The International Health Regulations (IHR) (2005) enters into force on 15 June 2007.  As a World Health Organisation signatory, The Bahamas has committed to meet the obligations outlined within the Regulations.  These regulations are “the world’s first legally binding agreement in the fight against public health emergencies of international concern” (WHO Epidemic and Pandemic Alert response:  www.who.int/csr/ihr/en)  The original International Health Regulations were developed in 1969 and were limited to the reporting and control of cholera, plague, and yellow fever.  Understanding that there were a significantly larger number of diseases, including the possibility of new and/or re-emerging diseases which could pose a threat to international public health and safety, the regulations were re-written with a much broader scope.  Divided into ten Parts, and incorporating 66 Articles, the IHR (2005) is an extensive legal framework stipulating the responsibilities of WHO and those of the Member States.  The Core Capacities for meeting the obligations of IHR (2005) are laid out in Annex I of the Regulations.

Time constraints for completion of specific activities have been included within the text of the Regulations.   With entry into force on 15 June 2007, Member States are required to submit their first written report to the sixty-first World Health Assembly in 2008.  From entry into force, Member States will have two years to conduct and complete an extensive assessment of the ability of current national capacity to meet the minimum requirements as set out in Annex I.  At the conclusion of this assessment, each member state shall develop and implement a plan of action to ensure that these core capacities are present and functioning throughout their territories.  These core functions are cross-cutting, in that they involve multiple agencies in an elaborate scheme of surveillance, investigation, inspection, and enforcement.  The need for a strong financial commitment to increase capacity, both technologically and through human resource development, will be key to the success of The Bahamas in meeting its obligations.  Full compliance with the regulations takes effect in 2012.

Within the response to IHR (2005), plans for dealing with potential public health emergencies of international concern include diseases such as pandemic influenza and other public health emergencies.  The Bahamas has been involved in Pandemic Planning since October 2005.  The Ministry of Health, as the lead agency, has been spearheading the development of a National Pandemic Influenza Contingency Plan. The successful completion of this plan requires a government-wide response.  This plan aims to provide essential health services to all residents of The Bahamas, while protecting and maintaining other essential services, such as public safety, communications, and utilities among others.  Working in collaboration with other Agencies, the National Contingency Plan is approximately 50% complete.  The completed Pandemic Contingency Plan is expected to provide the template for a National Plan for Public Health Emergencies, which will guide the nation’s response to IHR-related events.

The challenges to the planning process continue to impede completion of the plan.  A limited number of persons make up a small cadre of planners in each agency.  Competing priorities make it difficult to advance influenza planning to the top of the list, especially in light of the fact that the current strain of avian influenza is not seen as a direct regional threat at this time.  One only has to remember the impact of SARS to realize this is a false sense of security as a new disease can be an international event in mere weeks, leaving little or no time to rush to completion those plans not previously formulated.

In order to bring to fruition the planning process for these issues, emphasis on the importance of a completed plan and the allocation of adequate human and financial resources in all agencies will be necessary.