http://www.who.int/mediacentre/news/statements/2009/h1n1_20090425/en/index.html

In response to cases of swine influenza A(H1N1), reported in Mexico and the United States of America, the Director-General convened a meeting of the Emergency Committee to assess the situation and advise her on appropriate responses.

The establishment of the Committee, which is composed of international experts in a variety of disciplines, is in compliance with the International Health Regulations (2005).

The first meeting of the Emergency Committee was held on Saturday 25 April 2009.

After reviewing available data on the current situation, Committee members identified a number of gaps in knowledge about the clinical features, epidemiology, and virology of reported cases and the appropriate responses.

The Committee advised that answers to several specific questions were needed to facilitate its work.

The Committee nevertheless agreed that the current situation constitutes a public health emergency of international concern.

Based on this advice, the Director-General has determined that the current events constitute a public health emergency of international concern, under the Regulations.

Concerning public health measures, in line with the Regulations the Director-General is recommending, on the advice of the Committee, that all countries intensify surveillance for unusual outbreaks of influenza-like illness and severe pneumonia.

The Committee further agreed that more information is needed before a decision could be made concerning the appropriateness of the current phase 3.

Also, WHO has declared a public health event of international concern, and raised the pandemic threat level to 3. The U.S. is debating raising its threat level.

Meanwhile, in Mexico, “President Felipe Calderón published an order Saturday that would give his government extraordinary powers to address a deadly flu epidemic, including isolating those affected by the rare virus, inspecting their homes and ordering the closure of any public events that might result in more infection.”

As for SARS, there is an interesting relationship between new modes of detection and preparedness planning on the one hand, and very long-standing practices of ‘sovereign’ epidemic control on the other.

In spite of the WHO’s statement that the IHR are “the only binding international agreement on public health,” law prof David Fidler argues “the WTO {World Trade organization} became the central horizontal {meaning international} regime for international law on infectious disease after its creation.” He further claims that the WTO has pushed the IHR into “obscurity in global public health discourse.” This, he says, is the transition from the ‘classical’ to the ‘trade’ regime of of transnational health control.

I do not necessarily agree with him, especially because i am citing a 2003 article (ie before the latest IHR revisions), but given the financial weakness of the country at the moment I think it will be interesting to see how the differential modes of calculating and enforcing trade and travel restrictions will pan-out. In the past few minutes i have seen the first few mentions of trade restrictions on Mexico. i don’t know how we will get access to these mechanics of health intervention but perhaps it will be come evident which regimes are at play: will trade & travel be controlled to protect health, or will trade & travel be regulated to protect health as a ‘public good’?

The economic-centric calculus was certainly at play around Berkeley during the early 20th century plague outbreak when the Californian Governor attempted to hang a leading bacteriologist.

I also think that the pre-history of the IHR is interesting and relevant. The IHR were first conceived on the heels of a European cholera epidemic during the first International Sanitary Conference in 1851, although they were not birthed until 1892. This Conference was interpreted by some as “a civilizing mission geared towards the ‘orient’ under the aegis of hygiene.” how are (if they are) are missions of this sort also being deployed in countering the current epidemic? or are they not because of the non-preventative nature of the IHR as you discussed at the end of your post?

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