Rapid Response Team and Intersectoral coordination

Economic impact of an epidemic

International Health Regulations
Plan of presentation
• Principles of Primary Health Care
• Rapid Response Team (RRT) in Outbreak Investigation
• Intersectoral co-ordination in RRT
• Health economic & economic impact of a pandemic
• International Health Regulations
 Principles of Primary Health Care
Equitable distribution Intersectoral Co-ordination
Individual with more compromised Inclusion of other related sectors,
health condition to receive more other than health in achieving
health services universal health

Appropriate technology Community Participation

Scientifically sound, adaptable to Involvement of individuals, family
local needs and acceptable to those and community in identification of
who apply it keeping with the health problems, and making
principles of self reliance with informed choices
resources the country and
community can afford.
Preparing for outbreak investigation
• Trained Rapid Response Team
• Necessary drugs, diagnostics and other materials
• Identification of appropriate laboratories
• Vehicles & communication channels like mobiles etc
Rapid Response Team
• The Rapid Response Team (RRT) is formed during the phase of
epidemic preparedness.
• In the event of a suspected outbreak, RRT which is a multidisciplinary
team, which investigates various aspects of an outbreak, is alerted
and meeting is convened.
• At the same time general control measures should be started.
Composition of Rapid Response Team
• Epidemiologist:
• Technically competent to conduct field investigations systematically.
• Usually serves as one of the primary investigators and should be
involved in all the investigative steps.
• Microbiologists:
• Provision of basic and advanced laboratory support to the investigative
team.
• Laboratory technicians:
• Collection of specimens particularly when a special collection procedure
is required.
Composition of Rapid Response Team
• Specialists in the field:
• Example: Physicians, Paediatricians
• Veterinarian:
• Investigation in case of zoonotic infection.
• Social Scientist:
• Help identify risk behaviors among affected populations and assess
the acceptability of the recommended interventions.
• Public Health Administrators:
• Provision of logistic support, mobilizing resources, and providing
administrative expertise for the team.
Composition of Rapid Response Team
• Public relation person:
• Conditions when the outbreak has caused panic or has gained intense
attention of the public
• If available, Educator:
• Provide essential knowledge to community in clear terms will also be
very useful for disease control implementation.
Inter-sectoral coordination in RRT
• When an outbreak is suspected, interdisciplinary collaboration is
essential.
• While managing an outbreak, many of the determinants of health lie
outside the domain of health department.
• E.g.- Provision of safe drinking water, sanitation, nutrition, legal
measures for imposing strict interventions, good house and shelter
are some examples.
• Members of the community should have all the rights to participate in
their duties towards controlling an outbreak.
• To ensure such coordination, administrative system take lead with
suitable legislation and strong political will.
Health economics
• The comparative analysis of alternative courses of action in terms of
both their costs and consequences in order to assist policy decisions.
• Economic evaluation is not “choosing the cheapest”.
• It provides a set of analytical techniques to assist decision making, in
health care sector to promote efficiency and equity.
• Thus, ultimate aim is to about maximizing social benefits obtained from
constrained health producing resources.
• Need to study health economics
• For good planning and management
• For efficient use of resources
Economic impact of a pandemic
• India’s GDP is estimated to have fallen by 30% during the country’s
lockdown.
• National poverty rate increased by 22% points during lockdown.
• According to the World Bank, global growth is projected to shrink by
almost 8% with poorer countries bearing the most of the impact.
• Indian government imposed the strictest lockdown to control spread of
corona virus which led to disruption of services in every sector including
the health industry.
• Operational disruption in health care industry owing to staff quarantine,
supply chain failure.
• Decline in business in private hospitals had imposed a significant effect in
hospital’s ability to sustain fixed costs.
International Health Regulations
• The legally binding international agreement to prevent the spread of
disease.
• The IHR is a formal code of conduct for public health emergencies of
international concern.
AIM
“To prevent, protect against, control and provide a public health response
to the international spread of disease in ways that avoid unnecessary
interference with international traffic and trade.”
 International Health Regulations (2005)
• The International Health Regulations (IHR) are an international legal
instrument that covers measures for preventing the transnational
spread of infectious diseases.
• The IHR were adopted by the 58th World Health Assembly in 2005
• They constitute the legal framework that defines national core
capacities, including at points of entry, for the management of acute
public health events of potential or actual national and international
concern, as well as related administrative procedures.
The seven areas of work for IHR (2005) implementation:

