the principles of equitable geographical representation, gender balance, a balance of experts from developed and developing countries, representation of a diversity of scientific knowledge and expertise, approaches and practical and high-level managerial experience in various parts of the world, and an appropriate interdisciplinary balance. A list of members may be found in the Annex.
   • ORGANIZATION AND PROCESS OF THE MEETING
8. The first meeting of the Committee took place at WHO headquarters in Geneva, 12?14 April 2010, with the following provisional agenda:
   1. Welcome and introduction
   2. Director-General?s opening remarks
   3. Election of Chair, Vice-Chair, and Rapporteur and adoption of the agenda
   4. Overview of IHR and IHR review mechanism
   5. Overview of pandemic preparedness and response
   6. Statements of States Parties and invited organizations
   7. Review Committee discussions and consensus on scope, topics, and working methods
   8. Review Committee discussion on preliminary observations
   9. Initial Report of the Review Committee to the Director-General
9. Of the 29 members of the Review Committee, 27 were present. Two members were unable to attend this initial meeting. The meeting also included the following observers: representatives of States Parties to the IHR, the United Nations and its specialized agencies and other relevant intergovernmental organizations or nongovernmental organizations in official relations with WHO. Observers were invited to submit memoranda and to make statements on the subjects under discussion.
10. The first day of the meeting was called to order by the Special Adviser to the Director-General on Pandemic Influenza, followed by opening remarks by the Director-General. The Director-General made clear her intention to make available to the Review Committee all the documents, personnel, and other information that could inform its review. The Director-General noted that the Secretariat has been especially vigilant in seeking information about potential conflicts of interest among committee members. The Review Committee elected Dr Harvey V Fineberg as Chairman, Professor Babatunde Osotimehin as Vice-Chairman, and Dr Silva Bino as Rapporteur. WHO Legal Counsel reviewed the procedural arrangements for the Review Committee. Legal Counsel also reminded the Committee that all members participate in their personal capacity and are not allowed to take instructions from any government or any other authority.
11. The Chairman made a number of introductory remarks. He thanked the Director-General for convening the Committee.
12. The Chairman then proposed that States Parties, intergovernmental organizations and nongovernmental organizations be permitted to attend plenary sessions of the Review Committee meeting as well as any technical subcommittee meetings. In addition, the Chairman proposed that members of the media/press be permitted to attend the plenary sessions of this first meeting of the Committee. This proposal was endorsed by members of the Review Committee.
13. The Secretariat made two background presentations: an overview of the IHR and an overview of the influenza (H1N1) pandemic.
14. A number of States Parties and other organizations made interventions. Among the many issues and observations raised, five themes recurred: (i) First, it was noted that capacity to implement the IHR requirements and to deal with disease outbreaks is constrained by technical and financial resources and that improvements in this area are a high priority for countries. (ii) Second, all types of communications, including those with the public, regions, countries, and partners, require review. (iii) Third, equity of access to drugs and vaccines and other essential materials, with systems for financing, was an essential concern to be considered. (iv) Fourth, review of the virus naming conventions, characterization of pandemic phases, including considerations of severity, and their applicability to planning, alert, and response, was important. (v) Fifth, issues related to trade and travel, and pharmaceutical and other nonpharmaceutical interventions, as well as the economic ramifications of interventions, need to be considered.
15. The second day of the meeting began with a brief plenary session. The Director-General proposed to the States Parties that, in consideration of the high level of media interest in the Review Committee?s work and in the organization?s commitment to openness and transparency, the Chairman be available for media interviews. The States Parties provided their concurrence.
16. On the basis of the first day?s discussions, and to reflect and include the key issues raised by the States Parties, the Committee agreed to group itself, for the morning session, into three pandemicrelated technical subcommittees, to review: (1) capacity and preparedness; (2) alert and risk assessment; and (3) response. The Chairman then proposed that Committee members form two technical subcommittees for the afternoon: one to review IHR functions, with a special emphasis on non-pandemic functions; and a second to review communications issues. The Chairman?s proposal was endorsed by members of the Review Committee.
17. The Chairman requested that each technical subcommittee articulate the following: (1) the relevant key questions; (2) information, documents, or analyses needed to address the questions; (3) organizations or persons whose input might usefully inform the review; and (4) priority for each of the issues identified by the technical subcommittees. The Review Committee agreed also to look into criticisms that have been levelled at WHO for its management of the H1N1 pandemic.
18. A brief plenary session was convened in the afternoon. The morning?s discussions among the three technical subcommittees were reviewed. Then the two remaining technical subcommittees convened.
19. On the third day, the Committee reviewed the discussion of the two technical subcommittees on communications and the IHR. Three technical presentations were made: one on the functions of the Emergency Committee, one on WHO?s role related to pandemic vaccine, and one on the Strategic Advisory Group of Experts (SAGE).
20. The Chair proposed a tentative schedule for the Committee?s work, with a view towards holding a second meeting in late June 2010 and a third meeting in late September 2010. In the intersessional periods, the Committee and its technical subgroups would continue their work through teleconference and electronic exchange. The Committee decided to organize its work in part according to decisions taken during the H1N1 pandemic and the functions of the IHR. A final report will be presented to the Sixty-fourth World Health Assembly in May 2011.
21. The Committee discussed and endorsed the Chairman?s meeting report.

(1) Paragraphs 1?6 are taken from document EB126/Inf.Doc./3.
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