Strengthening health security by implementing the International Health Regulations (2005)

Evaluation of the functioning of Annex 2 of the International Health Regulations (2005)

The IHR (2005) and the related resolution adopting them require that the functioning of Annex 2 be regularly assessed after the Regulations entered into force. As discussed in the IHR Review Committee Report1the functioning of the Annex has been evaluated for the first time in 2009/2010.

Studies on the functioning of Annex 2

Quantitative and qualitative studies carried out by the University of Ottawa sought to ascertain the level of awareness and knowledge among NFPs of Annex 2, the practical use of the tool, their activities taken to implement it, and its perceived usefulness and user-friendliness ( A survey conducted by the University of Geneva investigated the reliability of the public health event notification assessment process under the IHR to better understand the strengths and weaknesses of the Annex ( The overall goal of the Annex 2 studies was to improve our understanding of the strengths and weaknesses of Annex 2 which will guide WHO in providing support to States Parties in the consistent use of Annex 2.

Conclusions made by researchers

The researchers concluded that barriers to notification are unlikely to be due to a malfunctioning of Annex 2, but to barriers within countries, e.g. inadequate surveillance infrastructure, poor flow of information within countries, or political considerations based on the threat of travel and trade restrictions

1Implementation of the International Health Regulations (2005). Report by the Director General. Geneva: World Health Organization; 2009. Available from: