8. International Health Regulations and Epidemic Control
International health regulations
IHR grew from International Sanitary Conference (1851), recognising that:
- free movement of people and goods will increase the risk of cross-border transmission
- quarantine is an impediment to free trade public health arguments can justify trade barriers
- International Health Regulations (1950) responsibility of WHO: Member States agree to notify specific infectious diseases & abide by measures allowed by countries to protect themselves
As mentioned, the classical way to stop the international spread of infectious disease is to erect border controls - for people as well as for goods. At the middle of the 19th century, such quarantine laws in the different European states had become so disparate - and seemed so inept at stopping the spread of cholera - that the First International Sanitary Conference was called in Paris in 1851 by the Foreign Ministers of 14 European countries. That it was the Foreign Ministers and not the Ministers of Health who met is important, since it demonstrates the appreciation that the issue of international infection control is inseparably connected to the issue of traffic. That is, that: (i) the free movement of people and goods will increase the risk of cross-border transmission; (ii) quarantine is an impediment to free trade; and (iii) public health arguments can therefore be used to justify trade barriers.
Since 1950, the International Health Regulations (IHR) have been the responsibility of the WHO. They are the only binding international agreement on public health, whereby all the WHO Member States have agreed to notify cases of certain infectious diseases, and to abide by the limits of the allowed counter-measures laid out in the Regulations. The link between public health and trade is stressed by a sentence in the portal paragraph that gives as its purpose to "ensure the maximum security against the international spread of disease with a minimum interference with world traffic". Very briefly, the Regulations oblige Member States of the WHO to notify cases of cholera, plague, and yellow fever to the Organization, and also state the maximum measures allowed by countries to protect themselves from importation of these diseases.