• Foster global partnerships

• Strengthen national disease prevention, surveillance, control and
response systems
• Strengthen public health security in travel and transport
• Strengthen WHO global alert and response systems
• Strengthen the management of specific risks
• Sustain rights, obligations and procedures
• Conduct studies and monitor progress
PHEIC: Public Health Emergency of
International Concern

It refers to an extraordinary public health event which may constitute a

public health risk to other states through the international spread of
disease; require a coordinated international response.
 International Health Regulation (2005)
1 2 3
Case of following Any event of Cases of following diseases
diseases potential (only if there is significant risk
• Small pox international public of international spread)
health concern, - Cholera.
• Poliomyelitis due to including:
wild polio virus - Pneumonic plague.
• those from
• SARS unknown causes or - Yellow fever
• Cases of human sources - Viral hemorrhagic fevers
influenza caused by • even if not listed in (Ebola, Lassa, Marburg)
new subtype points 1 or 3 - West Nile fever
- Dengue fever
- Rift valley fever
- Meningococcal diseases
 IHR Framework
• Determine PHEIC WHO Director- Emergency
• Make temporary & General Committee
standing recommendations

Review
• Accessibility at all times Committee
• Primary channel for
communications
• Disseminate information within WHO IHR
WHO Contact Point
• ACTIVATE the WHO assessment & Notification
response system Consultation
Report
• Accessibility at all times Verification
• Communications with WHO National IHR Ministries &
• Dissemination of information Focal Points Sectors
nationally (NFP) concerned
• Consolidating input nationally
Detect
Unusual Assess National
health Report Surveillance &
events response systems Community
Respond
IHR Amendments (2024)
• The 77th World Health Assembly in Geneva, influenced by geopolitical
events like the Gaza crisis and the war in Ukraine, saw the adoption of
Amended IHR by consensus among WHO member states on its final
day, June 1, 2024.
• COVID-19 Pandemic: Revealed gaps in the IHR, prompting the need
for amendments.
• Key Process:
Working Group on Amendments to the IHR (WGIHR): Formed with
representatives from all WHO member states.
Objective: Ensure the IHR’s universal application for protecting global
health equitably.
Key Changes in the IHR Amendments
• introducing a definition of a pandemic emergency to trigger more effective
international collaboration in response to events that are at risk of becoming, or
have become, a pandemic.
• According to the definition, a pandemic emergency is a communicable disease
that has, or is at high risk of having, wide geographical spread to and within
multiple States, exceeds or is at high risk of exceeding the capacity of health
systems to respond in those States; causes, or is at high risk of causing,
substantial social and/or economic disruption, including disruption to
international traffic and trade; and requires rapid, equitable and enhanced
coordinated international action, with whole-of-government and whole-of-
society approaches.
• a commitment to solidarity and equity on strengthening access to medical
products and financing. This includes establishing a Coordinating Financial
Mechanism to support identification of, and access to, financing required to
“equitably address the needs and priorities of developing countries, including for
developing, strengthening and maintaining core capacities,” and other pandemic
emergency prevention, preparedness and response-related capacities;
•
establishment of the States Parties Committee to facilitate the effective
implementation of the amended Regulations. The Committee will promote and
support cooperation among States Parties for the effective implementation of the
IHR; and
•
creation of National IHR Authorities to improve coordination of implementation
of the Regulations within and among countries.